Critically Ill Infants

Feeding Difficulties

When premature babies are born, their digestive systems may not be fully developed. As a result, many of these small infants experience feeding difficulties.

These may include:

• Difficulties establishing nipple feedings, at breast or with the bottle. This may occur because the baby is unable to suck and swallow properly.

• Gastric residuals, which occurs when a baby does not completely empty their stomach from a previous feeding.

• Gastro-esophageal (GE) reflux, which occurs when a small amount of stomach contents, including stomach acid, refluxes or regurgitates into the esophagus. This may be painful to the infant and, when severe, may cause signs of distress, including apnea. Apnea is a condition in which a baby temporarily stops breathing.

• Abdominal distension, which is an abnormal enlargement or swelling of the stomach. This distension may be a sign of more severe gastro-intestinal problems.

• Feeding is given special attention in the Intensive Care Nursery at UCSF Children's Hospital. Unless your baby is over 32 to 34 weeks of gestation, which is the amount of time after conception, he or she probably will not be able to nurse or drink normally from a bottle. Instead, these babies receive nutrients by gavage feedings, in which a tube is placed through their mouth or nose into their stomach.

  Although many premature babies are unable to breastfeed because they cannot coordinate sucking, swallowing and breathing, mothers can still pump breast milk and the staff of the Intensive Care Nursery will store it and feed it to the infant by gavage feedings.

In almost all infants, feeding difficulties are temporary and resolve as the baby matures and gets closer to their full-term due date. However, some infants may suffer from more severe feeding problems that can lead to other conditions, such as Necrotizing Enterocolitis (NEC), which is a serious problem of the intestines that affects a very small percentage of extremely premature babies and may require temporary stopping of intestinal feedings, treatment with antibiotics and, in severe cases, surgery.

Experts at UCSF Children's Hospital care for infants in the William H. Tooley Intensive Care Nursery.

Reviewed by health care specialists at UCSF Children's Hospital.
Last updated May 8, 2007