Preemie 101: The Doctor Said Your Baby Can Come Home – Now What?

Many new parents are often shocked when the time comes to bring their newborn baby home. They can’t believe that the hospital is going to entrust them with such a tiny little human, and oftentimes, they feel incapable of meeting the needs of their new boss.

To a new parent, caring for an infant can be intimidating, what if I can’t stop him from crying, how do I know if she’s hungry or just wet, how can I tell if he’s too warm or too cold? The questions are plenty, and parents generally do a good job of figuring it out as they go, but while all parents worry, it’s completely normal that the parents of a premature baby may be on heightened alert compared to the parents of a full-term infant.

Preemie babies are born before 37 weeks gestation, which means that their lungs, digestive and immune systems, and even skin may be underdeveloped, leaving them at a higher risk of contracting infections or getting sick. But if you’re a preemie parent, try not to worry. You need to know that your baby is coming home because he or she is healthy enough to leave the hospital environment and start getting settled in at home.

Still, when a preemie baby comes home, parents do need to do things a little bit differently from parents of full-term babies to ensure their little bundle stays healthy and happy. Below are a few tips to consider.

• Know your baby’s baseline breathing status – All parents need to know their child’s baseline, but especially for preemies, whose lungs are even more fragile. Practice counting the number of times your baby breathes in 10 seconds and write it down. Keep a symptom diary to note if any cough or noisy breathing occurs with feeds or when asleep. Knowing the baseline helps you to detect when your infant starts to worsen sooner, and if medicines are working or not.
• Keep visitors and traveling to a minimum – While your baby is healthy enough to come home, you still want to be sure you’re keeping your newborn away from dangerous germs and that your baby is able to get the rest that’s needed. Your baby’s immune system is still quite delicate, so you want to avoid passing the baby around at parties or taking road trips to the mall or venues with a lot of people. It’s important to avoid anyone who is obviously sick, but even people who are healthy need to wash their hands just before handling the baby.
• Practice safe sleep – Preemie infants are at a higher risk of sudden infant death syndrome (SIDS), so it’s important to place your baby on their back when putting them down to sleep. Dress your baby in layers instead of using heavy blankets. Keep blankets and bedding away from your baby’s face and nose, and don’t place stuffed animals in the crib.
• Schedule follow-up appointments – Premature babies may need follow-up care with specialists, in addition to seeing his/her pediatrician for well visits. Before you leave the hospital, talk to your baby’s doctor about what specialists your baby needs to see. It may even help to make your follow-up appointment before leaving the hospital.
• Have a sick plan – Know exactly what the next steps are when your baby gets sick, which is inevitable in New England fall and winters! Know what medicine to give your baby first, if prescribed, or whom to call when you need to.
• Got questions? Ask! – It’s likely that your baby’s hospital care team has invited you to call back at any time with questions, but it doesn’t hurt to ask up front about anything you’re not sure about. How often should your baby eat or have a bowel movement? Should your baby spend any time on his/her tummy? If you’ve got questions, they’ve likely got the answers, so ask away. You’ll be glad you did!

Perhaps the most important thing preemie parents need to remember is to take good care of yourselves. If you’re sick, tired, run down, or depressed, you will not be able to give your baby the care they need. Be sure to accept help when it’s offered, rest as often as possible, and talk to your doctor if you have any concerns. Remember, your baby loves you already and you’re going to do great!

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Guest Blogger: Lawrence Rhein, MD, Chief of the Division of Neonatology, UMass Memorial Medical Center – Children’s Medical Center