Premature baby care at home

Discharge and arrival home. Regardless of the reason, prematurity is a risk factor associated with certain health problems and, for that reason, premature neonates are hospitalised until they are able to suitably regulate their body temperature, feed correctly by sucking, and do not have episodes of apnoea. Normally, discharge from hospital takes place between weeks 34 and 40 of postmenstrual age, and with a weight of between 1800-2000 g, also depending on the level of seriousness the patient has displayed. Once home, these children have a series of healthcare requirements and need close medical monitoring, particularly during their first 1-2 years of life.

Hygiene. It is very important to always wash your hands with soap and water before picking up or handling newborns, and you must pay special attention to the cleanliness of their clothes and room. It is not necessary to systematically use antiseptics. Contact with people should be avoided as this can transmit infections.

Environment. Because preterm babies have less body fat, they should normally be wrapped up to regulate their temperature correctly. The temperature of the room should be between 21ºC and 24ºC; the neonate should be neither too cold nor too hot. Their body temperature should be between 36.5ºC and 37ºC. If it is below the recommended minimum temperature, they consume calories to increase their temperature and gain less weight; if they have a constantly high temperature, they are at greater risk of sudden infant death syndrome.

Feeding. The best way to feed newborn babies is with breast milk, as among many other advantages it helps fortify the immune system. Preterm babies need to eat very frequently (eight to ten times a day). When the baby is not able to breastfeed directly, they can be given their mother's milk through a feeding tube, syringe, or with a bottle. In general, these infants need a greater calorie contribution to be able to maintain a suitable level of growth.

Vaccines. These newborns must follow the official immunisation schedule and receive vaccines according to their chronological age. The anti-flu vaccine is recommended for everyone in the family environment.

Sleep. Newborns normally sleep between 16 and 18 hours a day, and premature babies may sleep even more. They should be laid down on their backs (in the supine position) and there should be no toys or other objects in the crib.

Visits. It is recommendable to limit visits, particularly at the beginning, and avoid contact with anyone with an infectious disease or cold. If someone has a respiratory disease, they should not be any closer than 2 metres to the newborn, and they must wash their hands frequently as they may transmit the disease via objects they touch with dirty hands.

Going out for walks. If the weather allows, the baby can be taken for a walk in the street. To prevent possible infection, is always necessary to avoid places where there are lots of people.

Neurosensory stimulation. Newborns should receive stimuli to facilitate their neurodevelopment. For this reason, contact between baby and parents is fundamental. They should talk to the baby softly, hold it, and play with it.

Medical follow up. Preterm newborns need specific medical monitoring, especially those with a birthweight of less than 1500 g. Their neurodevelopment should be periodically monitored. Extremely preterm babies, patients with neurological damage, or where warning signs are observed during follow up, should go to specific centres for early stimulation and multidisciplinary treatment from a physiotherapist, psychologist, speech therapist, and so on. Also, depending on their clinical evolution, they may require care from a pulmonologist, paediatric endocrinologist, cardiologist, gastroenterologist, and nutritionist or neuropaediatrician, among other specialists.