The Ultimate Guide to Raising a Healthy Preemie
Do you have a preemie on your hands and you’re intimidated about what to do with such a little baby? Are you worried you’re going to do everything wrong?
Babies who don’t reach full-term can be intimidating for parents. Moms and dads spend all their time preparing for a full-term baby and have no clue what a preemie needs.
Instead of freaking out, take a deep, calming breath and realize that your baby has what it most needs — your love.
Our guide will show you the rest of what you need to know, including how to take care of your baby in the neonatal intensive care unit, what your home will need for your baby, and how to form your support team.
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Before you feel comfortable with the idea of having a premature baby, you need to understand a bit more about them.
What Is Considered Premature?
Your baby will be considered premature if it is born before you reach 37 weeks of pregnancy. But remember, just because you begin to go into labor before 37 weeks, doesn’t mean you’ll deliver then. Approximately half of all women who begin labor before 37 weeks don’t have their babies that early, thanks to medical interventions (source).
The longer a baby can stay in your womb, the better off it will be. While a baby born at the 36-week mark may have some health consequences, they’ll have a better chance of dodging complications than a baby born at 32 weeks would. Every week in the womb makes them that much stronger.
Being a preemie can come with a host of problems. Some issues will be short term, such as a hospital stay, while others may be lifelong. Some of the issues preemies can have include (source):
- Breathing difficulties.
- Low body temperatures.
- Problems with sucking and swallowing.
- Cerebral palsy.
- Behavioral issues.
- Learning issues.
- Mental retardation.
- Visual problems.
- Hearing impairments.
- Social struggles.
- Heart complications.
- Intestinal issues.
- Neurological disorders.
- Dental issues that make them more prone to cavities and decay.
- Underdeveloped immune system.
A number of factors can cause or contribute to premature birth. While these following factors can be reasons for premature birth, moms should keep in mind that sometimes it isn’t possible to explain why it happens.
But here are some of the known reasons (source):
- Placenta issues: Placenta problems such as placenta abruption.
- Having multiples: Being pregnant with more than one baby at once makes it much more difficult to go full-term with your pregnancy.
- Infection: Infections during pregnancy can rupture membranes and lead to preterm labor.
- Genetics: Genetics strongly factor into premature labor. If you have family members who have had premature births, your risk is increased. And if you’ve already had one premature baby, you have a higher risk from that as well.
- Smoking: Smoking causes issues with the placenta, which can be one of the reasons why your baby may be born earlier.
- Maternal weight: Being extremely overweight or too underweight before and during pregnancy can contribute to the risk of premature births.
- Drugs or alcohol: This is just another reason to avoid drugs and alcohol during pregnancy.
- High blood pressure: There’s a reason pregnant women are sometimes put on bed rest when they have high blood pressure — it can help women carry their baby longer, cutting down on some of the health risks associated with being a preemie.
- Becoming pregnant through in vitro fertilization: The reasoning behind this isn’t entirely clear, but there is a link. Some experts think it’s because of the same reasons the women are infertile to begin with, including advanced maternal age and extra weight.
I remember wondering this fact and looking it up during my first pregnancy. I worried my whole way through my pregnancy and I couldn’t wait until I reached the week my baby would have a shot at surviving if it were to be born as a preemie.
So when I reached my 22nd week of pregnancy, I was mentally breaking out a bottle of champagne since I couldn’t do it physically. While babies still face a huge uphill battle if they are born at 22 weeks, they can survive.
In the past, doctors would say 24 weeks is when a baby could survive outside the womb, but more recent studies have shown a 25 percent chance of survival if a baby is treated properly in the hospital after being born at 22 weeks (source).
And, again, the longer you can hold off on delivering that baby, the better off it will be. So go to all your prenatal visits so any potential issues can be spotted and addressed.
NICU stands for neonatal intensive care unit, which is a section of the hospital that handles newborns who need a lot of medical care. The staff there is trained to deal with the particular challenges of taking care of preemies.
Parents always eagerly look forward to the day they can bring their baby home from the hospital and begin their new life. Unfortunately, with a preemie, that special day is often postponed for a while.
There is no specific amount of time a preemie will have to stay in the hospital — it depends on the particular challenges your child has. A preemie with few or no problems will go home as soon as any other newborn would. But a child with substantial issues may stay for weeks or even months in the hospital.
If a mom has already decided to breastfeed, she may wonder what having a preemie does to those plans. If your baby was born just before 37 weeks, there’s still a good chance it will be big, strong, and healthy enough to breastfeed.
