Congratulations on the birth of your baby! No matter when your little one decided to make their way into the world, their birth is a beautiful reason to celebrate. For some families, that first hello just comes a little sooner than expected.
We know that parents and caregivers of pre-term babies may feel a bit more nervous about bringing them home, especially if they have additional instructions for care. However, the PANW team wants you to know that you are not alone here!
What To Expect & Prepare For When Bringing Home Your Premature Baby
We have an incredible, full-spectrum team ready to support you and help your baby thrive from the very start. One of those team members is Nurse Practitioner Jeanette Haughton, CPNP-PC. She’s committed to helping our patient families feel informed, empowered, and competent in caring for premature babies at home and in understanding what to expect as they grow.
Here’s what Nurse Practitioner Jeanette wants parents and caregivers to know when transitioning from the hospital or NICU back to your home and “normal life.”
1. PANW is here for you 24-7
First, and more importantly, we want you to know that Pediatric Associates of the Northwest is standing by 24 hours a day, seven days a week. Our nurse advice hotline at (503) 227-0671 is always staffed, and we welcome your calls.
If you are having a hard time determining what’s normal and what’s not, if you can’t tell whether your baby is eating enough, or if you have any concerns at all, our nurses are on tap whenever you need us.
2. Preemies are only sent home when they’re ready
Once you load your baby into the car seat and arrive home, they can feel more vulnerable and fragile than when you held and cared for them surrounded by a team of healthcare providers in the hospital. However, we assure you that babies are never sent home unless their care team knows they’re ready.
In fact, as tiny as your baby is, they have already passed their first rounds of tests, proving that they:
- Maintain and regulate their own body temperature when dressed appropriately.
- Are feeding well (or they’re on a feeding tube, which you’ll know how to work with before you go home).
- Sustain normal blood sugar levels between feedings.
- They can sit in a car seat/baby carrier for at least one-hour intervals without showing any signs of distress.
If your baby is released to go home, you can trust they’re doing well and that you have all of the information you need to take good care of them.
3. Remember to honor the corrected vs. chronological birth date
Preterm babies are categorized by their weight, and how early they were born (chronological birth date) relative to their due date (corrected birth date).
- Low birth weight: less than 2500 grams.
- VLBW (Very low birth weight): 1000-1500 grams.
- ELBW (Extremely low birth weight): <1000 grams.
- Full-term: 37+ weeks.
- Late pre-term: 34-37 weeks.
- Moderate: 32 – 34 weeks.
- Very pre-term: < 32 weeks.
- Extremely pre-term: < 28 weeks.
Once you bring your preemie home, we’ll assess their growth and development by subtracting the time difference between their original, full-term due date and their actual birth date.
So, if your baby was born two months early and they were born four months ago, they’re corrected age is two months, and we assess their development from that two-month-old lens. This recognition of their corrected birth date provides a more realistic timeline for their developmental milestones through about two years of age. At that point, they’ll be more or less caught up unless they were extremely pre-term or other diagnoses are present.
In the meantime, be patient. Instead of looking for significant changes or comparing them to other babies, focus on the small changes that occur day to day. Their little brains and bodies are working hard in there, and when you look back at where they started, you’ll see how much they’re growing, changing, and developing day by day.
In the meantime, our pediatric support team will notice any signs that more attention is needed, and we’ll intervene early to help them bridge that gap.
4. Additional prep you can do to feel more confident caring for a pre-term infant
If you’re getting ready to bring your baby home and want to feel extra prepared, we recommend:
- Taking an infant/child CPR class. This is something every parent can take part in, and it may be something age-appropriate siblings can participate in as well. Knowing CPR saves lives and can help you feel more prepared in the unlikely event of an emergency. These days, most infant and child CPR classes take place online, and then you book an appointment at the agency’s local office to demonstrate the physical skills. Multiple agencies offer these courses in and around the Portland area, among the most common being the American Red Cross and the American Heart Association.
