Having a baby is often a time for celebration and sleepless nights. But sometimes, the little one arrives much sooner than anticipated, bringing along worries about his or her wellbeing. While at the hospital, it’s easy to rely on medical providers to care for their healthcare while you and your family focus on providing love. But what happens when it’s time to take the baby home? What can you do to ensure that they receive the best possible care?
What is considered to be a premature baby?
Generally, a full-term pregnancy is one that lasts for a full 40 weeks. However, some babies overstay the womb for a few days, while others are ready to come out a bit earlier. Yet, there’s a third group – babies who aren’t ready to be born yet, but who do arrive prematurely. This occurs when they are born during the 37th week of gestation or earlier.
Health Risks of Premature Babies
Premature babies — preemies — have a higher risk of health complications. The earlier they are born, the higher the risk. This is because their tiny bodies or some of their organs may not be fully developed yet. These often include their lungs, kidneys, and/or immune systems.
When a premature baby is firstborn, he or she is sent to the Neonatal Intensive Care Unit (NICU) for around-the-clock care from healthcare professionals. This is where your baby will be placed in an incubator or hooked up to any additional life-sustaining machines they may need – such as a ventilator, C-PAP machine, or a feeding tube. The equipment in the NICU sounds alarms periodically. While they sometimes indicate the baby needs care at that moment, it also often signifies that it’s time for a routine check-up.
When is the baby ready for discharge?
Most hospitals have a minimum weight requirement before discharging a premature baby to go home. Medical staff will also ensure that the baby can regulate his or her body temperature, as well as gain weight steadily.
How to Care for a Premature Baby at Home
Caring for a premature baby at home can be nerve-wracking. Once your baby is ready to go home, the hospital will provide you with specific instructions for the care of your baby. Always pay close attention to them, since every patient’s situation is different. However, there are several common denominators.
Infection Prevention
Once born, all infants are exposed to potential risks — such as infections. While this is a possibility for all newborns, preemie babies tend to have it worse because they are underdeveloped and their immune systems are weakened. In most cases, an infection can mean your newborn remains in the NICU for longer periods of time, but in extreme cases, an infection can be life-threatening. The most common infections for preemie babies include:
- Generalized infection, bloodstream infection, or sepsis
- Infection of the lungs or pneumonia
- Infection of the fluid that surrounds the brain or meningitis
- Infection of the urine or urinary tract infection (UTI)
- Localized infections under the skin called abscesses
- Methicillin-resistant Staphylococcus aureus (MRSA) — a bacterial infection
Infections can occur before childbirth, at childbirth, or in the NICU. While most of these infections can easily be treated with antibiotics, MRSA is particularly resilient. Fortunately, there are many options available to help prevent and/or treat the various infections putting your newborn at risk.
Preventative Medicine
In most cases, preventative medicine can be taken to fight infections before they become serious. Your doctor will likely recommend a preventive medication called palivizumab (Synagis). Synagis can help protect your baby from a serious viral infection before one occurs.
Vaccinations & Immunizations
By now, you’ve probably read up on the importance of vaccinations — not only for your baby but also for you and your entire family. You can protect your preterm infant by ensuring that others in the home are up to date on their immunizations, including influenza. Pregnant women, family members, and adult caregivers should also check with their doctors to be sure they’re up to date on their whooping cough vaccine.
You should work with your doctor on scheduling your baby’s vaccinations. It’s recommended that immunizations be given to medically stable premature babies according to their chronological age, but delays may occur. The first shot for Hepatitis B is the main priority, but your baby should begin receiving the following vaccines by the time they’re six months old:
- Hepatitis B
- Rotavirus
- Pertussis
- Hib
- Pneumococcal
- Polio
- Influenza (Flu)
Feeding Premature Babies at Home
Preemies need to eat more often to obtain enough nutrients to catch up on their growth. This is important for both nourishment and hydration. They typically require feeding every one and a half to three hours. This can be done with either breast milk or formula, and your baby’s healthcare team will instruct you as to specific amount requirements during each feeding. If you’ll be feeding your baby formula, be aware that most popular brands have special versions designed for premature babies.
