According to the National Center for Health Statistics, 12 percent of babies are born prematurely. If you’re a new parent to a preemie, take heart. Below are preemie-specific tips for caring for your extra-little one once you’ve left the confines of the Neonatal Intensive Care Unit. They will help you enjoy what every mom looks forward to—bringing your new baby home.
The appropriate carseat is crucial, says Phyllis Dennery, M.D., professor of pediatrics at University of Pennsylvania and chief of the neonatology division at The Children’s Hospital of Philadelphia. “Most hospitals will do a carseat test before the baby leaves the hospital, which allows them to know if the baby is able to tolerate the ride,” she says. “Premature babies sometimes get too bunched up and can’t breathe as well. So look for a carseat that’s appropriate for an infant.”
In other words, skip the convertible toddler seat and be sure there’s cushioning in the seat that will pad around the baby’s head. “Another option is a car bed,” Dennery suggests. “This way the baby lies down instead of sitting up for the car ride home.” Many new moms are more comfortable riding in the back with their new baby.
Consider lining up a baby nurse (or helpful parent) for at least the first few days at home. New mother Sara Chokshi, who gave birth to her son Kiran at 29 weeks, says, “Having someone there is crucial both for the added security in case of an emergency as well as taking a shift so you can get some sleep.”
The darker it is outside, the more parents tend to stress during the first few nights at home. For parents of preemies, that anxiety can be compounded, but these nights will be punctuated with feedings every three hours. “Smaller babies shouldn’t sleep through the night, but they may because they’re not very vigorous and they’re not going to cry out and say ‘I’m hungry,’” Dennery says. “They should feed every three to four hours every day and night, so always wake your baby for feeding if he or she’s sleeping through the night.”
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“I wish it had been stressed to me that many babies, even full-term babies, have feeding issues in the early months,” Chokshi says. “At the time, I thought it was something really serious, and for awhile I was petrified at every feeding because Kiran seemed to choke while he ate.” Feeding may be stressful, but your job is to keep the milk supply going as best as you can.
“Keep pumping as much as possible so you keep your milk supply up,” Dennery says. “It’s very challenging and arduous in the first few weeks, but you want to make sure your baby is getting the calories he or she needs. If you’re not planning to breastfeed, opt for formulas customized for premature babies so you’re sure your baby gains adequate weight.” Speak to your doctor immediately if your baby continues spitting up during every feeding.
Within a few days of returning home, check in with your doctor. “Find a pediatrician you’re comfortable with and follow-up with that person right away,” Dennery says. “Premature babies are more at risk for respiratory infections if they’ve been on a ventilator, so follow-ups with vaccinations and immunizations are key.”
It really helps to connect with parents of preemies who are a little older. “You’ll get support as well as hope by seeing their little ones,” Chokshi says.
And if you need a shot of confidence, Chokshi says, “Look at the pictures in the NICU of all the babies who have gone home and thrived. And my best advice: Actually listen to the nurses and staff when they tell you that this hospital stay will soon become just a blip in your memory.”
Every child’s situation is different, and parents should ask their medical team what criteria must be met before their baby can go home. Knowing the benchmarks for discharge will help you plan for your preemie’s special homecoming day. In general, most NICU babies need to meet these goals before going home:
• Feeding: With rare exception, babies must show that they can drink enough milk to grow without any problems feeding.
• Weight gain: Babies need to show a consistent weight gain of roughly 20 to 30 grams (about 1 ounce) a day. There is usually no specific final weight they must achieve prior to going home.
• Stable temperature: Baby must maintain a steady body temperature without the help of an incubator.
• Breathing normally: Most babies will not be discharged until they are off oxygen and breathing normally.
• Carseat capable: Most NICUs perform a test to check your baby’s breathing in a carseat.
• You feel ready: Doctors always make sure that parents feel prepared to care for their preemie at home. Use your time in the NICU to learn all about your baby’s care well in advance of his or her anticipated homecoming.
Excerpted from Twins 101: 50 Must-Have Tips for Pregnancy through Early Childhood from Doctor M.O.M., by Khanh-Van Le-Bucklin, M.D. Copyright © 2009 by Khanh-Van Le-Bucklin. Reprinted with permission of the publisher, John Wiley & Sons, Inc. This article, written by Lambeth Hochwald, originally appeared on The Cradle (thecradle.com). Hochwald is a lifestyles journalist who also writes for Health, Marie Claire, Parenting, Redbook, and Woman’s Day.