Bottle feeding your premature baby at home – what you need to know
An information leaflet for parents of babies born before 34 weeks gestation
Formula feeding after discharge from the NNU
Which formula is right for my baby?
Formula fed premature babies are advised to take a variety of different formulas depending
on their growth and medical condition. This section tells you about the different formulas
available:

Nutrient enriched post discharge formulas (Nutriprem 2). These formulas have extra
nutrients to help your baby grow and develop. Your baby will need to take Nutriprem 2
until they are around 3 to 6 months corrected age (unless a dietitian or paediatrician
advises you can stop before).
Nutriprem 2 powder will be provided on prescription from your GP. When your baby
reaches 6 months of age, you can swap your baby onto a standard stage 1 term formula
e.g. Aptamil 1, Cow & Gate 1, Hipp Organic 1 or SMA 1. You do not need to buy a special
milk such as follow on formula or hungry baby formula – there is no benefit to using
these.

Standard term formulas. Some premature babies do not experience any problems with
growth, and are discharged home on standard term formulas. You can buy whichever
brand of stage 1 term formula you prefer, and continue to use this for your baby’s first
12-18 months.

Special term formulas We occasionally use special formulas for babies with sensitive
guts or certain medical conditions. Your consultant or dietitian will give you instructions
on how long you need to keep using the special formula. It will be prescribed by your
GP.
How do I make up a bottle of formula?
You should be shown how to make up a bottle of formula before you are discharged from
the NNU. To keep your baby well, it is very important to make up the formula exactly as
recommended on the packet. A leaflet called ‘Bottle feeding’ is available from the
Department of Health website. Hard copies are usually available on the NNU or from your
health visitor
When can I swap to cow’s milk as a main drink?
We recommend swapping formula fed premature babies over to full fat cow’s milk between
15 and 18 months of age.
Written by the Paediatric Dietitians at the Royal Devon & Exeter Hospital 01392 406063 December 2012
Does my baby need vitamin and mineral supplements?
On the Neonatal Unit
Babies born early need extra nutrition to help them thrive, including vitamins and minerals
such as vitamin D for strong bones, and iron for healthy blood. On the neonatal unit, if your
baby received breast milk, your baby will have been prescribed extra vitamins (Abidec drops)
and iron (Sytron). Babies who were given special preterm formulas such as Aptamil Preterm
or Nutriprem 2 will not have had these extra vitamins, because the formulas already contain
them.
After discharge until age of 1 year corrected:
Mixed feeding (breast and formula) babies: will need a prescription of Abidec and Sytron
from your GP, to be taken until your baby is one year old
Babies on Nutriprem 2 Formula: Nutriprem 2 is already fortified with extra vitamins and
iron. However, when you switch to a standard term formula by 6 months corrected age, you
will need a prescription of Abidec and Sytron from your GP, to be taken until your baby is
one year old
Babies on standard term formulas or other specialist term formulas: will need a prescription
of Abidec and Sytron from your GP, to be taken until your baby is one year old
After the age of 1
The Department of Health recommend all children aged 1-5 take vitamin drops containing
vitamins A and D, because they don’t get enough from their food. These should be bought
in shops or from NHS clinics e.g NHS Healthy Start Children’s vitamin drops, and will not be
prescribed by your doctor. A fact sheet on children’s vitamins can be downloaded from
www.bda.uk.com/foodfacts
Weaning onto solids
Weaning is the process of introducing your infant to solid foods. Weaning helps babies take
in more nutrition to grow, develops their eating skills, and exposes them to lots of different
tastes. This will help them eat a wide variety of foods as they get older. For babies not born
early, we recommend solids are introduced at around 6 months of age. However, there are
special guidelines for babies born early.
When should I start?
- for babies born prematurely, weaning should start when they are between 5 and 8
months old (this is the age they are from their birth date, not from their corrected
age, which we often talk about in hospital)
- In addition to being between 5 and 8 months old, you should also look for signs that
your baby is ready to start weaning such as showing interest in what others are
eating, or bringing hands/toys to their mouth, and being able to be easily supported
in a sitting position.
- You do not need to wait until your baby reaches a certain weight, or has teeth
Written by the Paediatric Dietitians at the Royal Devon & Exeter Hospital 01392 406063 December 2012
Early or late weaning – why not?
- Premature babies’ digestive systems are not developed enough to manage solids
before 5 months of age. Weaning before this age may also replace milk with less
nutritious solids.
- Waiting until after 8 months age to wean means your baby misses the best time to
develop eating skills and accept new flavours, which may affect the types and
variety of foods they will accept later on.
Where can I get more information?
General advice about weaning, including suitable foods to give your baby, is available in a
leaflet called ‘Weaning: starting solid food’. This is available to download from the
Department of Health website, as well as through your health visitor.
More specific advice for premature babies is available from Bliss charity, in a leaflet called
‘Weaning your premature baby’. This can be downloaded from www.bliss.org.uk
Further sources of help and advice
Your health visitor and consultant can help you with any general queries. If you need further
assistance, you can ask to be referred to:

Infant Feeding Coordinators at the RD&E, for advice about breastfeeding 01392 406663

Paediatric Dietitian at the RD&E, for advice regarding growth, formulas and weaning
01392 406063
Written by the Paediatric Dietitians at the Royal Devon & Exeter Hospital 01392 406063 December 2012