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Weaning preterm infants

Expert advice from Caroline King Dietitian (Neonatal Specialist) Imperial College Healthcare NHS Trust

The department of health guidelines for weaning do not include babies born premature therefore health professionals working with this group have put together guidelines based on published evidence and experience. This has been summarised in a booklet published by Bliss. You can find out more information on their website http://www.bliss.org.uk/help-for-families/video5/weaning/

Premature babies are born any time from 22 to 37 weeks gestation and are a very varied group. In many aspects of development they may be behind term babies for example being able to sit, however due to feeding early into their stomachs their digestive systems develop earlier. This means that we don’t have to wait until babies are six months after their due date before weaning but it also means baby led weaning needs to be modified and cannot fully be tried until they can sit.

The guidelines take into account the great variety within the group of premature babies and suggest considering weaning somewhere between 5 to 8 months after birth (not due date). For more mature early babies it might be closer to five months for less mature babies closer to 8 months. It is also advised that a baby is at least three months after their due date to allow development of good head control. However, as for term babies the key factor in deciding when to start within this window is assessment of each individual babies cues, help with this is given in the Bliss booklet.

Caregivers are encouraged to be responsive to their babies throughout the weaning process to allow feeding to the babies hunger and textures according to the babies’ ability, and to introduce a wide variety of flavours. Finger foods are encouraged as soon as possible and lumps should be introduced at the latest when the baby is nine months old (from birth) to avoid gagging and vomiting which may occur if lumps are delayed.

As iron stores are laid down during the latter stages of pregnancy premature babies are at risk of iron deficiency so iron rich and nutrient rich foods should be prioritised.

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