- Having preemie-sized items. Your pre-term baby is much smaller than the average full-term infant, so be prepared. Buy extra preemie-specific diapers, onesies, and clothing so they fit a bit better. Before you know it, your little one will grow into the regular 0-3 month items waiting for them.
- Buy the right nipples. If you or other caregivers plan to bottle-feed your baby, they will likely need special preemie nipples that are ultra-low-flow because they may not have the strength to suck and swallow with the same vigor as their full-term counterparts. We’ll make sure that you have everything you need to support healthy feeding at home.
- The right thermometer. At this early stage, we recommend using a thermometer under the arms (in the armpits) or rectally. These are the most accurate options for taking a pre-term baby’s temperature.
Having preemie-specific clothes, diapers, and other relevant equipment makes it easier to go through your daily routines without having to make additional adjustments.
5. Getting comfortable with feeding may take time
It can take a little longer for premature babies to get the hang of feeding. The younger they are, or depending on other complications, they may struggle with sucking and swallowing. Be patient with yourself and the process. If your baby was in the NICU, they were on a regimented feeding cycle, and so you can work with that to start, modifying as your baby can eat more and gain more weight.
Remember that our board-certified lactation consultants, Katie Kennedy and Jennifer Siebold are always here to help.
Since pre-term babies may be weaker, they can also be slower feeders, and that’s just fine. It’s more time for you to be skin-to-skin with your baby. We’ll keep a very close eye on their weight through weekly appointments, and the feeding team will ensure their latch is working well. We may also recommend a fortified formula if we feel they need extra calories to boost weight gain.
6. Hold tight to your Baby Moon (and prepare others)
The concept of a Baby Moon is one that many cultures already honor; it’s the idea that mother and baby (and immediate family) should have at least two weeks to be together to bond and rest without a lot of visitors or outside activities. If you can, this idea is a good one to maintain in those first few weeks and months after bringing your baby home. It allows you all to adjust without juggling anybody else’s needs. Also, it helps protect your baby’s immune system.
Remember, in many cases, your baby is coming home before they were supposed to be out of the womb, so they are far more sensitive to (and easily overstimulated by) noise, lights, motion, and other stimuli. Most importantly, they have underdeveloped immune systems. Keeping them at home as much as possible, and limiting visitors, is wise until they’re vaccinated (which usually happens two months after they’re born, or by weight for the Hepatitis B vaccine).
It’s okay to say politely say “no” to visitors until you and your baby feel ready. If you do have visitors, remind them to:
- Stay home if they have any signs or symptoms of a cold or flu.
- Wash their hands with soap and water before handling the baby.
- Wait for the baby to be offered to them rather than automatically reaching out to take them.
- Move slowly, quietly, and gently, to keep from startling the baby.
Most loved ones are thrilled to help support you during this time and are itching for something to do to express their love and willingness to help. Consider having a friend or family member set up a MealTrain or a Care Calendar to help with chores or other needs so you can focus on the family and watch the love pour in.
7. Take care of yourself and keep your finger on your own pulse
Mothers of pre-term babies are doing extra work, and that can take its toll. Be on the watch for the Baby Blues or any signs of post-partum depression so you can get the support you need. Our Baby Hour parent group meets virtually every Wednesday and is a great way to connect with other new parents if you’re feeling alone.
These first few months or so are a good opportunity to keep the calendar clear of anything that isn’t a “must do,” so you can focus your time and attention on taking care of your baby and yourself.
PANW Will Support Your Return Home Every Way We Can
We are so excited that your pre-term baby “graduated” from the hospital and can return home. We also understand that it’s not always an easy transition, and you may need some extra support. Rest assured that your pediatric care team at PANW will monitor your baby’s development very closely and make sure your family has additional support and referrals if needed. Contact PANW anytime, and our fantastic team will connect you with the best resource to answer your questions and put you at ease.
