According to March of Dimes, 1 out of every 10 babies will be born prematurely – meaning before 37 weeks gestation. For these preemies, the journey from hospital to home can take weeks, typically beginning with an extended stay in the hospital’s neonatal intensive care unit (NICU).
Premature babies receive highly specialized care and attention during their stay in the NICU in order to help them grow strong enough to be discharged from the hospital. Once released, what can preemie parents expect when they’re home with their tiny miracle?
Criteria for discharge from the NICU
Dr. William A. Engle is a neonatologist at Riley Hospital for Children and an Erik T. Ragan Professor of Pediatrics at Indiana University. When evaluating whether or not a premature baby is ready to be discharged and sent home, Dr. Engle says that physicians will consider a number of factors. “My colleagues and I want to see that the baby has a stable medical status, which often means the baby is breathing regularly without apnea (pauses in breathing).” He adds that babies should also be gaining weight, maintaining their body temperature outside their incubators and eating well.
Dr. Engle also says that NICU staff work to ensure that parents are prepared to care for the baby. “We encourage parents to assume care responsibilities and learn about their baby’s ongoing needs as early as possible. This way, we know they are fully prepared once they go home.”
Preparing for discharge
While having a premature baby in the NICU can be scary, knowing there’s a trusted medical team with your baby around the clock can ease your anxiety. What about when it’s time to bring your infant home?
“I strongly encourage families to stay [at the hospital] for a day, sometimes two or more, and care for their baby without the nursing team, respiratory care or physician team’s assistance,” says Dr. Engle. This is called “rooming in” and he says it’s a great opportunity for families to get more comfortable and confident taking over their child’s care.
Caring for preemies at home
Parents should know that if their premature baby has been discharged from the hospital, it’s because hospital staff have determined that the infant is healthy enough for home care. Still, there are a few things preemie parents will want to be prepared for.
Oxygen and feeding tubes
“While most preterm babies go home feeding orally from the breast or bottle, oral feeding is a skill that develops with time,” says Dr. Engle. For this reason, some preemies will get sent home using a feeding tube. Other babies may require home oxygen, breathing treatments or cardiorespiratory monitors, but NICU staff are trained to help educate parents on how to use these devices.
Attending follow-up consultations
Following discharge, many preemies will require speech, physical or occupational therapy in order to help with feeding and motor development, as well as other forms of evaluations and specialty care.
Dr. Engle reminds parents that “In Indiana, the First Steps program provides for in-home speech, physical and occupational therapies for the first three years after birth.”
Preemie developmental milestones
Pay attention to your preemie’s development milestones, but try not to become too anxious about their progress. It’s normal for early babies to be a little late to the game.
“Parents should adjust their baby’s developmental and growth assessments based on the number of weeks premature,” says Dr. Engle. For example: if your baby is 4 months old, but was born 2 months early, then they are considered 2 months old developmentally.
All new babies, bring joy – and jitters – to their parents. If you have a preemie, remember that medical professionals are always there for education and guidance. Take advantage of their knowledge and reach out to other families in similar situations, or support groups for parents of preemies, to get the encouragement and support you need to make the experience with your new baby as positive as possible.