Congratulations! You’ve graduated from the NICU! You’re excited, scared, exhausted, and overwhelmed.
One question you may be asking is, “What should I feed my baby once we get home?” Most often, you will be discharged with a home feeding plan. No matter what your doctors recommend, you can explore these best formula for preemie options that I’ve outlined below.
Drawing on my own experience as a former medically-complex foster parent, hours of research, and speaking with current preemie parents, I’ve also included hypo-allergenic premature infant formula alternatives and answers to the most frequently asked preemie feeding questions.
|The Best Formulas for Preemies||Why It's Best||Rating|
|Similac Neosure||Brand recommended most by pediatricians and NICU. Lowest priced formula for premature infants. Proven growth benefits.||♥♥♥♥♥|
|Gerber Good Start Soothe HMO Formula||Includes HMO (prebiotic found in breastmilk) that helps digestion in underdeveloped tummies.||♥♥♥♥♥|
|Enfamil NeuroPro Enfacare||Pediatrician recommended. Proven growth benefits.||♥♥♥♥♥|
Similac NeoSure is specifically formulated for premature infants. The intent is to provide extra calories and increased protein, energy, vitamins and minerals for accelerated growth through the first year of life.
All formulas contain those categories of ingredients but the concentrations are higher in formula made for preemies than in other formulas. The objective is to see growth in the key measurements including head size, weight and length.
Neosure is an easy-to-digest milk-based formula.
- So exactly what is NeoSure formula? This formula includes:
- DHA and ARA – these additives have been shown to complement eye and brain development in some studies, and are also found in breast milk
- Calcium and Phosphorus – for baby’s growing bones
- Lutein – for eye development
- Vitamin E – cell development nutrient also found in breast milk
Similac claims that “Preterm infants fed Similac NeoSure through the first year of life showed significantly increased lean body mass and less fat mass at 12 months corrected age.” Studies have shown that preterm infants using this formula had improved visual acuity at 6 months corrected age, as well as improved early language development at 14 months corrected age.
It should be noted that some parents reported excess gas and increased constipation upon starting this formula. However, this seemed to resolve itself after continued use. Similac NeoSure comes in three preparations – 2 fl. oz. ready to feed bottles, 1 qt. container of ready to feed formula, and a canned powder to be mixed with water.
This best formula is named “Best Formula for Premature Babies” on our Best Baby Formula list, too.
Gerber Good Start Soothe HMO Formula
There really just isn’t a lot on the market in the way of preemie formulas. For a lot of preemies, the two or three main options might not work. Giving a regular formula a shot isn’t out of the question. They may be free from extra protein or extra nutrients, but they definitely have everything your baby needs to grow up strong and healthy.
What I like about this Gerber Good Start Soothe HMO Formula is that it’s pretty close to being a Gerber premature formula. It has HMO in it, which is Human Milk Oligosaccharide. This is a prebiotic that’s found in breast milk and it’s really good for baby’s digestion and immune system development. Many moms of premature babies want to give their baby breast milk or something really similar since it’s been proven to be the best nutrition that you can give a preemie. This HMO also makes the formula really easy for an underdeveloped tummy to digest.
The other thing that makes this a really good premature infant formula is that it has what Gerber has coined “comfort proteins.” They take high-quality whey protein and partially hydrolyze it. What this does is breaks down the proteins into smaller particles and makes it easy to digest and absorb. This works in preemies’ favor, and it’s also good for babies with colic, gas, fussiness, or other troubles related to eating.
Other bonuses include probiotics, DHA for eyes and brain development, and free from artificial growth hormones. Overall, this is a great choice for feeding your preemie. It’s the first regular formula to try.
Enfamil NeuroPro Enfacare
Enfamil NeuroPro EnfaCare like NeoSure was developed for feeding premature babies during their early months to achieve growth targets. With enriched nutrition and expert-recommended levels of DHA amd ARA, Enfamil EnfaCare is a milk-based formula that supports your baby’s healthy development.
The formula was improved in 2018 to add in MFGM (milk fat globule membrane) to help support brain development. It’s an ingredient found in breastmilk which makes this a stellar option for preemies.
Enfamil says “Premature babies fed this formula during the first year have achieved catch-up growth similar to that of full-term, breastfed infants.” This formula comes in three preparations – 2 fl. oz. and 8 fl. oz. ready to feed bottles, and a canned powder to be mixed with water. Parents reported more stomach discomfort with this formula versus its competitor and it also has corn syrup solids which some parents don’t like.
Similac Organic Non-GMO Infant Formula
When in doubt, go organic to give your preemie the most possible nutrition. With Similac Organic Non-GMO Infant Formula you get high quality formula without antibiotics or rBST-milk. Moreover, organic nonfat milk is the first ingredient in this formula.
Not only did they leave out GMOs but also pesticides and other creepy ingredients. You won’t even find corn syrup on the list as the company opted to use organic sugar instead, which is rare. Also, you won’t see palm oil on the list either instead, they opt for sunflower, soy, and coconut oils, which are healthier for your baby.
The only downside of the formula is it uses maltodextrin, but it is organic, which is a second sweetener, from a natural source. Otherwise, you get beneficial ingredients like DHA, vitamin E, nucleotides, and antioxidants along, with all of the essential vitamins and minerals.
Make sure to talk to your doctor before using it for a preemie as your doctor may suggest a formula designed for preemies first. However, if the doctor says this is the right option, you can use it for the first full year of your baby’s life.
Selecting the Best Formula for Preemies
Science Direct, a leader in scientific, technical, and medical research, states that many very preterm infants receive formula milk as a major source of nutrition during their hospital stay because human milk is not available. Standard term formula is designed for term infants, based on the composition of mature breast milk. The concentrations of protein, calcium, and phosphate are not sufficient to provide the recommended nutrient needs for stable and growing preterm infants.
