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Resources for Feeding, Eating, Drinking, Speech, and Mouth/Airway Function


Question & Answer - Development

I have a preemie. Now what do I do?

October 2014



When my daughter Kim submitted this Q & A, I felt a little self-conscious as she mentions my book a number of times. I did not ask her to mention the book, so I guess it really is a “useful book.” I am honored that Kim has chosen to share her experience with us and that my book was of value to her as a mom.

ANSWER FROM Kimberly DeFriez, MIS, MS, CCC-SLP, Speech-Language Pathologist in Baltimore, MD

When my daughter, R, was born at 36 weeks, I had no idea what exactly was in store for me. I suffered from a placental abruption that produced a critical situation leading to induced labor and the early birth of my child. From the constant screaming to sleepless nights after bringing my little girl home from the hospital, I soon learned that this was no ordinary circumstance.

In 2012, I was elated and scared to give birth to my beautiful daughter, R. She was gorgeous, weighing 6-pounds, 12-ounces; she hardly looked like the preemie. However, up close, you could tell, and her 5-day NICU stay confirmed that. She had no sucking pads and just seemed irritable and unhappy to be born earlier than expected. With the love and help of so many including my wonderful husband and my parents, we were able to keep R on track with her developmental milestones.

Despite being a speech-language pathologist myself with a background in feeding and having a mom (Diane Bahr) who has written and taught extensively about feeding, having a preemie was a challenge. The largest obstacles were helping R to develop appropriate jaw/mouth stability, as well as feeding skills and nutritional intake. My body was not ready to give birth, so I struggled to produce enough breast milk. With the help of my mom, I purchased an effective breast pump. Soon, I was making enough milk, though I continued to supplement R with high quality formula to help her gain weight. She ate every 2-3 hours for the first several months, and I finally found that Gerber Good Start Soothe was a safe and effective supplement for her immature digestive patterns. Gerber Soothe is marketed especially for those infants suffering from colic or those who do not have mature digestive systems.

As the months rolled along, I followed the feeding charts in my mom’s book Nobody Ever Told Me (or my Mother) That! Everything from Bottles and Breathing to Healthy Speech Development (pp. 181-186, 202-214). I introduced foods according to R's adjusted age, not her actual age. Slowly but surely, I introduced foods with increasing textures, smells, and tastes. R responded well, although we struggled a little getting her onto regular milk at 12-months of age. My solution was to introduce her to Lactaid milk at first (as lactose intolerance seems to run in our family) and then make a slow transition to regular milk around 18 months. It worked!

To reduce R’s jaw instability/problems, often observed in preemies, I helped R to appropriately use the Beckman Tri-Chews, P's and Q's, Chewy Tubes, and Baby Grabber. These tools provide ways for a baby to practice chewing and, in the process, can help correct some jaw problems. They can be purchased through,,, and others. In addition, I used the Munchkin Fresh Food Feeder to introduce R to new tastes and textures safely as she learned proper jaw movement for chewing. I found guidelines for using mouth toys, safe feeders, etc. in the book Nobody Ever Told Me (or My Mother) That! (pp. 136-147, 177-181).  

I am so very blessed to have been given this experience. I hope to encourage and inspire other mothers of infants, especially preemies, who feel frustrated or heartbroken because the developmental milestones are often harder for preemies to achieve than many full-term infants. I want you to know that you are not alone and fortunately, more than ever, we have so many wonderful resources. I encourage anyone with questions to refer to Diane Bahr's book and other appropriate resources. I also encourage parents to seek guidance from certified lactation consultants and other feeding specialists to ensure that their infants remain "on track."

About the Author

Kimberly DeFriez is a certified Speech-Language Pathologist in Baltimore, MD with Master Degrees in both Communication Sciences/Disorders and Information Systems. She currently works with Ages and Stages, LLC. With experience in Speech-Language Pathology, Instructional Design, Web Development, and Information Systems, Mrs. DeFriez has over 15 years of instructional and technology experience. As a mother of two small children, she is very involved in pediatric studies and researching cutting-edge solutions for feeding difficulties and developmental milestones.

Photographer: Meghan Harrison, M Rose Photography,