Introducing complementary foods to infants can be difficult, but if the baby is born ahead of schedule, introduction to new food should be done even more carefully. Given that premature babies need more nutrients to catch up with their peers in development, their digestive systems mature over a longer period than those of full-term infants.

Complementary feeding for premature babies is introduced according to a slightly different scheme than for babies born at term

• It is recommended to feed the baby before introducing complementary foods breast milk, and the mother’s diet should be balanced. If breastfeeding is not possible, a special formula is selected for the baby, designed to meet the needs of premature infants.
• The earliest acceptable period of complementary feeding is 4 months., although the recommendations of most doctors are to introduce new foods no earlier than 6 months of age.
• The new product is given to premature babies in smaller quantities than when introducing new food to full-term infants.
• After complementary foods, until at least 8 months of age, it is recommended give breast milk or formula so that the child washes down the new food.
• Porridge is usually chosen as the first complementary food for prematurity., and then the child is introduced to vegetable and fruit purees.
• If a premature baby is sick, has an allergy or dysbacteriosis, It is better to wait with complementary feeding until the baby is in a stable state.

After complementary feeding, the baby must be given his usual mother’s milk or formula.

How to calculate the age of introducing complementary foods

It is best to determine the age at which a baby should be introduced to new foods based on the missing period until the baby was born full-term. For example, if a baby was born 1 month prematurely, a month is added to 6 months (the age when it is recommended to start feeding full-term babies), respectively, the first portions of complementary feeding are given to babies at 7 months of age.

If the birth occurred two months earlier than the expected date, you should wait until eight months with complementary feeding.

The video, prepared by the Union of Pediatricians of Russia, describes in detail how to properly feed a baby and at what age complementary foods should be introduced.

Sequence of product introduction

• It is preferable to choose buckwheat as the first porridge. Next, the baby is introduced to rice and corn porridge. They are boiled in water and diluted with a mixture or mother’s milk.
• After the porridge, the baby is offered vegetables, which should be local.. It is optimal to start vegetable feeding with zucchini and cauliflower, then add carrots to them.
• When one feeding of the child is replaced by porridge, and the second by vegetables, you can introduce fruits, supplementing one of these feedings with them. Usually start with green apples and pears, and if well tolerated, then give the baby peaches, bananas and prunes.

Applesauce is the first fruit complementary food for a premature baby

• Juice is introduced into the diet of a premature baby no earlier than eight months. First, the toddler is given apple juice, then pear juice and a mixture of apple and pear juice, and after that they are gradually introduced to other tastes.
• Meat appears in the diet of a prematurely born child at 8 months of age.. First, the baby is treated to rabbit and turkey, then the baby is offered veal and beef, and after that – pork and chicken (white meat). Often, meat in the form of puree is added to porridge or pureed vegetables.

Soup and fermented milk products should be given no earlier than 8 months of age

• When a premature baby turns 8 and a half months old, he can cook vegetable soups, to which, in addition to vegetables, cereals and vegetable oil are added. This dish is included in the third feeding so that in the future it becomes lunch.
• Fermented milk products should appear in the diet of a prematurely born child at 9-10 months. The baby is introduced to baby kefir and yogurt, replacing the fourth feeding. Also at this age, the baby is offered cottage cheese, adding it to fruits or vegetables.
• It is recommended to give eggs to premature babies no earlier than 9 months. by mixing a small amount of yolk into the vegetable puree. Gradually increase the amount of yolk until the portion is 1/2 yolk.

Fish can be given from the age of 10 months, changing the meat 1-2 times a week. First, the baby is offered pike perch and cod, after them - flounder, tuna and saury, as well as hake, pollock and salmon. The fish is baked or boiled, then pureed and added to vegetables.

Table of introduction of complementary foods by month

Complementary food dish	Age in months
Dairy-free porridge	Start with 10 g and gradually increase the portion to 150 g
Vegetable puree	Start with 10 g and gradually increase the portion to 80 g
Fruit puree	Start with 5 g and gradually increase the portion to 50 g
Vegetable oil	1 g (about 1/5 tsp)	3-5 g (half to full tsp)
Cookies, crackers
Butter
Wheat bread
Fruit juice	Start with 10 ml and increase to 30 ml
Meat puree
Milk porridge	Start with 5 g and gradually increase to 180-200 g
Kefir and yogurt	Start with 10 ml and gradually increase to 30 ml
	Quarter	Half
Fish puree	From 10 to 30 g

Features of introducing complementary foods for children prone to allergies

If a premature baby has a tendency to allergic reactions, introduction to complementary feeding products is postponed to a later period and the following recommendations are taken into account:

