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Arrived Too Early: An Essential Guide for Parents of Premature Babies


Your miracle baby arrived sooner than expected – maybe weeks or even months earlier, and now he is cared for in a Neonatal Intensive Care Unit (NICU). Babies born before 37 weeks of pregnancy are called premature or premature babies. Parents of these infants should pay special attention to the needs of their newborns, as they are more sensitive to the environment. Premature babies need more attention when it comes to regular activities like bathing and feeding.

The birth of a premature baby leaves many parents with too many questions looking for answers about the health of your baby and how the baby will grow, mature and develop in the days and months to come. Before I try to respond to anything, as a practicing neonatologist, I would like to convey and share with all parents that prematurity is nobody’s fault – certainly not the mother’s fault. Most of the time, mothers continue to feel guilty about prematurity. We must offer and guarantee sufficient moral support for new mothers to deal with this guilt – as well as the added uncertainty of survival or survival without deficits.

Premature babies need more attention when it comes to regular activities like bathing and feeding. (Source: Pixabay)

Frequently Asked Questions Parents Asked About the Birth of a Premature Baby

* When is he going to come home and how are you going to deal with this unexpected situation?
* What types of health problems will the baby have?
* What kind of survival rate will the baby have?
* Can we touch and see the baby immediately after birth?
* What support will my baby need after birth?
* Will my baby have to go to the NICU? How long after birth and for how long?
* Will I or my partner be able to go to the NICU with our baby?
* When can I hold my baby?
* Will my baby need medication? Why? What will the drugs do?
* Will my baby need equipment? Why?
* Will my baby develop like other babies?
* Will I be able to breastfeed my baby?

Some common problems for premature babies include:

* breathing problems
*heart problems
* problems in their digestive tract

Although it is not easy, it is very important to stay stress free. Parental interaction with premature babies – including more frequently feeding babies expressed breast milk – “connects” them and makes them feel that they are caring for the baby and that the bond is better. Therefore, most mothers have been allowed 24/7 in most nurseries around the world and should be encouraged. More recently, there have been concepts of the mother’s stay in the NICU – the perinatal link – with the mother lying next to the baby’s incubator. This has gained momentum to encourage mother’s involvement with babies – but it has its own issues – babies should not be very critical and mothers should be prepared to stay in the NICU for the duration of the period. stay (sometimes it can be as long as 3 months for very premature babies) and so on.

Common conditions that occur in premature infants

* Respiratory Distress Syndrome (RDS): This is linked to baby’s immature lungs
* Chronic lung disease / bronchopulmonary dysplasia (BPD)
* Retinopathy of Prematurity (ROP)
* anemia of prematurity (low number of red blood cells)

Some practical advice for new parents

* Positive thoughts – avoid negative feelings and thoughts
* You are one of many and prematurity is not your fault
* Choose to read about prematurity and understand what is going on
* You can also feed her as soon as your doctor tells you everything is fine. The nurses will teach you techniques for breastfeeding or bottle-feeding, depending on the baby’s needs and your wishes. Start expressing breast milk from day 1 – even a few drops on day 1 are very helpful
* Get Informed: Seek support from a lactation consultant, other mothers, and support groups who have been through this. Talk to nurses at NICU, talk to doctor for any clarification
* Pump early, often and well
* Spend time with your baby: use “Kangaroo Care” whenever possible. It is a method of holding baby skin to skin with mom or other loved one, can help make breastfeeding easier for mom and baby.

Expressing breast milk

If your newborn baby is too small or sick 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 adequate milk supply.

As soon as possible after your baby is born, express your milk at regular intervals, around the times your baby was normally going.

Try to pump at least six to eight times a day; this provides nipple stimulation and encourages milk production. You need to pump at regular intervals throughout the night for the first few weeks, which encourages milk production. If you wake up in the morning and your breasts seem full, it means you are sleeping too long through the night.
Massaging the breasts before and during breast pump use has been shown to improve your milk flow and may even increase your milk supply. To do this, make small circular motions with your fingertips, starting at the outer edges of your breast near the chest wall, and slowly work your way towards the center. The massage should always be gentle to avoid rubbing the surface of the skin or massaging so deeply that it causes pain.

Keep in mind that you will only express small amounts of colostrum at first, but this immune-boosting substance is extremely beneficial for your baby. Some mothers find it easier to express colostrum by manual massage in a small cup or teaspoon than using an electric pump for the first few days. Manual expressing in a cup also allows you to keep every drop, instead of wasting milk trapped in the pump tube. Once your milk supply increases, the amount of milk you can express will likely fluctuate from day to day.

Therefore, you will need to increase the number of times per day that you express milk to maintain optimal milk supply. These fluctuations are normal, simply more easily observed during expression of milk than during breastfeeding. Once your baby begins to breastfeed, your milk supply is likely to increase because direct breastfeeding is always more pleasant than expressing the hormones which certainly help increase milk supply. To maximize your milk supply, try to get as much rest as possible, take your prescribed pain relievers, drink enough fluids, and minimize stress.


Direct breastfeeding is possible once the baby has reached a corrected age of 34 or 35 weeks, a little earlier in some babies.

Expressed breast milk is given by palada or bottle after a baby is just over 32 weeks old, when the sucking reflex appears and gradually improves before your baby receives your expressed milk through a tube inserted into the breast. his stomach.

After your baby comes home from the hospital, you may need to continue using your breast pump until your baby is exclusively breastfed (in fact, breastfeeding) and is growing well without need other additional foods.

(The author is the founding president and neonatologist, Cloudnine Group of Hospitals, Bengaluru. He is also a graduate in healthcare delivery from Harvard Business School)

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