Tips for parents of premature babies

The fact that a baby is premature adds to the anxiety for parents when they are discharged from the hospital. These are babies who have been born before term, that is, before 37 weeks of gestation, and who have spent a few days or weeks in the Neonatal Intensive Care Units (or NICUs) until they reach the necessary maturity.

“A child born before 37 weeks of gestation is considered premature, and is characterised by immature organs and systems. This immaturity will be greater the fewer weeks of gestation that have passed, that is, the shorter the pregnancy. This immaturity often means that the child needs to be admitted to the NICU to receive the help he needs to survive outside the mother's womb,” explains Dr. Mireia Beltran, coordinator of the Neonatal Pathology Unit and the Pediatric Intensive Care Unit at the Hospital Universitari General de Catalunya.

He says that it is also possible for a child to be born full term (between 37 and 40 weeks of gestation), but with a much lower weight for this gestational age, while recalling that 'extremely premature' children are those born before 28 weeks of gestation, and 'very premature' children below 32 weeks.

“Children born between 35 and 37 months, although they are also premature newborns, we try, whenever possible, to have them remain in the maternity ward with their families in order to guarantee the bond and encourage the start of breastfeeding,” she adds. In this regard, this specialist stresses that premature children are fragile patients, and are “extremely sensitive” to any stimulus or manipulation, so it is important to help and accompany families so that they can learn and be the main responsible for the care of their children.

The most awaited moment Most premature babies go home close to their original due date.

After the mandatory days of hospitalization, Dr. Beltran reminds us that most premature babies can go home close to the date of their expected birth; so that a child of 24 weeks' gestation, for example, can be admitted for three to four months in the NICU.

“The length of hospital stay will depend on the patient’s gestational development and any complications. Some of the requirements for discharge include, for example, that the patient can breathe and eat without assistance, and that he or she weighs around 2-2.2 kilos,” she adds.

In this sense, the specialist from the Hospital Universitari General de Catalunya maintains that going home is a “special” moment and one in which feelings of joy and anxiety are mixed. “Until that moment, parents have felt accompanied at all times by the staff of the Unit, but now they will become the caregivers of their child. For this reason, in many neonatal units, joint hospitalization is offered in the days or weeks prior to discharge, to facilitate this transition and empower families as caregivers.”

Care when leaving the hospital For the most premature babies, an outpatient follow-up program is established.

However, he maintains that the care given to these babies will depend on the complications and illnesses that the child has had or is going through, as well as the weight with which he or she leaves the hospital.

For the most premature babies, a multidisciplinary outpatient follow-up program is established in neonatal follow-up, neuropediatrics, ophthalmology, pulmonology, etc. consultations to be able to monitor the development and growth of the babies.

However, in terms of family care, she assures that, in general, these little ones only need a little more monitoring, patience, and some preventive measures such as those detailed below:

1. Make sure you understand the medical instructions correctly, review the medical appointments and resolve any questions that may arise before discharge, so that no questions are left unanswered.

2. If the baby is breastfed, it is advisable to contact a support group.

3. Low birth weight newborns, whether premature or not, tend to be small children during their early childhood and are sometimes children who are satiated quickly (what is often called “bad eaters”), and this often causes anxiety in families. If growth is progressive and check-ups with the neonatologist are correct, it is important to respect their times and feelings of hunger, to follow balanced and complete diets, such as those offered by the recommendations provided by the Public Health Agency of the Generalitat de Catalunya” to avoid the appearance of obesity and metabolic syndrome in adulthood.

4. Some preventive measures must be taken to reduce infections and respiratory problems, at least during the first two years of life:

• Frequent hand washing.

• Avoid smoky and crowded environments.

• Avoid contact with sick people.

• It is recommended to delay entry into nursery school as much as possible, and even in newborns before 32 weeks of gestation or with a weight of less than 1,500 grams, it is recommended to avoid it during the first two years of life.

5. Follow the measures to prevent sudden infant death:

• Avoid smoking at home. Motherhood is a great time to quit smoking if you have not done so during pregnancy.

• Lay the baby on his back (face up) with his head turned to one side, on a firm mattress without a pillow, to avoid overheating.

• Share a room with the baby, for at least the first 6 months of life.

• Promote breastfeeding and use resources to support it in case there are difficulties if it is the mother's wish.

• The use of a pacifier during sleep can be considered if the baby uses one.

6. When travelling by car, always use approved child restraint systems appropriate to the child's weight.

7. In rare cases, children may require supplemental oxygen, home monitoring or nutrition through a nasogastric tube for feeding. In these cases, specific monitoring is carried out by their referral hospital.

8. The postpartum period is a time of great change and a mixture of emotions. When your child is born prematurely and needs to be admitted to a Neonatal Unit, it is common for feelings of sadness, guilt, anxiety or a feeling of being overwhelmed to appear. It is advisable to carry out psychological monitoring of both parents during admission, but also after discharge. You can also find support in associations for families of premature babies (Petits Grans Herois, the association of parents of premature newborns at our hospital, or Som Prematurs, the association for premature babies in Catalonia, are some of them).