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Not Feeding Yet

Not feeding yet?

When your baby is admitted to the NICU and is kept "nil by mouth" she still  needs to get food.  She may not yet be fed milk, because her intestines are not properly developed and in case of stress (like being born prematurely), you do not want to put extra stress on the stomach. In this situation, the most important organs, namely the brain and heart need to be provided with blood that carries oxygen.  However, your baby still needs to receive energy in the form of nutrients and vitamins, which can then be given via a drip or parenteral feeding (TPN).

TPN is a liquid running into the baby's veins into the bloodstream and then to wherever it is needed.  This liquid can also take many faces.  It may look like water, or if some additional nutrients are added it may have a yellowish or milky colour,  but remember milk can never be given through the veins.  Ask your doctor or the sister what your baby is receiving through the drip.

During this time, it is important for your baby to get opportunities for non-nutritive sucking.  A pacifier is commonly used in NICU's for this purpose.

How will I know which pacifier to use?

The pacifier used for non-nutritive sucking is very important. It must be the appropriate size and shape to encourage as normal development. Using a pacifier with the correct size and shape will also help fast-track the complex milestone of and maturation of this complex milestone to enhance the transition from tube to oral feeding. Pacifiers that are too short and/or bulbous can encourage abnormal tongue movement. This that can be difficult to overcome during the transition to either breast or bottle feedings. In addition, a soft exterior shield will facilitate positive lip stimulation and enhance proper placement when the baby is either on her side or tummy with the head turned to one side . You get the best results with teats that are round at the front, small and as soft as possible. The mouth guard must be big so that the baby does not swallow it. It must be well shaped to provide stimulation of the lips to further the baby's suckling reflex.

Choosing a pacifier

A useful guideline is to choose a pacifier that is the size and shape of the baby's thumb for babies less than 1.2 kg since your baby would be sucking her thumb if she was still in the womb. When she weighs more than 1.2 kg and can suck with coordination, select a pacifier that is as close as possible to the nipple of a breast to promote successful feeding and later speech development. Be careful for any nipple shape that is not cylindrical, since that may prevent the tongue to "cup" around the breast, leading to choking and speech problems.
When bottle-feeding, you can use the same selection criteria and teats with wings can then be used since they encourage lip closing. Feeding of a premature baby is a very important activity, but it is also a very unnatural and stressful event for both parent and baby. Do yourself a favour, ask to see a lactation consultant while you are still in the NICU and do not just blindly follow the guide of friends and family. All babies do not necessarily go the same route. Remember, your baby is a unique little person! In addition, it would serve you well to follow professional advice.

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