Babies born before 37 weeks of gestation are considered preterm or premature and are vulnerable to many complications due to the physical and physiological immaturity. Parents often find it difficult to care for the “preemies” due to various reasons. These babies are often unusually small and have specific nutritional and developmental needs.

Why do premature babies need special care?

The gestation period for human beings is 290 days or 40 weeks. The babies who are born before 37 weeks have immature organs As a result, they are likely to face various health concern that affects the functioning of their body – including respiratory problems, cardiac issues or health complications associated with digestion and elimination. Preterm babies can acquire infections faster compared to term babies due to the immature immune system. The delicate skin could break easily as well. Their body temperature (in a room) could be lower than the expected levels due to the underdeveloped thermoregulatory system. Similarly, their nutritional needs vary from that of term babies.

5 parenting guidelines when your preterm baby is in hospital

Here are a few ways that would help you cope with the situation:

1. Visit your baby in the special -care nursery

For most parents, the stress of having a preterm baby is intensified after she is admitted to the special care nursery. Hence, you may miss the experience of holding, breastfeeding, and bonding with her immediately after the delivery. To cope better, visit your baby in the NICU as frequently as possible, and be pro-active while taking care of her.

2. Spend time with your baby in the special-care nursery

You can hold your baby if her health conditions permit you to do so. Even touching her is important. These auditory and tactile stimulations improve your baby’s physiological response. In many baby care nurseries, parents can carry out “kangaroo care” for their babies. This is practiced when the infants no longer require major medical support. The babies are in skin-to-skin contact with their mothers. Studies have proven that this technique helps to maintain the body temperature and optimum respiratory patterns among babies.

3. Protect her from infections

Your premature baby is highly susceptible to infections due to poor immunity. Wash your hands with soap and water as well as wear a face- mask while visiting your baby in the nursery. This will help reduce the number of microbes that come into contact with your baby.

4. Meeting the nutritional needs

Term or preterm, the best food for your newborn is breastmilk and it provides antibodies as well as other substances which enhance her immune response. Thereby, helping her resist infections. However, your baby may not have the ability to swallow or digest the milk as is the case among many premature babies. Depending on the scenario, she will be fed through a tube that is inserted through the nose to the stomach or through other medically approved methods.

Breastmilk for the premature baby

If your newborn is ‘ready’, the nurses will teach you either breastfeeding or bottle-feeding techniques, whichever is appropriate for the baby's needs and your desires. Once she is accustomed to breastfeeding, you should nurse her frequently to increase your milk supply. The nurses will also guide you on how you could express breastmilk using a breast-pump to feed your baby more frequently in the nursery to meet her demands. Colostrums-the yellow milk should be given to her as it contains immunoglobulins which provide her with immunity against infections.

5. Speak with the doctor

Before your baby is discharged from the hospital, ask the doctor for any recommendations related to your child’s well-being. She will advise you about bathing your baby, immunization and management of minor ailments

7 FAQs about caring for your premature baby at home

1) Which is best sleeping posture for your baby?

It is recommended that you place your baby on their backs while they are asleep. Babies who are placed on their stomachs to sleep are at a higher risk for certain severe ailments.

2) Is it necessary to feed the preterm baby more frequently than that of a term baby?

The growth rate in preemies is marginally high as compared to term newborns. To meet this increase in demand she should be fed more frequently than the others.

3) What are the precautions to be taken at home to prevent infections?

There are 5 effective ways of doing so:

a. Avoid permitting many people to handle your baby
b. The person who takes care of the baby should wash his or her hands each before she touches your baby
c. Avoid bringing your baby in contact with people suffering from infections
d. Sterilize the utensils that are used while feeding the baby (eg: Palade, feeding bottle, breast pump) after use
e. Avoid feeds other than breastmilk unless otherwise advised by the doctor.

4) Is it abnormal if the baby does not pass stools daily?

No, babies may take a few days to demonstrate a regular bowel pattern. If the baby does not pass stools for three consecutive days, you should seek medical help.

5) Is it important to keep the baby covered and warm always?

Yes, the ability to control the body temperature is poor among premature babies due to their immature thermoregulatory system. The heat is evaporated easily from newborn’s body. As a result, the body tries to generate heat from glucose and fat available in the baby’s body and her blood sugar levels are likely to be lower than before.

6) What is the ideal time to bathe your preterm baby?

It depends on the baby’s health status. Most experts advise mothers to postpone bathing their premature babies by a few days or weeks. The creamy substance (called vernix caseosa) covering the newborn’s skin provides her with natural protection against infections. It is recommended to clean her body with warm water. Spirit and antiseptic lotions are harmful to the tender delicate skin.

7) Can you vaccinate a preterm baby as per the schedule recommended for term babies?

Vaccination for preemies is usually delayed due to the poor immune status. Once the baby regains optimum weight and is deemed to be healthy, she is vaccinated as per the recommended schedule. Seek an opinion from the physician

It's all about Tender Love and Care

Your preterm baby is precious. Your tender love and care determine her the health and future. The physical and emotional stimulus from parents strengthens the newborn’s response. Hence, it is important to be actively involved with your preemie’s care whether it is in the special care nursery or at home.

This article has been written by Dr. Namitha Subrahmanyam. She has been working as a nurse for over 13 years and holds an M.Sc in OBG Nursing. Recently, Namitha Subrahmanyam has been awarded a PhD. She is also working as an Associate Professor at the Department of Obstetrical and Gynaecological Nursing of the MOSC College of Nursing, Kochi, Kerala, India.