But babies that are born earlier than that, especially those 34 weeks and under, may not be able to breastfeed initially. If you want to give your baby your breast milk, you may have to pump it instead and give it to the hospital so they can feed it to your baby.
You should definitely not abandon your plans to breastfeed just because your baby is premature. In fact, when you have a preemie, your breast milk compensates to help your baby by being more protein-rich for the first weeks of your baby’s life (source).
This may sound like something you’d do in the zoo, but it’s a great way to take care of premature babies.
What is Kangaroo Care?
Kangaroo care involves a parent holding a preemie skin-to-skin against them as much as they possibly can during the day.
The baby only wears a diaper, and a hat if they need it, and their back is warmed up by using a blanket or some other kind of fabric on it. The baby is cuddled upright against the parent’s bare chest.
It was first developed in the 1980s in South America at a hospital as a way to keep preemies warm because they didn’t have incubators. They realized body heat would be a good way to keep them warm, and the best candidates for snuggling those babies would be the parents who were at the hospital all the time for their baby anyway.
Benefits of Kangaroo Care
Kangaroo care has a host of benefits for babies. It can (source):
- Help a baby and parent establish a strong bond from day one.
- Assist a baby with regulating their temperature, which is often difficult for preemies. Your body heat is just what your baby needs right now.
- Improve brain functioning for a preemie, and the benefits will be there even years later.
- Help preemies sleep better – they’ll sleep deeper and wake up less frequently, which is good news for you too.
- Make their heart rate more stable.
- Help them gain more weight and faster than those who don’t.
- Help babies with breastfeeding because they have constant access to their milk source.
- Reduce the stress newborns experience, and make them feel safe and calmer. Just being next to you is enough to do that — it’s like your new super power!
- Give dads a little bonding time with baby. So many of the duties for a newborn fall upon the mom’s shoulders, but kangaroo care is something dads can do to chip in and help out.
- Offer some benefits for moms, not just their babies, like fighting off postpartum depression. It can help lessen the depression new moms sometimes feel.
While kangaroo care is good throughout your baby’s infancy, it’s best to begin it within the first two hours of your child’s life. That can help your baby with the stresses of being born.
If that’s not possible, begin doing it as soon as you’re able. Keeping doing it every day throughout your baby’s hospital stay.
You should aim for a minimum of an hour a day. It doesn’t have to be all at once — you can break it up into several sessions every day. Even just a few minutes at a time is long enough to help your baby.
You may want to wear a button-up shirt and a front-closure bra to give you a way to quickly get your clothes out of the way without having to take everything off.
Because skin-to-skin contact is the whole point of kangaroo care, you’ll strip your baby down to its diaper. But you should have a blanket handy to prevent your preemie from getting chilled while you’re cuddling.
At the hospital nursery, you can ask the nurses if there is a screen you can use to give yourself some privacy while you do kangaroo care. If not, you can turn your chair away from the entrance of the room so it’s facing a corner. If you’re wearing a button up shirt, no one walking into the room will be able to see what you’re doing.
You’ll likely need to ask a nurse to help you so she can make sure any monitors or other devices your baby is hooked up to aren’t affected by moving your baby around.
After you’ve unbuttoned your shirt and unhooked your bra, you’ll place your baby next to your bare chest. Then you’ll drape the blanket over your baby’s back. If you want, you could close your the front of your shirt and wrap it around your baby instead of using a blanket.
What To Avoid
Kangaroo care isn’t just a thing for moms to do — dads can get involved as well. They can do everything the mom can do, except for the whole breastfeeding thing. It’s a good idea for dads to do kangaroo care because it gives bonding time for them and their baby, and it gives moms a break so they can recover from childbirth.
Your Preemie in the NICU
When your baby is in the NICU, you can feel helpless and that there’s no way to help your baby with this battle. But that’s not true at all. There are a number of ways you can help.
Even adjusting your attitude can help you feel like you are up to the challenge of having a NICU baby. And when you’re feeling happy or at least can fake it when you aren’t, you’ll be of more use to your baby.
- Be your baby’s advocate: Ask all the questions you feel are necessary to make sure your baby is getting the best care it can. And if you see anything you’re not certain about, bring it to the attention of a nurse or doctor. While it should never be your goal to be a pain in the you know what, you should watch out for your baby’s interests and make sure you’re comfortable with everything that’s going on.
- Bring yourself up to speed: You’ll have to ask a lot of questions to make sure you understand what’s being done for your baby and why. And you’ll need to know how to take care of your baby when you bring it home, so ask away. It’s the only way you’ll learn.
