5 Important Precautions for Parents of Preemies

by David T. Tayloe Jr., MD

5 Important Precautions for Parents of Preemies

How to bring your (very) little one home safely

Somewhere around month nine of pregnancy — when the enormous bump, swollen ankles and frequent bathroom breaks haven taken their toll — many expectant moms are quite eager to welcome their little ones into the world. But increasingly, babies are arriving a little too early. Pre-term births, those occurring before the 37th week, have risen 36 percent in the United States since the early 1980s, and though some of this increase can be attributed to the surge in multiple births over the past two decades, even singleton preterm births are up 14 percent from 1990.

Early deliveries may not be easy, but bringing a new baby home is its own reward. Here are some special precautions parents of preemies can take to ensure the best possible start for the newest member of the family.

Prepare Yourself
Enlist your pediatrician’s help in preparing to care for your preemie at home: Schedule a consult before leaving the hospital, and be sure you know how to administer medications and use any special equipment your baby may need. It’s a good idea for all expectant parents to take an infant cardiopulmonary resuscitation (CPR) course, but if your baby arrived before you learned this lifesaving technique, ask the hospital staff to teach you.

Travel Safely
In order to leave the hospital in a car, all babies must be secured in a car-safety seat in the back seat. If your preemie is too small for a conventional car seat, he may not be able to keep his head properly positioned to stay upright and keep his airway clear, so look for a seat approved for babies weighing less than five pounds. The hospital may need to test it before your departure by placing baby in the seat and evaluating his heart and breathing with a cardiopulmonary monitor; if he has any difficulties, your doctor may suggest a car bed (available at, which will allow him to lie down safely in the car. Respiratory problems are common in preemies, so it’s best to keep car trips short and limit his time in the car seat to an hour or so — ideally with another responsible adult riding next to him to keep an eye on him.

Providing breast milk for your preemie is one of the most effective ways you can promote her health and development — breast milk is full of nutrients and antibodies that are especially important for vulnerable pre-term babies. Even if she’s unable to nurse at first (newborn preemies often lack the strength required to suckle), you can begin expressing your milk right after delivery so it can be given to her — either by tube or by bottle — as soon as she’s able to have it. Continue to pump at regular intervals, about six to eight times a day, to encourage milk production. If you can’t breastfeed, don’t despair: Modern formulas are a perfectly healthy option, and there are many other ways you can bond with your new baby, such as the skin-to-skin cuddling technique of kangaroo care.

Do the Math
Parents of preemies often find themselves frustrated by infant-development charts when their tiny babies seem to hit milestones later than their age indicates they should. But chronological age can be deceiving when it comes to premature babies, who miss out on development time in the womb — if your 3-month-old was delivered, say, two months early, he’d be only 1 month old now if he had been born on his due date. When assessing your baby’s development, use his gestational age instead. Your pediatrician can calculate this according to his original due date, and it will correspond more closely to his appropriate growth and development than the date on the calendar. You can also take heart in the fact that most preemies catch up to their full-term counterparts by the time they turn 2 years old.

With all the uncertainty, parents of preemies sometimes feel they missed out on the chance to celebrate their new child. Make a conscious effort to cherish every moment of her life: Take photos in the hospital and at home, and keep a journal or scrapbook to record her progress. And when your big arrival is big enough, share your joy with others. (Just make sure all visitors wash their hands before touching the baby, and that those with upper respiratory infections admire her from a safe distance.) After all, every baby is a miracle — preemies are just a little more miraculous.