Hooray! The moment you’ve been anxiously anticipating (for weeks, or maybe even months) is finally here: You’re heading home with your premature baby. Chances are you never took a prenatal class called “Caring for Premature Babies.” But after your neonatal intensive care unit (NICU) experience, you know more than you realize. One thing you’re likely already aware of is how different your baby is compared with full-term newborns.
It’s normal to be nervous, but there are ways to simplify the transition from hospital to home-sweet-home and make caring for your preemie as stress-less as possible.
What to expect when bringing a preemie baby home
While you’ve likely been dreaming of this day for a long time, taking your premature baby home may feel intimidating because you no longer have the entire NICU staff on hand for support. But knowing what’s in store can really help, especially because the experience is a little different than for full-term babies.
- You might need some extra equipment. Some preemies require extra help from at-home monitoring equipment for extra oxygen or for conditions like sleep apnea. If your baby is going home with an apnea monitor or oxygen equipment, make sure you know how to read and operate all the buttons and knobs, and know what to do if an alarm sounds. Now’s the time to ask questions, rather than trying to decipher some strange beeping noise at 2 a.m.
- It can be trying at first. Premature babies need to be fed more often because their tiny tummies can’t hold as much food, and as a result, they don’t sleep as deeply or for as long as full-term babies. To the sleep-deprived and already jumpy preemie parent, this can be difficult, but it won’t last forever. While it seems like a distant dream, soon enough your preemie will sleep through the night just like his full-term counterparts.
- Expect glitches. Things might not be perfect at first and your new life at home might come with some bumps in the road. Do consult your pediatrician with concerns, but also remember that the NICU experts wouldn’t have sent your baby home unless they felt you were both ready.
Tips on bringing your preemie home
Even though you’re no longer in the NICU, you still have a support network available to help once you get home. Here’s how to take advantage of it:
Read This Next
- Before you go, say "yes" to nesting. Most hospitals offer some form of "nesting," or staying overnight with your premature baby before your child is released. Typically, nesting takes place in a private room set aside for preemies and parents. Nurses and other staff are available at the press of a button, but you take care of your child by yourself throughout the night, which can definitely boost your confidence. Knowing that you can successfully feed your baby, change his diaper and check his monitors should really help ease your mind as you head home.
- Save the lactation consultant’s number. If you’re going to nurse your preemie at home, it’s best to get a pro’s help before your baby checks out of the hospital — and take his or her number with you. Preemies can present special breastfeeding challenges (like keeping your sleepy sweetie awake long enough to get in a decent feeding). A lactation consultant can help with that as well as issues like latching on, establishing your milk supply and getting used to pumping. Speaking of pumping, you’ll probably want to rent a hospital-grade breast pump for a few months after you get home, which is likely covered by insurance under the Affordable Care Act.
- Take a CPR class. Most hospitals require that you learn baby CPR before checking out with your premature baby, and many offer on-site classes. If yours doesn’t, contact the American Heart Association for info on classes in your area.
- Stock up on preemie equipment. Your premature baby will need a special wardrobe and other pint-sized items. (Hang on to one of those teensy onesies for his scrapbook. In a couple of years, you won’t believe he was ever that small.) Be sure to stock up on preemie diapers too. If you can’t find them at your local big-box store, look online. You may also need a special car seat made for low-birth-weight babies or at least an infant seat with a newborn insert that will cradle his smaller-than-usual frame. Some hospitals have loaner car seats, so ask before you leave.
- Remember back is best. Note that some preemies may have to sleep on their sides because of lung issues, so ask your doctor about sleeping positions. But for most babies, back is best, which is especially important for premature babies because they're at greater risk of Sudden Infant Death Syndrome (SIDS). Leave blankets, soft bedding, pillows and stuffed animals out of the crib. Maintain the room temperature between 68 and 72 degrees Fahrenheit. Keeping the room cool can reduce the risk of SIDS. Additionally, avoid smoking and make sure your baby goes to his regular check-ups.
