Bringing newborns home from the hospital for the first time is an exciting, yet anxious time for many parents. For those who have had premature babies, it can be even more stressful.

“The earlier a baby is born, the higher the risk of dealing with health challenges — especially breathing and feeding issues — that require special care,” said Dr. Addie Smith, a pediatrician in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center. “It can feel like a huge amount of pressure for parents.”

Premature or preterm birth is when a baby is born before 37 weeks of pregnancy. These “preemies” are typically cared for in a hospital’s neonatal intensive care unit or special care nursery, where they receive around-the-clock attention until they are medically stable and can be cared for at home, which is often close to 40 weeks post conception.

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“When a parent goes home with a preemie, they lose that element of their baby being in the tightly controlled environment of the hospital,” said Smith. “All of a sudden, you’re taking care of this medically fragile baby without any of the help you had been receiving from the medical team.”

Potential problems

The two top concerns for many preemies involve a baby’s breathing and feeding because their lungs and digestive systems have not had sufficient time to develop, and they may lack the ability to suck and swallow properly.

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Babies with respiratory difficulties may require supplemental oxygen or, in more serious situations, ventilation machines. To help with feeding problems, a baby might receive nutrients through an IV or a feeding tube. Some infants will go home on respiratory support or with a feeding tube.

“Most of these babies will require specialists and long-term follow-up,” Smith said. “That includes working with a speech therapist to help with swallowing and feeding, and with both physical and occupational therapists to promote motor development. The sooner they can begin working on any developmental delays the baby may have, the better.”

Once a preemie is stabilized, the baby is discharged from the hospital and referred for any pediatric subspecialty follow-up that might be necessary, including to a pulmonologist for breathing; a neurologist for babies who might be having seizures; an otolaryngologist for ear, nose and/or throat issues; an ophthalmologist for eye problems; and a pediatric surgeon if a procedure is necessary.

“There are complex medical issues to navigate, so it’s important to have a team of providers who understand all the problems medically fragile babies may have and who can help with referrals,” Smith said.

Tips for parents

For parents adjusting to life with a preemie, Smith offers some tips to help lessen stress and worry:

• Have a provider who is familiar with the medical issues preemies face.

• Begin follow-up care as soon as possible with developmental and medical specialists.

• Monitor weight gain and seek help from your pediatrician regarding supplementing breastmilk with formula, if necessary. Lactation specialists are available to support moms wanting to breastfeed if a baby is having problems latching.

• Make sure your baby sleeps on their back to help prevent sudden infant death syndrome.

• Don’t feel guilty limiting visitors. For those who do come over, ask them to wash their hands and enforce a strict “no smoking” policy. Don’t let anyone who is sick be near your infant.

• Don’t skip infant well checks, which sometimes include vaccinations.

• Ask for help when needed from families and friends.

• Lastly, avoid comparing your baby to others, as there are many factors that affect a baby’s physical growth, something that is especially true for preemies.

“When we look at children’s development, we look at their corrected gestational age,” said Smith.

For instance, babies born three months early at 28 weeks would not be expected to meet one-year milestones at 12 months, but instead at 15 months. According to Smith, most preemies “catch up” to other babies at about the two-year mark.

“The sky is the limit for many of these preemies, depending upon if they have complications and how many they may have,” Smith said. “But nowadays, with technology and advances in medicine, we can do some amazing interventions to help them grow into healthy children.”