As you and your premature infant
adjust to being at home, you will gradually establish a routine together. During the first weeks at home, consider these
Sleeping and wakefulness. Because their brains aren't as fully developed at
birth as full-term newborns, premature infants:
Sleep more than
full-term infants do but for shorter periods of time. Expect that you may be
awakened frequently at night until 6 months after your
Are seldom awake for more than
brief periods until about 2 months after their due date. It may seem like a
long time before your infant responds to your presence.
Fussiness and hypersensitivity. It's normal for full-term infants to
cry for up to 3 hours a day by 6 weeks after their due
date. Most premature infants will do the same and then some. Your premature
infant may be easily disturbed by too much light, sound, touch, or
movement or by too much quiet after living in the noisy NICU. If so, gradually
create a more calming environment, swaddle your infant in a blanket, and hold
him or her as much as possible.
Sleeping position. Laying your infant on his or her back reduces the risk of
sudden infant death syndrome (SIDS), which is more
common among premature infants than full-term infants.
Your infant probably will come home on a hospital feeding schedule, which will
tell you how often to nurse or bottle-feed at home. To avoid infant
dehydration, never go longer than 4 hours between
feedings. Small feedings may help reduce spitting up. If you see signs of
reflux during or after feedings, such as spitting up a lot, talk to your infant's
Nutrition. Your infant's doctor may
recommend adding iron, vitamins, or supplemental formula to a breast-fed diet.
Adding iron is typical treatment for all premature infants (preemies),
because they lack the iron stores that full-term infants have at birth. Some
preemies simply need extra energy and vitamins from formula (given in addition to breast milk) to
keep up their growth.
Exposure to diseases and smoke. Your premature infant needs more protection than a
full-term infant, particularly due to immature lungs at birth.
Keep your infant away from sick family
members and friends as well as from enclosed public places during his or her
first two winter seasons.
Don't allow tobacco smoke near your
Protection from serious illness (immunizations and RSV antibody). With the exception of
hepatitis B vaccine, the preemie's schedule for
childhood immunizations is the same as for a full-term infant, figured from the
date of birth (chronological age). In addition, the doctor may suggest that your baby get injections of RSV antibody in the winter, to help reduce the risk of problems from respiratory syncytial virus (RSV) infection.
Child care. You may need to find child care for times when you need a break or for when you return to work or other tasks. Avoid group child care if your baby is at high risk for infection, especially in the fall and winter when viral illnesses tend to spread. You'll likely need to keep your baby out of group child care until he or she is on a routine schedule. For more information about child care options, see the topic Choosing Child Care.
Hearing and vision screening. Premature infants are at greater
risk of hearing loss. Those born at or before 30 weeks or weighing less than
1500 g (3.3 lb) are more likely
to develop a vision problem called
retinopathy of prematurity.
Your infant's hearing will have been assessed in the NICU.
But be alert to new or increased hearing problems during your child's first 5
years of life.
Vision screening is recommended for infants born at
or before 30 weeks, whose birth weight was below
1500 g (3.3 lb), or who have
serious medical conditions. The first screening is recommended between 4 and 7
weeks after birth.1