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Feeding Issues

Infant learning to feed with bottle

In order for your baby to be discharged from the NICU, they will need to be taking in by mouth all of the nutrition they require. This is an area that can be very challenging for preemies and micropreemies. That's because they have relied on feeding tubes and may never have learned the natural urge to suck. Often times, the ability to feed naturally can be the last hurdle families face before taking their baby home.

What are feeding issues?

There can be a number of issues that make feeding challenging for babies in the NICU. The suck, swallow, breathe reflex is one that these babies often struggle with. Premature babies may have a tendency to stop breathing when they suck and swallow, causing their oxygen saturation levels to drop. They may also aspirate when swallowing which causes liquid to go into the lungs. This can be very dangerous. A swallow function test may be ordered to determine what is happening when the baby is swallowing the liquid. Often times, thickeners may be ordered for a baby s breast milk to make it easier for the baby to swallow and not aspirate.

What causes them?

Up until bottle or breast feeding, preemies will receive their food through a temporary tube placed from the nose or mouth to the stomach. As the baby has less and less medical issues, they can become ready to start learning to eat. This happens at different times for all babies. Typically, the younger a baby is born and the longer they require mechanical ventilation, the older they will be when they start to eat. Even when babies seem to be doing well, they may need more time before starting to practice eating by bottle or breast. This can be frustrating to parents, but babies learn to eat best when their brains, muscles, and lungs are ready.

How are they treated?

Cook Children's licensed speech therapists are skilled in the area of newborn feeding therapy. Along with your baby's neonatologist and medical team, they will determine which issues your baby has and then create a plan of action once your baby is ready to begin feeding.

Typically, your baby's feeding team will include a physical therapist and a speech therapist. Depending on the causes of the feeding issue and your baby's overall diagnosis, your team may also include a feeding and nutrition specialist from gastroenterology. Lactation consultants are also available to assist new moms with breast feeding.

Complex issues

For those babies who have been on ventilators for a long period of time, they can develop a negative association with anything being in their mouth. This can make them less likely to take to a bottle or breastfeed. Our feeding specialist are experts at helping babies learn to enjoy feeding.

Premature babies are more susceptible to reflex or GERD which makes it painful to eat. In extreme cause of reflux, a PH probe study may be ordered to determine the severity of a baby s reflux. If it s detected that the reflux is severe, medication can be ordered to make it more comfortable for the baby to eat.

Support for moms

Cook Children's lactation specialists can help you with many concerns from breastfeeding to storing your breast milk. If you have questions or need assistance at any time, please feel free to ask our neonatal staff.

We're here to help.
