What To Expect With A Premature Baby

What To Expect With A Premature Baby

The plan is to be pregnant for nine months. You need that time to get the nursery ready, to finish up your projects at work, and eat at least a dozen pints of guiltless ice cream that your loving husband goes to get at 2am. My son, Linus, was born when I was only 24 weeks pregnant. Weighing only 1 pound, 8 ounces and measuring 12.5 inches, he resembled a miniature version of the newborns I was accustomed to. All of a sudden I was faced with the reality that I was nowhere near ready and I had no idea what to expect with a premature baby. Here, however, is what you can…

1. After you give birth, you, most likely, will not get to hold your baby. The best part about being pregnant, is you get a baby at the end. When you have a preemie, that “new baby” smell is trapped within the walls of an isolette. Yankee Candle should look into trademarking that scent. In a flash, Linus was whisked away to the Neonatal Intensive Care Unit (NICU) and I was wheeled into a postpartum room, sans bassinet and baby supplies.

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2. A nurse/lactation consultant will wake you 3 hours after you give birth and thrust a breast pump into your hands. In your drugged up stupor, you will wake to find a woman fondling your breasts. Be ready to be manhandled as she positions those plastic horns around your nipples. Then, she turns up the suction. You will be able to borrow a pump while you are a patient and the NICU should have a pumping station in the parent lounge. If you are in it for the long haul, look into renting or purchasing a hospital grade pump.

3. Do not feel guilty if you decide to formula feed. You need to do what is best for you and the baby. Don’t be afraid to talk candidly with the NICU Staff about your concerns, they are the most dedicated and caring people I have ever met.

4. The NICU can be a scary place. Linus was so delicate and fragile when he was first born. There were so many wires and tubes attached to him that you could barely see his face. His skin was so thin, it was almost translucent. I wasn’t allowed to pick him up and hold him. Instead, I was instructed how to place my hands on his small body using a firm touch. I often wondered if he was crying, but was too weak to make a sound.

5. You will become jealous of the other moms in the postpartum wing. Every time you hear a baby cry or see another mother cradling her newborn bundle, your arms will start to ache.

6. You will become a walking medical dictionary. In order to advocate for your child and to fully understand each diagnosis, make sure you ask the medical staff all the questions that pop in your head. Stop consulting Doctor Google, because you have plenty of medical professionals at your disposal. Before long, medical terms you have only heard on Grey’s Anatomy will start rolling off your tongue.

7. Most importantly, if you have a concern, or your baby somehow seems to be acting different, say something. Make sure you ask if the feeding schedule has changed or if any new tests were done. If you don’t understand something, don’t be afraid to have the staff explain themselves.

8. The NICU is noisy. There most likely will be a dozen little incubators in the room you are in. Each bed will be attached to several monitors. Loud obnoxious alarms go off, literally, every few seconds. While the constant noise will totally freak you out, I think it comforts the babies. More than once I witnessed a cascade effect, where a relatively quiet room exploded in alarms. It was almost like one baby, said “Hey! Over here!” Only to be met with a reciprocating chorus of “Me too!” and “I want my mama.” I can still hear those monitors beeping and alarming in my sleep.

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9. Be mindful of the NICU schedule. I was not allowed to be in the NICU during shift changes, so I had to know what time those changes occurred. Before each shift change, find out which nurse will be in charge of your child. This way, you’ll know whom to address concerns to. It’s a great idea to keep a list of the NICU’s phone numbers handy in case you want to call for updates while you’re away. Once you are familiar with the NICU routine, it will make it so much easier to plan your visits.

If you want to be present during feeding time, bath time or weighing, find out your baby’s schedule and see if you can help with your baby’s care. Once my son was taking a bottle, I would inform the staff when I would be in so that they knew to wait for me to arrive before feeding him.

10. The NICU has rules to protect your baby. The smell of hospital soap and hand sanitizer will be your new perfume. Your hands will be red and raw by the time your baby is discharged. Just the smell of hospital soap brings me right back to sitting next to the isolette with my hand stretched through the porthole, resting firmly on Linus’ back.

11. Your touch is so important. Touch your baby as much and as often as you can. Preemies prefer a firm touch. Place your hand on your baby’s back and cup their head or hold onto their hand. Preemies benefit from kangaroo care. Don’t get down on yourself if your baby cannot tolerate being held for long periods of time.

