Popular Science Article | "Little Premature Birth" Big Challenge, Premature Babies' "Battle of Breastfeeding"

Does your baby get tired easily when feeding? Does he take a long time to feed? Does he always feel that he doesn't have enough strength to suck the pacifier? Does he keep the milk in his mouth and not swallow it?

The healthy growth of a premature baby often requires parents to be more patient and careful. The problem of feeding after discharge from the hospital always troubles many premature babies. With the continuous improvement of medical treatment, the epidemiological data of China in 2017 showed that the incidence of premature babies in cities was 7.8%. In addition to the various sequelae risks that may be encountered in the future, the various feeding problems mentioned above are also not uncommon.

1. Why is it better for babies to drink milk through their mouths as soon as possible?

Babies need an adequate energy balance to thrive in the environment outside the womb, and babies who eat slowly or uncoordinatedly often have immature brain development and spend a lot of time feeding, affecting sleep time, sleep quality and parent-child interaction time.

2. What are the differences between premature and full-term babies in terms of breastfeeding?

3. How to help your baby at home in the simplest way?

Adjust the best feeding posture:

Align the child's head and body (keep the head, neck and body in a straight line);

Do not let your child's head and neck tilt back too much (this may affect the movement of the jaw and tongue);

Make sure the child's ears are higher than the mouth to prevent liquid from entering the Eustachian tube (hold the child at 45-90 degrees) to adjust the speed of liquid outflow.

Tips to try to adjust your feeding:

Touch the pacifier to the lips;

When the child opens his mouth wide, place the pacifier in the child's mouth to prepare the child to accept the pacifier;

After every 4-5 sucks, let the child take a break by stopping the flow of liquid;

Use a slow-acting nipple;

Hold your child as upright as possible and keep the bottle as horizontal as possible to reduce the effect of gravity.

4. Professional treatment

Scientific assessment: Due to different premature birth situations and complications, many diseases will affect the baby's oral feeding, such as intraventricular hemorrhage, hypoxic-ischemic encephalopathy, cleft lip and palate, etc. Rehabilitation physicians and therapists will first conduct a scientific assessment based on the situation of each baby to determine how to treat and manage and whether other auxiliary examinations are needed.

Functional assessment: If the baby's condition is relatively stable, the therapist will conduct an oral function assessment on the baby. If the baby cannot feed well with his mouth, targeted oral function training will be carried out based on the assessment results.

Oral functional training: Early sensory deprivation and adverse stimulation can seriously affect the baby's physiological stability. Based on the assessment, the therapist will conduct functional training for the baby, including oral sensory and motor stimulation, feeding and swallowing training, etc.

References:

[1]Chawanpaiboon S, Vogel JP, Moller AB, Lumbiganon P, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modeling analysis. Lancet Glob Health. 2019 Jan;7(1):e37-e46.

[2] Rehabilitation Group of the Pediatric Branch of the Chinese Medical Association, Hou Mei, Sun Dianrong, et al. Expert consensus on the assessment and management of feeding disorders in pediatric rehabilitation clinics[J]. Chinese Journal of Practical Pediatrics, 2023, 38(8):561-566.

Author: Meng Fanzhe (Pediatric Hospital Affiliated to Fudan University)

First review: Wang Yanna (Pediatric Hospital Affiliated to Fudan University)

Final review: Zhou Hao (Children's Hospital Affiliated to Fudan University), Wang Sujuan (Children's Hospital Affiliated to Fudan University, member of the Standing Committee of the Science Popularization Working Committee of the Chinese Rehabilitation Medicine Association)