Can you tell me about premature babies?

[littlemisscomper]

I may be looking after one for a while. He was born 10 weeks early. That was about 3 months ago. I don't know anything about him at this point so I was hoping for some advice on what to expect, what care he'll need etc. My knowledge on premature babies is very sketchy. Will he be drinking from a bottle or will he have some sort of feeding tube? Any medication he's likely to need? I guess developmentally he'll be similar to a new born and can just be treated as such but I don't know!

Well that very much depends on the baby. Some go home with tube feeds, some don’t. Some have additional needs. Why may you be looking after they baby? You can’t tube feed unless you’ve been trained and signed off as competent by the hospital.

Developmentally, basically count from when they should have been born (handy to know the estimated date of delivery and use that). Growth is also charted according to when they should have delivered, until their second birthday.

Feeding - as above, if needs tube feeding then you would have to be trained in doing this. I'd say that the majority of ex 30 weekers go home taking sucking feeds. Depending upon weight gain etc may well be on a prescription formula, which would need regularly prescribing by the GP.

Breathing: hopefully a 30 weeker won't be needing home oxygen. If they do, there will be quite a bit of organisation/training required, but you would get extra back up.

Immunisations are done according to when they were born, not when they should have been, so often have started these whilst in hospital.

Medications vary, according to what problems they've had. Many will be on some combination of vitamins/iron, though that can vary according to factors like whether or not they still need prescription milk.

Temperature control tends to be more of an issue than in term babies. They won't be let leave the hospital until they can maintain their temp well wrapped in a normal (solid sided) hospital cot. Bear in mind that SCBUs tend to be kept warm.

Illnesses: ex premmies are a lot more vulnerable to the winter illnesses. This time of year, the big danger is bronchiolitis: starts as a nasty cold, then feeding starts to go off, breathing gets faster and harder, and they can get very ill. Basically, if their feeding goes off, they need to see a doctor that day. They tend not to get a fever if unwell, though a few do, but instead are more likely to drop their temp. So a low temp is just as worrying as a high one.

My son was premature ten weeks and weighed three pounds at birth. He was normal until he had a stroke in NICU. He was just like any other baby he cried and ate and needed changing when wet or dirty. I had my DH's relatives scared to hold him when on oxygen but my SIL told them off for being reluctant to assist and told them he was needing TLC as any baby would.

Thanks everyone. EKGEMS, I'm sorry to hear about your little one. If you don't mind me asking, how soon after birth was his stroke?

I've heard the term 'adjusted' before. Would it be right to say that a 16 week old born 14 weeks early was '2 weeks adjusted'?

Obviously we can expect physical developmental milestones to be delayed, but I was wondering about things like smiling, and then later recognizing their name, the separation anxiety that would normally occur around 7 months, that sort of thing?

Yes your adjusted age guess is correct.

So..a baby would normally smile at 6-8 weeks, a baby born 6 weeks prem would smile at 12-14 weeks. It feels like a lifetime but all the more special when it happens.

Thank you! I guess as every baby is different there's no right answer to this one, but when they're considered fit to leave the hospital (at 3 months old in this case) would they be in any sort of routine or is it like having a newborn where sleep and feeds just occur as and when?

I can imagine (though this is just an assumption) that babies who've spent months in the NICU aren't particularity fussy to be held as the cot feels more familiar to them. Is it best to try and re-establish that need for human closeness with keeping them in the sling or in your arms most of the time, or would that just create its own problems?

When I got my prem baby home he lived in a sling. Different situation obviously but in addition to my need to have him close, everything I read suggested the more human contact the better for both physical and developmental reasons (google kangaroo care).

Sounds like there might be a lot of other things going on, but in general a close and warm bond between carer and baby is key for future development so I would try to build that however you can.

That's what I thought. Bowlby's theory of attachment and all that! What sling did you use, and would you recommend it? I have a Manduca carrier but I think that would swamp him, and I can't get on with those wrap slings that are just a sheet of material you tie around yourself. Are there any other specific products or equipment you would recommend?