Premature and critically ill babies cannot usually tolerate full feeds from the start. Feeding progresses in stages: total parenteral nutrition delivered intravenously ensures the baby receives adequate calories when the gut is not yet ready; small trophic feeds then begin to prime the intestinal lining without demanding much of it; and volumes increase gradually as the baby demonstrates tolerance. Breast milk is strongly preferred in this population because it provides immune protection and reduces the risk of a serious gut condition called necrotising enterocolitis. Mothers are supported with milk expression even when a baby cannot yet feed directly. The pace of advancement is guided by the baby's response rather than a fixed timeline.
Written by Dr. Kabir Nanda, MD Paediatrics, Fellowship in Neonatology (NNF Accredited), Diploma in Pulmonology, Allergy and Immunology, Pediatrician, Neonatologist, Allergist and Immunologist, Sukhmani Hospital, Safdarjung Enclave, New Delhi, and Westend Hospital, Tilak Nagar, New Delhi. Phone: +91 8076178418.
