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Newborn preemie feeding. Timed interval or demand?

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Newborn preemie feeding. Timed interval or demand?

Postby somtamfetcher » Sun Jun 27, 2010 06:17 am

by somtamfetcher (12 Posts), Sun Jun 27, 2010 06:17 am

With the arrival of my premature son to our home, my wife and I are struggling with the best way to feed him.

The nurses suggested we continue with the timed interval feeding that the babies were receiving at the hospital. This means structured feeding at strict 3 hour intervals, and let the baby decide how much to eat at each feeding, making sure they get enough throughout the whole day.

Some perusing the internet has led me to believe some people believe that this is not the best thing for the baby, and we should instead let him eat whenever he feels he is hungry, what they call the demand method. Thailand generally adopts the practices of the US around 30 years ago, so it is not surprising this latter view is a rather recent development.

Does anyone have any opinions or advice on the proper way to feed our twins? They were born at 32 weeks, and they are about 35 weeks gestational age now. The boy has been home for 3 days, and the girl should be coming home next week. We are bottle feeding them as the pregnancy was achieved through a gestational surrogate.

Currently, due to a shortage of breast milk, we are giving them 50% breast milk and 50% preterm formula.
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Re : Newborn preemie feeding. Timed interval or demand?

Postby blythe » Sun Jun 27, 2010 09:26 am

by blythe (3060 Posts), Sun Jun 27, 2010 09:26 am

I'm a huge advocate of on-demand, rather than scheduled feedings. With my 37-weekers, though, I found out that was a bad idea until they got older! Your babies may be different, but mine would have slept six hours or more between feedings, and my firstborn lost weight very quickly for a few days when I tried to let him eat on demand. I also don't know if bottle-feeding on-demand is different from breastfeeding.

We are always more than happy to share our experiences, and since you're doing so much internet literature searches, it sounds like you might like some good preemie books as well. I'm not sure how quickly Thai postal service is, but my friend who had a 32-weeker loved this book http://www.amazon.com/gp/product/067103491X/ref=wms_ohs_product - and other similar books are suggested in the listing.

I'm glad your SIL has recovered - do keep an eye on her for about the next three weeks to be sure she is out of danger, post-partum PE can be sneaky - and that your babies are so healthy and doing so well! Your wife is an angel for letting you sleep, hopefully you can return the gift very soon!
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Re : Newborn preemie feeding. Timed interval or demand?

Postby catherine » Sun Jun 27, 2010 11:09 am

by catherine (2832 Posts), Sun Jun 27, 2010 11:09 am

One thing that you will need to bear in mind is that your children have proportionally sized stomachs. That means that they can only hold so much at one feeding. This is why they are on the 3 hour schedule. They will suckle until satiated, but once they start processing what they've taken on board... then they're going to run out of "gas" faster than a larger baby with greater capacity. Demand feeding is more common with nursing children, partially because the nature of breast milk and nursing is so dynamic that responding immedidately to a baby's hunger needs allows the mother's physiology to keep pace. Once that falls out of synch, it can be challenging to put it back together. Absent that issue, you are free to focus on issues of hydration and weight gain. As your babies grow you will find that they develop their own schedules and you will naturally fall into a pattern that works for you all. This is true for newborn term babies who can take 3-4 weeks to settle out of the 24 hour cycle they seem to come set at, you will need to pace yourself as you wait for your little ones to catch up. Sleep for all the adults involved is important... don't be shy, accept all useful help and don't feel obligated to maintain anything other than basic hygiene protocols (teeth/shower). Takeout saved my life and paper plates (we didn't have a dishwasher first time around).
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Re : Newborn preemie feeding. Timed interval or demand?

Postby love_the_daschies » Sun Jun 27, 2010 11:24 am

by love_the_daschies (863 Posts), Sun Jun 27, 2010 11:24 am

I did every 3 hour feeding with my little guy (not really early at 36 weeks - but tiny and under 5 pounds). Once he started to consistently gain weight we went to on demand feeding. He was about a week old. So I think if your babies are gaining - you can try to let them go a little longer some times.
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Re : Newborn preemie feeding. Timed interval or demand?

Postby tree » Sun Jun 27, 2010 12:29 am

by tree (819 Posts), Sun Jun 27, 2010 12:29 am

I think it depends on the baby. Our daughter would have peacefully slept through many of her feedings for the first week or two that she was home if we waited for her to demand food. She was small and struggling to gain while nursing, so we stuck to the 3 hour schedule when she first came home. She started waking up a little more after being at home for a few weeks, we went to feeding on-demand, as long as it was at least every three hours. Her doctor said we could stop waking her up at night to feed her after she had been home for about a month and had been gaining well for a while. That switch caused her to be hungry about every 2-2.5 hours during the day and start sleeping 4-5 hours at night. You can almost function on 4-5 hours of sleep.
We were always happy to feed her more often. We used the schedule to make sure that she was eating enough. There is still a lot of debate/strife in the US over scheduled vs. demand feedings. It really does boil down to what works for you and your kids. We had it easy, and I think the NICU schedule had some role in that success.
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Re : Newborn preemie feeding. Timed interval or demand?

Postby tracym » Sun Jun 27, 2010 11:39 pm

by tracym (375 Posts), Sun Jun 27, 2010 11:39 pm

Congrats on your new babies :)

We came home on demand feeding with a 3 hour limit (this was what they did in the NICU)...so if baby wanted to eat earlier that was fine, but was to go no longer than 3 hours between feeds. This was start of feed to start of feed. I was told not feed any longer than 20 minutes or they'll start burning more calories than they're eating. After a couple of weeks of a consistent gain, the limit was increased to 4 hours. I stuck with this for quite some time with my daughter as she was still tiny but not so long with my son who started out nearly 2 lbs bigger.

I think the bad thing about scheduling is not letting baby eat when they're hungry because it's not yet time according to the schedule. I can't see a problem with demand feeding with a time limit.
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Re : Newborn preemie feeding. Timed interval or demand?

Postby marialynn242 » Mon Jun 28, 2010 09:31 am

by marialynn242 (144 Posts), Mon Jun 28, 2010 09:31 am

I did the 3 hours but if he fussed before 3 hours were up I just feed him and started again on the regular schedule I usually tried to feed him every 3 hours even if he ate early or later. Actually he is still on a 4 hour schedule and does absoulutly fine with it. Its makes it easier for me becuase I worked and the schedule worked out for me dad and grandma(babysitter)! Good luck!
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