• They begin to feed the baby with one-component dishes, for example, with rice porridge or with zucchini puree.
• A new product is given to try in the morning, in order to note by the end of the day whether an adverse reaction has appeared to it.
• Injected per week maximum one new product.
• It is important to keep a diary in which to note all the dishes, eaten by the baby, as well as the baby’s well-being and reaction to food.
• If an allergic reaction occurs, then No new products are introduced until the manifestations disappear.
• For an allergic child under one year old, it is enough to include 1-2 porridges, 1-2 types of vegetables and fruits, as well as one type of meat complementary food on the menu.
• It is important for mom to know in advance which foods are the most allergenic and introduce them to your baby much later. For example, the introduction of eggs and fish into the menu of a premature baby with allergies is postponed until one year of age.

Complementary feeding for children prone to allergies should strictly be one-component

Komarovsky's opinion

The well-known pediatrician's complementary feeding scheme differs slightly from traditional recommendations. Komarovsky suggests starting to introduce a child over 6 months old with kefir and cottage cheese, since these products are more similar to mother's milk than cereals and vegetables.

It is decided for each child individually. As a rule, premature babies have high rates of physical development and experience high calorie needs. But difficulties may also arise due to poor functioning of the digestive system of premature babies in the first 2 weeks of life.

Start feeding premature baby with small portions of milk. First, give 3-5 milliliters at each feeding. Increase the portions a little every day, but at the same time watch your baby very carefully. Add milk very gradually, as a premature baby can only handle a small amount. With the permission of your pediatrician, you can put your baby to your breast about 2 times a day; all other feedings must be done from a bottle.

The daily amount of food for a premature baby should be calculated by a pediatrician. As a rule, he makes this calculation using Rommel’s formula: the amount of milk (formula) for every 100 grams of the child’s body weight = 10 + the number of days of life (in milliliters).
Calculation of the required amount of food for children over 10 days old can also be done using the volumetric method: the daily amount of food for a child aged 10-14 days = 1/7 body weight, at the age of 2-3 weeks = 1/6 body weight, at the age of 1 month = 1/5 body weight.

In addition, the amount of food that a premature baby consumes depends on its condition. If you notice that your child's health is deteriorating, be sure to reduce the amount of food.

If your baby is bottle-fed, buy only special formulas that are intended for premature babies. They are enriched with all the nutrients and minerals necessary for development.

Introduce juices and complementary foods only under the supervision of a pediatrician.

Video on the topic

Premature babies need to be raised under constant medical supervision. Such children need tactile contact with their mother, a certain temperature of the environment and water for bathing. All possible complications In case of illnesses, one should try to prevent them before they occur.

A child born before 37-38 weeks of pregnancy weighing less than 2.5 kg is considered premature. Such children have small stature and disproportionate physique, hyperemic skin, fluff on the back, soft bones and unfused cranial sutures. Like a premature baby?

The first days after maternity hospital

First of all, the parents of such a child should be prepared for the fact that his motor and mental skills will develop somewhat later than those of ordinary children. A baby born at seven months will roll over, hold his head up, and sit up 1.5 times later than his peers born at full term. Premature babies need to be provided with constant tactile contact with their mother: they need to be stroked more often, carried in their arms, placed on their stomach skin to skin, and the like. As for nutrition, every effort must be made to ensure that the baby is fed breast milk and not artificial formula. Moreover, a premature baby needs to be fed more often and in small portions.

The room where the child is located should be cleaned regularly and all contact with relatives and friends should be excluded for several months, because such children are most susceptible to infections, their the immune system is still in its formation stage. The temperature in the children's room should be maintained at a constant level of 23-25°C; for swimming, the ideal water temperature would be 37°C. However, it must be remembered that premature babies are constantly at risk of hypothermia or overheating, so you need to change them quickly, and pre-iron clean clothes and diapers, but do not overdo it.

Health care

All bottles and nipples used must be sterilized. Premature babies benefit from massage, which the mother can perform herself, after taking lessons from a specialist. Children who were on mechanical breathing for the first days of life are susceptible to bronchospasms. Therefore, in case of ARVI, in order to prevent such consequences, it is necessary to begin treatment of the spasm in advance. Premature babies need to be raised in the first two years of life under the constant supervision of a cardiologist, orthopedist and neurologist. Parents should be prepared for constant intestinal colic in the baby, so a mother who is breastfeeding her child should monitor her diet and exclude from the diet foods that provoke the formation of gases in the child’s intestines.

In general, such babies should be under the supervision of all doctors and undergo all necessary examinations. A young mother should pay attention to the slightest problems in the behavior and development of her child and immediately seek help from a specialist.

