Because babies younger than a gestational age of 34 weeks do not usually have the coordination to suck and swallow, they must be fed by some means other than the breast. Premature babies are almost always given a “nasogastric” or NG tube immediately following birth. This is a thin tube running from the baby’s nose to her stomach. Depending on the condition of the baby, feedings may not start for 24 hours and will always begin slowly with small amounts of breast milk increased over time. If the baby’s mother is already pumping milk, this can be poured into the feeding tube. If not, formula will be given in the same manner. As soon as a baby has developed the coordination necessary for breast feeding, she will be encouraged to do so.
Babies whose gastrointestinal (GI) tract is too immature to absorb nutrition properly, or who have a complication that makes GI tract feeding impossible, are fed intravenously. This is called parenteral feeding. These babies are fed a nutritious substance called total parenteral nutrition or TPN. This feeding method bypasses the GI tract completely, giving the baby’s digestive system time to mature or heal. How long a baby receives TPN depends on how soon she can tolerate feeding through her GI tract.
TPN is made up of a glucose and amino acid solution with electrolytes, minerals, vitamins, and fats. It provides what a baby needs to grow and become healthy while breastfeeding, formula feeding, or tube feeding remains impossible. As soon as a baby can be fed using her GI tract, an effort will be made to do so. Even when the baby is being fed intravenously, small amounts of formula or milk may be given at intervals through a feeding tube to stimulate the functioning of the GI tract, essentially priming the baby’s digestive system for the future.