Every day I asked if it was the day I could hold Linus. Finally, the day came, and the sweet nurses helped untangle all of the wires and tubes. I think he was in my arms for less than 30 seconds before he needed to be put back in his incubator. He was already over one month old, and it was the first time I was able to kiss the top of his tiny head.

I thought my arms ached to hold him before. That 30 seconds was the worst tease ever. It was another two weeks before I was able to attempt to hold him again.

12. Be prepared for a host of follow-up visits, with specialists you never knew existed. Your medical experience will not end with the NICU. You will visit at least a half dozen specialists, in addition to your pediatrician, just about every week for the first year. However, there is only one that I was not ready for. The first visit to the ophthalmologist freaked me out. Preemies need to have their optic nerve checked. This consists of inserting a metal clamp thing into the eye, and tucking the eyelid in somewhere behind the ear. It was like something out of Total Recall. I couldn’t take it. Send your partner instead.

13. It’s okay to go home. You will have a lifetime to raise your baby. While your child is in the NICU, put your trust in the medical team. They are there for your baby. Each shift, your baby will be assigned their own personal nurse. As a 24 weeker, Linus’ nurse was usually strictly dedicated to him, or shared with just one other little friend.

You job, right now is to take care for yourself. Get rest. Get your flu shot. Pump. Finish all the preparations you didn’t get to do while you were pregnant.

14. Better days lie ahead. The time your baby spends in the NICU will seem like an eternity. After 94 days, I was finally able to bring my son home. Now, he is an extremely active and healthy two year old who finds new ways to make our lives interesting every day. As a matter of fact, in the time it took me to write this post, he has managed to swing upside down from the bottom of the highchair, squeeze a juice box in my lap, and wrestle the cat. Rest up while you can.

15. Once your baby is discharged, you can leave the house…and have visitors.The nurses will warn against visitors and germs. Listen to them, the truth is there are a lot of dangers out there, especially ones that are only half-baked.

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But you can have visitors as long as no one is ill (not even the sniffles) and practices good handwashing habits. No toddlers or preschoolers outside of the immediate family. No offense to your sister-in-law’s best friend’s third cousin, I’m sure they want to see your baby, after all he or she is the cutest baby in the whole world. However, there is a reason your baby just spent three months in a sterile environment. To your child, everyone else in the the world is a big, festering, pus filled, germbag, and the smaller they are the germier they are.

Use your best judgment. Unless you have an underground tunnel leading from your house to the pediatrician, you’ll need to take the baby out into the world. I know mothers who quarantined themselves and their babies for months, and one for almost a year. I am not sure how they did it, because I would have gone crazy. With seven other kids to care for, quarantine was just not practical, and the reality was my own little germbags brought more icky bugs home off the bus than Linus would have ever picked up in his stroller at the mall.

About the writer

Jennifer is a duct-tape wielding, tissue carrying, referee to 8 crazy kids. Her blog, Beyond The Crib, explores the challenges moms face. You can also find her on Facebook and Twitter.


Melissa 7 months ago

I wish I read this before now. My son is now 2 months old and was born at 29+3. He has done so well and he was only in the NICU for 5 weeks. I was able to hold him the day after he was born. We are going through the weekly eye checks now and it is super stressful. ROP terrifies me.

Kayla 11 months ago

I just had my baby girl. 27 weeks and 4 days. She was 2 lbs and 7 oz. I’m nervous and don’t 100% know what to expect.

Ruchi 12 months ago

Thanks a lot for this article it helped me out a lot as on this 9th April 2015 we are blessed with a preemie boy in 26th week he is in NICU now and this is the toughest time I am having today it’s just 29 week n 4 days m only praying best for him

anna 1 year ago

I was shocked when my 8th child was born technically premature at 36 weeks. I had no idea what to expect. Amazingly he had no serious problems and was shipped home with us three days later. He was so tiny, skinny and fragile. I did end up supplementing with formula and I’m glad that at my ancient old age of 41 I no longer cared what other people might think. He is 10 weeks this friday and a bruiser with chubby cheeks.

Grace 2 years ago

I can totally relate! I had a 25 week preemie and spent 193 days in the NICU. Our son had multiple health problems that include 4 months on the vent and heart surgery. He has some delays, but we feel so blessed on the other side.

Both during that time and now, it is isolating and scary as very few people I know can relate to anything we have been through. When people with preemies that were only a couple of weeks early describe their “long” NICU stays, I roll my eyes and want to scream. Others tell me how it was 12 whole days before they could hold their babies. I waited from September 29th to January 8th to begin holding and cuddling our son.