You’ll need to burp your baby regularly during feedings. This ensures that all air is out of their bellies, so that there’s more room for milk. Signs that your baby is not getting enough milk include crying without tears, sunken eyes, and fewer than six diaper changes in a 24-hour period.
If you see your baby sucking on his or her fist, offer them a feeding. However, do not force them to eat if they resist. Talk to your doctor about how to get them to eat more if feeding time is a problem.
How to Bathe a Preemie
Before giving your preemie a bath, pay close attention to their belly button. If a portion of the umbilical cord is still attached, or if it’s bleeding, give your baby a sponge bath instead of placing him or her in a baby tub – getting the umbilical cord wet can delay healing.
Once your baby is ready to get a bath in a tub, gather everything you need before getting started – since once you start, it’ll be pretty much impossible to walk away from the baby. Things you need include washcloths, baby soap, baby shampoo, a towel, a clean diaper, a change of clothes, and a thermometer.
Fill the baby tub with lukewarm water. Take the baby’s temperature before placing him or her in the water by putting the thermometer in one of the baby’s armpits. If the temperature is between 97.5 and 99 degrees, go ahead and bathe your baby (if it’s a bit lower, your baby could get cold in the water).
Leave the hair washing for last, also to prevent your baby from getting cold. Do not use soap on the face and use a different washcloth for the rest of the body. Do pay special attention to the neck, as it’s common for it to have dried spit and milk.
Sleeping
Sleep time is perfect after a bath. When it’s time for your baby to go to sleep, you can do what’s commonly known as kangaroo care. This is skin-to-skin contact with either mom or dad. When your baby is only wearing a diaper, place him or her on your bare chest, and place a blanket over the baby’s back. This type of care helps your baby regulate his or her body heat and breathing, as well as learn to recognize your scent, touch, and rhythm of your breathing.
Be aware that your preemie won’t sleep through the night. Use a soft or dimmed light and set a routine so that your baby will get used to a specific pattern. This may include rocking them to sleep, patting them on the back, or playing white noise in the background.
Instead of placing the baby in a crib, use a bassinet. The smaller space will feel cozier for your baby. When you are ready to put your baby in bed, place him or her on their back to avoid the risk of Sudden Infant Death Syndrome (SIDS).
Some preemies experience sleep apnea. If this is the case with your baby, the doctor will provide you with monitoring equipment. Familiarize yourself with it and ask as many questions as necessary until you are fully informed on how to use it and what each sound means.
Schedule Medical Appointments with a Pediatrician
It can feel like such a relief to finally bring your baby home from the NICU. But, keeping your newborn safe and healthy doesn’t end there. To ensure your baby’s health care journey is on the up and up, it’s important that you schedule medical appointments with your child’s pediatrician. They’ll be able to track the health of your child and monitor for any complications. Not only can your pediatrician provide the equipment you may need right then and there (such as a sleep apnea machine), but they can also talk you through the next steps and provide options as your child becomes stable enough to do things on their own.
Practice Self Care
Perhaps the most important step for caring for your premature baby is making sure that you’re caring for yourself too. Newborns are a full-time responsibility — especially if they require additional monitoring and care. So, before you experience caregiver burnout, take time to implement these self-care techniques into your routine:
- Be realistic about what you can accomplish and don’t be afraid to take a break.
- Accept what you’re feeling — your mental health is important and being honest with yourself about feelings of frustration or irritability doesn’t make you weak, it makes you human.
- Know your limits and understand that you don’t have to do everything on your own to be a great caregiver.
- Get help when you need it — whether it’s from a family member, loved one, or skilled home health care nurse.
- Look for coping mechanisms and implement them into your daily, weekly, or monthly schedules — understand that caring for a newborn is a marathon, not a sprint, so take time to recharge and recoup.
Schedule Your Child’s Care Assessment Today
At Care Options for Kids, we understand the unique challenges of caring for a child with basic to medically fragile health conditions. Our dedicated team of pediatric home health care nurses are here to support your family with compassionate, expert care tailored to your child’s needs. Contact us today to schedule an assessment and learn how we can help you navigate this journey with confidence and care.
Click here to start your journey to better care.
