The Austin Chronicle

To Your Health

By James Heffley, Ph.D., July 22, 2005, Columns

Q. My baby was born about eight weeks early weighing 2 pounds, 11 ounces. He still has some fluid on the brain but has gained almost 2 pounds and may get to go home from the hospital soon. I've been extracting my milk to give him, and now he's learning to nurse; is there anything else I can do nutritionally to improve his chances?

A. When a pregnancy lasts less than 37 weeks, rather than the normal 38 to 42 weeks, the baby is considered premature. Due to recent medical advances, more than 90% of babies who weigh 2 pounds or more will survive, but premature infants have many special needs that make their care different from that of full-term infants. For instance, because premature babies lack the body fat necessary to maintain their body temperature, even when swaddled with blankets, incubators or radiant warmers are used to keep the babies warm.

Premature babies have special nutritional needs because they grow faster than full-term babies. A premature baby's birth weight often increases tenfold in the first year of life. In comparison, full-term babies usually only triple their birth weight over that same period of time.

Because the digestive system of a premature baby is immature, breast milk is usually the best choice. Although many have difficulty feeding directly from the mother's breast, a breast pump can be used and the breast milk given from a special bottle. Breast milk has many advantages over formula but, because premature infants have higher vitamin needs than full-term infants, special supplements may be added to it.

For a number of reasons, premature infants may develop anemia. In the first few weeks of life, infants don't make many new red blood cells, and an infant's red blood cells have a shorter lifespan than an adult's, so they rely on what is known as the "placental transfusion" to increase the baby's blood supply. If the cord is not clamped or cut until it stops pulsing, studies indicate that the baby can receive about one-fourth a cup of extra blood without an undesirable buildup of bilirubin. This is especially important for a premature infant.

Frequently, premature babies are born before their bodies have had the chance to store certain important nutrients needed for growth, especially the fat-soluble vitamins like vitamin K, and thus supplements are needed. Also, supplements of the amino acid L-arginine have long been recognized as helpful to infants, and recently another amino acid, L-glutamine has been shown to slow the loss of protein in low-birth-weight infants (see The Journal of Pediatrics, May 2005).

Each nutrient is important, but for the important tasks of visual development and brain growth, none may be more important than the omega-fatty acids. The brain of an infant grows by about half an ounce per week, and about half of that weight is fat, primarily omega-3 fatty acids. Brain growth continues for a year or two after birth, so omega-3 fatty acids are beginning to show up in many infant formulas. Through an effort known as Omega-3 for Baby and Me, the Women, Infants, and Children program is now distributing education materials emphasizing the importance of adequate maternal intake of docosahexaenoic acid during pregnancy and afterward (see Maternal and Child Health Journal, June 9, 2005). These efforts can shorten the baby's stay in the neonatal intensive care unit and hasten mother/baby bonding while saving thousands of dollars.

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