Every pregnant woman knows that the “interesting situation” lasts for 9 months. Due date of birth small miracle The period from the 37th to the 42nd week is considered. However, not all babies are born at this time. For some reasons, birth may occur earlier.

If a baby is born at less than 37 completed weeks, it will be considered premature. Such a baby requires close attention to himself, because in the process of nursing him various problems can arise (for example, diseases can be detected in premature babies).

Parents of a premature baby, seeing him for the first time, experience incomprehensible feelings, because he does not look like those children depicted in the pictures: he is not plump, pink and smooth.

Premature babies have certain characteristics:

• small size and disproportionate physique;
• little weight;
• adynamia (lethargy, muscle weakness, weak cry);
• compliance of the cranial bones;
• softness of the ears;
• soft fur located on the shoulders and back;
• gaping of the genital slit in babies;
• the presence of an empty scrotum in boys;
• visual impairment in premature babies;
• weak development of nails.

All these features are inherent in children in the first months of life. As they grow and develop, they disappear.

Development of a premature baby by month

Parents at the birth of the baby earlier due date The question of how premature babies develop is beginning to raise concerns. So baby in 1st month life is susceptible to various infectious diseases, the course of which can be accompanied by serious complications. This is why parents should protect their child. During the first month after birth, the baby gains very little weight. With normal development, a sucking-swallowing reflex appears. In its absence, feeding is carried out using a tube. At poor development respiratory reflex requires artificial oxygen supply.

On 2nd month The baby begins to gain weight. This is a sign of good development. When breastfeeding, premature babies become very tired. It is necessary to supplement with expressed mother's milk from a spoon.

On 3rd month weight increases 1.5 times. The baby sleeps more, so parents should take care of the climate in the children's room and the change in the position of his body during sleep and wakefulness.

A child whose age is 4 months, is already beginning to try to raise his head and hold it, make sounds, fix his gaze, and 5th month Already smiling, trying to grab toys with his hands.

U 6 months babies' weight increases 2–2.5 times. They are already turning their heads, playing with toys, reacting to various sounds, distinguishing relatives from strangers. At this age, premature babies are already catching up with their peers in development.

On 7th month The child can independently roll over onto his back from his tummy. He is already playing more actively.

IN 8 month age, the baby easily turns over, makes his first attempts to crawl, and at 9 months can stand on his feet while holding onto a barrier, plays more actively with toys, and independently picks up pieces of food with his hands.

Kids in 10–11 months become even more active. They make different sounds, respond to their name, and crawl.

One-year-old premature babies catch up in development with their peers who were born on time. They are already beginning to pronounce syllables. Parents should not teach them to walk yet, because babies should develop gradually.

Feeding premature babies in the first days of life

Feeding babies born prematurely is a rather complex problem. When feeding, certain difficulties arise due to the following reasons:

• absence or decrease in sucking and swallowing reflexes;
• small stomach volume;
• reduced rate of evacuation of gastric contents;
• decreased intestinal motility;
• reduced activity of gastrointestinal enzymes;
• limited supply of nutrients.

Thus, a premature baby has a limited ability to receive and absorb nutrients, although his body needs them very much.

The method of feeding is selected by a specialist depending on body weight, severity of the condition, and gestational age.

Newborn babies weighing more than 2000 g in the first hours of life can be attached to the mother's breast. Mothers should monitor their baby's condition while feeding. The appearance of signs of fatigue (shortness of breath, periorbital cyanosis) indicates the need for breastfeeding for a shorter time and additional feeding with expressed milk.

A baby whose body weight is 1500–2000 g is given a trial feeding of breast milk from a bottle some time after birth. If he sucks with unsatisfactory activity, the doctor prescribes tube feeding.

Very premature babies weighing less than 1500 g are fed through a tube. Nutrition can be provided through a long-term infusion method or in portions.

For long-term tube feeding, syringe infusion pumps are used. Doctors feed premature babies with breast milk or formula according to a specific schedule. For example, one of the following methods may be selected:

• 24/7 administration without interruption at a constant rate;
• infusions lasting 3 hours with breaks of no less and no more than 1 hour;
• infusions for 2 hours with breaks of the same duration.

Your doctor may prescribe glucose solutions at night.

When feeding portioned meals, it is recommended to feed the baby 7–10 times. Since the volume of the stomach is very small, the body does not receive enough nutrients. In this regard, doctors additionally administer parenteral nutrients.

In rare cases, premature babies may be prescribed artificial feeding. An indication for this may be the mother’s lack of milk or the child’s intolerance to it.

Complementary feeding for premature babies

Complementary feeding for babies born prematurely is not recommended before 6 months. This is explained by the immaturity of the digestive system and metabolic processes. You can calculate when to introduce complementary foods for premature babies.

