When you have a premature baby at home, many parents feel lost with the precise and high needs of care. As much as they ask doctors for guidance and follow the recommendations, they are afraid they have missed something. I understand because premature babies really demand a lot of special care and undivided attention.
Premature babies need a lot of care even after discharge from the Neonatal Intensive Care Unit. They must strictly follow all consultations with the pediatrician and the medical team that will accompany them in this next step; these visits can be weekly or every fifteen days from the beginning, as they are important for your premature baby to be able to develop well, being monitored correctly, identifying possible issues and have measures taken promptly if and when they arise as they can pose problems or delay in their development, such as:
- Hearing loss or impairment;
- Retinopathy of prematurity, which can even cause blindness;
- Apnea: pauses of more than 20 seconds in breathing, this is because your respiratory system has not fully developed;
- Jaundice: yellowish color due to excess bile in the body;
- Learning difficulties;
- Delayed growth and development;
- Late language development.
In order to help you a bit, I will share a few things I have learned throughout my career as a Newborn Care Specialist and give you tips on the main care that your preemie baby needs at home and what questions are important to ask your doctor:
Food
Most premature babies need a dietary supplement to fortify breast milk or special formulas for premature babies. Everything will depend on their degree of prematurity, medical recommendations, and the development of their reflex to be able to suck on the mother’s breast. It is possible that, at first, breast milk has to be given in syringes, droppers, or cups, in case they are still unable to make the suction movements.
Before each feeding, though, you may try to give the breast to see if they can suck. The important thing is to always try to encourage them to feed on the chest if you are able and aiming to breastfeed, and we know that as the baby gains weight and develops, they will learn to suck and make the correct movements. Preemie babies usually sleep a lot, so it is necessary to create a routine and wake them up for feeding.
Environment and contact with people
Premature babies have a weakened immune system, so they are more exposed to viruses, bacteria, and infections. It is recommended that parents do not visit crowded places, and that visitors are minimum, and that anyone who touches the baby should be cleaned, with hands washed and who have used hand sanitizer.
At home, keep all rooms well ventilated. If you are allowing visitors, control the number of people who will be in the environment at the same time and the duration of the visit. Do not let people with the flu or showing symptoms to come by, as it is very common for premature babies to have respiratory infections, especially the Respiratory Syncytial Virus (RSV), which can turn into bronchitis.
Because it is difficult to maintain adequate body temperature, the premature baby in many cases needs to be warmed up. It is possible to check if your baby is cold when touching their skin, and it is cold or trembling, and by the extremities, if their little fingers are purple, for example. In these situations, swaddling will help them stay warm.
Skincare
Ideally, baby clothes should be washed separately with antibacterial products suitable for washing baby clothes. Diapers should be changed more often, as the skin of a premature baby is thinner than that of a baby born from a normal pregnancy, being more likely to have diaper rash. When bathing, be quick and try to leave them undressed as little time as possible due to the cold. You may wash them in parts, keep them wrapped in a town, unwrapping bits by bits, washing legs first, then belly, and so on.
Watch out for your baby’s crying
Crying is a way for the baby to tell you that something is not right. However, it can be for several reasons and there are several types of crying. To help you, I will specify here what are the most frequent reasons babies cry:
- If more than 2 hours have passed since the last feeding, it may be hunger;
- If they are very restless, agitated, it may be wet diapers or clothes/diapers may be tight;
- They can be cold or warm;
- The position they are in can be uncomfortable;
- As premature babies sleep a lot, it can be tiredness and lack of sleep;
- Breathing difficulty, their little nose may be congested;
- Many stimuli, can bother or irritate them, and they may be in need of silence;
- Pain due to colic;
- Reflux
- Otitis
Indications that your baby is not well
Parents need to be attentive to any behavior that may indicate that the baby has a health problem or that the baby is not doing quite well. Especially because of their low immunity and their organs not yet being fully developed, which can aggravate any simple problem. There are some indicators that your baby may not be well:
- Hypothermia: check with the thermometer if it is below 97.7°F;
- Watch for any changes in their breathing pattern;
- Tremors;
- Cry weakly or just vocalize, without a strong cry;
- If they are sleeping more than usual and is responding very little to interaction stimuli;
- Convulsions
- Frequent vomiting
- Distended abdomen (bigger, stiff belly)
- Has a dry diaper or pee coloration is dark
- Be very pale or cyanotic (purple)
- Any indication of jaundice
