Caring for a Premature Baby
Katie Hilton – iCandy Expert Midwife & Health Visitor
November 17th marks World Prematurity Day, it is a day that millions of people around the world join together to show how much we care about protecting the health of babies and raising awareness around premature birth. 15 million babies are born prematurely each year, in the UK this figure is 756,000. For the parents it can be a traumatic experience and they often don’t know who to turn to for advice, or where to even start when it comes to caring for their baby. In honour of this day we have asked iCandy Expert Midwife & Health Visitor Katie Hilton to give us her advice for the parents of a premature baby.
In many ways, a premature baby is exactly the same as any other baby born at term (37 weeks+). Your baby will need to be fed, changed, and kept warm, but above all your baby will need the comfort and love of their parents.
Premature babies aren’t able to keep themselves warm initially; this is in part because they haven’t built up enough fat stores. This is why premature babies are often placed in heated cots or incubators to keep them warm. To help your baby stay warm you can try kangaroo care, this is when you hold your baby against your bare chest with skin-to-skin contact. Kangaroo care can also bring many other benefits to both baby and parents; which include helping the bonding process, and providing general comfort as your baby can detect your sense and hear the rhythm of your heart and breathing.
The neonatal unit is also kept at a warm temperature to help this process, usually at about 23c. If your baby is in the transitional care unit, which is a step down from neonatal unit and where you and your baby may spent some time before going home, the temperature will be roughly 18c. It will feel very warm to parents and you may want to pull out your summer clothes, even in winter, but it’s just perfect for premature babies.
When you take you baby home, you can gradually start to adjust the temperature as your baby grows and adapts to the environment. Over a period of approximately 2 weeks, reduce the temperature from the level the baby has been used to in the neonatal unit or transitional care to about 18c. Once your baby has acclimatised to this temperature, 16-18c will become a comfortable temperature for them.
As soon as your baby is strong enough and breathing is stable, the midwives or neonatal nurses will show you how to change your baby’s nappy and to give them their first bath. They will also show you how to participate in daily care activities if your baby is unable to come out of the incubator just yet. This can include such things as a little wash and keeping your baby’s mouth clean and moist. It is really helpful to both the neonatal unit staff and for your own bonding as parents if you take responsibility for some of these areas.
How can I help my baby to settle?
Premature babies have to learn pretty quickly to cope with the world outside of the uterus, often before they are completely ready. This can at times be hard and tiring for them. However, there is a lot as a parent that you can do to help your baby: -
- Learn to recognise your baby’s cue so you can tell when they need to feed, change, cuddle or simply to be left alone
- Consider trying kangaroo care
- Learn simple baby massage techniques that you can use when your baby comes home from the hospital
- Talk or sing quietly to you baby so they can hear the soothing tones of your voice
- Put something scented of you into your baby’s cot to help them be soothed by your smell, be sure to check this is okay with the staff first
- Learn how to swaddle your baby; this keeps your baby warm and secure. This will come in useful a little further down the line
- Ask the neonatal staff to teach you containment techniques
- It is recognised that noisy, bright and busy hospital environments are often overwhelming for premature babies. Try to keep noise to a minimum, limit handling of your baby and understand why lights are dimmed.
How do I feed my premature baby?
Breastmilk is the best form of nutrition for a premature baby, however your baby may not to be able to feed at the breast initially due to both their size, lack of suck swallow instinct, and simply being unable to come out of the heated cot or incubator. The neonatal nurses will encourage you to pump frequently to stimulate your milk supply and will provide you with a hospital grade electric breast pump. Pumped breastmilk may then need to be fed to your baby through a tube directly into their tummy. Your neonatal nurse will be able to show you how to do these tube feeds for your baby.
How should I dress my premature baby?
While your baby is in the neonatal unit, they may only wear a nappy and a hat. The hat is necessary as babies lose a lot of heat through their head. It is likely that most of the clothes you will have bought during your pregnancy are too big for premature babies. You can however purchase premature nappies, vests and sleepsuits from all the leading retailers.
Further Support
The nurses and midwives on the neonatal unit can support and help you with any aspect of caring for your baby. However, there are also a couple of charities that can provide additional support, guidance and advice as necessary.
- Bliss – a charity for sick and premature babies and their families. They have a family support line on 0500 618 140. They also have a range of information, booklets and a chat forum available on their website
- Great Ormond Street Children's Hospital- An institution for children around the world who need pioneering treatment and world class care.