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With every 10 babies born in the US, one is born premature. Going into premature labor is a frightening experience for new parents. Sometimes, a medical condition requires pregnancy to be induced early. Other times, the cause of premature labor is unknown and parents are taken by surprise. Learning how to care for your premature baby can feel intimidating to new parents. In the days, weeks or months of NICU care afterward, the hospital staff will help you understand what you need to know about the unique needs of preemies. Here’s what parents need to know about caring for a premature baby.
How Your Preemie Looks + Acts
While the average full-term newborn is about 7.5 pounds, premature babies can weigh significantly less. The smallest preemies to survive, micro-preemies born at 22-23 weeks, have weighed about half a pound! Very premature babies can weigh less than 3.5-4 pounds, and moderately premature babies can weigh between 4 and 5 pounds. Late preterm babies born in the 35th or 36th week of pregnancy tend to weigh close to 6 pounds.
Premature babies look differently than many parents expect their newborns to appear. Without time to fully develop in the womb, they are skinnier and more fragile than full-term newborns. Their skin may be thin and transparent, their features appearing sharper and less rounded. Depending on the age of gestation at birth, they may be covered in a fine hair called lanugo or even still have fused eyelids.
Preemies are characteristically sleepier than their full-term peers. They may cry only softly or not at all, due to an immature respiratory system. Micro-preemies may not yet startle, while older preemies may startle easily at the slightest sounds due to an immature nervous system. Just working to maintain their breathing, heart rate, and temperature can be exhausting for preemies. They may require extensive life support and complex medical care, or simply warming and monitoring, depending on their gestational age and development.
Taking Care of Your Preemie
The hospital staff will immediately move your preemie to an incubator to keep them warm and attach breathing and heart monitors. They may need to insert IVs, feeding tubes, or breathing tubes. Witnessing this rapid response to your newborn’s arrival can be very scary for parents. Remember to care for yourselves during this sensitive time, and that the staff is there to help your whole family – parents included.
Your preemie needs to be kept warm at all times. In addition to warming in the incubator, once your baby is stable you may be able to hold your baby skin-to-skin, called kangaroo care. The staff will help you learn to hold your baby while navigating the medical wires and tubes. Kangaroo care not only keeps your baby warm, but being close to your heartbeat and the rise and fall of your chest has been shown to improve outcomes for premature babies.
Breastfeeding also improves health outcomes for newborns of all gestational ages. But many preemies are too young to feed effectively at the breast or bottle. To keep up your milk supply, mothers of preemies can to pump. The NICU staff and lactation consultants can provide you with a breast pump and help you get accustomed to pumping. If your baby is not yet able to take bottles or nurse, you may be able to feed your baby your breastmilk through their feeding tube. Once your doctor gives the okay, you can begin practicing to nurse at the breast, with the help of nurses and lactation consultants.
In the NICU, the staff works around the clock to monitor your baby’s progress. In addition to the 24/7 monitoring of vital signs, your baby may undergo routine blood work to check glucose, hormone and nutrient levels. They may also require further testing such as CT scans, MRIs, ultrasounds, echocardiograms, EKGs or ECGs, hearing screens, or eye exams. Some preemies require additional medications or surgeries. Many premature babies receive additional therapies such as physical or occupational therapy.
It’s normal to feel intimidated about how to care for your premature baby. The NICU staff will help you learn to interact with your preemie, encouraging ways you can be involved with their care. Talk to your baby, touch them, sing to them, and simply spend time with them. Ask your nurse for help in learning to change their diaper, take their temperature or bathe them. Ask lots of questions about your baby’s care plan and share your thoughts and concerns. You are your baby’s best advocate. As your baby progresses and gets stronger, the staff will work with you and your baby to help you prepare for life beyond the NICU.
Taking Care of Yourself
Having a baby in NICU is a stressful experience, especially if you are discharged home much earlier than your baby. Remember to care for yourself by eating well, resting as much as you can, and accepting help with any logistical or household duties you can pass off. Spending time with your baby will help both of your nervous systems settle, but do not feel guilty when you need to take time to care for your own needs as well.
Your premature baby may be at higher risk of immediate or long term health challenges as well as developmental delays. It is normal to feel worried about your baby’s well being and future health outlook. Your baby may need more frequent health check-ups, specialist visits, medications and therapies. Modern advances in medical care have vastly improved short and long term outcomes of preemies. Many premature babies have no long term health problems and quickly catch up to their full-term peers in growth and development.
Many parents find solace in connecting with other families of NICU babies. Getting to know other parents who have been through the NICU journey can help to normalize your experience and remind you that you’re not alone. Life in the NICU can feel like an eternity, but day by day you will be closer to normal life at home with your baby. And as your baby gains strength, you too as a parent will be stronger and more resilient. In time, you will feel confident in knowing how to care for your premature baby.