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Premature Expectations

By Candace Campbell, DNP, RN, CNL

Premature Expectations

During a normal pregnancy that goes to term, parents have time to work through various stages of planning and anticipation as they prepare for their babe’s arrival. When your baby is born prematurely, that all suddenly changes.

Joy, grief, fear and despair—you experience the range of emotions. The dream of the perfect birth and all of your well-made plans are disrupted. Even if you’ve been confined to bed rest for some concerning complication, even when you know your chances of going “the full 40” are slim, early labor still shocks most women.

And even though we can put a man on the moon and navigate the deep reaches of space, we still do not know exactly why or when a woman will go into labor. Each year, some 500,000 premature babies are born—about 13% of all live births in the US. Prematurity is as common today as polio was in the 1940s.

Also read: Taking care of your premature baby

New realities around prematurity

With a premature birth comes the realization that you’ll be separated from your baby while she’s in the NICU—the neonatal intensive care unit. Returning home to face an empty nursery inspires bouts of inevitable anger, fear, depression and anxiety. For most couples, the earlier the gestational birth, the longer these feelings linger.

Expect to be stressed and short-tempered from lack of sleep. Expect to feel jealous of other parents who have big, bouncy full-term babies. Expect to feel overwhelmed. The process of grieving “what might have been,” and facing the fearful, unknown future for your preemie tests the resolve of even the strongest couples. The good news is so many preemies survive and go on to live normal, healthy lives.

Your premature baby

Babies born between 34-37 completed weeks are called “late preterm infants” (LPTI). Infants born before 34 weeks are “premature” and those born between 24-28 weeks (usually weighing less than 1,000 grams, or about 2.5 pounds) have been dubbed “micropremature.” The differences in growth and development for each group are remarkable.

Obviously, the LPTI infant arrives better equipped and stronger than the micropreemie. However, all babies born too early arrive with deficiencies. We now know that even a few weeks short of full term can translate into major neurological delays and impaired brain development that can interfere with speech, language and overall education for years to come.

How to bathe your premature baby

How you can help your preemie

You can help your premature baby thrive in the most positive environment for her growth with two leading tactics: Skin-to-skin care and breastfeeding.Your touch and the heat of your body is therapeutic to your baby. Skin-to-skin care, sometimes called “kangaroo care,” can help stabilize your baby’s vital signs, promote weight gain, and shorten her stay in the hospital. Plan to go skin-to-skin every time you visit; dad too!

Let your nurse know you’d like to hold your baby for at least an hour each time, if possible. Studies show parents who hold their preemies more often reap greater rewards than those who only hold their babies intermittently. Remember: your baby misses you as much as you miss her! We are social creatures, we need to feel the warmth of another human being. This practice lays the foundation for all human learning and behaviors.

Pump your breast milk early and often. “Breast is best,” is the mantra you’ll hear the most in the NICU. The soothing properties of your milk, which is specifically designed for your baby, is key to your baby’s stomach maturing. If you’re on medications that will keep you from pumping breastmilk for your baby, or if you’re unable to pump, ask your hospital to acquire breast milk from a human milk bank. You may have to educate your insurance company about why they should cover the expense, but avoiding gastrointestinal problems, and possibly surgery, will be worth it in the long run.

Also look at: Premature babies and how to protect them

Taking your preemie home

When the joyful day finally arrives and you take your premature baby home, know that you will still face many challenges. There will be many more appointments with doctors and follow-up clinics, more immunizations, more therapy appointments, and more time to marvel at how this experience has changed you and your child. Knowing some children will grow to be disabled, some people ask, “We can, but should we save some of these tiny babies?” The answer lies with their parents, who typically ask in return, “How can you put a price on love?”

Survival rates for premature babies

Gestational birth ageChances of survival
27 weeks or older95%
26 weeks85%
25 weeks75%
24 weeks60%

One of AWHONN’s nurse experts, Candace Campbell, DNP, RN, CNL, is a clinical nurse and educator. Her research with families of premature babies became the award-winning film, Micropremature Babies: How Low Can you Go? Find her at candycampbell.com


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