No woman ever expects to give birth prematurely, yet about one in eight American moms deliver before their 37th week of pregnancy. We've pulled together a guide to nurturing your baby in the NICU (neonatal intensive care unit) and at home.


Breastfeed Your Preemie, If You Can

Because preemies grow at a faster rate than full-term newborns, they have special nutrient needs. Preterm formulas can provide all the nourishment your baby needs to develop, but your breast milk has one advantage: It contains antibodies that will protect him from infections his immune system can't fight off. "As soon as her baby is born, a mother will start producing milk," says Toby Debra Yanowitz, MD, a neonatologist at Magee-Womens Hospital of the University of Pittsburgh Medical Center. "We see babies born at 24 to 25 weeks whose moms start pumping within hours of delivery." Babies born before 32 to 34 weeks are usually too immature to suck from a breast or a bottle, but NICU nurses will feed your milk through a tube inserted into your baby's nose or mouth.

Perhaps one of the best arguments for pumping (which you need to do every three hours until your baby can nurse) is how it will make you feel. "With their baby in the NICU, a lot of moms feel helpless," says Mandy Brown Belfort, MD, a neonatologist in the NICU at Children's Hospital Boston. "Breastfeeding gives you a sense of empowerment because you know you're the only person who can provide this for your baby."

Hold Your Preemie Close

Bonding with a baby in the NICU can be tough. Many preemies are attached to feeding tubes, IV lines, and ventilators. To top it off, they're sleeping in a plastic-enclosed isolette. "We try to get parents involved early," explains Dr. Yanowitz. "As soon as the baby is stable, we encourage 'kangaroo care.'" It's called this because of the way you hold your baby: directly on your chest, under your shirt. Studies have shown that skin-to-skin contact can help your baby maintain body warmth, gain weight, sleep deeply, and reduce stress. Plus, it gives you the perfect opportunity to bond with your newborn.

Help Your Preemie Sleep Right

Sleep apnea (when a baby stops breathing for 20 seconds or more) is a common condition in preemies. "We monitor for apnea in the NICU, and a baby can't go home till there is no apnea for a full week," says Dr. Yanowitz. Unlike most newborns, babies in the NICU are positioned on their tummy to help expand their underdeveloped lungs. This is safe in the hospital because preemies are on a breathing monitor and under the watchful eye of an attentive staff. At home, however, you'll need to lay your baby down to sleep on his back. "Preterm babies are at a higher risk for SIDS," says Dr. Yanowitz.

Another sleep ritual you'll have to get accustomed to: waking your infant for a feeding every few hours. Preterm babies don't have a lot of reserves and need to eat more often in order to catch up to their full-term peers.

Take Your Preemie Home

Most preemies go home on or around their original due date -- the average is 36 to 38 weeks, depending on how premature she is -- and the majority do so without needing any special equipment. Even so, you'll have to take precautions. After she leaves the NICU, your preemie is still extremely susceptible to viral infections, especially RSV (respiratory syncytial virus), which can lead to breathing problems and even another stint in the hospital. "Buy some alcohol-based hand gel and ask everyone to use it. And don't allow anybody who is sick to hold the baby," cautions Dr. Belfort. To keep your preemie super safe and healthy, Dr. Belfort also recommends that all family members and caregivers get a flu shot.

Finally, try your best to keep your home as peaceful as possible. Loud music, bright lights, and lots of commotion can be especially upsetting to premature babies. "Every infant is different," says Dr. Belfort. "But preemies can be particularly sensitive to crowds, light, and noise."

Mom-to-Mom Advice on Preemies

Accept help! If a friend offers to watch your older children so that you can be in the hospital, or your neighbor wants to make you meals, or your mother wants to clean your house -- let them!-- Katie Agate; Pittsburgh, Pennsylvania

Mom to Sawyer, born at 24 weeks

In those first days, I was in a state of disbelief, confusion, and denial. So I checked out every book on prematurity I could find in the library. It helped me realize that my son's premature birth was not my fault.-- Holly Maudsley; Winnetka, California

Mom to Asher, born at 27 weeks

Don't get hung up on what's "normal" or whether your baby has "caught up." Forget the charts, ignore the books. What your baby is doing will be different, and that's okay.-- Justine Zammit; Canoga Park, California

Mom to Joshua, born at 33 weeks

Best Web Sites for Info on Preemie Care

Check out the comprehensive guide to premature birth, including a useful glossary of the new NICU language you'll need to master. You can also order the video When Baby Comes Early: A Parent's Guide to Prematurity ($45), which introduces parents to life in the NICU, neonatal staff, tests, equipment, and procedures.

Specializing in products that were designed for preemies by healthcare professionals, this site offers everything from teensy diapers and pacifiers to made-for-preemies swaddlers and oral suction devices.

You'll find an abundance of clothing and accessories for premature babies as small as a pound at the website Nurture Palace.

Read about another mom's experience raising a son born prematurely on our Following Elias blog.

All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

Parents Magazine