A late preterm (near-term) infant is a baby born three to six weeks early, or between 34 and 36 completed weeks of gestation (almost 37 weeks). In the last six weeks of pregnancy, the baby usually gains about one half pound per week, so babies born a few weeks early are somewhat smaller than full-term newborns. Although late preterm infants are usually significantly larger than very premature newborns, they are still premature and have their own, unique health considerations.
Recent studies show that babies born just three to six weeks early are at greater risk for potentially serious health problems than full-term newborns. It is important for parents to be alert for the special situations or needs that may arise because their baby is just a few weeks early.
1. Feeding. Late preterm infants tend to feed slower and may need to be fed more often than full-term babies. In addition, a late preterm infant may not be able to take in as much breastmilk or formula as a full-term infant. It is essential these infants feed often for the first several days to help prevent jaundice. As with all infants, if a baby begins to refuse feedings, even for less than a day, the parents or caregiver should contact the baby’s nurse practitioner or pediatrician. Some late preterm infants may have problems initiating or maintaining breastfeeding; so a mother who chooses to breastfeed may need to ask for support from a nurse, physician or lactation consultant.
2. Sleeping. Late preterm infants may be sleepier than most full-term infants and may sleep through needed feedings, in which case she or he should be awakened to eat after three to four hours. All infants, including late preterm infants, should always be placed on their backs to sleep.
3. Breathing. Late preterm infants may be at greater risk for respiratory distress. If a baby seems to be having trouble breathing, parents or a caregiver should contact the baby’s nurse practitioner or pediatrician immediately or dial 911.
4. Temperature. Late preterm infants, like all preemies, have less body fat and may be less able to regulate their own body temperature than full-term infants. Like all newborns, late preterm infants should be kept away from drafts. Room temperatures should be warm enough to maintain the baby’s normal temperature. A good rule of thumb is to dress your baby in one more layer than you are wearing.
5. Jaundice and Infections. Late preterm infants may be more likely to develop jaundice, a symptom of a condition called hyperbilirubinemia that can lead to severe nervous system damage if not identified and treated early. Parents should make sure that their infant is screened for jaundice prior to discharge. Infants should be seen by their nurse practitioner or pediatrician within 24 to 48 hours of discharge; and should be seen at any time if their skin becomes yellow or if they are not feeding well. Late preterm infants have immature immune systems and may be more likely to develop infections and, like all babies, should always be watched for signs of illness or infection such as high fever or difficulty breathing.
For more information about late preterm infants, read about AWHONN’s Late Preterm Infant Initiative.