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Caring for your preemie

It happens from out of nowhere. You're chugging through your pregnancy -- months from your due date -- when suddenly you're told you're having the baby NOW. Terrifying, yes. But fortunately, South Florida is a good place to be if you have to go through this.

In fact, mothers are sent to South Florida from all over the state, Latin America and the Caribbean to have their preemies because there are several top hospitals with Level 3 Neonatal Intensive Care Units.

That is the highest level of NICU, for babies who are born at 32 weeks of gestation or younger, or who are critically ill or require surgery. Level 3 units are at Joe DiMaggio Children's Hospital at Memorial Regional in Hollywood; Baptist Children's Hospital; and Holtz Children's Hospital at Jackson Memorial in Miami.

Any baby born under 37 weeks of gestation is considered a preemie, and will be admitted to the hospital's NICU for observation and treatment. Survival rates are increasingly high for babies born at 26 weeks and up, although some are at risk for disabilities later on.

Babies born after 30 weeks of gestation have a greater than 90 percent survival rate.

Once your baby is released from the NICU, he is on his way to growing into a perfectly healthy child.

Here are some special issues you might face along the way, from the book Preemies, by Dana Wechsler Linden, Emma Trenti Paroli and Mia Wechsler Doron, M.D.



Post questions and connect with other local moms in our Babies and Toddlers forum.March of Dimes

Preemies Today

Your preemie did not have enough time in your womb to get all of your antibodies, so his or her immune system is weaker than a full-term baby's. It is very important that you limit your baby's exposure to colds and flus.

  • Do not be shy about making sure visitors scrub carefully before seeing your baby. And don't let anyone visit who has been exposed to any contagious illnesses.
  • Small children should keep their distance from your preemie. If there are small iblings, make sure they wash their hands every time they come into the house and are kept away from the baby when they are sick.

  • Do not let anyone smoke around your preemie.

  • It is good to take your preemie outside, but don't expose him or her to extreme temperatures, as your baby has trouble regulating his or her temperature.

  • Avoid crowded indoor places like malls and restaurants until your pediatrician says it is OK.

How often your preemie is seen by doctors - and what kind of doctors - will depend on what problems he or she faced in the NICU. But here are some guidelines:

  • Synagis shots: This is a vaccine to protect your baby against RSV, a respiratory virus that can send your preemie back to the hospital. Preemies born under 32 weeks are generally eligible for these monthly shots - how many months will depend on your insurance, but it usually for 6 months to a year.

  • Develpmental follow-up clinic: Two to three months after your baby's due date, you should take your baby to your hospital's follow-up clinic where they can be evaluated for cognitive development, motor skills and behavior. The doctors will determine whether your preemie is developing normally, or whether there are areas in which he or she needs extra help.

    You can expect that your baby will have regular visits to this clinic until he or she is 2 or 3 years old. At that point, your child may move on to a clinic for older children, or to a more specialized clinic of he or she has continued medical issues.

    As a guideline, you can expect your baby to have developmental lags equivalent to the amount of time they were born early (so a baby born at a gestational age of 30 weeks should hit his or her developmental milestones 10 weeks later than an average baby), but by the age of 2 your preemie should be on par with other children his or her age.

  • Eye doctor: Your baby will probably be tested in the hospital for retinopathy of prematurity (ROP) , a condition that affects some preemies - mostly those born before 28 weeks. A simple eye exam can determine whether your baby's retinas are developing normally, and it is best to do this every few weeks until your baby is 40 weeks old.

    Even if everything is normal, your eye doctor will want to follow up at 6 months and then again at a year and a half.

  • Pediatrician: While your child may need to see some specialists, a regular pediatrician will be appropriate for most preemies. You will probably want to pick one affiliated with the hospital that cared for your preemie.

  • Vaccinations: Your preemie can get vaccinated on the same schedule as full-term babies. You might want to consider talking to your pediatrician about an alternative schedule to split up some of the sessions, so that your baby is not getting so many shots at once.

Your baby will have two ages for the first two years:

  • Gestational age: Based on your last period before getting pregnant, it is usually expressed in weeks.

  • Adjusted age: How old your child would be if it had been born on his or her due date. Many of your baby's developmental milestones will happen based on this age.
  • Some companies like Baby Gap and Carters make preemie size clothing, but don't buy more than a few outfits. By the time your baby is big enough to wear clothing, he or she will have almost outgrown this size. Instead, invest in the NB size, which your baby can grow into. The Gerber brand runs fairly small, so your baby will fit into that first.

  • Huggies and Pampers make preemie size diapers.