An evidence based guide to weaning preterm infants

There have been national guidelines for weaning infants for many decades in the UK however none have addressed preterm infants until the COMA report of 1994 which gave brief recommendations. More recent publications don't include recommendations for preterm infants and it is acknowledged that for this group there is a need for separate guidelines; however none to date have been published. In this article the evidence base around weaning preterm infants is discussed and updated guidelines are suggested.It is suggested that preterm infants should be considered for weaning between 5 and 8 months uncorrected age to ensure that sensitive periods for the acceptance of solids are not missed and to allow development of appropriate feeding skills. The exact time within this 3 month window will depend on the individual infants' needs and cues. Although prematurity is usually defined as birth before 37 completed weeks, those healthy preterm infants born from 34 completed weeks onwards in general may be weaned according to the same guidelines as for term infants.To allow for a degree of motor development which may help with positioning it is suggested that it may be useful to delay weaning until after 3 months corrected age. However the assessment of infant cues are paramount when making the final decision and each baby should be treated as an individual according to his/her own developmental readiness.