World Prematurity Day is observed every year on November 17 to raise awareness about the challenges women face with their babies when they are born preterm, which occurs before the 37th week of pregnancy as it is meant to last about 40 weeks. UNICEF said in the latest report that preterm birth is a leading cause of death among children under the age of five. Preterm cases have several risk factors, including immature lungs, difficulty regulating body temperature, poor feeding, slow weight gain, delicate digestive systems, and more. 

An estimated 15 million babies, which means one in 10, are born prematurely worldwide every year — which highlights the magnitude of this lesser-addressed problem. Babies born preterm need special and tailored nutrition that meets their unique dietary needs for growth and development. The nutritional plans should be personalised, catering to the baby’s age, weight, and specific health issues. 

The world strives to find solutions and opportunities to address preterm birth and sick newborn care.

There’s a need to come up with practical approaches to spread awareness to the grassroots levels.

To understand the issues in depth, WION spoke to experts so that their experiences with patients became a lesson for all the mothers who struggle.

Dr Preetha Joshi, consultant, neonatal, pediatric and cardiac intensivist at Kokilaben Dhirubhai Ambani Hospital, Mumbai, said that preterm babies have more nutritional needs than term babies. 

Dr Siva Narayan Reddy Vennapusa, DCH, DNB, Consultant – Neonatology & General Pediatrics at Rainbow Children’s Hospital, Secunderabad, said that the importance of nutrition emerges as a “cornerstone in nourishing the growth of our tiny patients in the complicated terrain of preterm care”. 

He said that in such cases, every moment is a “delicate ballet of medical knowledge and caring dedication”.

He said, “As a doctor traversing this complex path, my viewpoint extends beyond the clinical domain to an intense dedication to building solid foundations for these little patients.” 

Emphasising the precise orchestration of micro and macronutrients, he said that the task of proper nutrition has become both an art and a science. Optimal preterm nutrition involves an active combination of evidence-based solutions and personalised care and not just a list of vitamins and minerals. 

He said, “Every decision is an investment in the future well-being of these premature babies, from the careful balance of breast milk fortifiers to the perfect timing of introducing nutrient-rich foods.” 

For preterm babies, mother’s milk should be the first choice as it has many benefits, particularly colostrum which is the first milk produced.

Dr Joshi also said that for very preterm infants, total parenteral nutrition might be necessary, delivering essential nutrients intravenously. “This method carries risks like bloodstream infections and is therefore administered in a protocolised manner in Level III Neonatal Intensive Care Units only,” she said. 

To support the mothers, supporting mothers can provide expressed breast milk, which may be the most important intervention available for preterm infants.

Experts have noted that feeding with expressed human milk reduces the risk of serious infection, which is a major cause of neonatal morbidity and mortality in preterm infants in developing countries. 

Dr Joshi said that most term babies require about 85 to 100 calories per kilogramme of body weight, but preterm infants need more, they mostly require slightly higher energy, 105-135 kcals per kilogramme per day. “These extra calories help the baby catch up to reach a healthier height and weight,” she said, further adding that caloric intake is important as premature infants require more calories than full-term babies to support their rapid growth. 

“A higher intake of protein is also vital for the development of organs and muscles. Fats play a critical role in brain development and are often supplemented in preterm infants to ensure adequate growth. Vitamins and minerals are required in greater amounts due to the accelerated growth rate of preterm infants, particularly for bone development,” Dr Joshi told WION. 

Not just the diet, Dr Vennapusa weighed in on an important aspect which goes beyond physical. He said it involves the emotional and psychological components that are essential for overall growth. “Our advice as doctors extends beyond formula and feeding tubes to areas such as parental education, compassionate communication, and creating a supportive atmosphere,” he said. 

He said that the value of kangaroo care, bonding via shared experiences, and parental warmth. “In this holistic approach, medical expertise converges with the deeply human elements of care, recognising the intricate interplay of physical, emotional, and developmental well-being for our tiniest patients,” he said. 

Dr Joshi highlighted the importance of care once the babies are discharged from hospitals.

She said, “Post-discharge, these infants often have nutritional deficits, requiring supplements like iron and vitamins, and possibly protein and energy-enriched formula milk.”

She added that they also need very close growth and development monitoring over the first 3-5 years of life by a dedicated multispecialty high-risk follow-up team.