In utero, the lungs require 37 weeks of gestation to be ready for the outside world. Preterm infants, therefore, are at a disadvantage when it comes to breathing in that they are still developing their lungs at the same time they need to use them to breathe. Even if they were born just one month shy of their due date, “preemies” have to finish the fetal development of their lungs outside the womb.
Because of this situation, preterm infants often breathe differently than full term infants. They may breathe faster, and even bear down slightly when breathing. When they are feeding and need to hold their breath in order to swallow, they breathe a little faster and bear down a little more. This extra effort is tiring, so some preemies tend to gulp instead taking the time to smoothly suck, swallow, then breathe. Gulping their feedings leads to more air in the babies’ stomachs and trouble burping. They then feel full before they have finished feeding, and may fall asleep. Sometimes they expend so much energy they are too tired to take their next feeding and end up losing instead of gaining weight.
Preterm infants often have inconsistent feeding patterns. Mothers tell me their infants will feed very quickly for some feedings and then at other times take thirty minutes to feed the same amount. They also take less per feed than other infants their same (adjusted) age. This results in more time spent feeding and more feedings per day and a protracted time parents may be awake for feedings throughout the night.
Working with the underlying breathing issue, I help infants to release the pattern of fast breathing and bearing down. Once the babies learn they can breathe just fine without this habit, they have are able to take full consistent feedings in less time without gulping and swallowing air.