For example, if newborns were born a month earlier, then the diet should be supplemented with new food not at 6, but at 7 months (that is, you need to add 1 month to the age when it is recommended to introduce complementary foods). It is also wrong to introduce complementary foods later, because the supply of vitamins and minerals in premature babies is limited.

When introducing complementary foods, you should not deprive the baby of mother's milk. After each feeding, it should be applied to the mother's breast or given milk formula. The expansion of the diet begins with the introduction of various cereals, and then the menu is supplemented with vegetable and fruit purees.

It is recommended to introduce buckwheat, rice, and corn porridge first. They can be bred with those specialized milk formulas for newborns that the baby feeds on. You cannot add any additional products (sugar, fruits, etc.). After porridge, you can gradually introduce vegetables, meat, and then dairy and fermented milk products.

You should not introduce juices too early, especially if they are freshly prepared. If the baby starts using them too early, he may experience: an allergic reaction, diarrhea, colic. In addition, juices have little nutritional value.

It is advisable to consult a pediatrician before introducing additional food into the diet, because adequate and timely introduction of complementary foods is a success proper development a baby born prematurely.

Caring for a premature baby

Premature babies require careful care. Moms need to pay Special attention the following factors:

1. The climate in the children's room.
2. Newborn clothes.
3. Bathing.
4. Take a walk.

1. Climate in the children's room

The climate in the room where they are located has a huge impact on the development of a newborn child over the months. The room should be regularly ventilated. If it’s hot outside, you don’t have to close the window, but you need to make sure that there are no drafts.

Optimal air temperature in the children's room - 23–25 degrees. Near the baby (under his blanket) the temperature should be higher - about 28–32 degrees. Often there is a need for additional heating. Your doctor may recommend using rubber heating pads, the water temperature in which should be about 60–65 degrees.

They are placed under the blanket at the feet and on top of the blanket on the sides at a palm's distance from the body. Hot water bottles should not burn the baby, so they should be wrapped in towels, diapers or placed in special bags. Caring for a premature baby should include changing water in heating pads every 1.5–2 hours. At the same time, you cannot completely deprive the baby of heat. The heating pads need to be changed one at a time.

Artificial heating can be abandoned by the end of the 1st month of the child’s life, since by this time he will already be able to “maintain” body temperature on his own.

Of no small importance is air humidity. Indoors, its optimal level should be about 50–70%. You can monitor this parameter using a special device - a hygrometer. During operation of central heating batteries, air humidification may be necessary. A special humidifier will be an excellent help. It can be replaced by wet towels or fabrics hung around the room, or placed vessels with water.

2. Newborn clothes

If the child's weight is more than 2000 g, then the newborn does not need additional clothing or blankets. It can be dressed in the same way as a full-term baby. If the baby weighs less than 2000 g, then he needs more things. The baby needs such products for premature babies as a blouse with sewn-up sleeves and a hood, a knitted cap, a diaper, and rompers.

Mothers should not swaddle their child tightly, because this will make it harder for him to breathe. In addition, the baby needs to be regularly shifted from one side to the other.

3. Bathing

Babies whose body weight is less than 1500 g are not recommended to be bathed during the first 2 or 3 weeks of life. Other premature babies can be bathed 7–10 days after birth.

Bathing a premature baby during the first 3 months should be done using boiled water. In the bath, the water temperature should be about 38 degrees, and in the room - at least 25 degrees.

4. Walks

Mothers with premature babies should be very careful when walking. A sharp change in temperature can affect the health of the baby. If the child weighs more than 1500 g, then you can go for a walk with him after more than 2 weeks have passed since his birth. The weather should be warm outside, and the air temperature should be about 25–26 degrees. The first walk between mother and baby should be short – 10–15 minutes. Gradually, the time spent in the fresh air should be increased to 1–1.5 hours.

In spring and autumn, when the air temperature is at least 10 degrees, you can walk with babies whose age is 1–1.5 months, and whose body weight is not less than 2500 g. If the thermometer on the street shows less than 8–10 degrees, then you can go out at that time only with 2-month-old babies whose body weight is 2800–3000 g.

Vaccinations for premature babies

For babies born at the wrong time, the pediatrician draws up an individual vaccination schedule, paying attention to the baby’s health status, as well as its psychomotor development. If the baby is absolutely healthy and his birth weight is more than 2000 g, then the vaccination schedule will be the same as for full-term children.

Newborns born with a body weight of less than 2000 g, in maternity hospital do not receive the tuberculosis vaccine (BCG). The pediatrician will perform it after the child’s weight reaches 2500 g. Vaccinations are not given to newborn children weighing less than 1500 g during the 1st year of life.

