Preemies often have a hard time sucking on a nipple, either from a bottle or the breast. It takes time and patience to get your preemie to coordinate the reflexes he needs to suck, breathe and swallow. This is a developmental issue that can't be rushed. He might eat much more slowly than a full-term baby for a long time. You can take steps to make it easier for him to eat by taking feedings slowly and following his cues.
Understanding Preemie Development
Babies in the womb don't develop the ability to coordinate their suck, swallow and breathing reflexes until at least 32 weeks gestation, according to an article in the journal "Advances in Neonatal Care." If your baby is born before that point, he'll need to be fed through a tube into his stomach or possibly through an intravenous line. By 34 weeks, some otherwise healthy babies can use a nipple for an entire feeding, speech-language pathologist Amy Thorpe explains on the Ohio Speech-Language-Hearing Association website. But if your baby has health issues, as many preemies do, he might not yet be ready for full oral feedings.
Overcoming Oral Aversion
Even once he reaches the gestational age of 34 weeks, your preemie might have trouble sucking on a nipple for his feedings. Many preemies develop oral feeding aversions, which occur when they experience unpleasant mouth procedures, such as nasogastric tube or ventilator tube placements. Oral feeding aversions might not manifest themselves until your baby is 3 to 4 months old, according to the textbook "Primary Care of the Premature Infant." A speech-language pathologist can help you overcome oral feeding aversions by desensitizing your baby's mouth and lips through gentle stroking before starting a feeding or through other techniques.
Choosing the Right Nipple
Your preemie might not be able to suck as strongly as a full-term baby without getting tired. A softer nipple or one with a slower flow can make it easier for him to get the nutrition he needs without using up extra energy or gagging during the feeding. Extra expended energy burns calories and interferes with a preemie's weight gain; feedings should take no longer than 30 minutes, according to "Advances in Neonatal Care" article. Using a pacifier between feedings, starting as early as 24 weeks gestation, can help your baby develop his sucking reflex, suggests the Ohio Speech-Language-Hearing Association.
Giving Him Time
You can't rush a preemie drinking from a bottle. If you do, he could gag, choke, spit up or aspirate formula into his lungs. Let your baby set the pace and the progress to full bottle feeding at a rate consistent with his developmental stage. Watch him for signs of tiring or frustration during the feeding. If he arches his back, tries to turn away or starts gagging, stop the feeding for a few minutes and help him recover. When he's had enough and can't be coaxed further, don't try to force the milk into his mouth.