Guidance for looking after prem baby once home?

[minipie]

dd was born at 34 weeks and we brought her home at 37+2, she is now 38 weeks.

As far as we know (of course nobody can be sure) she has no particular ongoing health issues, touch wood, other than being small (she is now 5 lb 8 oz) and early which means eg she is sleepier and doesn't breastfeed as reliably as a term baby would.

I have various books on "looking after your baby" which set out guidance on what to do for your baby in each week/month, like when to try to get her into a regular nap pattern/bedtime routine, or when to start tummy time, etc, but they all apply to full term babies. How do I apply these to DD? Do I use her corrected age (minus 2 weeks at present so obviously the books don't even apply yet!) Or can't I apply these guidelines to her at all?

If that's the case, then is there a preemie specific book which could give me guidance? The ones I have seen seem to focus more on the hospital experience and medical issues rather than more basic day to day stuff.

Thanks

Congratulations on getting her home! That in itself is a huge achievement.

Our elder DD was born at a similar stage (32+6) and to be honest we just concentrated on sorting out the feeding for the first few weeks at home - lots of Velcro baby cuddles and not much else. I don't think we got into anything approaching a routine until about 12 weeks corrected, by which time I was desperate to have a bit if predictability and started to use The Baby Whisperer approach because it seemed to offer a bit of structure without strict clock watching.

I don't know of any books specifically about prem babies - maybe that's a gap in a crowded market!

I found it hard sometimes in the first year that my DD wasn't reaching her milestones (rolling, sitting, crawling) at the same time as other babies born full term at the same time and worried about developmental delay, neurological damage etc so be prepared for that. But she soon caught up - now she's 8 and one of the tallest in her class and doing great. I'm sure your wee one will be fine, so try not to worry.

Op you are right that the books seem to focus on the hospital. we were told that in some respects to work from her actual birth date, in others her during date, and in others just being prem would skew everything, but we weren't told which things went with which date, except that sleep and night/day confusion likely to fit an extended newborn period. so we've been trying to chill out and go with the flow! Dd now 9w actual and 2 adjusted

If it helps, my baby was born at 38+2 weight 5lbs 5oz, so was at 38 weeks the same size as your baby is. The only thing I did was disregard all the 'routine' advice on breast feeding for the first 12 weeks and just fed, fed, fed. Constantly. And didn't take him out much till he was a month old to protect from the cold and infections. (He is a 10 month old now). He hated tummy time anyway. The only routine thing I did was a rough bedtime routine but he'd be awake 45 minutes later hungry, but I kept him in a dark quiet room. The only thing you might want to take some advice about later is weaning. Otherwise, I would say go with the flow and don't worry too much about weekly routines. Also if it helps, I kept a diary of his feed/sleep patterns from about 6 weeks, and now he is on a fairly regular routine. So I waited for him to catch up a bit weight wise and then gently nudged him towards a schedule.

Congratulations to you all.

Firstly don't panic and worry about what you are doing. I am sure it's great.

I second the advice on ditch the books for now and enjoy. It's best to just get feeding established and the baby growing. The routines come later and there is plenty of time. I speak here as the parent of two prem babies, one at 34 weeks weighing 3lb13oz and the other at 32 weeks weighing 4lb12oz. The advice I hit was feed and sleep and worry about routines when they are older.

I didn't crack the sleeping feeding routine until about 6 months and even then night feeds went on until 15 months with my first and at about 12 weeks with the second but then he has always been a good sleeper.

Have fun and enjoy, take loads of photos to remember how small they are as you will soon forget.

Thanks all. Yes, Feeding is my number one obsession at the moment, as DD is still very sleepy for a lot of feeds, so a lot of persuasion is required to get milk into her! Any kind of routine or other "developmental stages" clearly have to wit till that is sorted. Sounds like it could be a while...

I bought 'Your premature baby and child' and 'the premature baby book', after scouring amazon for a while, these 2 books seemed the best i could find, both american i think, still browse through both occasionally

My DTs were born at 35 weeks, both just over 4lb. The only specific advice we were given was to not go longer than 3 hours between feeds (ha, as if!)) but that was because of size rather than prematurity. And One of them was jaundiced, but that can happen to any baby.
Both mine failed some elements of 6 week check as that's done by birth age rather than corrected age. That kicked off extra monitoring, they were having their eyes tested till they were 2 for instance.
They were always a bit on the small side until 18 months when they caught up. They're now both big strapping 9 year olds.

Oh and weaning, we were advised to wait the extra few weeks so they were at corrected weight. But you're a long way off that!

corrected age* not weight.

Congrats MiniPie on your DD. :) MiniPop was born at 30+1 and we brought him home at 36 weeks and I think he was about 5lbs when he came home. I bought the 'Your Premature Baby' by Nikki Bradford, which was an interesting read but most of it was about the hospital, which is of no use when you get home..! :D

I've always gone by corrected age for developmental purposes, but we were told that premature babies will do some things early, some things on time and some things late. So, we got smiles at the right time and he found his voice abotu the right time he should of, but MiniPop still can't grab his foot or roll over (he's 6 months actual).

I also noticed that once he hit his due date, he was more awake and alert.

For routines and tummy time I used his corrected age to go by and also just paid attention to see if he was ready. He still HATES tummy time with a vengence, but we persevere with it.

MiniPop had really bad reflux and tummy problems when we brought him home, so getting him into a routine actually helped with that a bit as he never got to the screaming hunger stage.

Try not to stress or worry too much (easier said than done I know), but do ask your health visitor or GP or even call your old team if you need too (I still do). You're doing an amazing job during a very hard time.

congratulations... Firstly dont pay too much attention to milestones, prematurity can cause disordered as well as delayed development so some things your dd may do at her corrected age and some at her real age.

ds2 was born at 28 & was very difficult to feed. As others have said, concentrate on feeding, cuddles & sleep. Everything else will follow in time

My triplets were born at 33+2 weeks. I concentrated on feeding and sleeping and didn't bother with books. For developmental stuff, go on corrected age for now. Also, don't let any visitor who even has a hint of a sniffle in and ask people to wash hands before having a cuddle, as it's RSV season and prem babies are more susceptible. My lot are now hormonal, grumpy, nearly 14 year olds.