How To Care For A Premature Baby After Bringing Them Home

When Priya’s baby arrived early, she felt overwhelmed by worry and uncertainty. Premature babies can be weaker than full-term babies and need special care. Navigating the NICU and learning special care routines was a lot to take in. But as she prepared to bring her little one home, she realised that with the right guidance, she could give her baby the best possible start.

Let's look at what Priya did and what you can do if you are in a similar situation.

Creating a safe and comfortable environment for your premature baby is crucial for their health and development. In an Indian household, especially in joint families, it’s important to limit visitors and keep noise levels low to avoid overstimulating your baby. Ensuring cleanliness is essential, as premature babies have weaker immune systems and are more vulnerable to infections.

Maintain a consistent room temperature, ideally between 24-26°C, to keep your baby warm without overheating. Also, ensure the baby’s crib is safe, with a firm mattress and no soft toys, pillows, or heavy blankets, reducing the risk of suffocation.

Your premature baby’s nursery should be a safe and comfortable space. Here's how you can ensure that:

• Use a firm mattress in the crib and avoid soft toys, pillows, or blankets to reduce the risk of suffocation.
• Cleanliness is critical, as premature babies have weaker immune systems and are more susceptible to infections.
• It’s important to position your premature baby’s crib away from windows or direct sunlight to maintain a consistent temperature.
• Use breathable cotton sheets to reduce the risk of overheating, especially during hot months.  
• Install a baby monitor, allowing you to keep an eye on your baby’s comfort, even from another room.

Feeding your premature baby is vital for their growth, as they require more frequent nourishment to meet their nutritional needs. According to the Indian Academy of Paediatrics (IAP), premature babies need to be fed every 1.5 to 2 hours to promote weight gain.

• Breast milk: Mother's milk is strongly advised for premature babies  for its ability to strengthen their immune system. According to the World Health Organization (WHO), breast milk provides essential nutrients, antibodies, and enzymes that support a baby’s development.
• Nasogastric feeding: Premature babies may not be strong enough to suckle effectively, making NG tube feeding (nasogastric feeding) necessary in some cases.

Holding your baby upright during feeding and using paced feeding techniques can help reduce reflux, a common issue in preterm babies. Always consult your paediatrician for guidance on premature baby feeding guidelines to ensure your baby is receiving adequate nutrition.

For a premature baby, breast milk is a critical source of nutrients, providing antibodies and enzymes that aid development. If breastfeeding isn’t feasible, expressing milk or using a formula specifically designed for preemies is a common alternative.

For preterm babies, a specialised formula designed to meet their unique nutritional needs can help support growth and development, especially when breastfeeding isn't possible or sufficient. Options like Nestlé  NAN pro or Similac Neosure are widely recommended by paediatricians for premature babies due to their enriched nutrient content. Always follow your doctor’s premature baby feeding guidelines to determine the best option. 

Premature babies have smaller stomachs and often tire quickly during feeding, which means they need to be fed more frequently than full-term infants. Regular feeding is essential for their growth and development, as well as for increasing their weight steadily. 

Adopting the right feeding schedule and techniques can make a significant difference in how well they feed and digest. Techniques like paced feeding, cue-based feeding, and breastfeeding with a nipple shield can help ensure they are getting adequate nutrition without becoming overwhelmed or fatigued.

Below are some key points to keep in mind for feeding schedules and techniques:

• Premature babies require more frequent feeding than full-term babies, typically every 1.5 to 2 hours.
• Frequent feeds are required to help increase the weight of premature babies.
• Practice paced feeding, allowing your baby to feed at their own pace to avoid overfeeding or choking.
• Experiment with different feeding positions, such as holding your baby upright, to see what works best for their comfort and digestion.
• If your baby tires easily, shorter and more frequent feeds can ensure they get enough nutrition without becoming too fatigued.
• Cue-based feeding helps respond to your baby’s hunger cues, allowing them to guide the feeding process.
• Nipple shields can assist breastfeeding by making latching easier for babies who struggle with sucking. 

Monitoring your premature baby’s growth is vital to ensure they are developing as expected. Healthy weight gain is one of the most important signs of good health. Your paediatrician will likely provide you with a growth chart to track weight, length, and head circumference. It’s common for premature babies to grow at a slower pace than full-term infants, so regular check-ups are essential to monitor progress. 