Massage for premature babies

Babies born too early are developmentally behind their peers. To catch up with them according to age standards, it is recommended to carry out a massage. It can be started from the 1st month of life if the child weighs more than 2500 g.

If the child is 1–1.5 months old, then it is recommended to limit yourself to simple stroking. After the baby is 2-3 months old, you can move on to more intense massage techniques for premature babies: kneading, rubbing, tapping, passive gymnastics (bending legs and arms, etc.).

Parents of premature babies should consult a pediatrician and a professional massage therapist. Experts will recommend individual exercises that will not harm the baby and will be beneficial to him.

In conclusion, it is worth noting that nursing a premature baby is an important and rather complex undertaking. Recommendations for taking specific actions should be given pediatrician. Only he can advise what will benefit the baby and will not harm him. And remember that the most important thing for a baby is your love. If he feels it, then soon you will no longer remember that the child was born prematurely and lagged behind other children in development.

How premature babies develop (video)

I like!

The normal pregnancy period is nine months, and the expected time of birth of the baby is from 37 to 42 weeks. But not everyone is born on time. There are many reasons for this, including unfavorable environmental factors. A baby born before the 37th week of pregnancy is considered premature. Caring for his health, development, growth and nutrition involves increased attention by parents and medical staff.

Premature babies are low weight. But, as a rule, over time they move into a phase of active growth and catch up with their peers. This process requires intensive energy intake into the body. However, the digestive system in premature babies is not fully developed, some of its abilities are limited, and reflexes associated with food intake, such as sucking or swallowing, are often poorly expressed.

The diet and composition of nutrition for each premature baby is prescribed strictly individually. In this case, the initial weight of the newborn is taken into account. A baby weighing up to 1.5 kg is significantly different in development from a two-kilogram baby, which will also affect nutrition. At first, it will be parenteral (nutrients are administered intravenously), because the baby does not yet know how to eat on its own.

Important first feeding

The baby was born premature. When is he fed? Here you need to focus on the general condition of the baby. If the condition is assessed by specialists as normal, the first feeding begins a few hours later. Provided that the baby is able to suck. Here the time may vary, but, according to doctors’ recommendations, it should not exceed a day from the moment of birth.

But if a child has hypoxia, it is necessary to extend the “hungry” period. Also, premature babies are often given intravenous glucose solution (a type of parenteral nutrition).

Feeding frequency

When it comes to feeding premature babies, several factors influence the frequency of feedings:

• general condition of the baby;
• body weight immediately after birth;
• degree of immaturity.

If the baby has pathologies, he needs to be fed often - up to 10 times a day. The norm is 7 or 8 meals a day with 3-hour breaks.

Babies who cannot swallow and suck are fed using special tubes - they are inserted into the ventricle through the nose. As the baby grows, transfer to bottle feeding or breast-feeding.

Mother's milk

It's no secret that the best option The food for any baby under one year old (including premature babies) is breast milk. The protein composition of colostrum, which is produced in the first 3-5 days after birth, as well as transitional and especially mature milk of a nursing mother, is optimal for a premature baby.

Such food is rich in lactose, which is quickly broken down, absorbed and absorbed by the child’s body. Mother's milk has a number of important functions, including:

• provides reliable protection of the intestinal mucous membranes;
• prevents the attack of viruses and bacteria;
• minimizes the negative impact of allergens.

In women who gave birth to a child earlier than planned, the composition of the milk is slightly different from the standard. The fat content is much lower than normal, but the percentage of proteins, on the contrary, is increased. But this is exactly what a premature baby needs.

Attaching to the breast

As soon as the premature baby develops a sucking reflex and doctors note that he is feeling well, the baby begins to be breastfed.

To save the strength of a baby weighing more than 2 kg, latching onto the mother’s breast is carried out only 1-2 times a day. Other feedings are done using a pacifier.

With the appearance of signs of fatigue, which are manifested by sluggishness of sucking, as well as blueness of the area around the mouth, breastfeeding is temporarily suspended and a bottle of pre-expressed milk is used. At this time, the doctor should monitor the amount of milk the baby eats by weighing the baby before and after feeding.

Quantitative norms

On the first day of the baby’s life, the volume of each subsequent feeding should be 5 ml greater than the volume of the previous one. Ideally, on the 3rd day, the amount of breast milk drunk at one time reaches 15-20 ml. But this is only average data.

Acceptable portions are determined by the pediatrician on an individual basis. To calculate whether a child has received the norm of basic nutrients, doctors use the so-called “calorie” calculation method.

According to the data, when a premature baby reaches the 1st month, the energy value of food per day should be 130-140 kcal per 1 kg of weight. Whereas a timely born baby will need only 115 kcal.

