Babies born before 37 weeks are known as preterm or premature babies. According to the World Health Organisation (WHO), approximately 15 million babies are born preterm each year and the number continues to rise.
Since premature babies are delivered before their due time, some of their internal organs may not be fully developed, thereby making them more vulnerable. Consequently, premature babies spend a few days in the neonatal intensive care unit (NICU) before parents are permitted to take them home.
The transition from hospital to home can be worrisome for new parents as a premature baby requires special and undivided care and attention. But parents must rejoice in the fact that their preterm baby is finally stable enough to be moved from the hospital to the comfort of home. By following the instructions of doctors religiously and keeping in mind some vital tips, parents can nurse their premature baby back to health.
Feeding the baby correctly
Ideally, Mother’s own milk is best nutrition. But premature babies have more nutritional requirements, so feeding a preterm baby is an amalgamation of breast feeding along with supplements and expressed breast milk with fortifiers. So caregivers should be well-versed with the feeding techniques (paladai, spoon feeding, tube feeds), avoiding spillages leading to better growth and development.
A preterm baby requires 8 to 10 feeds a day and in intervals not exceeding four hours. Comprehension of the cues given by the baby is important both for initiation and completion of feeding, to have adequate feeding as well as avoid overfeeding. Do not forget to burp the baby after every feed.
Maintaining the ideal temperature
While in the hospital or the NICU, the doctors take care of the premature baby’s body and room temperature. Maintenance of body temperature is paramount importance for baby’s growth as the energy consumed should not be used up in maintaining body’s temperature.
Once at home, parents should pay special attention to maintaining the ideal room temperature, which is 20-23 degrees Celsius. Similarly, the baby’s body or axillary temperature should range between 36.5-37.0 degrees Celsius. Proper layering should be done. Baby’s temperature should be assessed by comparing hands and feet with the abdominal temperature. Try to avoid over heating as well as low temperatures. In case of doubt, try skin to skin contact for better temperature regulation.
Practicing kangaroo care
Kangaroo Mother Care, now better as kangaroo family care is an essential modality of care of premature babies. Caregivers should learn it at hospital and once home, should practice it with their premature baby regularly. Kangaroo care is a special method of holding the baby close to your chest to establish skin-to-skin contact.
Mothers, fathers as well as other caregivers, can practice it in a warm room by dressing the baby in a diaper, cap and front open shirt and placing him/her on their chest inside their robes or putting a cloth over, lasting till baby is comfortable. Practicing skin-to-skin contact with the little one can enhance bonding, promotes breastfeeding, stabilizes the baby’s heart and breathing rate, better temperature regulation, faster weight gain, gain in sleep time better development also parents have increased confidence and sense of control.
Helping the baby sleep accurately
For the first few months, parents should pay close attention to their preterm baby’s sleep requirements and habits. sleep is essential to brain development and optimizing physical growth. It is completely normal for the premature baby to sleep the day out and parents should ensure an optimal temperature, dim lighting and no noise in the room. Sleep baby on the back, never on the tummy or side, with head and face uncovered. Wrapping and swaddling have proven benefits. Additionally, parents should make sure that the baby is sleeping on a firm mattress without any pillows or extra blankets that may suffocate him/her, preferably on a separate cot. Skin to skin care sessions also encourage sleep.
Avoiding visitors and public places
The preterm baby’s immunity is very low and has a higher risk of catching infections and diseases. It is advisable to limit the number of visitors to your home for the first few crucial weeks, especially anyone with an illness. Do not allow smoking inside your house or near the baby. All visitors should wash their hands thoroughly before holding or touching the premature baby. Too many visitors can also overstimulate the little ones as preterm babies are extra sensitive to sounds and touch and get tire easily. Moreover, you should also avoid visiting public or crowded places lest baby’s exposed to unwanted infection or smoke.
The journey of a premature baby is a roller coster ride, more so for the parents. So the transition from hospital to home and from a premature baby to a mature, stronger baby can be trying and tiring. But regular follow-ups with the doctors, following all the necessary recommendations and devoting extra care and time to the young one can help the new parents and the newborn find stability and safety. Prematurity should not be seen as an encumbrance but rather a blessing to welcome your little one earlier.
(Dr Vivek Choudhury, MBBS, MD (Paed), DNB (Neon), Neonatology & Pediatrics, Apollo Cradle & Children’s Hospital- New Delhi)