FROM THE NICU TO YOUR HOME: RAISING YOUR PREEMIE

After a significant period of emotional, mental, and emotional toll on parents of premature babies while observing their precious baby battle it out at the neonatal intensive care unit (NICU) and the eventual transition to the nursery (NSY), your precious preterm baby is ready for discharge from the hospital. Babies born before 37 weeks of pregnancy are called premature or preterm babies. They can also be called preemies, sort of a term of endearment. Owing to the preemie’s early, abrupt or oftentimes, unscheduled introduction into the world, the infant’s development and organ systems are immature as well. This relates to the health issues that the preemie struggles with at birth, after birth, through the first year of life, toddlerhood, and up to his childhood years. 

Why are some babies born too early? Maternal risk factors may have contributed such as diabetes, high blood pressure, and heart and kidney disease; multiple pregnancies either twin or triplets may have contributed as well. ¹ At times, a specific cause cannot be pinpointed.

Preemies have to stay for some time at the NICU-NSY ward because of the medical issues connected to the immaturity of their organ systems, such as the lungs, heart, kidneys, brain, nervous system. A multidisciplinary team composed of the immediate healthcare provider, subspecialists such as neonatologist, pulmonologist, cardiologist, infectious specialist, neurologist etcetera is formed to make sure your baby’s condition stabilizes and later on, can be sent home for continuing care.  While anticipating the green light from your baby’s hospital team, it would be wise and practical to engage with the team as much as you can, learn all you can from the medical staff and nursing staff about caring for your baby and interact with your baby (if allowed), letting him know your presence via your voice and warmth. This is an opportune time for parents, caregivers at home, and the medical team to discuss various concerns such as feeding, keeping your baby warm and safe, monitoring neurodevelopmental delays, and the like. A proactive relationship between the medical team and the parents is encouraged for a smooth transition to home care. Discussion on schedule of follow ups and routine checkups can be outlined.

Finally, the day has come for your baby to be sent home! The long wait is over! As a mom, you are expected to be anxious, nervous, excited, and a bit tentative on how to continue the care provided by the hospital staff to your home. These concerns are valid.  An interview with a veteran NICU-NSY nurse revealed that mothers’ main concerns are on how and when to feed their premature babies, when to burp and how to burp, and what to do in case their baby stops breathing or turns pale while feeding. 

According to the Mayo Clinic Staff, adjustment in lifestyles and home set up should be made before the baby comes home.² They suggested the following areas to prepare or work on for an informed transition to home care especially for a preterm baby with special needs. The points are as follows:

• Environment. The immune system of preemies are not that developed yet, so limit exposure of your baby to sick visitors or household members. The temperature of your home should not be too hot or too cold for the infant as well. Keep it just right.  

• Hand hygiene. Make sure that everyone who wants to touch your baby has washed their hands prior to playing with your precious baby.  This act prevents transmission of some illnesses. 

• Vaccination. Aside from the baby being vaccinated, parents and household members should have shots for flu, COVID-19, and pneumonia. Keep your preemie up-to-date with his vaccination. 

• Keep a close watch on your baby’s development – physical, neurodevelopmental, cognitive, etc. Note for delays and consult with your primary healthcare provider if such are noted. 

• Limit outings. Limit trips outside the home to medical visits for the first several weeks. It would be advisable to visit your doctor first thing in the morning to avoid exposure to other patients in the waiting room who usually have viral illnesses. ³ 

• Avoid public places and visitors who might be sick.⁴ As much as parents would like to take their baby out to public places, like the mall, market, park or similar public places, it would be wiser to leave your baby at home. His immune system is not that strong yet to defend itself from viral illnesses that may be present in those areas. Of most health concern are viral respiratory illnesses like the flu, pneumonia, seasonal cough and colds, and the like. Try to keep your baby away from areas where people smoke or where air quality is not that favorable. Once your baby’s immune system is stronger and boosted,  some visits outside the home can be scheduled. In the meantime, cherish those bonding moments with your baby at home. 

• Parents should learn how to perform infant CPR.⁵ What?! Learn infant CPR? But my baby is breathing fine, a parent may ask. A premature baby with episodes of apnea (nonbreathing) might have repeat episodes at home. Ask your baby’s medical team on what symptoms to look out for such as breathing or feeding problems. It is better to be equipped rather than become frantic if such an event happens at home. 

Let’s face it, caring for a premature baby will sap much of your energy and time. Maternal self-care especially mental health is core for taking better care of your premature baby. Try to take good care of yourself so you can take better care of your infant. 

Parents, caregivers and other people taking direct care of a preemie can do the following: 

• Get enough rest, eat well, and exercise moderately. Nourish yourself so you can deal with the physical demands of caregiving for a premature infant. Find a physical activity that you enjoy and can sustain. Join a support group who can help you with your concerns. Search for online communities with similar concerns.

• Be open to accept offers of help from family and friends. Two heads or in this case, two or more physically-able warm bodies can be your extra hands to babysit your other children, run errands, or clean the house so you have time to care for the baby or rest.

• Lastly, do not hesitate to get professional help, if needed. Post-partum depression is real for some parents who have sailed through a sea of emotions in the first few months of adjusting or finding a workable schedule  of caring for their baby. 

Your preemie has hurdled the first few days, weeks or maybe months of his life at the hospital with the help of a dedicated medical team along with your emotional and physical support. As parents, you can now enjoy his healthy growth and development in the days, weeks, months, and years to come. Happy parenting!