Caring for Your Premature Baby

Last Updated November 2022 | This article was created by familydoctor.org editorial staff and reviewed by Kyle Bradford Jones

The birth of a baby is usually a happy time but can also be stressful. There are many things that can add stress, including if your baby is born premature. A baby is premature if it is born before the 37th week of a normal pregnancy. Sometimes premature babies are called “preemies.”

Path to improved health

Babies who are born premature will likely need special care during their first 2 years. This is especially true if they weigh less than 3 pounds when they’re born. But you can help your baby be healthy, grow, and develop when you bring them home from the hospital. Here’s some advice:

  • Make an appointment to take your baby to the doctor soon after the baby leaves the hospital. Your doctor will check your baby to confirm that they are gaining weight and discuss how your baby is doing at home.
  • Talk with your doctor about feeding your baby. Breast milk is the best baby food but breastfeeding may not be an option with premature babies. Premature babies often have more difficulty with breast feeding because of their delayed development. It’s also difficult because it may take longer for the mother’s milk to come in given the premature birth. If your baby is having trouble nursing, your doctor may be able to help you solve this problem. Or your doctor may refer you to a lactation consultant. Breast milk can be fed from a bottle as well as from the breast. It can be pumped and stored if you prefer to feed breast milk from a bottle. This is helpful if you’re away from your baby due to his or her care needs or your work. If your baby takes formula instead of breast milk, a special formula may be needed. Your doctor may recommend you give your baby vitamins and iron. Vitamins are often given to premature babies to help them grow and stay healthy. Your baby also may need extra iron. That’s because premature babies don’t have as much iron in their bodies as full-term babies. Your doctor may want your baby to take iron drops for a year or longer.
  • Watch your baby’s growth. Premature babies may not grow at the same rate as a full-term baby for the first 2 years. Premature babies are usually smaller during this time. Sometimes they grow in spurts. They usually catch up with full-term babies in time. To keep a record of your baby’s growth, your doctor can use special growth charts for premature babies. Your doctor also will want to keep track of your baby’s milestones. This would include things like activity level, sitting up, and crawling.
  • Be consistent with your baby’s feeding schedule. Most premature babies need 8 to 10 feedings a day. Don’t wait longer than 4 hours between feedings or your baby may get dehydrated (not getting enough fluids). Six to 8 wet diapers a day show that your baby is getting enough breast milk or formula. Premature babies often spit up after a feeding. This is normal. However, you want to make sure your baby is still gaining weight. Talk to your doctor if you think your baby has stopped gaining or is losing weight.
  • Prepare for solid food. Most doctors advise giving a premature baby solid food at 4 to 6 months after the baby’s original due date (not the birth date). Premature babies aren’t as developed at birth as full-term babies. It may take them longer to develop their swallowing ability. If your baby has medical problems, your doctor may recommend a special diet.
  • Give your baby plenty of opportunity for sleep. Although premature babies sleep more hours each day than full-term babies, they sleep for shorter periods of time. All babies should be put to bed on their backs, not on their stomachs. This includes premature babies. Use a firm mattress and no pillow. Sleeping on the stomach and sleeping on a soft mattress may increase your baby’s risk of sudden infant death syndrome (SIDS). Also called “crib death,” it is the sudden and unexplained death of a baby younger than 1 year. It usually happens while the infant is asleep.
  • Check your baby’s vision. Crossed eyes are more common in premature babies than in full-term babies. The medical term for this condition is strabismus. This problem usually goes away on its own as your baby grows and develops. Your doctor may want you to take your baby to an eye doctor if your baby has this problem. Some premature babies have an eye disease called retinopathy of prematurity (ROP). This is where the small blood vessels in the eye grow abnormally. ROP usually occurs in babies who are born at 32 weeks of pregnancy or earlier. If there’s a chance your baby has ROP, your doctor will advise taking them to the eye doctor for regular checkups.
  • Check your baby’s hearing. Premature babies are also more likely than full-term babies to have hearing problems. If you notice your baby doesn’t seem to hear you, tell your doctor. You can check your baby’s hearing by making noises behind or to the side of the baby. If your baby doesn’t turn his or her head, or react to a loud noise, tell your doctor.
  • Get your baby’s immunizations. Immunizations (also called vaccines or shots) are given to premature babies at the same ages they are given to full-term babies. Your baby may need a flu shot when they are 6 months old. Premature babies might get sicker with the flu than full-term babies. Talk with your doctor about flu shots for your entire family. This can help protect your baby from catching the flu from someone in the family.
  • Protect your baby while traveling in a car. When traveling with your baby in a car, use a safety-approved infant car seat. Be sure that your baby’s head and body don’t slump over when they are in the car seat. Your premie baby may need extra support in the car seat. You can use rolled-up towels or receiving blankets to give your baby this extra support. The car seat should be installed in the back seat. You can have a friend or family member ride in the back seat with your baby to watch them. Your baby should start off in a rear-facing car seat. Ask your doctor when it’s safe to move your baby to a forward-facing car seat. Never leave your baby alone in the car, not even for a few minutes.

Things to consider

If your baby is born premature, there are certain things that can affect his or her health, learning, and your family’s schedule. Babies born prematurely may need to stay in the hospital longer than full-term babies. They may be in a special section of the hospital called the NICU (newborn intensive care unit). This hospital stay can be a strain on your family’s routine. It requires daily visits to the hospital until the baby is released. If you have other children, it requires dividing your time between the hospital and caring for your children at home. One or both parents may need to take additional time away from work during this period.

Once your baby comes home, you will need to protect them from exposure to others and illness. Germs and illness can be tougher on a premature baby. Finally, some premature babies struggle with learning, gross motor (crawling, walking), and fine motor (picking up things, feeding themselves) development. They will eventually catch up. However, it may take them longer to learn those skills.

Questions to ask your doctor

  • If my first baby was born premature, does that increase the risk for prematurity for additional babies?
  • How can I help my premature baby catch up on his or her developmental milestones?
  • How long should I wait to take my premature baby out or expose them to others once we’re home?
  • Can being born premature increase my baby’s risk of cerebral palsy or other chronic health conditions?

Resources

March of Dimes: Premature Babies

National Institutes of Health, MedlinePlus: Premature Babies