- Make the hospital your second home: You should go to the hospital every chance you have during the weeks or months your baby stays there. But, even though you’ll want to be there for your child as much as possible, remember you still need to eat, sleep, and shower. You have to focus on your well-being too.
- Do kangaroo care: Now that you know how to do it, you can make your baby healthier just by dedicating an hour a day. All you have to do is hold your baby, which is something you’ve probably been dying to do anyway.
- Pump your breast milk: One of the best things you can do for your preemie is give them breast milk. If they aren’t capable of breastfeeding yet because they’re too little, you can pump your milk and give it to the NICU personnel. They should have no problem with giving it to your baby.
- Don’t bottle up your feelings: If you’re feeling upset or worried about your situation, make sure you vent those feelings to someone, whether it’s a professional counselor or a friend. Dealing with those feelings can make you a better parent — you’ll be less consumed with guilt or depression when you see your baby.
- Don’t forget your relationship with your partner or other children: It can be tempting to give your preemie all your attention, so much so that you don’t have anything left for anyone else. But that’s a mistake. You need to keep your other relationships going strong — you don’t want your other children to resent their new sibling or your marriage to go down the tubes because of the stress.
- Make sure you show your appreciation to the health care professionals: Yes, it’s their job to take care of your baby. But for many nurses and doctors, it’s more than a job — they worry about your child too, even during their off hours. So say thank you for the effort and care they’re giving — you’ll feel good about it and so will they.
- Stay positive: Your baby will be able to sense your stress and if you’re feeling negative about your baby’s situation, you might not stop by the NICU as much as you should. While it can be hard to stay positive when you see your baby struggling, try to celebrate the small victories, like a bit of weight gain or improved respiration.
Preparing Your Home
It’s the day all NICU parents dream about — the day your baby can come home. While you have to do some preparations with any newborn you bring into your home, there’s more to think about when you have a preemie. You may need to take these additional measures for your home or get gear you wouldn’t have needed with a full-term newborn.
- Make sure you have the correct sizes: Most of the diapers and clothing you received for your baby at your baby shower is likely way too big for your preemie, even after it has gained some weight in the NICU. You’ll have to have a stash of smaller diaper and clothes on hand to fit your baby. But you don’t have to break the bank on clothing — it’ll be soon that those newborn sizes will fit.
- Get hand sanitizer: Guests are going to come into your home and they may not care at all about your doctor’s rules that everyone should wash their hands before handling your baby. They may think you’re being overprotective by insisting they take a bit of the hand sanitizer you’ll keep in your home. But do it anyway — you need to protect your preemie’s tiny body by keeping away all the germs you can.
- Invest in a baby monitor: After all you’ve been through with your baby’s health, you’ll likely want a baby monitor for extra peace of mind.
- Buy a sling wrap: You may want to keep up skin-to-skin contact once your baby is out of the hospital, and a sling wrap can be a great way to keep your baby close to you.
- Get a hands-free breast pump: Now that you and your partner don’t have a team of nurses and doctors at your disposal, you’ll have to do all the work of parenthood. That means you’ll have less time on your hands and multi-tasking will become your new best friend. A hands-free breast pump gives you a way to get as much done as possible while you’re pumping that liquid gold.
- Give your house a good cleaning: While you don’t have to sterilize every surface, a good cleaning is a great idea. Avoid any strong cleaning solutions or chemicals that could irritate your baby’s airways though. You’ll be so busy when your baby comes home that you won’t have time to clean for a while anyway — so enjoy that clean home while it lasts!
- Introduce your pet to your baby’s scent: If you’re a pet owner, you may want to grab one of your baby’s used baby blankets, bring it home, and let your pet sniff it (source).
- Talk to your other children: Your new baby is going to take a lot of your time. Let your children know their new sibling is really little and you’ll all have to be gentle for quite a while. Try to spend as much time with your other child as you can once your preemie comes home too so they don’t struggle with jealousy.
- Find the right bottles: Unless you’re prepared to breastfeed around the clock, you should get some bottles — at least enough to get through one whole day in which you don’t have to wash the bottles. That will be a time saver for you. To ensure you don’t get a bunch of bottles your baby hates, ask the NICU nurses which brand your baby is currently using.
- Setting up a crib in your bedroom: New research shows the safest place for a baby to sleep is in a crib in their parents’ room. This is especially important for preemies — and you’ll probably feel better having them close by as well.
- Buy a thermometer: You’ll have to keep a careful eye on your preemie’s health, so it’s important you buy a thermometer you can use quickly and without fuss if you think your baby has a fever.
