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Premature birth

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Will have baby in next 2 weeks so somewhere between 32+4 and 34+4 what to expect?

14 replies

flippityflip · 27/02/2015 01:56

Posted about this in pregnancy but someone directed me on here, at my consultant appointment today I was told baby's growth had slowed even more and waters were still low,and that they would try and get me to 34 weeks (I am 32 currently) but that would be the longest they could foresee keeping baby in. Because the reason for the early delivery is slow growth I'm not sure what that means in gestational age,apparently baby is doing well ie strong heartbeat,good bloodflow through cord and good condition of placenta and moving well etc but 'skinny' hence measuring underweight/behind.Does this have any bearing on how early baby will be considered when born?
I am now trying to mentally prepare for a preemie. I obviously have a million and one concerns about baby's health but other random questions too,such as:
I had planned to breastfeed as with my other children,will that be possible?
What size clothes do I get for baby?(Currently measuring a skinny 3lb5 from scan today)
Is there any special equipment/stuff anyone would recommend?
Is it still ok to use handed down stuff for a preemie?
These may sound odd but I am totally panicked,everything was fine up until about 3 weeks ago and has got gradually more concerning.
I have some experience of neonatal unit as DC2 was in there for a bit after delivery due to meconium aspiration but no experience of premature babies as DCs all went to term as did all nephews and nieces etc.

Also did everyone go through this 'what have I done that was against the rules?' analysis I am going through now?I am analysing every thing I might have done wrong to cause it,the one bath I had that may have been too hot,the two times I ate soft egg yolks and whether I might have eaten the wrong type of Brie over Christmas/ate too much/ate too little/drank too little etc. etc.
Driving myself crazy.Hmm

OP posts:
flippityflip · 27/02/2015 08:32

Also another possibly stupid question, can preemies use standard car seats?I just saw lay flat ones which say safe for premature babies but the one I have doesn't say that.Does that mean it isn't suitable?It is a maxi cosi I think pebble or something?

OP posts:
sparky28 · 27/02/2015 11:33

I had my daughter last year at 34w 2 days. She was small for gestational age too at 3pds 3. She was delivered early though mainly due to my health (blood pressure problems, preeclampsia and then HELLP) rather than just her size, although that worried the consultants too. There were problems with the blood flow/resistance flowing away from the placenta too...the first few weeks were extremely hard (first baby though so a complete shock). We found bf hard but I preserved for nearly six weeks and we cracked it (I expressed and bottle fed her to start with). The hospital should have some prem clothes to lend to you if you need them. Something I wish I did, is to have sought a 2nd opinion when I was in hospital and the discussions started about getting her out early as I am small and was small at birth too (around 4pds but close to full term). Obviously I am not a medic but I would ask that if your health is ok and baby's only problem is that he/she is just on the small side, then surely it would be safer for he/she to stay put...maybe ask for monitoring at home or at the hospital too. Oh and we padded out her maxi cosi car seat with towels/blankets so it was fine. Good luck! I hope you get as far as possible in your pregnancy.

flippityflip · 27/02/2015 14:39

Thankyou!I am still taking it all in and making amazon lists etc. for anything I hadn't thought of.
What happens about your milk coming in?Presumably it takes a while longer than at term?

OP posts:
sparky28 · 27/02/2015 17:21

Took a few days I think but it was fine. Started expressing afew days later. It can take a while for little babies to get the hang of bf but they can get there in the end. Also, I saw a lactation consultant privately at home and this helped enormously but the neonatal unit will have a bf specialist there so just make yourself known to them (ours was always manically busy so it was difficult to get the one on one support)...

StrawberryMojito · 27/02/2015 17:42

I had dd at 34+4 after being induced because of severe pre eclampsia. She was 4lb2oz and dropped to 3lb 11oz following birth (though there were complications as she caught an infection after birth). Establishing bf was a nightmare as she was tube fed to start with with expressed bm and then got used to instant gratification, she didn't like having to work for the milk and would become frustrated. She also struggled with confusion as was then fed via a bottle of ebm which then led to latch problems. We persevered and she was exclusively bf by about 4 weeks. My milk came in just as quickly as with ds who was born at term.
Re clothes, buy early/tiny baby stuff but the hospital do clothe them whilst there if you are unprepared. We are donating our tiny baby stuff that we did buy to the nicu as dd is doing well and now into her newborn clothes comfortably (she is 9 weeks).

