For parents of premature babies, or “preemies,” there is nothing more exciting or scary than learning your baby is ready to come home. Good preparation and knowledge of what makes your baby’s needs different from full-term babies can make life much easier and the transition smoother.
Premature babies are babies born before 37 weeks of pregnancy. The United States has made steady gains in treating babies born too early. Due to the hard work of the medical community, public health officials, private agencies and others, the percentage of babies born pre-term in the United States has declined to 9.6 percent of all births. Many preemies grow up to be just as healthy, active and intelligent as their full-term peers. For the first few years of their lives, however, they need a little extra care to make sure they progress well and catch up.
The first step will be to select a pediatrician who is comfortable following your baby. Every infant needs a medical home, and your pediatrician will monitor your baby’s growth and development with a special eye for issues related to prematurity. At the time of discharge all of your baby’s vaccines should be up to date, any special follow-up appointments should have been explained and you should be comfortable with all medications or equipment your baby may need to go home.
A very important decision is car seat selection. Pick a seat that is meant for preemies and bring it into the hospital so the staff can test it to make sure it fits properly. Then, have it correctly installed by a certified car-seat technician. Car seats should always be in the rear seat, facing the rear and tilted back to protect your baby’s neck. This is the safest way for your baby to ride until that seat is outgrown.
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The baby’s bed at home needs to be safe. Every baby needs to sleep in his or her own bed, on the back. The mattress should be firm, without pillows, bumpers, heavy blankets or quilts. These are not safe as they increase the risk of Sudden Infant Death Syndrome (SIDS). It is safest for your baby to wear a sleep sack in an environment that is not too hot. Premature babies have a higher rate of SIDS, so it is very important to follow the latest recommendations for SIDS prevention, which your pediatrician will be happy to share with you.
The next question involves baby shots. Preemies are now given shots at the same age and in the same amount as term infants; your baby’s age does not need to be “corrected” for prematurity when timing shots. By the time your baby is 6 months old, all vaccinations for diphtheria, pertussis, tetanus, polio, hepatitis B, strep pneumonia and hemophilus influenza should be complete, protecting your baby from many infections that can cause serious diseases, including pneumonia and meningitis.
If your baby was born at less than 29 weeks or is diagnosed with a chronic lung condition known as bronchopulmonary dysplasia (BPD), it is likely that during winter months your doctor will recommend five monthly injections of a product that significantly reduces your baby’s risk of getting a very serious respiratory infection known as RSV. During flu season, all adults and children over 6 months of age who are around your baby need to be vaccinated yearly for the influenza virus. Babies under 6 months are not candidates to get the flu vaccine, so their protection requires that everyone in contact with them be protected against flu. Flu can be very dangerous to infants who were born premature. Remember that clean hands will protect your baby from these and other infections.
Specialty clinics such as the pediatric eye clinic, developmental follow-up clinic and intervention clinics for speech, occupational or physical therapy can all be effective for early detection or intervention for problems like lazy eye (strabismus), developmental delay or other specific problems.
Growth and nutrition are usually closely followed by the pediatrician, and sometimes a dietician, as these infants may have special nutritional needs or getting acceptance of solid foods may take special effort. The intent is to enable your baby to achieve his or her growth potential by school age.
On the whole, while preemies need special attention for certain needs, and the care given to full-term infants may need to be modified for them. But the majority of these special little ones grow into healthy children, ready for school by the time they are 5 years of age. Enjoy this precious time with your new baby and look forward to the many years of joy you will experience together.
Joanne Duara is a M.D./MPH student at the University of Miami Miller School of Medicine. Ilene RS Sosenko, M.D., and Shahnaz Duara, M.D., are neonatologists at UHealth – the University of Miami Health System. For more information, visit UHealthSystem.com/patients/pediatrics.