Appearance of a Premature Baby

If your baby is born prematurely, she may neither look nor behave like a full-term infant. While the average full-term baby weighs about 7 pounds at birth, a premature newborn might weigh 5 pounds or even less. The earlier she arrives, the smaller she will be, the larger her head will seem in relation to the rest of her body, and the less fat she will have. With so little fat, her skin will seem thinner and more transparent, allowing you actually to see the blood vessels beneath it. Her features will appear sharper and less rounded than they would at term, and she probably won't have any of the white, cheesy vernix protecting her at birth, because it isn't produced until late in pregnancy.

Because she has no protective fat, your premature baby will get cold in normal room temperatures. For that reason she'll be placed immediately after birth in an enclosed bed in which the temperature can be adjusted to keep her warm. After a quick examination in the delivery room, she'll probably be moved to a special-care nursery.

Breathing Difficulty of a Premature Baby

You may notice that your premature baby will cry only softly, if at all, and may have trouble breathing. This is because her respiratory system is still immature. If she's more than two months early, her breathing difficulties can cause serious health problems, because the other organs in her body may not get enough oxygen. To make sure this doesn't happen, your doctors will keep her under close observation. If she needs help breathing, she may be given extra oxygen, or special equipment may be used temporarily to do some of her breathing for her.

As important as this special care is for your baby's survival, her move to the nursery will probably be wrenching for you. On top of all the worry about her health, you may miss the experience of holding, breastfeeding and bonding with her right after delivery. You won't be able to hold or touch her whenever you want, and you can't have her with you in your room.

Coping with a Premature Birth

Your best defense against the stress of a premature birth is to ask to see your baby as soon as possible after delivery, and become as active as you can in caring for her. Spend as much time with her in the nursery as your condition and hers permit. Even if you can't hold her, touch her through the portholes of the enclosed bed. Breastfeed her if possible, or ask the nurses to help you express milk to feed her; this will stimulate your own milk production so you can nurse her when she's able.

The more you participate in her process of recovery and the more contact you have with her during this time, the better you'll feel about the situation and the easier it will be for you to care for her when she leaves the nursery. If you have questions, be sure to ask them of the doctors and nurses. Also, don't forget that your own pediatrician will be participating in, or at least will be informed about, your infant's immediate care. Because of this, he or she will be able to answer most of your questions.

Your baby should be:

• Breathing on her own,
• Able to maintain body temperature,
• Able to be fed by breast or bottle, and
• Gaining weight steadily at time of discharge.

Other medical problems should also be resolved, or home care should be set up before your baby leaves the hospital.

Your pediatrician will talk with you before your baby leaves the hospital. Be sure that he or she explains the following:

• How to care for your baby at home
• When to call his or her office or go to the hospital
• How to know if your baby is eating properly, getting enough sleep and gaining enough weight
• What medicines to give, if any are needed
• How often you will need to bring your baby in for an exam

Regular contact with your pediatrician is very important to your child's health. Be sure to discuss any worries that you have about your baby.

Some premature babies need monitors and other equipment at home. For example, if apnea is a problem, monitoring may be done at home. Some babies may also need to go home with oxygen or other treatments. You and other caregivers will be trained on how to take care of your child's special needs before you take her home. You will also be taught how to perform infant cardiopulmonary resuscitation (CPR).

Before heading for home, premature infants should be observed in a car seat to see if the semi-reclined position adds to or causes breathing problems. If your pediatrician recommends that your baby lie flat during travel, a crash-tested car bed may be used for a short period.

The back seat is the only safe place for babies. Whenever possible, an adult should ride in the back seat next to your baby to watch her closely. Depending on your baby's condition, you may want to limit her amount of car travel for the first month or two at home. You can check this with your pediatrician.

When it comes to a feeding schedule, premature babies need to be fed more often. And it will take a little while for them to adjust to being at home. Accept any offers of help around the house during the first few weeks, so you can take time to get used to having a new baby in the house.

Your baby also needs plenty of sleep in order to grow and develop.  He will rest easier — and you will, too — if you follow a few simple rules when you put your baby down for a nap or for the night.

The American Academy of Pediatrics recommends that healthy infants be placed on their backs to sleep. Babies who are placed on their stomachs to sleep are at higher risk for sudden infant death syndrome (SIDS).

Placing babies on their backs to sleep does not increase the risk of other problems (for example, choking, flat head, or poor sleep). However, premature infants with certain medical problems (such as lung problems) may need to sleep on their side. Whether your baby sleeps on his back or side, a certain amount of "tummy time" is needed when he is awake. Ask your pediatrician about the best sleeping position for your baby.

In addition to proper sleeping position, you can reduce the risk of SIDS by:

• Keeping blankets, pillows, soft bedding, and large stuffed toys out of your baby's crib;
• Making sure your baby's room is not too hot or too cold;
• Not smoking in your home;
• Getting regular health care for your child; and
• Breastfeeding.

Because your child was born early, you should think of her progress in terms of "adjusted age." For example, if your baby was 8 weeks early, adjust your expectations by 2 months. Therefore, a 4 month old premature baby may act like a full-term 2 month old. Try not to compare your child with full-term babies or focus too much on developmental charts. Your pediatrician will follow your child's developmental progress.

If there are any developmental problems, the important thing is to catch them early, so that your child can be helped to adapt.

Some problems can show up right away; others do not show up for some time. You are in the best position to monitor your child's development. Become familiar with your child's general pattern of development, and if you think your child is showing signs of a hearing, vision, speech, muscle or learning delay, see your pediatrician as soon as possible. Early intervention programs that work with children from birth to 3 years may do a lot to lessen any long-term effect on your child's learning.

One of the most important things you can do for your child is to make sure he receives all recommended check-ups and immunizations. Check-ups will help make sure your baby's growth is on track, give your pediatrician a chance to catch any health problems early, and help you get your questions answered. If your baby has trouble gaining weight, has breathing problems, or any other problems that are of concern, your pediatrician may wish to see your child more often.

Immunizations can make sure your child's health is not put at risk by serious childhood diseases, such as whooping cough, hepatitis, and meningitis. These diseases can cause death or leave your child with long-term health problems.

Some parents think their children do not need immunizations until they enter school. Actually, they should start when they are infants. Children should receive most of their immunizations during their first 2 years.