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Your Preemie’s First Year

By Candace Campbell, DNP, RN, CNL

Your Preemie’s First Year

Many preemie parents feel like one father, who admitted, “When we took our little 4-pound baby girl home, [she had been in the hospital 14 weeks] we were thinking, ‘well, now she’ll just be like a normal baby girl.’

We had no idea what the next year would be like.”

Since every child born is a unique individual, and every preemie’s condition depends on so many different variables, it’s impossible to precisely predict what you may encounter during your first year at home with your preemie. So, let’s just tackle the top 3 questions asked by most preemie parents about this time.

1. When will my baby “catch up” to his age group?

Typically, the younger your baby was at birth (gestational weeks), the more time he or she will need to “catch up” to peers in terms of developmental milestones.

Experts estimate some micro-preemies (born at 24-28 weeks gestation) may take 2-3 years to catch up. Much depends on her health at birth and since that time, any medical challenges, and her care and wellbeing at home.

Say your child was born at 30 weeks rather than at term—around 40 weeks—then she may need an additional 10 weeks to reach normal newborn milestones. So, for example, instead of sitting up by herself at 6 months, your child may wait until 8½ months to accomplish this task. And she may not tolerate solid foods until after 8 months as prematurity effects every system within a baby’s body, including her digestive system.

2. Will my baby need extra doctor appointments?

Generally, yes. If she is a preemie, she will be followed more closely by her healthcare provider through the first year of her life.

If she was born at a very low birth weight (less than 3 pounds), was on a ventilator for more than 2 days, or was in critical condition for more than a few days, she may also need to be seen by a public health nurse or premature infant follow-up clinic. Typically, such appointments happen twice a year for 2 to 3 years.

Your baby may be referred to other healthcare providers, such as pediatric developmental specialists, physical or occupational therapists, respiratory therapists, gastro-intestinal specialists, pulmonologists, or ophthalmologists. Of course, if baby was born with another specific problem (e.g. cardiac), there will be a specialist to match!

3. How can I protect my baby from infection?

Breastmilk is the first line of defense for any baby. The antibodies contained in breastmilk will help protect baby for those first critical 3 months. Afterward, in a full term baby, his or her natural antibodies begin to develop throughout the first year.

For a preemie, this process is also premature. Baby’s gestational age at birth and her individual challenges play a big part in determining how long you will need to be hyper vigilant about avoiding infection. Although it is unrealistic to keep baby in a bubble, some precautions are wise:

  • Keep baby’s environment as healthy as possible: Ask guests to STAY AWAY if they have or have recently had cold, flu or sniffles, or even if they “just don’t feel quite right.”
  • Always wash your hands, and ask others to do the same, in caring for baby: Studies show good hand washing is the best way to prevent infection. Sometimes we are in such a rush to care for a crying baby, we forget to care for ourselves. Always wash your hands after using the toilet and before and after each diaper change. Always wash your hands before nursing your baby. Share this habit with family and friends.
  • Avoid crowds: Limit excursions to high-traffic public places where groups gather. For example, go to the mall early or late to avoid the hordes of people; if you see a crowded elevator, wait for the next one. This is especially important during the fall and winter cold and flu seasons.
  • Protect against flu: It’s safe to get the flu shot during pregnancy or afterwards; your partner needs one too. During flu season, your preemie will be more susceptible than other babies. This is also true for families with a toddler in the home. Ask your healthcare provider if your preemie (born at less than 32 weeks) should have injections of Synagis, a drug that provides a temporary “shield” forbaby’s immune system. Note, however, that not all insurance plans may cover this so ask about costs.

First Year Risks

Call your healthcare provider if you see any of the following in your preemie:

  • Fever, or variations in her temperature
  • Feeding or weight gain problems
  • Difficulty breathing, including asthma-like sounds
  • Any signs of infection, including redness or warmth, lethargy, fever, sleeping longer or a lack of interest in feeding
  • Intestinal problems like vomiting, colic or gas
  • Eye problems
  • Being overly sensitive to light or sound

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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