By the end of 2 months, children who weighed more than 1.5 kg at birth can reduce their caloric intake by 5 kcal per kg of weight per day. For babies who weighed only 1-1.5 kg at birth, it is not recommended to reduce caloric intake until they reach 3 months.

The volumes of food required specifically for your baby are prescribed by your pediatrician during a general examination.

Drink

Regarding drinking in the diet of infants, pediatricians rely entirely on breast milk, considering it both food and drink. Indeed, breast milk is quite enough to quench a baby's thirst.

But we have to make allowances for prematurity. Babies born prematurely need to regularly quench their thirst not only through breast milk, but also through boiled, slightly sweetened, clean water.

Vitamins

There is an opinion that breast milk contains a complete set of all substances necessary for growth and development. Even if the baby does not need to be given special vitamin preparations directly, a nursing mother may need to think about it, especially if her baby was born premature.

But! Taking vitamins by a breastfeeding woman is associated with high risks and requires medical supervision. Do not neglect consultation with your doctor!

About iron deficiency

Premature babies often suffer from iron deficiency in the body. Moreover, this mineral substance is not present in sufficient quantities either in mother’s milk or in most types of special baby food.

Therefore, you have to rely on drugs in the form of syrups and drops, but with a limited course of administration. Here, too, you cannot do without medical advice, otherwise you can harm the baby.

Formula feeding

Artificial nutrition of premature infants involves the use of special infant formula. But this can only be done after the doctor’s approval.

Large baby food companies have started producing formulas for low-weight babies who are in a hurry to be born ahead of schedule. The most famous brands for children under one year old:

• "Humana O";
• "Pre-Nan";
• "Pre piltti";
• "Frisopre";
• "Novalak-MM".

It is necessary to dilute the mixture with special bottled baby water, since simple boiled water is “heavy” for the baby’s stomach.

Even in the last century, it was recommended to feed premature babies with kefir, but today pediatricians do not advise giving this product to prematurely born babies. Breast milk or formula is a much safer choice.

Complementary feeding tactics

Premature, weak, and underweight babies need to introduce complementary foods as carefully as possible, taking into account all the physiological parameters of the baby.

In case of prematurity (oatmeal, rice or buckwheat) with the addition of a small amount of breast milk or an adapted formula.

It is very important to strictly follow the steps to increase the concentration of porridge, which is introduced into the children's diet:

• At first, only 5% is given (100 ml of water per 1 tsp of crushed cereal).
• Next, the baby is allowed 7-8% (100 ml of water per 1.5 tsp).
• The final stage is 10% (100 ml of water per 2 tsp).

Closer to one year, you can add a drop of olive or sunflower oil to this baby dish, and only then add butter (3-4 g per serving). But oil should not be included at all in ready-made packaged instant porridges.

Juices

As a rule, pediatricians recommend that their patients begin complementary feeding with vegetable and fruit juices at the age of 3 months with one or two drops, gradually increasing the amount. However, today some experts question this technique and do not recommend giving juices at all for up to six months.

If you support the idea of ​​early complementary feeding, learn a few simple rules that will help you avoid problems.

1. Babies under 6 months should not be offered undiluted juices. This can be bad for a weak stomach. Usually the juice is diluted warm boiled water in a 1:1 ratio.
2. The main type of juice that is used for early complementary feeding– apple.
3. For babies prone to constipation, it is recommended to try blackcurrant or beetroot juice.
4. There is no need to rush into introducing carrot and grape drinks. A child will try them after a year, and a tomato one after 3 years.
5. Children with allergies should avoid red juices (strawberry, raspberry, strawberry, etc.).

Puree

Fruity or vegetable puree is introduced only after the baby gets used to the juices. They usually start with 1/4 tsp.

From 3-4 months, you can add a quarter of chopped boiled yolk to the vegetable puree. It is necessary to observe the reaction for several days after this. child's body for a new product.

It is undesirable to introduce two or more new products into the diet at the same time. Otherwise, if allergic reaction you will not be able to determine its source.

At approximately the same age, a premature baby begins to be introduced to cottage cheese: about 10 g during the first month, then up to 20 g and so on - up to a single serving of 50 g.

From vegetables to meat

To prevent anemia, meat puree is included at the age of 5 months. Portions should not exceed 10 g, they should not be given more than 2-3 times during the week.

A premature baby should definitely eat meat purees. At this time, the single portion increases and reaches 50 g by one year.

Already at 8 months, it is quite logical to supplement the baby’s menu with unsweetened cookies or bread. At the same time, vegetable soups are introduced, which are replaced by meat broths by the year.

