Premature baby? Understand your preemie's special needs

If your baby is born too early, the miracle of birth might be overshadowed by concern about your preemie's health and the possible long-term effects of prematurity. However, there's much you can do to take care of your premature baby — and yourself — as you look toward the future.

Your preemie's special challenges

A premature or preterm baby is born before 37 weeks of pregnancy have been completed. Generally, the earlier a baby is born, the higher the risk of complications.

At first, your premature baby might have little body fat and need help maintaining body heat. He or she might cry only softly and have trouble breathing. Feeding your preemie might be a challenge. Yellowing of the skin and eyes (jaundice), low blood sugar, and lack of red blood cells to carry oxygen to your baby's tissues (anemia) are possible. More-serious concerns might include infection, episodes of stopped breathing (apnea) and bleeding into the brain. Some preemies have impaired hearing or vision. Others experience developmental delays, learning disabilities, motor deficits, or behavioral, psychological or chronic health problems. Many, however, catch up and experience normal healthy development.

Taking care of your preemie

Your preemie's special needs call for special care, probably in a neonatal intensive care unit (NICU). In some cases, a premature baby needs to be transported to a hospital that can provide specialized care. The medical team caring for your baby will do everything they can to help your baby thrive. Your role as a parent is essential, too.

• Find out about your preemie's condition. Uncertainty can be frightening — as can the monitors, respirators and other types of equipment in the NICU. Write down your questions and seek answers when you're ready. Read material provided by the hospital, or do your own research. The more you know, the better you'll be able to handle the situation.
• Share your observations and concerns. If you notice changes in your preemie's condition, tell your baby's medical team right away.
• Establish your milk supply. Breast milk contains proteins that help fight infection and promote growth. Although your preemie might not be able to feed from your breast or a bottle at first, breast milk can be given in other ways — or frozen for later use. Begin pumping as soon after birth as possible. Aim to pump at least six to eight times a day, round-the-clock. Also, ask your baby's doctor about your baby's need for supplementation — either in the form of breast milk fortifiers or preterm infant formula.
• Spend time with your baby. Speak to your baby in loving tones and touch him or her often. Reading to your baby also can help you feel closer to him or her. When your baby is ready, cradle him or her in your arms. Hold your baby under your robe or shirt to allow skin-to-skin contact. Learn to feed, change and soothe your preemie. If you're concerned about interfering with intravenous tubes or monitor wiring, ask your baby's medical team for help. Consider personalizing your baby's bed with a special blanket or family pictures.

Taking care of yourself

You're concentrating on your baby now, but remember that you have special needs, too. Taking good care of yourself will help you take the best care of your preemie.

• Allow plenty of time to heal. You might need more time to recover from the rigors of childbirth than you imagined. Eat a healthy diet, and get as much rest as you can. When your health care provider gives you the OK, make time for physical activity, too.
• Acknowledge your emotions. Expect to feel joy, sadness, anger and frustration. You might celebrate successes one day, only to experience setbacks the next. Give yourself permission to take it one day at a time. Remember that you and your partner or spouse might react to stress and anxiety differently, but you both want what's best for your baby. Keep talking and supporting each other during this stressful time.
• Take a break when you need it. If you leave the hospital before your baby, use your time at home to prepare for your baby's arrival. Your baby needs you, but it's important to balance time at the hospital with time for yourself and the rest of your family.
• Be honest with your baby's siblings. If you have other children, try to answer their questions about the new baby simply. You might explain that their baby sister or brother is sick and you're worried. Reassure your children that the baby's illness isn't their fault. If your children aren't allowed to see the baby in the NICU, show them pictures.
• Accept help from others. Allow friends and loved ones to care for older children, prepare food, clean the house or run errands. Let them know what would be most helpful.
• Seek support. Surround yourself with understanding friends and loved ones. Talk with other NICU parents. Consider joining a local support group for parents of preemies, or check out online communities. Seek professional help if you're feeling depressed or you're struggling to cope with your new responsibilities.

Bringing baby home

When it's time to bring your baby home, you might feel relieved, excited — and anxious. After days, weeks or months in the hospital, it might be daunting to leave the on-site support of your baby's medical team behind. Keep in mind that as you spend more time with your baby, you'll better understand how to meet his or her needs and your relationship will grow stronger.

Before you leave the hospital, consider taking a course in infant CPR. Make sure you're comfortable caring for your baby, especially if you'll need to use special monitors at home or give your baby supplemental oxygen or other treatments. Ask as many questions as you need to. Nothing is silly or unimportant when it comes to caring for your baby. Schedule follow-up visits with your baby's doctor, and find out whom to call if you have questions or concerns in the meantime.

Because sitting semireclined in a car seat can increase the risk of breathing problems or a slow heartbeat, your baby might need to be monitored in his or her car seat before hospital discharge. When you have the OK to use a car seat, use it only during travel. In addition, don't place your baby in a backpack or other upright positioning devices — which might make it harder for him or her to breathe — until you talk to your baby's doctor.

To measure your premature baby's development, use his or her corrected age — your baby's age in weeks minus the number of weeks he or she was premature. For example, if your baby was born eight weeks early, at age 6 months your baby's corrected age is 4 months.

You'll always remember your baby's time in the hospital. Now cherish the opportunity to begin making memories at home.