1. Immediate Care for Your Newborn
When a baby is born early, many things
can happen very quickly. A preemie needs more care because his body
can’t take over and perform some normal body functions. If baby has
difficulty breathing, the nursing staff will help him, which can be
done in many ways. After baby is tended to in the delivery room, he
will be moved to the infant-care nursery or to a special unit for
treatment, evaluation and care.
If baby needs wide-ranging, in-depth
care, he will be moved to the neonatal intensive-care unit, also called
the NICU (pronounced NICK-U). The nurses and physicians who
work in these units have received specialized education and training so
they may care for preemies.
The first time you see baby for any
length of time may be after he has been moved to the NICU. You may be
amazed by his size. The earlier he was born, the smaller he will be.
As time passes and baby grows, you’ll
probably be able to hold him. You will also be encouraged to care for
him, such as giving him a bath, changing him and feeding him. Kangaroo
care—holding a naked baby against your naked chest—for 1 hour a day,
several times a week, provides many health benefits for a preemie.
You’ll see many
pieces of equipment and machines in the unit. They are there to help
provide the best care possible for your baby. Monitors record various
information, ventilators help baby breathe, lights warm baby or help
treat jaundice. Even baby’s bed may be unique.
2. Feeding Your Preemie
Feeding is very important in a premature
baby. In fact, a baby being able to feed on his own for all of his
feedings may be one of the milestones the doctor looks for when
considering when to release him. Breastfeeding or bottlefeeding for
every feeding is a major accomplishment.
For the first few days or weeks after
birth, a premature baby is often fed intravenously. When a baby is
premature, he may not have the ability to suck and to swallow, so he
can’t breastfeed or bottlefeed. His gastrointestinal system is too
immature to absorb nutrients. Feeding him by I.V. gives him the
nutrition he needs in a form he can digest.
Premature babies often have digestive problems. They need to be fed small amounts at each feeding, so they must be fed often.
If you’re going to breastfeed baby,
you’ll need to supply your breast milk. Pumping may be the answer.
Studies have shown any amount of breast milk is good for a preemie, so
seriously consider this important task.
DHA (docosahexaenoic acid) and ARA
(arachidonic acid) are two nutrients present in breast milk that can
really help a preemie. If you can’t breastfeed, ask the NICU nurses if
baby will be fed a special preemie formula that contains these
nutrients.
The composition of your breast milk when
baby is born prematurely is different from the breast milk when baby is
full-term. Because of this difference, baby may also be supplemented
with formula.
Choosing a Pediatrician for Your Preemie
The care your baby receives
after he leaves the hospital is very important. Try to find a
pediatrician who has had experience caring for premature babies. You’ll
probably be seeing this doctor quite frequently during the first year,
so it’s important to feel comfortable with him or her.
3. Problems Some Preemies May Have
When a baby is born prematurely, he
hasn’t had time to finish growing and developing inside the womb. Being
born too early can impact on baby’s health in many ways. Today, with
all the medical and technological advances medicine has made in the
care of premature babies, we are fortunate that many children have few
long-term difficulties.
Some immediate problems your baby may
have are listed below. Some are short term; others may need to be dealt
with for the rest of the child’s life.
• jaundice
• apnea
• respiratory distress syndrome (RDS)
• broncho-pulmonary dysplasia (BPD)
• undescended testicles
• patent ductus arteriosus
• intracranial hemorrhage (ICH)
• retinopathy of prematurity (ROP)
• respiratory syncytial virus (RSV)
4. Taking Baby Home
At some point, you’ll be able to take
baby home. Your baby will be ready to go home when he has no medical
problems that require him to be in the hospital, can maintain a stable
body temperature, takes all of his feedings on his own (no tube
feeding) and is gaining weight.
People in the NICU will help you prepare
for this important event. They can help you plan for any special-care
needs before you take baby home. Once home, most preemies do well.
Your premature baby may be at an
increased risk for SIDS. To help protect him, follow established
guidelines for reducing SIDS for the entire first year of your baby’s life. It’s important to put baby on his back every time you put him in his crib or bassinet!
5. Mental and Physical Development of Your Baby
As baby grows and develops, you must
always keep in mind that he was born early. For as long as the first 2
years of his life, development may be slower than the development of
children who were born close to their due date. Your baby will have two ages—his chronological age (when he was born) and his developmental age, which is based on the date he was due. Developmental age is also called adjusted age.
Experts believe children born early may
need help well beyond the early years. As parents, you’ll want to be
involved in measuring your child’s learning and behavior activities.
Discuss this with your physician so you can work together as a team to
help your child.
When a baby is born early, it may take him longer to reach an event marking a new development or stage. These are called milestones and help you determine how baby is advancing. It really doesn’t matter when your child reaches a milestone as long as he eventually reaches it!
When you evaluate how your
child is developing, correct his age for the weeks of prematurity.
Consider his developmental age from his due date, not his actual date
of birth! For example, if baby was born on April 18th but his due date was actually June 6th, begin measuring his development from June 6th. Consider this his “developmental birthday.”