I have to remind myself often that these people had real experiences, and that I need to be compassionate. Having a preemie has been hard, but we have survived and our son is so wonderful!

Judy 3 years ago

Thank you for sharing you are so right on every point. I had my now 15 month old baby girl at 35 weeks but she only weighed 3lbs. In addition to going through all the NICU stuff i was pretty much all alone. I had her in Moscow Russia and i don’t speak the language, I’m Syrian so my mother couldn’t come and help out due to the war there. One point that I would like to add is that for me at least the 40 day NICU experience still hasn’t left me, it’s to the point where i can’t smell a certain brand of wet wipes that they used in the hospital because it brings back awful memories. I look at my daughter and i know what a blessing it is that she is happy and healthy and i couldn’t be more grateful, but i wonder if the whole NICU experience will ever be a very very distant memory.

Sam Reene 3 years ago

Our Son Nathan was born May 7, 1992. My wife was in her 24th week of pregnancy when she went into Labor drove herself to the hospital since I was at work, thinking it was indigestion or gas she was shocked to learn she was in labor. The Dr gave her some medicine and got her labor to stop, but before long it started again and the Dr told her she was having a baby that day. There were no cell phones and since I work construction we had no telephone so by the time I got to the Hospital it was pretty much Chaos Central. A nurse came into the room telling us they had lost every 24 week baby in the past so it would surely be a miscarriage and did we have any idea where they should send the body? A few choice 4 letter-words later she ran crying from the room, a short time later the Neonatal Dr explained how 26 week birth the lungs had developed enough to function much better and at 22 weeks there would be no chance for survival. So the Dr asked us if there was any chance of immediate survival, there was a bigger chance of Blindness, Brain damage and his chance of surviving was still 15-20%. We told the Dr if it he’s alive to go all out to save him. It was probably one of the easiest deliveries ever out slid my son weighing in at 1lb 7.5 oz-12 inches of bouncing well he looked like a baby-bird/frog. they got him to neonatol and for 6 hours we waited and hoped until they said come see your New Son. I sure hope its got a little better in the past 20 yrs. He is now 21 with a mild learning Disability, very polite, very ornery, very fun.

Grace | Yummy Baby Gifts 3 years ago

My 1st baby was not a premie but she had to go to the nicu right after birth so she can be checked. She was fine but I had to be away from her those first two days and never liked the nicu for many reasons you mentioned.

Sarah 3 years ago

This is such great advice! My daughter Riley was born at 30 weeks. I wasn’t even close to being

Kara T 3 years ago

I admire the strength you had and all mothers who go through this experience and am overjoyed to hear about the babies that end up thriving and growing up to become healthy, successful kids/teens/adults. I am 17 weeks pregnant with my third and am one of those lucky ones whose buns bake for 40+ weeks and are still stubborn about coming out {but there is always that worry in the back of my mind}. However, I’m sure we ALL look at our children and think about how lucky we are to have them in our lives, no matter what birth experience we had.

    Jennifer Swartvagher 3 years ago

    Thank you. Wishing you a happy and healthy remainder of your pregnancy.

Amber 3 years ago

This would be scary. I’ve never had to deal with the NICU. This is a wonderful post for those who have had a premature baby.

    Jennifer Swartvagher 3 years ago

    Thank you.

Kristine 3 years ago

THANK YOU for this post. I had a healthy baby one day before his due date, after several scares he might come way too early. When I’m stressed out or losing it (he is 8 weeks old now) I need posts like this to remind myself how lucky we are when things go as they should, and keep that feeling with me always. I held him immediately and I shouldn’t take that for granted!

    Jennifer Swartvagher 3 years ago

    Congratulations on your new baby!

Diane Tolley 3 years ago

My preemie was just five weeks early, so my story is very much different.He was only in the incubator for a week! He is now 35 years old, six foot eight, a cop and father of four. But when I look at him, I still see that tiny boy and remember aching to hold him. Thank you for this informative post! I will pass it on!

    Jennifer Swartvagher 3 years ago

    Thank you. It is sweet that you still see the tiny baby your son used to be.

Sharon Edelen 3 years ago

Praise God for you and Kaitlyn!! Our God is so Amazing. We are so very Happy to have such a wonderful daughter & she is a Great MOM!

Robin Lamont Huntley 3 years ago

Our God's not dead…He's surely alive!

Nichole 3 years ago

Beautifully written! My twins were born at 31 weeks and spent 4 or 5 weeks in the NICU. The hardest part for me was being discharged without them, I bawled the entire way home and all through the pharmacy waiting for my prescriptions.

