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Caring for a Preemie

People - Preemie Baby Hand
iStockphoto/Michael Blackburn

According to the National Center for Health Statistics, 12 percent of babies are born premature. If you’re a new parent to a preemie, take heart. There are a few tips to smooth the process of doing what every mom looks forward to – bringing your baby home from the hospital.

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Below are six preemie-specific tips for caring for your little one once you’ve left the confines of the Neonatal Intensive Care Unit.

1. Make sure your ride home is safe.
The appropriate car seat is crucial, says Phyllis Dennery, MD, professor of pediatrics at the University of Pennsylvania and chief of the division of neonatology at Children’s Hospital of Philadelphia. “Most hospitals will do a car seat test before the baby leaves the hospital which allows them to know if the baby is able to tolerate the ride,” she says. “Premature babies sometimes get too bunched up and can’t breathe as well. So look for a car seat that’s appropriate for an infant.” In other words, skip the toddler seat and be sure there’s cushioning in the seat that will pad around the baby’s head. “Another option is a car bed,” Dr. Dennery suggests. “This way the baby lies down instead of sitting up for the car ride home.”

2. Get help if you can.
Consider lining up a baby nurse (or helpful parent) for at least the first few days. New mother Sara Chokshi, who gave birth to her son Kiran at 29 weeks, says, “Having someone there is crucial both for the added security in case of an emergency as well as taking a shift so you can get some sleep.”

3. Stay calm during lights out.
The darker it is outside, the more parents tend to stress during the first few nights at home. For parents of preemies, that anxiety can be compounded, but these nights will be punctuated with feedings every three hours. “Smaller babies shouldn’t sleep through the night, but they may because they’re not very vigorous and they’re not going to cry out and say ‘I’m hungry,’” Dr. Dennery says. “They should feed every three to four hours every day and night, so always wake your baby for feeding if she’s sleeping through the night.”

4. Be prepared for feeding issues.
“I wish it had been stressed to me that many babies, even full term babies, have feeding issues in the early months,” Chokshi says. “At the time, I thought it was something really serious and for awhile I was petrified at every feeding because Kiran seemed to choke while he ate.” Feeding may be stressful but your job is to keep the milk supply going as best as you can.”Keep pumping as much as possible so you keep your milk supply up,” Dr. Dennery says. “It’s very challenging and arduous in the first few weeks but you want to make sure your baby is getting the calories he or she needs. If you’re not planning to breastfeed, opt for formulas customized for premature babies so you’re sure your baby gains adequate weight.” Speak to your doctor immediately if your baby continues spitting up during every feeding.

5. Follow-up with your pediatrician.
Within a few days of returning home, check in with your doctor. “Find a pediatrician you’re comfortable with and follow-up with that person right away,” Dr. Dennery says. “Premature babies are more at risk for respiratory infections if they’ve been on a ventilator, so follow-ups with vaccinations and immunizations are key.”

6. Network with other parents.
It really helps to connect with parents of preemies who are a little older. “You’ll get support as well as hope by seeing their little ones,” Chokshi says.

Finally, says Chokshi, “Look at the pictures on the wall in the NICU of all the babies who have gone home and thrived. And my best advice: actually listen to the nurses and staff when they tell you that this hospital stay will soon become just a blip in your memory.”

In a nutshell:

  • Tiny babies need extra cushioning to pad their head in a car seat.
  • It’s best to feed a preemie every 3-4 hours, day and night.
  • Note that if they were on a ventilator, they’re at higher risk for respiratory infections.
  • If formula feeding, choose formula customized for premature babies.
  • Find support in other preemie parents.

-Lambeth Hochwald


Lambeth Hochwald is a lifestyles journalist who writes for Health, Marie Claire, Parenting, Redbook and Woman’s Day. Lambeth has worked on such launches as All You, Bundle and For Me and is an adjunct professor of journalism at NYU.

She is also co-founder of parent P-L-A-Y (www.parentplay.com), a family-events company based in Tribeca.

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