7 Tips for Late-Term Preemie Care

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preemie
Photo by Michele Zipp
Hunter, a month old

My twins were late-term preemies, which means they were born between 34 and 37 weeks. I delivered via c-section due to preeclampsia HELLP syndrome at 36 weeks. But both Hunter and Penelope were born healthy, even though each weighed under 5 pounds. Their lungs were functioning well, they didn't have jaundice or need to be under the lamps, and no NICU time was required. After a scary ordeal, I felt very, very lucky because this isn't always the case with preemies.

They were tiny, so tiny in fact that one of my friends screeched when she saw them. Of course, I thought they were perfect. But looking back at those first photos, I realize how frail they looked. Especially compared to how they look now, all chubby at 5 months.

There are some important things to keep in mind when caring for a late-term preemie or any preemie once they get home.

  • preemie
    Photo by Michele Zipp
    Penelope just a few weeks old
    They'll sleep through feedings. We set an alarm to go off every three hours to wake the twins up to eat for the first few weeks of their life. There were some feedings they were up and ready to eat, but others they had to be roused to nurse. They needed the nourishment to grow and not get dehydrated, so we made sure we kept a tight schedule.
  • A preemie's neck is even more prone to slouching, which can constrict the airways. Support for the head and neck is even more imperative for a preemie.
  • A lot of preemies have issues with latch. I've heard nipple shields help, but I didn't have to get one because Penelope, the one who had some latch issues, worked it out. 
  • Some have nipple confusion because they aren't introduced to breast first. I didn't encounter this because my twins wanted to eat (the placentas weren't supplying enough nutrients to them near the end) and they ate out of everything -- a bottle, a cup, a special straw, and even my breast. I sadly couldn't breastfeed the first day because of all the drugs I was on to stabilize me due to my preeclampsia HELLP, so that's why these other measures had to be taken.
  • They have extremely sensitive immune systems. My babies were born in December in NYC at a time when it seemed everyone had swine flu. I was so freaked out I didn't want any visitors in those early days. Too risky, plus I was still sick and felt awful. Not just hand-washing, but arm-washing was so important. Plus, I didn't want anyone to hold the babies without their blanket as a barrier against their skin in case the person was wearing perfume or had a lotion on or even a detergent on their clothes that could irritate the babies.
  • twins
    Photo by Michele Zipp
    The twins today
    Kangaroo care is essential. Sometimes after nursing the babies, I had a twin, sometimes both, lying on my chest with skin-to-skin contact. My husband did the same. This really helps them thrive.
  • A lot of things don't fit a preemie. Not even the preemie clothes fit my babies, but more importantly, sometimes the car seat is too big. Be sure you have an infant-only car seat and consult a certified expert to keep your small baby safe. Read the manual for the car seat and this car seat safety post.

Was your baby a preemie? What are some of the special precautions or things you did to care for your preemie?

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