Leaving the Hospital
Taking any newborn home from the hospital can be unnerving, but caring for a preemie can be even more intimidating. "At the time of discharge, ask the neonatologist if he or she has any recommendations for your child," says Dr. Barden. Often, he or she can suggest a local practitioner who is experienced in treating children born prematurely. Choose someone you feel comfortable with for the long term. "It's important to have ongoing, consistent medical care by one practitioner -- be it a pediatrician, family physician, or nurse practitioner -- who sees your baby regularly," says Dr. Barden.
The NICU staff should be able to advise you on choosing a car seat that will work well for your child. Babies weighing less than about 4 pounds are usually given an oxygen saturation test while sitting in their car seat to ensure that they can maintain an open airway while in their seat, explains Dr. Barden. "Some very small babies need to use a car bed instead to maintain appropriate oxygen levels," he adds.
When it comes to how often and how much babies need to eat, check with your child's doctor, as different babies have different needs. In general, though, premature babies need to eat every four hours until they reach their original due date, explains Dr. Barden. "After that, they can usually be fed in exactly the same way as other babies." Finding clothes small enough to fit a preemie can require a little digging. "Most of the 'preemie clothing' I found at local stores was made for babies weighing about 5 to 7 pounds, so they were enormous on Logan at first," recalls Milder. To find a good fit, she ended up ordering bodysuits, gowns, and sleep sacks online. Another tip: Opt for clothing that snaps up the front rather than zippers, so you can easily feed the wires for monitors and other equipment between the snaps.
Guarding Against Illness
You will need to be especially on guard against respiratory illnesses, which can be particularly troublesome for preterm babies. "Many times, if preemies acquire viruses such as respiratory syncytial virus [more commonly known as RSV] or influenza, they will be sicker, so it's important to avoid them, particularly if your child has underlying heart or lung disease," says Dr. Barden. His recommendations: Don't smoke, and limit your newborn's exposure to other children.
Finally, be aware that premature babies face an increased risk of sudden infant death syndrome (SIDS) and that the timing of their risk differs from that of full-term babies. "The peak incidence of SIDS for term babies is 14 weeks," says Donna R. Halloran, MD, assistant professor of pediatrics at Saint Louis University School of Medicine. "Preterm babies born between 22 and 27 weeks' gestation tend to die from SIDS at 20 weeks -- six weeks later than full-term babies." Her advice: Be extra vigilant about following SIDS risk-reduction guidelines, and stick with them for a full year. Here's a refresher: Always put your baby to sleep on his back in his own crib, don't smoke, don't let him become overheated during sleep, and keep soft toys and loose bedding out of his sleep area.