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Premature birth and how to cope with a preemie baby
newborns

Premature birth and how to cope with a preemie baby

10/11/2023

Finding yourself in the neonatal intensive care unit (NICU), sitting beside your baby in an incubator isn’t how anyone imagines those first few weeks or months of their newborn’s life to be. When your baby isn’t supposed to be here for another few weeks, or even months, it can feel like an out-of-body experience.

Every year, tens of thousands of preemie parents are thrown into a parenthood they never envisaged.

If you’re sitting there right now, or you know someone who is, we’ll share some wisdom and insights from those who’ve been there in this guide. Learn more about what is considered premature birth, what the causes of early labour are, the premature baby milestones to look out for and how to cope with the stresses of frequenting NICU.

What is considered a premature baby?

A baby is classed as preterm if they are born before 37 weeks.

Much of their development hasn’t finished, which can result in several difficulties, including breathing, feeding, and regulating their blood sugar.

Their skin is especially delicate. Our article on premature babies’ skin can give you more insight into how to care for it, and WaterWipes baby wet wipes have been specifically developed to be mild and gentle enough for your premature baby’s delicate skin.

Some premature baby development problems are resolved before they leave NICU, and some can last a lifetime. Premature babies can usually leave the NICU once they can feed by mouth, breathe independently, and gain weight.

How premature can a baby be?

Medicine has come a long way, and so it is possible for a baby as young as 22 weeks to be born and survive, but they may have to spend many months in NICU before they can go home.

Babies born at 22 weeks have a survival rate of around 28%, this rises to 55% for a baby born just a week later.

What are the different levels of prematurity in babies?

Babies are classed differently depending on how early they arrive. Here we’ve broken down what to expect at each stage of prematurity.

Micro preemies

These babies are born extremely early, typically before 26 weeks.

They will require a huge amount of medical support to help them develop, as their brain and other organs will not be fully functioning yet.

There is a high chance that micro preemies can develop some disabilities, but the medical staff in the NICU will do all they can to reduce the chances of this.

Extremely preterm babies - 26 to 28 weeks

Babies born between 26 and 28 weeks will spend time in NICU to continue their development.

They will need feeding via an intravenous drip and will require help to breathe. They typically weigh less than three pounds – the same weight as a small laptop.

Very preterm babies – 28 to 32 weeks

Babies born at this time are commonly multiples – so twins or triplets. Very preterm babies are a little more developed but usually still need oxygen and breathing support.

They may be able to have breast milk or formula through a feeding tube. Some babies born at this stage can cry and even grasp your finger.

Moderately preterm babies – 32 to 34 weeks

Some moderately preterm babies can breathe independently but may sometimes need supplemental oxygen. They usually weigh between three and four pounds, and their skin appears wrinklier than a full-term baby’s.

These preterm babies may need the incubator at times but should be able to control their body temperature at this stage.

Late preterm babies – 34 to 37 weeks

Most premature babies are born around this time – 7.4%. Most babies born after 34 weeks are as healthy as those born at full term, although they may be at higher risk of issues such as jaundice, feeding, and even breathing problems.

They can usually learn how to breastfeed or bottle feed, but some may need a little help with a feeding tube at times.

What causes early labor?

There are many reasons why someone may go into labor earlier than expected. Some factors may include but aren’t limited to:

  • Age – teen pregnancies and those over 35 have a higher risk of preterm birth

  • Infection – sometimes an infection (a UTI or diarrhoea and vomiting) can result in an earlier birth.

  • Health condition – pre-eclampsia is a common reason for babies being delivered earlier.

  • Carrying multiples – twins and triplets are typically born before 38 weeks.

How to make sense of becoming a preemie parent

If you find yourself next to a tiny baby you weren’t expecting to meet for quite some time, it may feel like you’ve landed in an alternate universe. The fact is, the NICU is just that. And until you've experienced it, it’s hard to imagine until you become a preemie parent yourself.

Your head will spin, you may be in shock (mom’s body almost certainly will be), and the fear is real. It will take time to come to terms with a situation you weren’t emotionally or physically prepared for.

You never dreamt you’d be caring for a premature baby, and you have every right to feel overwhelmed. The first hours, days, and weeks can be all-consuming and scary, so try to focus on just the minutes and hours ahead of you instead of looking too far ahead.

One mom told us: “In the first few days I asked every doctor and nurse who’d listen how long it’d be until we could take our baby home. But no one could answer me. It took me a few days to realize that every preemie is different, and I just had to take it one hour, or one day at a time.”

Premature baby milestones

It’s important to note that every baby’s experience is different, but babies born before 37 weeks sometimes need to have their age ‘adjusted’ when it comes to milestones.

This means if a baby is born eight weeks early (29 weeks) you would expect them to hit two-month milestones four months after birth.

However, many babies catch up when they hit around 12 months of age and may be hitting the usual milestones around this time.

Do I need to treat my preemie baby differently to a typical baby?

Many preemie babies recover and finish their development in NICU, then once they’re home, you wouldn’t know they’d decided to arrive a little earlier.

For some preemie babies, however, there may be a disability or health issue to factor into your everyday lives and care of your newborn. This is particularly the case if your baby is born before 27 weeks.

