Caring for Your Premature Baby
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Do premature babies need special care?
Yes, babies who are born prematurely (before the due date) may need special care during their first 2 years, especially if they were very small at birth (less than 3 pounds or 1 kg). Here’s some advice on how to care for your baby when they come home from the hospital.
Your baby’s growth and development
It’s important to take your baby to your healthcare provider’s office soon after the baby leaves the hospital. Your healthcare provider will check your baby’s weight gain and find out how your baby is doing at home.
Talk with your healthcare provider about feeding your baby. Your healthcare provider may recommend vitamins, iron and a special formula if the baby is bottle-fed. Vitamins are often given to premature babies to help them grow and stay healthy. Your baby also may need extra iron because premature babies often do not have as much iron stored in their bodies as full-term babies. After about 4 months of taking iron drops, your baby will have about the same amount of iron as a full-term baby. Your healthcare provider may want your baby to take iron drops for a year or longer.
Your baby may not grow at the same rate as a full-term baby for the first 2 years. Premature babies are usually smaller during this time. Sometimes they grow in bursts. They usually catch up with full-term babies in time. To keep a record of your baby’s growth, your healthcare provider can use special growth charts for premature babies. Your healthcare provider will also want to know things like how active your baby is, when your baby sits up for the first time and when your baby crawls for the first time. These are things healthcare providers want to know about all babies, not just premature babies.
Your baby’s feeding schedule
At first, most premature babies need 8 to 10 feedings a day. Don’t wait longer than 4 hours between feedings or your baby may get dehydrated (dehydrated means lacking fluids). Six to 8 wet diapers a day show that your baby is getting enough breast milk or formula. Premature babies often spit up after a feeding. This is normal, but you want to make sure that your baby is still gaining weight. Contact your healthcare provider if you think your baby has stopped gaining or is losing weight.
Switching to solid food
Most healthcare providers advise giving a premature baby solid food at 4 to 6 months after the baby’s original due date (not the birth date). Premature babies are not as developed at birth as full-term babies are, so it may take them longer to develop their swallowing ability. If your baby has medical problems, your healthcare provider may recommend a special diet.
How your baby sleeps
Although premature babies sleep more hours each day than full-term babies, they sleep for shorter periods of time. All babies, including premature babies, should be put to bed on their backs, not on their stomachs. Use a firm mattress and no pillow. Sleeping on the stomach and sleeping on soft mattresses may increase your baby’s risk of sudden infant death syndrome (SIDS), which is the sudden and unexplained death of an baby who is younger than 1 year old (usually while the infant is asleep, which is why it is also called “crib death”).
Your baby’s vision and hearing
Crossed eyes are more common in premature babies than in full-term babies. The medical term for this condition is “Strabismus (Cross-Eyes)” strabismus (say this: “straw‑biz‑mas”). Often, this problem goes away on its own as your baby grows and develops. Your healthcare provider may want you to take your baby to an eye healthcare provider if your baby has this problem.
Some premature babies have an eye disease called retinopathy of prematurity (ROP). In babies who have this condition, the small blood vessels in the eye grow abnormally. ROP usually only occurs in babies who are born very early, at 32 weeks of pregnancy or earlier. If there’s a chance your baby has ROP, your healthcare provider will advise you to take the baby for regular check-ups by an eye healthcare provider. ROP can be treated to help prevent vision loss.
Premature babies are also more likely than full-term babies to have hearing problems. If you notice that your baby doesn’t seem to hear you, tell your healthcare provider so your baby can be checked for hearing problems. You can check your baby’s hearing by making noises behind or to the side of the baby. If your baby doesn’t turn his or her head, or jump at a loud noise, you should contact your healthcare provider.
Your baby’s immunizations
Immunizations (also called vaccines or shots) are given to premature babies at the same ages they are given to full-term babies. Your baby may need a flu shot when they reach 6 months of age. Premature babies might get sicker with the flu than full-term babies. Talk with your healthcare provider about flu shots for your entire family. This can help protect your baby from catching the flu from someone in the family.
Traveling in a car with your baby
When traveling with your baby in a car, use an infant car seat (or another kind of infant carrier, as your healthcare provider recommends). Be sure that your baby’s head and body don’t slump over when they are in the car seat. You can use rolled-up towels or receiving blankets to give your baby support in the car seat.
The car seat should be installed in the back seat. When you’re driving in the car with your baby, keep an eye on your baby by looking at them in your rear-view mirror. Or you can have a friend or family member ride in the back seat with your baby. If you’re using an apnea monitor for your baby, it should be used even while your baby is riding in the car. Your baby should never be left alone in the car, not even for a few minutes.
Office Care of the Premature Infant: Part II. Common Medical and Surgical Problems by DE Trachtenbarg, M.D., and TB Goleman, M.D. (American Family Physician 05/15/98, http://www.aafp.org/afp/980515ap/tracht.html)