Babies 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). Here’s some advice on how to care for your baby when he or she comes home from the hospital.

Generally, the earlier a baby is born, the higher the risk of complications.

At first, premature babies often need help breathing and maintaining body heat. Feeding your preemie may be a challenge. Yellowing of the skin and eyes (jaundice), low blood sugar and lack of red blood cells to carry oxygen to the baby’s tissues (anemia) are possible. More serious concerns may include infection, episodes of stopped breathing (apnea) and bleeding into the brain, especially if your baby was born before 34 weeks. Some preemies have impaired hearing or vision. Others experience developmental delays or learning disabilities in childhood.

Your baby’s growth

It’s important to take your baby to your doctor’s office soon after the baby leaves the hospital. Your doctor will check your baby’s weight gain and find out how your baby is doing at home.

Talk with your doctor about feeding your baby. Your doctor 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 infants. After about 4 months of taking iron drops, your baby will have about the same amount of iron as a full-term baby. Your doctor 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 doctor can use special growth charts for premature babies. Your doctor 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 doctors want to know about all babies, not just premature babies.

Monitoring systems

Monitoring machines vary depending on the hospital and NICU. However, all monitors record the heart rate, respiratory rate, blood pressure, and temperature. A pulse oximeter may be taken to measure the amount of oxygen in the blood. You may notice that your newborn has various sticky pads or cuffs on his chest, legs, arms or other body parts. These sticky pads and cuffs have wires that connect to the monitor which often looks like a television screen and displays various numbers.

*Alarm systems go off periodically in the NICU and it does not always indicate an emergency. In fact more often than not it is nothing to worry about. Therefore do not panic when you experience this and do not be surprised when everyone else does not panic.

Methods of respiratory assistance

Endotracheal tube – This is a tube that is placed down the newborns windpipe. It delivers warm humidified air and oxygen.

Ventilator – This is also sometimes referred to as a respirator. This is the breathing machine that the endotracheal tube is connected to. It can monitor the amount of oxygen, air pressure and number of breaths.

Continuous Positive Airway Pressure (C-PAP) – This method is used for babies who can breathe on their own but just need some help getting air to their lungs.

Oxygen hood – This is an actual clear plastic box that is placed over the baby’s head and is attached to a tube that pumps oxygen to the baby.

Methods of feeding (Depends on the premature newborn’s individual needs)

Intravenous lines – This method carries nutrition directly into the blood stream. This method is used for premature babies who have immature digestive systems and are not able to suck, swallow and breathe in a coordinated manner. This method may also be used when treatment for other health complications is being implemented. An IV may be placed in the scalp, arm or leg.

Umbilical catheter – This method involves a tube that is surgically placed into a vessel of the umbilical cord. Don’t worry it is not painful. This method can carry potential risks (infection or blood clots) and therefore is used only for the most critical babies and with those who may need this type of feeding for several weeks. For these critical babies, it is the safest and most appropriate way to supply nutrients.

Oral and nasal feeding – This method involves a narrow flexible tube threaded through their nose (nasogastric tube) or mouth (orogastric tube). This method is provided for babies who are ready to digest breast milk or formula but still not able to suck, swallow and breathe in a coordinated manner.

Central line (sometimes referred to as a PICC line) – This is an intravenous line that is inserted into a vein, often in the arm which allows use for a larger vein. This is normally used to deliver nutrients and medicines that would otherwise irritate smaller veins.

Other equipment

Incubator – A clear plastic crib that keeps babies warm and helps protect them from germs and noise.

Bili lights – This is a bright blue fluorescent light that is located over your baby’s incubator. This light is used to treat jaundice (yellowing of skin and eyes).

Bringing baby home

When it’s time to bring your baby home, you may feel relieved, excited – and anxious. After days, weeks or months in the hospital, it may be daunting to leave the on-site support of your baby’s medical team behind.

Before you leave the hospital, consider taking a course in infant CPR. Make sure you’re comfortable caring for your baby, especially if you’ll need to use special monitors at home or give your baby supplemental oxygen or other treatments. Ask as many questions as you need to. Nothing is silly or unimportant when it comes to caring for your baby. Schedule follow-up visits with your baby’s doctor, and find out who to call if you have questions or concerns in the meantime.

You’ll always remember your baby’s time in the hospital. Now cherish the opportunity to begin making memories at home.

At Home With Your Baby

Expect to live quietly with your preemie at first. Because their immune systems are still developing, preemies are susceptible to infections. Therefore, you need to take some precautions. Visits outside the home should be limited to the doctor’s office for the first several weeks, especially if your baby is discharged during the winter months.

Because doctors’ offices commonly have several kids with viral infections, try scheduling your appointment as the first of the day or request to wait in an examining room instead of the main waiting area. Ask the doctor how limited your baby’s contact with other kids and adults should be during these first weeks.

Most doctors recommend not visiting public places with preemies. And limit visitors to your home: anyone who is ill should not visit, nobody should smoke in your home, and all visitors should wash their hands before touching the baby. Talk to your doctor about specific recommendations – some family visits may need to be postponed to allow your little one’s immune system to grow stronger.

Babies’ success at feeding and sleeping is important to their health. Expect your preemie to sleep more than a full-term baby, but for shorter periods. All babies, including preemies, should be put to sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS).

Most preemies need 8 to 10 feedings a day with no more than 4 hours between each – any longer and the baby may become dehydrated. Six to eight wet diapers per day show that the baby is getting enough breast milk or formula.

Take advantage of these quiet weeks together to enjoy skin-to-skin contact, also known as kangaroo care. Most intensive care nurseries encourage parents to begin kangaroo care prior to discharge; the nursing staff can show you how.

In a warm room at home, dress your infant in only a diaper, then place the baby on your chest and turn your baby’s head to one side so that his or her ear is against your heart. Research indicates that kangaroo care can enhance parent-child bonding, promote breastfeeding, and improve a preemie’s health.

Sources: American Pregnancy, Family Doctor

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