Do premature babies have problems later in life?

Some children born prematurely may face developmental challenges such as struggling with controlling their body movement or delays with speech.

Vision problems are common as premature babies are more susceptible to eye diseases such as retinopathy of prematurity. This means the blood vessels behind their eye grow too much and scar the retina, causing blindness if not treated.

Asthma and cerebral palsy are also linked to premature births, so speak to your doctor if you notice any signs.

Letting go of the journey you’d imagined

Julie’s twins were born at 23+6 weeks, “It was a surreal experience. I was initially a little naive about NICU, thinking that they’d be fine and would be discharged when they reach their due date. Of course, as the days went on, I knew our journey as parents would be so, so different.”

Premature babies might need to stay in hospital for weeks or even months. Part of the NICU experience is learning to let go – your baby is fighting a brave fight with an incredible team around them, but so much is out of your control. It’s normal to grieve for the birth and beginning you thought you were going to have, Julie shared, “I learnt to accept and let go of the picture of what I thought life would be like.”

Riding the preemie parent rollercoaster

Every minute of every day in the NICU is an emotional ride you never wanted to be on. Your premature baby is unique and will follow their own development path. Comparing them to the other preemies around you is natural, but it’s a shortcut to heartbreak.

One mom told us: “Things can change in a moment – they might have had a really difficult night then by the morning things are looking positive again. You can go through every emotion in the space of a day: fear, guilt, jealousy, anger, pride, happiness. It’s exhausting, but all totally normal.”

Befriending the other NICU parents around you can be a great support. You’re going through the same thing – they get it. That sense of shared experience is vital, as it means you have someone to listen to when things get tough and celebrate when you have moments of joy.

While not being by your baby’s incubator is hard, allowing yourself to actually leave the NICU and take short breaks to clear your mind, get some fresh air, or hear the voice of a friend is essential. Yes, it’s tough to see the world carrying on while yours is upside down, but the space helps you re-center and return re-energized – your baby needs you at full strength.

Celebrating every premature baby milestone

Premature baby development week by week is unpredictable. Every little step your baby makes is amazing progress and a huge victory in their journey to home – it’s important to find joy in and celebrate them. The day their feeding tube is removed, the day they come off oxygen, the day they are ‘promoted’ to SCBU (Special Care Baby Unit), and you get one step closer to bringing the car seat in. Celebrate inchstones rather than milestones.

Julie remembers, “When Jack was about 5 months old, I came in one morning and called his name, he instantly smiled as he knew it was his mommy and that it was his name. It was such a special moment.”

It takes a village

If it takes a village to raise a child, imagine the support you need as a preemie parent. Not just during their NICU stay but well beyond as you rebuild and recuperate from the experience. Although well-meaning requests for updates from friends and family can feel annoying, always take up offers of help. Or better still, ask.

They will be desperate to support you through this difficult time in whatever way they can, but they won’t know what you need. Ask them to make you some home-cooked meals to heat up when you get home from a day at the hospital. If you have other children, let your family take them out to have fun during this time. And if they offer to come and meet you for a coffee, take them up on it.

Recognising your resilience

Preemie parenthood is relentlessly tough. But caring for a premature baby teaches you so much, and you discover reserves of strength and resilience you never dreamt you had. This will be your parenting super-power, which you’ll use endlessly on the rest of your parenting journey.

How WaterWipes is supporting preemie parents

We’re working with Bliss – a leading UK charity for premature or sick babies. To support preemie parents, WaterWipes and Bliss have launched the About Neonatal Care guide, designed to inform and support parents during this challenging experience. The guide answers many questions you might have if you find yourself in the NICU.

For more information on your journey with your newborn be sure to check out our other articles on the Parenting Community:

FAQS

What does premature mean?

For babies, premature means they have been born before 37 weeks. Premature babies are also known as preterm babies.

What is considered premature birth?

Any birth before 37 weeks is classed as preterm and therefore premature. Babies can be born at 22 weeks and can recover and continue development in the NICU.

When is a premature baby out of danger?

A premature baby who can breathe without support and is showing all the typical signs of functioning normally is likely to be out of danger.

Do premature babies teethe later?

A premature baby’s teeth may come in a little later than typically expected. They may come in later but will usually follow the normal order.

Do premature babies struggle at school?

When NICU is a distant memory and your little one starts school, you may worry. Some preemie children take a little longer to grasp things and may struggle at times but overall, they’ll have a fairly typical school experience.

References
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  1. https://www.tommys.org/our-organisation/why-we-exist/premature-birth-statistics

  2. https://raisingchildren.net.au/newborns/premature-babies-sick-babies/development/premature-development-concerns

  3. https://www.babycenter.com/baby/premature-babies/whats-the-outlook-for-a-premature-baby-born-at-28-31-33-or-3_10300031

  4. https://www.healthychildren.org/English/ages-stages/baby/preemie/Pages/Preemie-Milestones.aspx

  5. https://www.webmd.com/parenting/baby/features/premature-milestones

  6. https://www.verywellhealth.com/what-is-cerebral-palsy-2748620

  7. https://www.ucl.ac.uk/news/2012/dec/more-babies-survive-27-weeks-severe-disability-rates-unchanged