question about twin premature babies

[malak_alssalam]

بسم الله الرحمن الرحيم
السلام عليكم ورحمة الله وبركات
thank you doctor for your effort and jazaka allaho khairan
i have a question about my twin doughters
they are 9 monthes old but they were born at 32 weeks and they were in the hospital for 10 days just to let them gain weight because they were 2,100 kg and the other one was 2,300 kg and the problem is that they didn't breast feed and even from the bottle they don't drink much formula that they must have daily
now they are 9 monthes old and they just have 3-4 oz 3-4 times a day
and because of this till now they don't set and crawel and they are too much weak
i don't know what to do please help me
jazaka allaho khiran
note : i changed the formula type for them too many times and now they take similac advance

[د.اسامه ايبش]

بسم الله الرحمن الرحيم
The amount of milk they recieve now is not enough for their growth, but you can add 2-3 meals a day plus the milk, one meal at least should be cereal and the rest can be vegetables, fruits, boiled egg youlk, yougurt, or chicken
also you can give them daily multivitamine like poly-vi-sol 1 ml pe day to prevent vitamine deficiency
also you can add one teaspoon of rice cereal to each bottle of milk and that will add more calories to their diet, but in this case you need to make the nipple holes little wider by using a pin
in rare cases when the children are not growing and not taking enough an overnight tube feeding can be used for few months until they gain more weight but this is the last resort
و صلى الله على محمد وآله وصحبه وسلم

[malak_alssalam]

بسم الله الرحمن الرحيم
jazaka allaho khairan and inshallah i will do so about adding the rice cerial to the bottel , and i forget to add that i already giving them vegitables, fruite and meat
but what concerns me more that they are sooooooooooooo weak they don't set by themselves yet , they don't crawel and even they cann't stand up right when i hold them
i hope if you can give me a suggestion about this and what to do to help them improve . jazaka allaho khairan

[د.اسامه ايبش]

بسم الله الرحمن الرحيم
some preterm infant stands and wlks later than their peers due to many factors, nutrition is one of them, but also they can develop ricketes, fine and gross motor delay , and lack of stimulation due to their stay in incubators for prolong period.
they should be followed closely but a pediatrician experience in preterm infants and should have an evaukation by a physical therapist also experienced in babies for the possibility of physicial therapy early in life to strengthen the weak muscle
also if their feeding strength is not satisfactory they should be evaluated by an occupational therapist

[malak_alssalam]

jazaka allaho khairan
and inshallah i will try my best to follow your advices
thank you again doctor