Tracking your premature baby’s weight gain is important, as steady progress, even if slower than full-term babies, indicates healthy development. Weigh your baby weekly at home or during paediatric visits to monitor growth. Keep a close eye on developmental milestones.

• Making eye contact with caregivers and responding to visual stimuli
• Smiling in response to familiar faces or voices
• Holding up their head during tummy time or when being carried
• Rolling over from tummy to back or back to tummy
• Reaching for objects or toys and attempting to grab them
• Responding to sounds by turning their head toward the source
• Making cooing or babbling sounds as early signs of communication
• Kicking legs and moving arms in response to stimuli or during play

These milestones might be delayed in premature babies, but every small achievement is significant. It’s essential to be patient and celebrate these developmental steps, as they indicate your baby’s ongoing growth and adaptation to the world outside the womb.

Premature babies tend to sleep more than full-term babies, but their sleep may be lighter and more fragmented. Establish a calm, quiet environment, and keep the room dimly lit to encourage restful sleep. Stick to a consistent sleep routine, placing your baby on their back to sleep, as recommended by the Indian Academy of Pediatrics (IAP). Safe, uninterrupted sleep is essential for brain development and helps your baby’s body grow stronger during this critical time.

Safe sleep practices are essential for your premature baby. Always place your baby on their back to sleep on a firm mattress. A simple, clutter-free sleep environment meets the primary needs of a preterm baby. Many Indian parents opt for light cotton sheets, especially during warmer months, to keep their baby comfortable without overheating, ensuring a safe and restful sleep.

Managing the medical needs and follow-up care of a premature baby is essential for their long-term health. These visits often include weight and head circumference measurements, hearing and vision tests, and assessments of motor skills. Premature babies may require more frequent immunisations, and your doctor may advise additional vaccines, like the flu shot, to protect them from infections.

Routine screenings for conditions such as anaemia, jaundice, or respiratory problems are also essential. Ensuring that you follow your doctor’s recommendations on nutrition, sleep, and physical activity will help support your baby’s development and prevent complications over time.
 

Attending regular check-ups is vital for monitoring your premature baby's growth and development. Hospitals often offer comprehensive preterm care in the NICU, which extends into follow-up services after discharge. These check-ups allow paediatricians to assess your baby’s weight, growth, and developmental milestones, ensuring any potential issues are addressed early.

Immunisation may be delayed or adjusted based on your baby’s health, and your doctor will provide guidance on the appropriate schedule. Regular appointments help keep track of critical aspects such as feeding, respiratory health, and overall progress, giving your baby the best chance for a healthy start.

Bonding with your premature baby is a crucial part of their emotional and physical care. Research conducted by UNICEF has shown that kangaroo care, or skin-to-skin contact, significantly improves a premature baby’s overall development and well-being. Studies highlight that this practice helps regulate the baby’s body temperature, breathing, and heart rate, while also fostering emotional bonds between the baby and parent. Kangaroo care can be given either by the mother or the father.

Additionally, a study published by the American Academy of Paediatrics (AAP) supports the idea that talking, singing, or gently touching your baby during feeding or playtime further enhances emotional bonding, contributing to both the baby's and parents' mental and physical well-being.

Caring for a premature baby can be both emotionally and physically exhausting, so it’s essential to prioritise your own well-being too. While you focus on your baby’s needs, make time for self-care, even if it’s just a few minutes a day. Don’t hesitate to seek help from family members, whether it’s with household chores or baby care.

Reaching out to healthcare professionals can provide emotional relief and guidance. Several support groups in India, such as NICU Parent Support Group India, Preemie Support India, The Birthplace Premature Baby Support Group, and Cloudnine Care Premature Baby Support Group, offer emotional support, practical advice, and access to healthcare professionals for parents of premature babies. 

Bringing your premature baby home is a joyful yet challenging experience. With the right care, such as creating a safe environment, following proper feeding routines, and attending regular medical check-ups, your baby can thrive. Celebrate each milestone no matter how small, as they represent your baby’s strength and progress. Most importantly, care for yourself, as a healthy parent equals a healthy baby.