Bringing home a new baby from hospital is exciting but also daunting, especially for new mums; but with a premature baby, stress levels can go through the roof. Emirates Home Nursing team clinical manager, Doreen Setenane, answers your questions.
US figures put premature births at anywhere between 11-13% of all pregnancies and giving birth then looking after a pre-term baby requires specialist care as well as mum’s (and dad’s) undivided attention.
Harder to comfort with increased tendency to cry more, as well as follow irregular eating and sleeping patterns, premies may also have medical issues due to their early arrival, and require NICU care prior to coming home.
Before being discharged from hospital, your premie must reach a minimum agreed weight, be able to maintain body temperature in a regular cot/crib for 24-48 hours, and generally be able to be fed without supplemental tube feedings.
The transition from hospital to home is a big adjustment, but with resources such as the expert team at Emirates Home Nursing, parents will be able to get back on track and hopefully celebrate some of baby’s important milestones sooner rather than later.
Do pre-term babies need a warmer room?
Comfort and safety is paramount and a good starting point is baby’s clothing, with layers such as a vest, sleepsuit, blankets or baby sleeping bag basic requirements.
Premies can get cold quickly but higher temperatures have also been linked to cot death (Sudden Infant Death Syndrome). Keep the room at an ideal temperature of 18oC or between 16-21oC. A room thermometer comes in handy here.
Is his or her sleeping pattern likely to be different?
Yes and no. Babies vary when it comes to sleep patterns but there is a stronger chance that your premie will be hard to settle or sleep irregularly. Establishing a positive sleeping protocol is important, such as making sure the room is quiet with subdued lighting. As with full term infants always lie your baby on their back, never use duvets or pillows (light blankets only and tuck in firmly), and keep the crib well away from heaters/direct sunlight.
My premie has trouble breastfeeding, any advice?
Premies can tire easily or find feeding difficult. If breastfeeding, you can alternate with expressed breastmilk feeds. You can also buy bottles and teats suitable for pre-term babies, which have a slower flow and that are obviously smaller.
What do I need to be aware of at bath time?
How often you wash your baby will depend on how premature they are and the condition of their skin. Plain, tepid water is best and the use of soft cotton wool for nappy changing. Avoid regular moisturisers if they have dry skin and only gradually introduce approved baby products (the gentle variety). A daily bath isn’t necessary, just a ‘top ‘n’ tail’. And make sure you don’t bathe him or her in a draughty area, with the towel always close by.
Where can I buy premie-sized clothes and nappies?
Most major stores now sell baby clothes for every eventuality and the world of online shopping is a great go-to resource for smaller, specialist retailers. Once your baby reaches 3kg then regular newborn clothes should fit. The same goes for sourcing premie-size nappies.
Can premies be put in a regular infant car seat?
Pre-term babies can have breathing difficulties when sitting propped up and, where possible, you should recline them as far back as possible (and safe). You can also buy special premie car seats (Group 0) or babies up to 10kg. The usual safety touchpoints apply: get a car seat with a three or five-point harness system and you may need one with extra padding and head supports to keep baby’s head in position.
Is it OK to have visitors?
Yes, but limit visits initially to necessary doctor’s appointments as you don’t want to expose your baby to the risk of infection as their immune system is still developing. It’s also wise to avoid busy public places and sick visitors are a no-go!
EMIRATES HOME NURSING: PREMIE CAR PLAN
Following NICU discharge there is often a number of therapies that need to be continued at home, at least for the immediate future. These can include oxygen administration and tube feedings.
The Emirates Home Nursing pre-term infant care plan covers:
- Basic infant care including bathing, skin, cord, and genital care, temperature measurement, dressing and comforting
- Post-circumcision care
- Post tongue-tie care
- Nutritional care including oral bottle feeding, tube feeding and assistance with breastfeeding
- Administration of required medications, proper storage, dosage, timing, and recognition of potential signs of toxicity
- Assessment of clinical status, including understanding and detection of the general early signs and symptoms of illness, as well as signs and symptoms specific to an infant’s condition
- Infant safety precautions, including proper infant positioning during sleep and proper use of car seats or car bed
- Oropharyngeal and tracheal suctioning to maintain clear airways
- Management of nasal cannula
- Management of CPAP or mechanical ventilation to provide positive pressure ventilation
- Tracheostomy management for premies with upper airway abnormalities or, occasionally, for infants who cannot be weaned from assisted ventilation
- Provision of information regarding immunisations given, and schedule for next immunisation round
- Hygienic cord and skin care at home to prevent infection
- Infant cardiopulmonary resuscitation and emergency intervention