There is no greater joy than expectant parents awaiting the arrival of their baby. But what if your miracle arrives earlier than expected — may be weeks or even months earlier? The premature baby is then cared for in a Neonatal Intensive Care Unit (NICU).
Babies who are born before 37 weeks of pregnancy term, are called preterm or premature babies. Parents of such infants need to take extra care of the needs of their newborns, as they are more sensitive to the environment. Preterm babies need more attention, when it comes to regular activities like bathing and feeding.
The birth of a premature baby leaves such parents with too many questions regarding the baby’s health, his/her growth, maturity and development.
Before we attempt to answer anything — as a practicing neonatologist, I would like to convey to the parents that prematurity is no one’s fault; certainly not the mother’s fault. Most of the time, mothers experience guilt, when they are faced with prematurity.
We need to offer and ensure enough moral support is given to new mothers to cope with this guilt.
Health issues faced by a premature baby
Before we move to that, here are some common symptoms experienced by premature babies:
Problems in their digestive tract
Frequently asked questions about a premature baby:
When will he/she get to go home, and how are you going to cope with this unexpected situation?
What kind of health problems will the baby have?
What kind of survival rates will the baby have?
Can parents touch and see the baby immediately after the birth?
What support will the baby need after birth?
Will the baby need to go to the NICU? How soon after birth and for how long?
Will I or my partner be able to go to the NICU with our baby?
When will I be able to hold my baby?
Although it is not easy, it is very important to remain stress-free. Parental interaction with premature babies — more frequently, including feeding babies with expressed breast milk — “connects” them and makes them feel they are caring for the baby. Hence, most mothers have been allowed 24/7 in most nurseries around the world.
More recently, there have been concepts of in-NICU mom’s stay — also called perinatal bonding — with the mother lying next to the baby’s incubator. This has been gaining momentum to encourage mother’s involvement with the babies – but this has its own issues.
Mothers need to be prepared to stay in the NICU for as long as three months in the case of extremely premature babies, and so on.
Some handy tips for new parents of a premature baby
Try to avoid negative feelings and thoughts
You are one among many and prematurity is not your fault
Choose to read about prematurity and understand what’s going on
You can also feed your child, as soon as your doctor says it’s fine. The nurses will instruct you on either breast-or bottle-feeding techniques, whichever is appropriate for the baby’s needs and your desires. Start expressing breast milk from day 1; even a few drops is useful
Seek support from a lactation consultant, other mothers and support groups who have gone through this. Talk to the nurses in NICU or your doctor for any clarifications
Pump early, often, and well
Use Kangaroo care wherever possible. It is a method of holding the baby skin-to-skin with the mom or another loved one.
Expressing breast milk for a premature baby
If your newborn is too small or ill to breastfeed at first, or if a birth condition prevents the baby from breastfeeding directly, use a breast pump which is an effective way to express milk and establish and maintain an adequate milk supply.
Beginning as soon as possible after your baby’s birth, express your milk at regular intervals, at approximately the times when your baby would usually feed.
Aim to pump at least six to eight times a day; this provides nipple stimulation and encourages milk production. You should pump at regular intervals throughout the night for the first few weeks, since that encourages milk production. If you wake up in the morning and your breasts feel full, it means that you are sleeping too long through the night.
Breast massage before and during the use of the pump has been shown to improve your milk flow and may even boost your milk production. Keep in mind that you will express only small amounts of colostrum at first, but this immune-boosting substance is extremely beneficial for your baby. Some mothers find that expressing the colostrum by hand massage into a small cup or spoon is easier than using an electric pump in the first few days.
You will need to increase the number of times per day you express milk to maintain an optimal milk supply. These fluctuations are normal—just more easily observed when expressing milk than when breastfeeding. Once your baby begins breastfeeding, your milk production is likely to increase. To maximise your milk production, try to get as much rest as possible, take your prescribed pain medication, drink adequate fluids, and minimise stress.