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Parenting Preemies

By: Ma. Jocelyn A. Niere-Quidlat, MD, FPPS, DPSAMSParenting Preemies

Babies are a source of joy to parents. Many couples look forward to having their own healthy little one. But what if he/she comes earlier than expected?

A premature infant is defined as one who is born before 37 weeks’ of estimated gestational age. A preterm infant is born between 34 and 36 6/7 weeks of gestation. Present advances in medical technology have dramatically improved the survival rate of premature infants and now almost 100% of infants born at 34 weeks of gestation survive. In fact, infants born at 24 weeks of gestation have a survival rate of 40% to 60%.  However, premature babies have more problems compared to those who are born full term – they are vulnerable to a wide range of complications because they did not reach the full 40 weeks of developing safely in the mother’s womb.  Some are born healthy while some have serious problems such as heart conditions, bleeding in the brain, poor kidney function, jaundice, and anemia.  The immune system of premature babies is also immature, hence they easily succumb to infection. 

Premature birth, followed by a rigorous excursion through the neonatal intensive care unit (NICU), is very stressful and may even be traumatic.  Health and developmental problems in these infants are also associated with higher rates of psychosocial symptoms in the parents. Stressors for the parents are meeting the preterm baby’s daily needs, the heavy financial burden, and the strain of preserving marital and familial relationships through infancy that may lead to a dysfunctional family. Providing developmental information to parents and giving strong emotional support to the family may serve as protective factors for better adaptation to the situation, improved resistance to risk factors, and may contribute to a successful outcome of a difficult situation.  Studies have shown that the long-term outcome of prematurity is largely influenced by the individual responses of each caregiver to the infant and by the quality of the caregiving environment. 

How do you care for your premature baby once he or she is home? The family should be educated about how to deal with their new bundle of joy and here are some guidelines for them with regards to caring for their late preterm infant (born after 32 weeks but before 37) at home:

1. Feeding

  • Late preterm infants usually eat less and may need to be fed more often.
  • They have difficulty coordinating sucking, swallowing, and breathing during the feeding and thus may need to be observed more closely while eating. Parents should discuss with the pediatrician the amount of feeding, weight gain, and expected growth of the premature baby. Appropriate feeding techniques should be learned as well as recognizing the baby’s cues regarding hunger, feeding tolerance, and when feeding should stop.
  • Some late preterm infants may feed well initially while in the hospital and then become tired and feed poorly at home.  Families should contact their primary care provider if the infant’s oral intake has decreased.
  • Infants should have five to six wet diapers for every 24-hour period.

2. Sleeping

  • Late preterm infants may be sleepier than full-term infants and sleep through feedings, in which case the family should wake the infant to feed.
  • All infants, including late preterm infants, should sleep on their backs. This will decrease the incidence of Sudden Infant Death Syndrome (SIDS) also known as cot death.

3. Temperature Regulation

Late preterm infants have less subcutaneous fat and may have more difficulty regulating their body temperature than full-term infants. If the environment is cool, late preterm infants should wear hats to prevent heat loss. Families should be aware of their primary care provider’s protocol for assessing an infant’s temperature.

4. Jaundice

Late preterm infants are at greater risk for jaundice (yellowish discoloration of the skin), so families should be taught how to look for the condition.

5. Infection

  • Families should watch out for signs of infection such as fever, difficulty of breathing, and/or lethargy since late preterm infants are more prone to develop infections than their full-term counterparts.
  • Families should minimize exposure of late preterm infants to crowded places.
  • Families should practice good hand washing.

6. Car Safety Seat

Minimize the amount of time late preterm infants are placed in car seats until the infant demonstrates they have achieved good head control.

7. Touching and Handling

  • The importance of positive touch and close skin-to-skin contact or ‘kangaroo care’ is encouraged. Dress your infant in only a diaper in a warm room at home. Place him or her on your chest and then turn their head to one side so that his or her ear is against your heart. Studies have shown positive effects, such as a slightly improved result on the Neonatal Behavioral Assessment Scale. Kangaroo care enhances parent-child bonding, promotes breastfeeding, and improves a premature baby’s health.
  • Massage therapy is also encouraged and may result in better weight gain.

Do bring your premature baby for a regular check-up with your pediatrician. Monitoring their growth and development is very important.  Do not hesitate to bring your baby to the doctor anytime you deem it necessary.

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