Your Baby: Feeding and Breathing in the NICU

As your baby grows and develops in the NICU, feeding and breathing independently is a critical goal.

In most cases, a baby will need to be able to feed on their own and breathe room air (without oxygen) before they are able to leave the NICU. If your baby was born prematurely, they may reach this developmental milestone near their due date.

Feeding your baby

Feeding is a common challenge for babies in the NICU — that’s why nutritionists and lactation consultants are important members of the Rush NICU teams. They’ll work with your daily care team to make sure your baby gets the nutrients they need to grow and thrive.

Your baby’s nutrition plan will depend on their gestational age, birth weight and medical issues. There are a number of ways to feed your baby, including the following:

  • Total parenteral nutrition (TPN): TPN gives your baby the nutrients they need through an IV in their veins, instead of through their digestive system. With TPN, we’ll use a special fluid packed with carbohydrates, protein, fat, vitamins and minerals to feed your baby.
  • Enteral feedings: Also known as tube feedings, enteral feedings use a thin, flexible tube inserted into your baby’s nose or mouth that leads into the stomach or small intestine. Breast milk or formula can then be delivered directly into the gastrointestinal tract to feed your baby.
  • Gastronomy tube (g-tube): If your baby requires tube feedings for a longer duration of time, a g-tube may be placed through the wall of the stomach. Tube feedings allow your baby to be fed small amounts every hour or larger amounts every two to four hours.
  • Bottle feeding: Once your baby can suck, swallow and breathe at the same time, they may be ready for bottle feeding. You can feed your baby breast milk or formula through the bottle. Your baby’s doctor or nutritionist will recommend the best formula and concentration for your baby.  
  • Breastfeeding: Some babies are ready to breastfeed around 34 to 36 weeks gestation. We believe that breastmilk is the best source of nutrition for your baby, and offer lactation consultants who have experience working with premature babies.

Helping Your Baby Breathe

When your baby is born prematurely, their lungs often don’t have time to develop fully which can lead to breathing problems. Our NICU respiratory therapists are trained in caring for babies with heart and lung issues and will be at your baby’s side during tests and treatments.

Your baby’s respiratory therapist will also partner with your doctor to recommend treatments to strengthen your baby’s lungs and assist with breathing. These treatments could include:

  • Surfactant: The most common lung problem in premature babies is respiratory distress syndrome (RDS). Babies develop RDS when the lungs do not produce enough surfactant, a substance that keeps the tiny air sacs in the lungs open. Your baby may need surfactant placed in the lungs after birth to help the lungs work better.
  • Ventilation support: Some babies in the NICU need breathing or ventilation support devices. Rush offers multiple types of ventilation devices to help your baby breathe, including the following:
    • High-frequency oscillation
    • High-frequency jet ventilation
    • Continuous positive airway pressure (CPAP)
    • Nasal canulas
  • Intubation: Certain types of ventilation devices require babies to have a breathing tube placed in their windpipes (also called the trachea). This tube will be in your baby’s mouth and run just past the vocal cords, helping your baby breathe.
  • Oxygen and nitric oxide: Respiratory therapists also administer special gases to babies, if needed, to help care for their heart and lung problems. The most common gas used is oxygen, and under special circumstances, nitric oxide may be used. Your NICU care team can give these special gases through a breathing tube or through the nasal canula, a small device placed slightly in the nostrils.

Once your baby can suck, swallow and breathe at the same time — meaning they can breast or bottle feed and breathe room air — your NICU team will start preparing your baby to go home.