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.”

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