- Contact your power company: A power outage is going to be more than a minor inconvenience if you have a preemie at home. If your preemie is going to be hooked up to oxygen or monitors when you bring it home from the hospital, you should contact your power company before you bring your baby home. They can put you on a high priority list if there’s a power outage.
- Get a white noise machine: The NICU isn’t the quietest place. There’s a lot of equipment noises, talking, and crying going on there at all hours. Your baby isn’t going to be used to the silence at your home so a white noise machine may help with the adjustment.
- Set up changing stations in your house: If you have a bigger house or one with the bedrooms on the upper floor, you’re not going to want to run to the nursery every time you need to change your baby’s diaper. Instead, set up mini changing stations in other rooms of the house, such as a main floor laundry room.
- Order extra monitor supplies: Preemies who come home attached to a monitor will burn through the monitor supplies, such as extra leads. It helps to have some on hand so you aren’t scrambling for replacements when you need them.
Having a preemie at home is going to take a lot of work — more than the typical newborn. You’re definitely up to the challenge, but you need to prepare yourself mentally and physically for the task you’re about to take on.
- Prepare for an emergency: While you can of course handle dialing 911 in an emergency situation, you should have a list of any other numbers you need pre-programmed into your phone or set aside at home. You should also have your child’s doctor’s number entered into your phone. Map out the fastest way to get to the nearest hospital, as well as an alternate route in case of emergencies.
- Put out the word about visitors: Unless you want an endless parade of well-meaning family and friends swarming your house the second you get home, you may have to let people know to give you some time before the descend upon your home to see your baby. Or, at the very least, you can request they keep their visits to just a few minutes so you have enough time for adjusting to your new schedule and duties. And don’t forget to insist on that hand sanitizer.
- Learn the art of how to swaddle: Swaddling is a skill that has to be learned — just like anything else you should put some practice in to make sure you can rock it before your baby comes home. That’s especially important if your baby is colicky.
- Stash some freezer meals: You’re going to be strapped for time and energy once your bundle of joy comes home. Make your life easier by preparing a number of freezer meals ahead of time that you can just pop in the oven each day instead of cooking each one from scratch.
- Practice how you’ll feed your baby: This may seem obvious, but a preemie is harder to feed than a full-sized newborn. And if your nurses have been doing the bulk of the feedings, it’s time for you to practice. Figure out all the methods of feeding you might do, including breastfeeding, bottle feeding, using syringes, and make sure if you’re breastfeeding that you have a freezer stash started.
- How to administer medications: Your baby might be sent home with medications you’ll have to administer. If this happens, you need to know which ones to give and when. Practice giving them at the hospital under the nurses’ watchful eyes before you attempt to do it at home solo.
- Make sure you understand all the equipment: Some of the medical equipment you’ll be sent home with is bound to be intimidating and confusing. As soon as you know what equipment your baby will likely be sent home with, you should begin learning how to operate and troubleshoot it.
- Learn CPR: While it can be terrifying to think you might need to perform CPR on your baby, it’s not nearly as scary as not knowing it when you need to perform it. Being prepared is the way to go. Check with your local hospital to see if there is a CPR class you can take.
- Look for the good every day: Some days are going to be difficult, and the best way to get through days like that is by keeping a positive attitude and looking for the silver lining. Those little things — the special smile your baby gives you and the little victories and signs of improvement — can carry you through the bad days.
- Learning how to recognize the signs of respiratory distress: Preemies are more prone to infections than full-term babies are. Getting a cold or flu could be enough to block their little airways. You need to learn how to determine if your baby is having trouble breathing.
- How to deal with your emotions: Your journey to parenthood is going to be harder than some people’s and it’s okay to feel cheated or stressed by that. Giving yourself permission to admit how you’re feeling can be freeing. Whenever times get tough, just remember how far you’ve both come.
- Get comfortable with house arrest: If you have a spare few hours before your baby comes home, go stock up on groceries, take a long walk, or go see that movie you’ve been dying to see. Before long, you’re going to be tied to your home and your baby pretty much around the clock. Even with a strong support system, you may find you feel guilty about leaving for any reason.
- Brace yourself for long-term effects: While your baby is likely to be fine, there are probably going to be health consequences for your child since it was born prematurely. You might want to consider talking to your doctor more about how to recognize any of the signs of those health challenges.
Creating a Support Team
Even the Avengers need a team that can assemble and get the job done. And parenting a preemie is just like that — it’s a lot easier for parents when they have a team behind them. Here are some tips about who you’ll want to have your back on this tough, but rewarding journey.
