Nutrition and Feeding Care for Preterm Infants

How to Express Breastmilk

1. The mother must wash her hands thoroughly using the 8 steps of handwashing.
2. Place a 30 ml measuring cup near the breast while expressing milk.
3. Massage the breast gently for 5–10 minutes in circular motion towards the nipple.
4. Press the thumb above the nipple and areola and the first finger below the areola.
5. Press the breast behind the nipple on the lactiferous sinuses beneath the areola.
6. Press similarly in all directions (360 degrees) so that all segments of the breast are expressed.
7. Empty one breast completely before repeating the same process on the other breast.

How to Store Expressed Breast Milk

• At room temperature: up to 6 hours
• In refrigerator: up to 24 hours

Steps of Cup / Spoon / Paladai Feeding

• Wash hands thoroughly using 8 steps of handwashing.
• Keep the baby in head elevated position on the mother’s lap.
• Place a cotton cloth around the neck to mop spillage.
• Take required amount of expressed breast milk in measuring cup.
• Hold the cup with handle without touching milk.
• Keep the tip of the cup at corner of baby’s mouth and pour small amount.
• Baby should swallow milk slowly and actively.
• If baby does not swallow, stimulate gently on foot or behind ear.
• Deduct milk left in cup and approximate spillage while measuring intake.
• Wash cup with soap and water and sterilize in boiled water for 20 minutes.

Amount of Feed Required

At full feed, the baby should receive approximately 200 ml per kilogram of body weight per day. This provides adequate calories and essential macronutrients. Supplementation with vitamins, iron and calcium-phosphorus may also be required.

The total feed of 200 ml/kg/day should be divided into feeds every 2–3 hours (8–12 feeds per day).

• Urine frequency of 8–12 times in 24 hours
• Weight gain of about 15–20 grams per day