When planning nutrition for premature babies, attention should be paid to the child’s physical parameters, not forgetting to monitor his weight gain monthly. The growth and development of premature babies often occurs more intensively. And therefore, at 2 years old, such children often “catch up” and even “overtake” their peers.

Premature babies require special and more careful care than babies of normal weight. A premature baby is a baby born before 37-38 weeks of pregnancy and weighing less than 2.5 kilograms. Such children are characterized by thin skin and reddish wrinkled skin, lethargy and decreased muscle tone, inactivity and slow weight gain.

Often, early children begin to master various skills and abilities later. Therefore, such babies may lag behind in development by 1.5-4 months. However, when proper care and nutrition, regular monitoring by a doctor, the child will soon catch up with his peers. If you follow the recommendations, the baby’s condition will be closer to normal by the age of one year. In this article we will look at the rules of care and feeding of premature newborns.

Rules for caring for premature babies

• Children born prematurely are often characterized by poorly developed swallowing and sucking reflexes, so in the first weeks of life the baby may be prescribed tube feeding;
• After the birth of a premature baby, they are not immediately put to the breast, but are examined and placed in an incubator with automatic feeding oxygen and maintaining optimal conditions for the child’s life;
• Try, because mother's milk is the best nutrition and medicine. It strengthens the immune system and promotes weight gain, gives strength and accelerates the development of the baby;
• If feeding is still provided only through a tube or bottle, regularly offer the baby the breast to develop the swallowing reflex;
• Create comfortable conditions for babies in the children's room. The appropriate room temperature for premature and low birth weight babies is 22-25 degrees Celsius;
• You can bathe a baby weighing less than 1.5 kg only after two to three weeks from birth. In other cases, swimming is allowed already on the 7-10th day. In this case, the suitable water temperature is 38 degrees above zero, and the air temperature in the bathroom is at least +25°C;
• You can start walking with your baby only in warm weather 1.5-2 weeks after birth. The first walk should be short and take no more than ten minutes. Gradually increase your time in the air to 1.5 hours. It is not recommended to walk with a premature baby in hot or cold weather;
• The doctor draws up an individual vaccination schedule and makes a personal calculation of the nutrition of premature babies depending on the weight, height and developmental characteristics of the baby;
• Massage brings invaluable benefits to the development of a low birth weight baby. More than half of these children begin to gain weight faster. In addition, this procedure strengthens muscles and immunity, promotes the development of reflexes and improves physical state child. However, it is important to have the massage performed by a professional;
• Before starting a massage or gymnastics, be sure to consult your doctor! Massage can be introduced already in the second week of life, and special gymnastics after 1-1.5 months from the moment of birth;
• If the baby weighs less than two kilograms, it is important to dress the child warmly. With a higher body weight, infants are dressed in the same way as children born at term. Read how to dress a newborn.

Features of nutrition of premature babies

The peculiarities of feeding premature babies are associated with the fact that such babies have a poorly developed digestive system, sucking and swallowing reflex. Under no circumstances should you overfeed your baby while trying to achieve the desired weight! This can cause serious harm digestive system and cause severe intoxication.

To monitor a newborn’s nutrition, it is recommended to regularly weigh the baby and carefully measure the amount of food. For convenience, you can keep a food diary for your premature baby by month. It is important to establish a comfortable feeding regimen and follow the recommendations.

Modern pediatricians advise introducing feeding for infants on demand, and not according to a schedule. However, this is quite difficult to do for premature babies, since such babies sleep most of the time and do not express the desire to eat. In this case, it is recommended to combine the on-demand and on-demand modes. It is important that there are no long gaps between feedings. But don’t force-feed your baby!

In addition to basic nutrition, the doctor may recommend including additional vitamins in the child’s diet. In the first three days of life, vitamins C and K are needed, after two to three weeks - vitamin D. In addition, it is important for a premature baby to take iron. These beneficial elements can be included in a special therapeutic diet or administered separately.

Norm and frequency of feedings

In the first two weeks of life daily norm food for the baby is calculated using Rommel's formula. For every hundred grams of body weight, there are 10 ml of milk or formula, to which you need to add the number of days of the baby’s life.

For example, to determine the amount of nutrition for a one-week-old newborn weighing 2 kg, we use the following calculations: 10 ml + 7 (days of a child’s life) – 17 ml for every 100 grams. Thus, for 2000 g 17*20 and we get 340 ml.

Artificial feeding and formula milk

If a nursing mother for some reason cannot feed her baby breast milk, she needs to choose the right formula. This should be high-quality and suitable nutrition with the necessary set of vitamins and nutrients. When choosing a formula, it is important to take into account all the characteristics of the child, including premature birth, weight and height, age, reaction to certain components.