Therefore, preterm infant formulas should be used. According to Gerber Medical, the overall goals for ongoing nutrition of the preterm infant are to continue to meet their increased nutritional needs to safely support catch-up growth and development while supporting GI function and helping to build their developing immune system. The best preemie formula will contain the right amount of protein, which is an essential requirement for babies born at an early postconceptional age, and has a good protein/energy ratio, per expert recommendations.
Similac NeoSure and Enfamil NeuroPro Enfacare have been specifically formulated for preemies because they have been enriched with nutrients like calcium, magnesium, and phosphorus. They also have more calories and a higher protein level. This formulation is made to help your baby gain the essential lean mass that they’ll need to leave the hospital and get onto regular infant growth charts.
*Source: NINA R. O’CONNOR, MD, American Family Physician. 2009 Apr 1;79(7):565-570.
- Higher calorie count
- Increased amount of protein
- Enriched nutrition
- Proven growth benefits
- Warming formula in microwaves is risky because it can cause serious burns.
- Since premature infants may not have fully developed their immune systems, caution should be taken with powdered infant formula. Powdered formulas have been found to contain contaminants and should only be used on the recommendation of your doctor, following procedures to reduce the potential of infection.
FAQs about the Best Preemie Formula
How do I use the ready to feed bottles?
- Do not use if opened or if the breakaway ring is damaged or missing.
- Ready to feed formula already contains the correct percentage of water. Do not add extra water. Additional water can dilute the effectiveness of the formula. This is especially important for preemies who need to receive a high concentration of nutrients in each ounce they drink.
- Shake very well.
- Twist off cap.
- Twist on clean nipple and ring. (To avoid contamination, wash your hand thoroughly before applying the nipple to this product. It is already sterile, so this will maintain the integrity of the sterile process.)
- Use this product within 1 hour of the start of feeding.
- Keep sealed and at room temperature, avoiding storage in locations that might have temperature swings, like a garage.
- Bottles are not reusable.
- Keep away from direct light.
- It is best to keep the bottles in their carton until ready for use
How do I use the ready made formula?
- Do not use if the band around cap or inner foil seal is damaged.
- As mentioned above, do not add water.
- Always shake well.
- Check for damage when you take off the protective band. Clean the cap before using.
- Invert cap; press down to pierce foil, then turn cap a half turn.
- Remove foil.
- After inserting a cap, pour the formula into a clean bottle and attach a clean nipple.
- Once feeding begins, use within 1 hour or discard.
- You need to use all the formula in the 1 Qt. container within 3 days after it is opened. If any is unused it should be thrown away.
- Store at room temperature until opened and then store in the refrigerator.
- You can prepare bottles in advance and keep them in the refrigerator for only 48 hours.
How should I use a powder preparation?
- It is extremely important to maintain strict hygiene when using powdered formula.
- If in doubt, ask your doctor for the correct process.
- In some cases your doctor may recommend sterilization by using boiled water with the formula.
- It is always advisable to clean bottles, nipples and rings with hot water and soap.
- Always wash cleaning utensils as well as your hands and preparation surfaces.
- Fill the bottle to the desired level with water first.
- Use 1 unpacked level scoop for every 2 fl oz of water.
- Return dry scoop to can.
- Cap bottle; shake well; attach nipple.
- Once feeding begins, use within 1 hour or discard.
- Premixed bottles should be stored in the refrigerator and used within 24 hours.
- Powdered formula should be stored at room temperature.
- Once opened, a can of formula should be used within one month.
What if my preemie can’t tolerate these and needs a hypo-allergenic formula?
- If your baby needs a hypo-allergenic formula, I urge you to consult with your child’s pediatrician or nutritionist to avoid any stomach issues. There are many options available to you. Most commonly, it will be suggested that you try Similac Alimentum, Enfamil Nutramigen, or Neocate. However, instead of the standard preparation, your baby’s healthcare provider will suggest a specific recipe for preparation to ensure that your baby gets the correct amount of intended calories. Please speak with a healthcare provider before making this change. Not enough calories will result in poor weight gain. Too many calories may result in a host of tummy troubles and issues.
How long should your baby use preemie formula?
- There is no specific timeframe for how long you’re baby should use preemie formula. Depending on their health and needs, they may need to stay on preemie formula for 3, 6, or even 12 months. It’s best to keep in contact with your doctor to determine together when the best time would be to stop using preemie formula.
Where can I get more information about caring for my premature infant?
- Healthychildren.org, powered by the American Academy of Pediatrics, has a wonderful website filled with informative and helpful information for parents of premature infants. This website goes beyond how to feed your preemie, and even includes a section about how to deal with the stress of being in the NICU.
You’ve ridden the NICU roller coaster and came out on the other side. It wasn’t an easy ride and now you’re studying different types of baby formulas. During this time, you most likely experienced some of the scariest moments of your life. If I could offer you one piece of advice, I would tell you to take the help. Anything they offer you – therapists, nutritionists, social workers, assistive devices, etc – to ease your transition home, take it. Let them help you. It will make your days and nights easier while giving you extra peace of mind. It takes a village to raise a baby. Take their help and build your village.
Embrace each tender, God-given moment with your precious little one. He chose you, Momma. He handpicked you to care for this tiny, new life. You can do this. You were made for this. Throughout your journey, I want you to remember this one thing – although we don’t know you personally – all of us here at Experienced Mommy, myself included, are praying for you. Parents of preemies and special needs children are our unsung heroes. May God bless you on the days, nights, and years ahead.