- Look at your inner circle: This is going to be the basis for your support team. It will likely include your spouse or partner, your immediate family, and your close friends.But you should be aware that just because these people are in your life doesn’t mean they are going to be the greatest support system for you — some people are intimidated by the idea of helping with a preemie, while other people seem to vanish when the going gets tough. You’re going to quickly learn who will be there for you and who won’t when you’re in a situation like this.
- Let them know what you’re up against: Unless they’ve had a preemie themselves, most people are going to be oblivious about how time-consuming and overwhelming it is. They may want to help you and have no idea how to go about doing it. It’s your job to educate them and let you know what you need.
- Think about what you want: Some moms just want help with household chores, while others want a sounding board — someone to talk to. You should make a list of items you’ll want support with, including if you want anyone’s help watching your baby so you can have a quick break. If you don’t have time for all those conversations, it’s perfectly fine to send out an email with a sign-up sheet to everyone who has expressed a desire to help you.
- Think about joining a support group: You’ve been through a lot and you’re about to go through even more. Finding other moms or professionals to talk to about that doesn’t make you weak. You might find a lot of benefit from talking to people who know what it’s like to walk in your shoes.Plus, if any setbacks or health challenges do arise, it’s likely at least one person in your support group will have experienced it before. That will be a valuable resource for you.
- Give a lot of thought to your pediatrician choice: Who you choose to be your baby’s pediatrician can make a big difference. Before you choose one, ask other moms of preemies in your area who they went with and how that has worked out for them. Whichever doctor you choose, you should feel comfortable with them and not like they’re dismissing your concerns and questions.You also need to consider the location of your pediatrician, especially as it relates to your work schedule and how much time off you may or may not be allowed to take off. While a good pediatrician is worth the extra drive, you may want to try to find a great doctor who is a bit closer to your home if you have a demanding job that doesn’t allow for much time off.
Tips for Grandparents
When dealing with family after the birth of your preemie, you should always keep in mind that most of them won’t have any idea what you’re going through or the toll having a preemie is taking on you. They’ll want to be supportive, but they may not know what to do or say to help your through your situation. Try to cut them some slack, but don’t be afraid to set some ground rules and express yourself either.
Here is a list of tips you can share with your baby’s grandparents to let them know what to expect.
- Respect the wishes of the parent: With so much to take in after the birth of their preemie, the parents’ concentration is going to be firmly on their new baby. Introducing you to the baby or making sure you’re involved with your grandchild right away isn’t going to be their top priority. Even if it’s hard, try not to overstep your boundaries if your child asks you to give them some space by not coming to the hospital for a visit right away.
- Learn about the NICU and how it works: Your child is going to have a lot on their plate and they’re going to feel like they’ve had to explain things repeatedly to a lot of people. They’re going to be physically exhausted and mentally drained. Instead of solely depending upon them for your information, try to learn about the NICU by asking staff at the hospital or doing some reading.
- Don’t repeated the horror stories: Unfortunately, there are a lot of scary situations out there about preemies who took a turn for the worse and didn’t pull through. That is the last thing your child needs to hear about right now. Don’t let anything come out of your mouth while talking to your child unless it’s positive.
- Be useful: Your child will be tied up at the hospital indefinitely, and there’s not a lot of help you can give your child in that setting anyway. But you could be a huge help to them in other ways. You can babysit their other kids, provide rides to them if they need it, take care of their household duties like cleaning and paying the bills, and cook meals for them.
- Be a good listener: Your child doesn’t need a million questions right now — what they most need is a shoulder to lean on and a good listener who will let them vent when they need to. So when you notice your child is showing signs of being stressed, ask them how they’re holding up and listen to the answer. Don’t try to solve their problem — just listen!
- Watch the religious comments: Unless your child shares your religion and is just as intense about it as you are, you may want to skip any comments about this early birth all being a part of God’s plan. Any seemingly innocent comment you make about religion won’t be appreciated at a time like this.
Getting through a premature birth isn’t going to be easy. It’s not the birth you imagined or would have chosen, but your baby is relying on your to do your best with the situation you’ve been given.
Rely on the healthcare professionals to do what they can for your baby and do your best to learn about your baby’s needs and how to best meet them. Don’t be afraid to voice any concerns or questions you have.
Are you a parent who has experience with a premature birth? Do you have some tips to share with our readers? We’d love to hear them.
And if you know a mom who is going through this situation now, please share our article with her.