Choose specially adapted milk formulas for premature or low birth weight babies. Such compositions are distinguished by increased energy value and increased calorie content, which contributes to rapid weight gain. This saturates the child with energy and gives strength.

Adapted formulas for premature or low birth weight babies often contain calcium and phosphorus, which strengthens bones and teeth and stimulates growth and weight gain. In addition, the composition includes a high protein content, quickly digestible carbohydrates, various vitamins, macro- and microelements. The mixtures include nucleotides for normal digestion and the formation of healthy intestinal microflora, as well as polyunsaturated fatty acids for mental abilities and the full functioning of nerve cells.

Tube feeding

Feeding a premature baby through a tube is carried out if the baby was born before 33-34 weeks. The doctor prescribes this method of feeding in case of deep or extreme immaturity, when there is no sucking-swallowing reflex, in case of a critical condition of the child after birth and in case of abnormal development of the nasopharynx.

When feeding through a tube, it is important to maintain sterility. The installation of the device is carried out by professional doctors. As a rule, it lasts three days, after which it is replaced. When the probe is inserted, the baby is fed with heated milk or formula with a temperature of up to 40 degrees via a syringe. The process is carried out under the strict supervision of a doctor.

This method is fed until the child’s condition stabilizes. When the baby develops a sucking and swallowing reflex and gains weight, you can switch to normal nutrition. It is important that infants do not experience nausea and vomiting, excessive regurgitation and bloating. To determine the sucking-swallowing reflex, periodically put the baby to the breast or put a bottle with a nipple to the mouth.

Introduction of complementary feeding for premature babies

A premature baby needs to be fed a little differently than a full-term baby. In this case, the first complementary feeding begins at 5-6 months with 5% buckwheat porridge, and not with vegetable purees. Do not start feeding your baby if he is sick and unwell, during active teething, with severe colic and tummy problems!

The first porridges are prepared with water or vegetable broth in a ratio of 5 grams of cereal per 100 ml of water. Add a few drops of breast milk or formula to the dish, then gradually switch to 7,8 and 10% porridge. After buckwheat, add rice and add sunflower or olive oil. It is not recommended to switch to milk porridge before eight months.

At the age of six months, include vegetable puree from cauliflower and broccoli, potatoes and zucchini. At the eighth month, the baby is given meat puree from rabbit and turkey, then chicken and mashed egg yolk are included.

At the age of eight months, complementary foods in the form of fruit and vegetable juices also begin. The main juice is apple, but the baby can also be given drinks from pears, cherries and black currants, and a little later carrot juice is introduced. By the ninth month, you can give baby cookies and vegetable soup.

The table below will tell you about the timing of introduction and volumes of food into complementary feeding for a premature baby.

Lure	Age	Portion volume
Dairy-free porridge (buckwheat and rice, later corn)	6 months
(zucchini, potatoes, cauliflower and broccoli)	6-7 months	From 10 g and increase by year to 180-200 g
Fruit puree (Apples, pears, apricots)	7 months	From 5 g and increase by year to 100 g
Vegetable oil (olive or sunflower)	7 months	From 1 gram and by nine months increase to a teaspoon
Meat puree (rabbit, turkey, chicken)	7-8 months	From 10 g and increase by ten months to 80 g
Butter	7-8 months	From 1 g and by nine months increase to 5 g
Cottage cheese	7-8 months	From 10 g and increase by nine months to 50 g
Fruit and vegetable juice (apple, pear, cherry)	8 months	From 10 ml and increase by ten months to 80-100 ml
Egg yolk	8 months	From ¼ and gradually increase to ½
Milk porridge (buckwheat, rice, corn, oatmeal)	8-9 months	From 5-10 grams and increase by year to 180-200 grams
Kefir and yogurt	9-10 months	From 10 ml and increase by year to 150-200 ml
Fish puree (pollock, hake)	9-10 months	From 10 g and increase by year to 50-70 g

Introduce each new product gradually and carefully. For the first time, let the baby try no more than half a teaspoon, and then wait two days. If they didn't show up Negative consequences in the form of allergies, poisoning, stomach or stool upset, the product can be included in the child’s diet. General rules introduction of complementary feeding for infants can be found at the link.

After the baby receives complementary foods, supplement him with breast milk. Don't stop breastfeeding at least until 8-9 months, and it is better to continue feeding along with the introduction of complementary foods until 1.5-2 years. This improves the absorption of new food and normalizes digestion, reducing the risk of poisoning and deterioration of stool. Milk continues to provide the necessary elements for the full development of the child, as it changes along with the baby’s growth and adapts to his needs.