StrawberryMojito · 27/02/2015 17:44

Dd was 4lb 4oz when she left hospital and we used a normal maxi Cosi car seat.

StrawberryMojito · 27/02/2015 17:44

Good luck by the way!

minipie · 27/02/2015 19:38

DD was born at 34 weeks though was average size.

Expect DC to spend a few weeks in hospital, and spend most of that time asleep or having tests done (and not being too pleased about those...). Will be tube fed as won't be able to suck yet. Hopefully won't need breathing support but depends. Likely to have jaundice and spend some periods under the blue lights. Other likely (but minor) issues will include being unable to keep warm (so will need heated cot, hat etc), "desats" where their oxygen levels drop, and some level of reflux. They will probably have anti reflux meds and vitamins given by the nurses.

regarding BF: I suggest, get someone now to show you how to hand express colostrum into syringes. you will ideally start doing this ASAP after birth, it's slow and frustrating but will bring on your milk production. Then after a day or two your milk should come in and you can start using the hospital pumps (and pump in the night at home). Ask about hiring a hospital grade pump to use at home, they are much more effective. Ask them to do any top ups by mouth (which happens after the tube comes out) using a cup rather than a bottle so they don't get used to the bottle.

The usual pattern once they get strong enough to suck is for you to try to BF at each feed (the ones you are there for anyway), then they will give a tube feed top up. As pp said the tube feed top up can mean they aren't very motivated to BF. One suggestion (which I never tried) is to give the tube feed during the BF attempt, rather than after, so they associate gratification with BF.

It can be very tempting to switch to bottle feeding so as to get the baby home earlier (as home is not allowed till they can feed reasonably well and show weight gain) and the nurses may even suggest this, but it will be difficult to go back from bottle to BF, so if you really want to BF you may need to be firm and accept a slightly longer hospital time.

Car seat - we bought something called a "tiny traveler" which was a special insert to pad the seat out more for a prem baby. But used a normal maxi cosi seat with it.

Clothes - most "early baby" clothes start at 4lb something I think. Mothercare and Boots had decent prem ranges iirc. Depending on size and health you may find your baby is naked for a bit anyway. Hospital will have clothes to lend you.

Kit - the only prem specific thing we bought was the car seat insert. Weaning was tricky kit wise as the advice is to do it at 6 months actual so only 4.5 months corrected. So they cannot sit up yet in a high chair, or grasp food well. I used a Babybjorn bouncer chair on most upright setting, it worked well, and I spoon fed purées.

When you get home, be prepared for the baby to be a bit more tricky than the average newborn. Digestive issues (bad wind/reflux) are common and may mean your baby is more uncomfortable and less able to sleep well than the average. DD was very sleepy until her due date but from about 40-48 weeks (probably longer, it's a blur!) she would only sleep propped up on my chest or in a moving pram. (However she did have tongue tie which may have been more of an issue in this regard than being prem!)

Developmentally everything goes by corrected age so eg if an average baby smiles at 6 weeks then a 34weeker will only smile at 12 weeks actual/6 weeks corrected, and sometimes later as they have so many other things to be working on. It will feel like a very long "newborn" stage so do take care of yourself in any way you can - try to rest as much as possible now. tricky with other children though...

Please don't worry about having caused it - that is so so unlikely. Eating the wrong things would have caused an infection rather than slow growth.

Best of luck.

laurenamium · 27/02/2015 20:28

Hi OP I'm in a similar position! I'm 31+6 and my waters have gone. I'm currently in hospital as they are giving baby steroids to strengthen him up but he will be induced at 34 weeks if I last that long without going into labour or getting an infection. Hovering for the good tips! And good luck on your journey! Thanks

dancestomyowntune · 27/02/2015 20:57

I had my baby at 30+2 three weeks ago.

Dd was delivered by emergency c section because I had high blood pressure which was uncontrollable.

