A birth is considered 'pre-term' when a baby is born before 37 weeks. These days, premature babies have much better chances of surviving and developing healthily without any serious long-term complications.
Having a preemie newborn is a tough time for parents, particularly if their little one has health complications or has to stay in hospital for a long time.
Premature babies often have massive hurdles to overcome, but they are tougher than they look. This is a basic guide to caring for premature newborns, both in hospital and at home.
Caring for your baby in NICU
Many premature babies need to be admitted to a neonatal intensive care unit upon their birth, which is very distressing for parents. However, this is the best place for your little one to get stronger and bigger.
Most NICUs will allow parents to spend some bonding time with their baby every day.
Infection is one of the biggest risks to premature babies as their immune systems are underdeveloped.To prevent the spread of infection, always clean your hands thoroughly before holding or touching your baby. If you are sick, seek advice from your baby’s doctors on whether your illness could be a risk to your tot.
Skin-to-skin contact, playing music, and talking to your baby have all been shown to have positive effects on preemie babies.
Ask staff for advice on the best way to hold or cuddle your baby without disturbing their equipment.
Feeding your preemie baby
Breast milk is the best source of nutrients for premature babies. In fact, if you give birth prematurely, your body produces milk with extra protein, calories and vitamins to nourish your tiny tot. The live cells in breast milk can also protect your baby from infection.
There are baby formulas designed for premature infants, but they don’t offer the same range of benefits.
However, your baby may be too immature to feed and will need to be fed through a nasogastric tube instead. In this case, you can pump milk to give to staff to feed your baby.
Once your baby is strong enough to feed by themselves, expect small, frequent feeds. If breastfeeding, you’ll need to pump after feeds to keep up milk production.
The length of your gestation will generally determine whether your baby might face additional health issues. Babies born later, pre-term, generally have fewer or milder problems.
Babies born before 32-34 weeks are at risk of the following conditions:
Premature babies often suffer from anaemia, which means they don't have enough red blood cells. Normally, the baby stores iron during the later months of pregnancy and uses it late in pregnancy, and after birth to make red blood cells. Infants born too soon may not have had enough time to build up a supply of iron.
Babies with anaemia tend to develop feeding problems and grow more slowly. Anaemia also can contribute to any existing heart or breathing problems.
Anaemic infants may be treated with dietary iron supplements, drugs to stimulate red blood cell production, or, in severe cases, blood transfusion.
This condition causes babies to stop breathing for 15 seconds or more, and can be accompanied by a slow heart rate.
Premature babies are monitored for apnoea, and if your baby stops breathing, a nurse will stimulate them by tickling the soles of their feet or patting them gently.
Chronic Lung Disease
Babies who have had severe respiratory distress and need long treatment with oxygen and breathing equipment are most at risk of developing this illness.
These babies develop fluid in the lungs, scarring, and lung damage, which can be seen on an x-ray. Affected babies are treated with medications that make breathing easier and will need to be slowly weaned off their ventilators.
Their lungs usually improve over the first two years of life but some will develop asthma.
Taking your baby home
Your baby will only be allowed leave hospital when staff are satisfied that they have reached a healthy weight and are thriving. Staff usually use the following criteria to evaluate whether your baby can go home.
1. Can the baby maintain body temperature in an open crib for at least 24-48 hours, depending on how premature the baby was at birth?
2. Can the baby take all feedings by bottle or breast without supplemental tube feedings?
3. Can the baby gain weight steadily?
If the answer to any of these is no, your little one will have to stay in hospital until they are stronger. Most preemies will reach this criteria within two to four weeks of their original due date.
Babies with health problems or who relied on breathing apparatus for longer require longer stays.
Before you bring your preemie home, talk to doctors about their needs and make sure you learn infant CPR.
Keep your home as sterile as possible and limit visitors until your baby is older as they may pose an infection risk to your baby.
If you have any questions, ask your public health nurse or GP for advice.