Parenting a Premature Baby

Babies born too soon need extra care. Here's what to expect and how to manage the challenges.

Early Bird

Up close of newborn baby

When Darcy Milder's water broke at 4 a.m. on May 6, 2003, she and her husband, Randy, could have been any pair of expectant parents scrambling to get dressed, throwing clothes into an overnight bag, and loading their two sleeping sons into the car. Except that Milder, of Adel, Iowa, was only 28 weeks pregnant, and not nearly ready to welcome her baby into the world.

Within 52 hours of Milder's arrival at the hospital, Logan Milder was born, weighing a mere 2 pounds 4 ounces and measuring just under 14 inches long. He was immediately put on life support in the neonatal intensive care unit (NICU). "His lungs weren't mature enough to breathe, and he couldn't digest milk," says Milder. In fact, Logan was so fragile that his parents couldn't touch or talk to him. "His eyelids were so thin that he needed foam patches to block the light and his ears so sensitive that he wore earmuffs," recalls Milder. During his three-month stay in the NICU, Logan battled severe breathing issues, patent ductus arteriosus (a condition in which a passageway in the heart that normally closes shortly after birth remains open), and dangerously high blood pressure.

Finally, in July -- the month he was originally due -- Logan was released from the hospital. Because he still required oxygen and was vulnerable to infection, keeping him healthy was a daily battle for the Milders. "Since Logan still had tubes in his nose supplying oxygen, if he got congested, his oxygen level plummeted. To keep him from getting sick, we couldn't take him out of the house except to go to the doctor. We didn't even share Thanksgiving, Christmas, or Easter with our families, because we couldn't chance being around other people," says Milder. Now 3 1/2, Logan recently came off oxygen and is doing fantastic, says Milder. "The only sign of Logan's prematurity is his tiny size -- he's about as big as an average 1-year-old," she says.

Logan is one of approximately half a million babies -- about 12 percent of all births -- who arrive prematurely, or before they've reached 37 weeks of gestation, in the U.S. each year. The number of premature babies has increased by 30 percent since 1981, but the survival rate for these tiny babies has improved dramatically over the last few decades. "When I started my training in 1987, a baby who survived at 25 weeks gestation was quite amazing," says Andrew R. Barden, MD, medical director of the NICU at St. Luke's Hospital, in Cedar Rapids, Iowa. Although extremely premature birth still significantly increases a child's chances of dying before hospital discharge, "now our expectation is that a baby born at 25 weeks will live," he says.

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