Bringing Your Preemie Home

by Carden Johnston, M.D.

Bringing Your Preemie Home

One out of every eight babies in the United States will arrive earlier than expected this year. But thanks to medical advances, a premature infant (one born before 37 weeks) has a brighter future than in the past. Today, a “preemie” delivered as early as 28 weeks and weighing at least two pounds, three ounces has a 95 percent chance of survival. Here’s a new-parent guide to caring for your tiny bundle of joy.

• Get ready. Most preemies spend some extra time in the hospital before they go home, so plan to visit often. When it’s time to leave, your pediatrician will explain how to care for your baby at home  — including how to know if he’s eating properly, getting enough sleep, and gaining enough weight. She’ll show you how to administer medications and use any special equipment your baby might need, such as an apnea monitor or supplemental oxygen. You’ll also learn infant cardiopulmonary resuscitation (CPR) and emergency procedures. This can be a lot to take in, so don’t hesitate to ask questions.

• Make every ride a safe one. All babies, including preemies, must be secured in a car-safety seat in the backseat in order to leave the hospital in a car. Be sure to choose a car seat approved for use at weights under five pounds, ideally one with less than five and a half inches from the crotch strap to the seat back and less than ten inches from the lowest harness-strap position to the seat bottom. Avoid seats with a shield or tray  — they can injure a preemie in a crash or sudden stop.

Once you have a car seat, ask hospital staff to monitor your baby in it a few days before you head home, since your child may have difficulty breathing in a semireclined position. If that’s the case, your doctor may recommend a car bed that will allow your baby to lie down safely while traveling. If possible, have an adult ride next to your newborn in the car and watch him closely.

• Adjust your thinking. Your baby’s first year is a time of great change. No two babies develop at the same rate or in the same way. Development even varies from day to day and week to week. If your baby was born early, you should think of his progress in terms of “adjusted age.” For example, if he was born eight weeks early, adjust your expectations by two months. That means a 4-month-old preemie may act like a full-term 2-month-old. Try not to compare your child to full-term babies or focus too much on developmental charts. You are in the best position to monitor your baby and, over time, you’ll become familiar with his development pattern.

• Have regular checkups. One of the most important ways to keep your preemie healthy is to make sure you don’t miss any of his recommended checkups. Your pediatrician will use the time to monitor your baby’s growth and development, vaccinate him against serious diseases, and provide you with support and information.