Dd spent three weeks in an incubator, and progressed to a cot this week. She started wearing clothes at about a week old. My mum and husband got them from Asda/tesco/mothercare and next.

My main concern was the thought that I wouldn't be able to hold her but this was unfounded. I had my first cuddle before she was 24 hours old.

Don't be afraid to ask questions, and go and look around the neonatal unit before the birth if you get the chance. My husband and mother did this and it really helped them.

Good luck

FamiliesShareGerms · 27/02/2015 21:14

Good luck with the next few weeks

Your milk will come in as normal, as it's birth that triggers it rather than a certain number of weeks gestating

Good advice upthread on establishing bf - the other thing to be aware of is that if s/he is on IV drugs these can make them sleepy and less inclined to feed

Also, prepare yourself for having a new born for 6 weeks longer than normal... So it will be longer before they sleep through, smile etc and all the other early developmental stages. You will be knackered Flowers

Don't worry about getting clothes and nappies immediately - hospital will have some to use until you can get some in the right sizes

The normal rule of thumb is that preemies stay in hospital until they reach their due date but there are lots of exceptions (both ways) but do prepare to be there a while. Investigate the best way to pay for long term hospital parking without needing a second mortgage Angry

flippityflip · 28/02/2015 07:31

Oh thankyou all so much this is all really helpful.I'm prepared for the reflux as both of mine had it before anyway and were poor sleepers.My youngest was tube fed for a couple of days because even though he was born at term he aspirated meconium so was in special care,I think the feeding is the thing I'm most concerned about but from memory our hospital has a pretty good team devoted to this so hopefully they will be able to provide some one on one advice if have problems. I'm so sore at the moment,I think because there's really no fluid round baby it is making everything inside feel sort of bruised,which is making me worry baby is sore too because doesn't have any cushioning!
Such a roller coaster with these little ones,good luck to you all and thanks so much for the tips,sending DH up to the roofspace to find my pump and hoping to nip to mothercare this afternoon to get a few bits.I like the look of the mothercare clothes because they wrap over baby and don't need pulled over the head.

OP posts:
sunflowered · 02/03/2015 08:05

dd was born at 33+5 and needed a bit more help than we'd expected - they had to incubate her because her oxygen levels were slightly lower than they needed to be, and once that was done they had to step down the help she was getting over a few days, which made things look very medical with many wires and tubes even though they had no concerns about her for the long term. Even though she was on oxygen it was possible to hold her when I finally got to nicu 24 hours after she was born. Every baby's journey is different, there was a 29 weeker opposite us who was out of the incubator and bf at 10 days but a 32 weeker who was in a lot longer than us. We also had a battle with feeding - my big flat nipples and her little mouth weren't well matched, but we had excellent support on scbu and then later at a local bf drop in. We brought her home when she could latch on and feed a little but she had an expressed milk top up in a bottle until she was about 12 weeks actual age. My milk came in in style on about day 3/4 I think and then just kept on coming, again the hospital were very good about helping me to express. I hope all is going as well as it can at the moment.

Crazyqueenofthecatladies · 04/03/2015 10:22

Good luck OP. Dd arrived at 27 weeks but we saw lots of 32-34 weekers while we were in scbu. many hospitals run a car seat challenge to check Los oxygen saturation levels in their seat before they go home, and the prem inserts are excellent - and much safer than shoving towels etc in to pad it out, which would compress in a crash leaving enough room for a baby to be ejected from a car seat ??. As for extra gadgets we bought a breathing sensor mat because dd had multiple blue baby incidents due to severe reflux, I loved that thing, she also had a womb sounds noise maker as prems tend to need noise to fall asleep after weeks of listening to beeps and brings in a unit (it also muffled the sound of her toddler brother during daytime naps). A good wrap sling suitable for prem babies is also invaluable. Because they need that physical closeness to you that they missed out on in the final weeks of pregnancy. Other than that normal hand me downs are fine (although it took Df five months to hit newborn sizes), and breast feeding is totally, totally doable esp if you're prepared to be a wee bit bloody minded. Dd fed for two years. Barley water and expressing at least 8-10, and pref 10-12 will have your milk in in no time.

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