Coming Home With A Premature Baby

Now that your premature baby weighs more than 4lbs and is in stable condition, it is time to (finally) come home from the hospital with your newborn. But what special care do you need to be concerned about?

Arriving Home
Babies born prematurely need to weigh at least 4 to 5lbs, be in sufficient health and have reached or surpassed their original due date before they can be released from the hospital. And while you may be taking home oxygen tanks and ventilators with your baby, who seems so tiny, be assured that they are not as fragile as they look.

The general care of your infant will be pretty much the same as the care of any newborn. However, your time spent caring for your child in the neonatal intensive care unit will have provided you with some valuable training in the needs of your child. This will help you to feel more at ease handling your baby when you change their diaper, feed them or even just pick them up.

Although your friends and family will probably form an orderly line at your door once your baby finally arrives home, you will need to establish some visitation rules. Premature babies tend to be more vulnerable to infections due to their weakened immune system. Having many different people handle your baby exposes a preterm baby to more germs and increases their risk of an infection. Encourage your guests to wash their hands before they handle your baby to help minimize your child’s exposure to germs.

You should also keep in mind that visiting with too many people will over-stimulate your baby. This can cause your baby to be fussy, more irritable and even affect their eating habits for the rest of the day. Limiting the number of guests that interact with your baby can help avoid this.

Stomachs of premature babies tend to be smaller than other newborns. As a result, it is often necessary to feed preemies as often as every 2 to 3 hours. Also, their sucking abilities may not be as efficient or effective thereby restricting the amount of milk they can take in at one time. This can result in longer feeding times, sometimes up to an hour.

If you are bottle-feeding, you will need to sterilize the bottles every time. While it is a good idea to sterilize any bottle a child will be drinking out of, it is especially important to do so for a premature baby because of their higher susceptibility to infections.

Since milk alone may not always provide all the nutrition a premature baby needs, you may be advised to provide your baby with a supplement to ensure that all their dietary requirements are being met. However, you may want to use a supplemental feeding system to help your baby avoid nipple confusion.

You should also check with your baby’s pediatrician before starting them on solids. Premature babies need extra time to develop their ability to swallow properly and shouldn’t be started on solids before they are ready. Generally speaking, though, a premature baby can start on solids around six months after their original due date, not their actual birth date. So, if your infant was born two months early, then you could look to start feeding them solids when they were about eight months old.

Keeping Warm
In preparation for your baby’s homecoming, set your thermostat a few degrees higher than usual. Preterm babies often have less body fat than full-term babies and therefore need the extra heat. But don’t overheat your home! Just two or three extra degrees for a few weeks should be sufficient.

Because of their lower amount of body fat, your premature baby will need some additional clothing to help keep them extra warm. When dressing your premature baby, give them two more layers than what you need to stay warm. Once they reach the average weight of a full-term baby, only one extra layer will be necessary.

Although you will probably need to buy diapers and clothing specially designed to fit premature babies, don’t go overboard in your shopping. Like all other babies, premature babies can grow pretty quickly so buy only a few of the necessary items. Before you know it, you will need the regular full sizes for your baby.

Growing Pains
Although you’re probably in no rush to see another doctor now that you’re finally home with your baby, it is important for your preterm baby to visit his pediatrician a few days after he arrives home. This check-up will allow the doctor to record his height, weight, and find out how he is doing at home. If you have any special concerns, perhaps about his vision or hearing, now is a good time to bring it up with the pediatrician.

Much to the dismay of many parents, premature babies always seem to be behind in development compared with other children their age. However, comparing a six-month-old premature child with a six-month-old child born at full-term is wrong since they are not at the same stage of development.

Premature children need to have their development evaluated at the "corrected age." That is, the age they would be if they had been born at term. Therefore, a six-month-old child who was born two months before their due date should be on par with a four-month-old when it comes to development. This pronounced difference will be noticeable until your child is about two years old. By this point, development has slowed down enough so that a one or two month age difference does not have much effect on overall development. However, if your child is still behind in development after accounting for the "corrected age," you should schedule an appointment with your child’s doctor to discuss your concerns.

Sleep and Your Preemie
The sleep habits of premature babies can differ from babies born at full-term, too. A preterm baby is more likely to sleep more frequently, although for shorter periods, compared to a full-term baby. It can also take longer for a premature baby to sleep through the night.

Car Seat for Your Premature Baby
Because of their small size, it may be difficult to find a car seat that provides the correct support a premature baby needs. If your baby’s head and body are slumped over when they are placed in their car seat, then they need more support. While there are car seats that are designed just for premature infants, you may find it easier to just add your own support. Simply adding a rolled up blanket or diaper and placing it where it is needed can help provide that important extra support.

You may feel the need to talk with other parents of special needs children. Chat in our forum.

Learn how to care for a premature baby by talking to other moms in our baby forum.