Caring for Your Premature Baby
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The birth of a baby is usually a happy time. However, if your baby is born premature, it also can be a stressful time. A baby is premature if they are born before the 37th week of a normal 40-week pregnancy. Sometimes premature babies are called “premies” because they’re born premature.
Path to improved health
- 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). But you can help your baby be healthy, grow, and develop when you bring them home from the hospital. Here’s some advice:
- Make an appointment 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. Breast milk is the best baby food. But if your baby is having trouble nursing, your healthcare provider may be able to help you solve this problem. If your baby takes formula instead of breast milk, a special formula may be needed. Your healthcare provider may recommend you give your baby vitamins and iron. Vitamins are often given to premature babies to help them grow and stay healthy. Your baby also may need extra iron. That’s because premature babies don’t have as much iron in their bodies as full-term babies. Your healthcare provider may want your baby to take iron drops for a year or longer.
- Watch your baby’s growth. 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 want to keep track of your baby’s milestones. This would include 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.
- 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.
- Prepare for 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.
- Give your baby plenty of opportunity for sleep. 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. 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”).
- Check your baby’s vision. Crossed eyes are more common in premature babies than in full-term babies. The medical term for this condition is strabismus. 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.
- Check your baby’s hearing. 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 their head, or jump at a loud noise, you should contact your healthcare provider.
- Get 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.
- Protect your baby while traveling in a car. When traveling with your baby in a car, use a safety-approved infant car seat. 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. You can have a friend or family member ride in the back seat with your baby to watch them. Your baby should never be left alone in the car, not even for a few minutes.
Things to consider
If your baby is born premature, there are certain things that can affect their health, learning, and your family’s schedule. Physically, babies born prematurely may need to stay in the hospital for weeks or months longer than full-term babies. They may be in a special section of the hospital called the NICU (newborn intensive care unit). Here, they can get the care they need since premature babies often struggle with underdeveloped lungs, being underweight, and other problems. This hospital stay can be a strain on your family’s routine, even if it’s your first child. It may require daily visits to the hospital until they are released. If you have other children, it requires dividing your time between the hospital and caring for your children at home. One or both parents may need to take additional time away from work during this period.
Once your baby comes home, you will need to protect them from exposure to others and illness. Germs and illness can be tougher on a premature baby. Finally, some premature babies struggle with learning, gross motor (crawling, walking), and fine motor (picking up things, feeding themselves) development. They will eventually catch up. However, it may take them longer to learn those skills