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Caring for a pre-term baby

60,000 babies are born in Ireland every year. Of these babies, 3,000 are born prematurely (before 37 weeks gestation). 600 of these babies are very immature, born at least 8 weeks before their due date.

Many parents of pre-term babies will find this to be an emotional time that involves unexpected experiences of specialised medical care. However, remember all the doctors, nurses and other staff on the unit are highly skilled in providing the best possible care for your baby.

What will happen if my baby’s born prematurely?

• If your baby is born prematurely he’ll need to be admitted to the Neonatal Intensive Care Unit (NICU).
• This is a special area of the hospital that’s been created specifically for the special care of newborns who’ve been born prematurely and require careful monitoring and observation.
• It will contain a great deal of specialised equipment that will help the doctors and nurses to imitate the conditions your baby has been used to in the womb.
• It can look intimidating when you first see it, but the nurse will explain to you what equipment is being kept there and what it’s being used for.

How long will my baby stay in the unit?

• The length of stay can vary tremendously from less than 24 hours to more than 4 months.
• Babies who are born between 24-37 weeks, or who have a birthweight of less than 5lbs will need to stay for longer than others.

What will happen to my baby in the unit?

• Your baby will have very little body fat, so he will be kept in an incubator to keep him at the right temperature.
• Your baby will probably not be clothed, apart from a nappy, so that his skin colour and breathing can be easily monitored.
• Babies who are on breathing machines (ventilators) will also be on heart and oxygen level monitors.

When can my baby come home?

• Your baby is ready to return home when he breathes without assistance, and when he can digest breastmilk or formula independently.
• He will also need to display good muscle control and nervous system development, and regular sleeping and waking patterns.

Feeding your premature baby

Premature babies need to take in more calories per pound than full-term babies, and that means feeding your baby small amounts of nutritious food on a very regular basis.

Why does my baby need such small feeds?

Your baby can only manage small amounts of food at one time because digestion uses up a great deal of his energy.

How will my baby be fed?

Your baby may need feeding by IV line, tube or cup before progressing to the breast or bottle.

Intravenous (IV) feeding

• Tiny babies who are less than 2lb 3oz or those on a ventilator, are fed via a fine tube directly into a vein.
• The tube is known as an intravenous, or IV line.
• Your baby will be fed with a mixture of glucose, salts, amino acids, fats, vitamins and minerals.
• Your baby will also be given a few drops of your colostrum or early milk which is sent down the IV line.
• Colostrum contains many essential nutrients, including hormones, which helps your baby’s delicate digestive system to mature and become stronger.

Tube-feeding

• If your baby is less than 32 weeks post-conception age, breathes faster than 75 breaths a minute and can’t yet co-ordinate swallowing with sucking and breathing he’ll be fed by a tube.
• This is because his stomach is ready to digest milk, but he can’t yet drink properly.
• The nurses will feed your baby with breastmilk or formula by dripping it down the tube with a syringe or electric pump in tiny amounts every few hours.

Cup-feeding

• The next step-up from tube feeding is cup-feeding.
• Cup feeding starts from 30 to 32 weeks.
• You may start teaching your baby to cup-feed while the feeding tube is still in place.

Bottle-feeding

• It’s usual that a baby will weigh over 3lb 5oz, or be 32 to 34 weeks post-conception, before he’s allowed to breastfeed or bottle-feed.
• When you’re first bottle-feeding you’ll need to use a special teat which your nurse can advise you about.

Progressing to breastmilk feeds

• Your body will produce milk for your new baby, perhaps even too much for his currently small appetite.
• You will need to express breastmilk that can be fed to your baby from a sterilised cup, either by you or by a nurse.
• Your breastmilk’s protein level will begin to fall after the first four weeks, so your doctors may start to fortify it with a combination of protein, vitamins and minerals.

Pre-term formula

• You may choose, or it may be necessary to feed your pre-term baby with formula instead of breastmilk.
• Premature babies younger than 37 to 40 weeks can be fed with a specialist pre-term formula.