What to expect when caring for a preemie at home
Even though your preemie has received the okay to head home, that doesn’t mean he'll look or act like a full-term newborn just yet. Here's what to expect:
- He’s (still) smaller. Your baby was born tiny and it’s likely that when he leaves the hospital, he’ll still be smaller than a full-term newborn. (Many healthy premature babies are released well before their original due date.) So instead of a robust 8- or 9-pounder, you’re caring for a premature baby who may tip the scales at barely 5 pounds. But remember, small doesn’t necessarily mean frail. If your baby was healthy enough to come home, he’s strong enough for you to handle him without fear of hurting him. And do yourself a favor: Have a short explanation ready ("He was born early, so he’s still catching up") for anyone who raises an eyebrow about his age-to-size ratio over the next few months.
- He’s much more susceptible to germs. One very important thing to know about caring for premature babies: Their immune systems weren’t fully developed before birth, so they get sick more easily than full-term babies. That means you must be extra careful for a while. Avoid public places and too many visitors.
- He gets tired faster. It’s exhausting for preemies to simply be awake, much less in an alert state or nursing. That’s why caring for your premature baby may be all-consuming, at least for a while. He’ll spend less time in deep, restful sleep than a full-termer and he probably won’t sleep through the night as soon as other babies. Your preemie will need to eat more often and get tuckered out from nursing. (The sheer physical effort of sucking and swallowing is huge for a preemie.) So don’t worry as much about getting your preemie (or yourself!) on a sleep schedule at first.
- He won’t be on a "newborn" schedule until his due date. When you’re caring for a premature baby, it’s best to ignore the typical infant milestones and consider your child’s adjusted age. That means your preemie won’t act like a full-term newborn until at least his due date (and possibly not even then). So if your baby was born eight weeks early, he won’t be a "newborn" until he’s at least 2 months old, and so on.
Premature baby care tips
At first, caring for a preemie can be trying, both because you’re short on sleep and you’re worried about your baby’s fragile status (even though he’s stronger than you think). In the beginning especially, these tips can make preemie parenting a smoother ride.
- Learn to swaddle. If born full-term, your preemie would have still been in the womb, which is why the security of the swaddle is even more important. Get help learning to swaddle your little one from the nurse before you leave the hospital and keep practicing until you can do it with your eyes closed. Though preemies still don’t snooze as deeply, swaddling does help.
- Don’t feel badly about waking him up. They say you should never wake a sleeping baby, but when it comes to preemies, it can be a must because they’re likely to sleep through feedings if you don’t. Many preterm babies don’t start off breastfeeding for a variety of reasons, but once they start, it can be hard to keep them awake during a session. If your little one falls asleep constantly during feedings, try burping her, switching positions, singing a vibrant song, rubbing his forehead with a cool towel or changing the scenery.
- Set ground rules when it comes to visitors. Family members eager to meet your baby may not understand that preemies are more prone to illness, so you’ll have to be firm about telling them that your baby isn’t ready to be passed around (but reassure them that the day will come). Always err on the side of caution. Postpone visits from anyone with a cold (especially curious preschoolers or toddlers), and of course, no smoking around your baby is a no-brainer.
- Get the support you need. Keep in touch with other preemie parents who were at the hospital with you after you leave the NICU. You’ll be amazed at how much extra time you have to text when you’re burning the midnight oil breastfeeding your sleepy preemie. Additionally, take a parenting class at the hospital to get support from others who know what you're going through. If you think you have postpartum depression, be sure to tell your doctor immediately so you can get the help you need. Hormone fluctuations post-pregnancy are normal, but those coupled with the lack of sleep and the anxiety of caring for your teeny baby can sometimes feel like too much.
It’s normal to have some less-than-perfect moments with your premature baby, especially in the early days as you get the hang of caring for him without the security of neonatal physicians and nurses nearby. With each day, though, you’ll get a little more confident, your baby will become better at communicating his needs, and you’ll find your rhythm, just like any other parent-baby team.
And the good news: Most preemies catch up completely by the time they’re toddlers. Your little one likely won’t be little for long.
Yes 
No 
Trending On What to Expect
