What should I do if my baby is going to be premature

In Australia, approximately 1 in 10 births are premature. This is quite a high number and something that you should consider if you are expecting a baby. Sometimes premature births are unexpected, due to a complication with your ability to carry a baby full term or perhaps there is a risk to your baby. In some cases, you may be aware of a heightened risk of premature birth beforehand. An example of this is if you have a thyroid condition, in this case it is important to discuss the possibility of premature birth with your OBYN or together you might discuss that it is safer to deliver baby early to avoid the chance of stillbirth which is what we chose for my daughter who we delivered at 37 weeks.  If that is the case, then using time during pregnancy to prepare both emotionally and in a practical way as the first few weeks of your baby’s  life may be spent in special care with you travelling back and forth to the hospital.

When is a baby considered premature? 

A birth that occurs prior 37 weeks of pregnancy is considered preterm. This is not to say that babies born after this time may not need a little time is the special care ward, however the chances of taking baby home with you are better if baby is 37+ weeks.

The causes of premature labour are different in every situation, however, you may have been told of an increased risk to expect premature labour if the following applies:

• You’re expecting to have twins or multiples
• There is a complication with your uterus or cervix.You’ve had a premature birth in the past.
• You have a medical or health condition such as pre-eclampsia, thyroid issues, diabetes or high blood pressure.
• You are a smoker throughout pregnancy. Talk to your doctor if you need extra support quitting smoking.

Premature labour may involve some extra steroids to receive corticosteroid  which can improve your baby’s chances of doing well. These help the baby’s lungs to function. Steroids are usually injected into one of the large muscles (arms, legs, or buttocks) of the pregnant person.

How developed will me premature baby be? 

A premature baby will be small and fragile.

• The skin may need more time to develop.
• Premature babies Eyelids may could look fused shut.
• Your premmie may have no head hair but a lot of body hair called Lanugo’  Hair
• Genitals may appear  quite small.

Build your resilience as you may need it

With any pregnancy, there is a flood of emotions and having a premature baby is going to challenge these more than any other Mother. You baby may not have the ability to breastfeed and you may be expressing collustrum with a colostrum collection kit or by hand. This is really challenging and every little drop will count so this is necessary. You may experience feelings of anxiety, loneliness and feel overwhelmed.

Your little baby may need to stay in the neonatal intensive care unit (NICU), which is the safest place for them to be for now. This means that you will have to go home without your baby and travel back and forth to the hospital. If you are unable to drive, this means having someone driving you back and forth every day. I recall my Mum driving me to the hospital in the morning and we would express and they would add this to baby’s feeding tube and then we would leave for awhile and then return for the next feed and then go home in the afternoon for a rest and then I would go to the hospital with my husband when he returned from work. Together we would bath baby  (when bub was ready) and I would express again and we would add this to the feeding tube.

There are some things which you may have made your mind up about that might be dashed in reality, for this reason you are going to need to be flexible. As an example the following occurred for me.

1. I planned a natural birth and had an emergency caesarean section.
2. I was not going to introduce a dummy, however my son had zero sucking ability so hospital staff said that it was necessary to develop my baby’s sucking ability.
3. I was going to breast feed. There were times where bottle feeding was quite simply necessary by hospital staff, in my absence as my son awoke hungry ahead of the anticipated time.

I suggest that you tell some relatives and friends wanting to visit they they may not be able to visit at the hospital. Communicate early that you will update via your facebook page and add photos as you can and they are welcome to come and see baby when you are both home.

Get ready at home for a premature baby. 

If your baby is spending lots of time in the NICU, you will be too. These first weeks won’t allow you time for anything other than caring for your newborn. Now might be a good time to hire a cleaner once a week and cook in bulk and freeze meals. If anyone asks what they can do to help, suggest a meal instead of saying thank you but no thanks. This is not the time to try and appear like you have everything under control because , in truth your baby’s health will control you so say yes when help is offered, especially if you have other children at home.

If you have older children prepare a care plan for them and tell them that they may not be able to visit baby straight away as some NICUs don’t allow children to visit. They may feel included by drawing pictures for their new baby brother or sister and reading them the book “MY BROTHER TOM” IS A GREAT WAY TO SHOW THEM VISUALLY WHAT MIGHT HAPPEN. 

While some hospitals have clothes to dress newborns during NICU stays I suggest you have a few 00000,0000,000 clothes on hand and a tiny beanie for your baby.

Remember to pack a bag for yourself with snacks and perhaps a laptop or ipad or book to keep yourself occupied while your baby sleeps and in-between expressing.

Once your premature baby comes home 

Your child’s Paediatricians will often refer to your baby in terms of their ‘corrected age. That is their age minus the number of weeks they were born early as  it is often recommended that you measure your child’s developmental milestones against their corrected age up until their second birthday.

You are so blessed to be the parent of this little baby. The day that you bring your baby home is seriously the most amazing day ever. Cherish it.

My two births looks like this. 

Daniel – Water broke 24 weeks. In hospital from 28 weeks and delivered via an emergency caesarean section as a breach baby coming at 32 weeks. Daniel was born not breathing when he was born and was quickly revived. This moment and his early birth led to him being in special care for 4 weeks.

Sophie – Daily contractions from 22 weeks, in the labor ward and told my daughter would be shipped to another hospital with specialised facilities if born at 22 weeks, while I would stay in that hospital until I recovered. Luckily this moment passed however I was in the labor ward on and off resulting in the last ten weeks in hospital. Steriods injected and Sophie booked to be delivered at 37 weeks and she was perfect and only in special care for 7 days.

Years later, they are perfect, happy healthy children and not my premies at all.