    Jennifer Swartvagher 3 years ago

    Thank you. It was so hard leaving the hospital without him.

Charissa Hobbs 3 years ago

Great article…I had my miracle at 28 weeks- 1 lb 10 oz & 13". She is amazing and even though I didn't get to deliver 'normally' I wouldn't change a thing.

    Jennifer Swartvagher 3 years ago

    Thank you. Congratulations on your little miracle.

Jessica 3 years ago

I loved this! My son was a preemie. I didnt know what it was like to miss my child until I found out I couldnt go home with him. At first, I put on a brave face, but once I was home, it was a completely different feeling. I had all of these gifts from family and friends, and the baby bassinet waiting to be used, but no baby..

I sat down on the edge of my bed thinking: Now what? I wasnt tired, like I expected to be, and I didnt have my baby… It was awful!
The nurses though were amazing! As soon as I walked up to the NICU, they basically knew my name, and led me to my son. My beautiful 5lb 1 oz son.. that moment, when the nurse put him in my arms, was simply beautiful!

    Jennifer Swartvagher 3 years ago

    It was so hard to leave, but the nurses soon became our second family. I still consider them to be Linus’ aunties.

Marcia 3 years ago

All that you wrote is all so true. After sixteen years I can still hear the alarms. At 34 weeks I had twin girls, 2lb 11oz and 4lb 4oz. The hardest thing I had to do was bring one home without the other. After two weeks Sarah was discharged but Robyn was there for 4 1/2 weeks. Those two and a half weeks leaving Robyn “alone” was torture. The NICU staff was fabulous and I know they got the best care possible.

    Jennifer Swartvagher 3 years ago

    I couldn’t imagine how hard it would be to take one baby home and still have one in the NICU. It must have been a beautiful day when they were reunited again.

Sarah 3 years ago

Thank you for this! One of my best friends is currently NICU parenting her two surviving triplets, born at 26 weeks. She’s at day 88 and they are doing well. We were very lucky to not have NICU with our twins, and I am amazed every day by the strength of NICU parents, the incredible medical team and the amazing care those two are getting.

    Jennifer Swartvagher 3 years ago

    I will keep your friend in my thoughts. I hope she is able to bring her babies home soon.

Anna 3 years ago

Our 30-week premie twins turn one on Sunday! Wish I had had this to read then. All of it speaks to our experiences. We were lucky to have wonderful nurses who balances the chaos with love. Thank you for sharing!

    Jennifer Swartvagher 3 years ago

    Happy birthday to your preemies!

Rebecca Dugas 3 years ago

I cried when I read this. Especially the part about finally holding your son, if only for 30 seconds. Brought me back to the many weeks my twins and I spent in the NICU. The were 29 weeks & 2.5 lbs. I thought I would die the day I was released from the hospital and had to go home and leave my babies behind. They are now 3 years old, happy, healthy handfuls and no worse for the wear. They are my constant reminder of how resilient and precious life is. And I found out the strength, love and dedication of a mother knows no bounds. Well almost- I send them to preschool two mornings a week so they can drive someone else crazy for awhile. We all have our limits. ;). Thank you for sharing your story.

    Jennifer Swartvagher 3 years ago

    Thank you. Congrats on your happy, healthy, handfuls.

Allison 3 years ago

I am so happy to see you do a post on Preemies! My second child was born at 25 weeks and 1 lb 4 oz almost 2 years ago. How I wish I had read this then!!! It is an experience my family will never forget that irrevocably changed my parenting experience. 100 days we spent in NICU and took us time to learn many of the things you have listed. I hope your post reaches all those mothers who are starting their NICU journey and gives them a helping hand!! Thank you so much for writing this!

    Jennifer Swartvagher 3 years ago

    Thank you. Yes, the NICU experience has changed us as parents as well. I hope this post reaches all the moms and dads starting out on their NICU journey.

Kathy R. 3 years ago

This. This. Oh my yes this. Our son spent a month in the NICU and it seemed like forever. (Now he’s 11 and entering puberty!) The NICU nurses are the most wonderful people ever; make it your job to learn their jobs so you can work with them to bring your baby home.

    Jennifer Swartvagher 3 years ago

    I will be forever grateful to Linus’ NICU nurses. I can’t wait to go to the reunion next month.

Anna 3 years ago

Something you don’t hear about are the potential medical problems later on. My daughter was born at 30 weeks in 1989 and when she was 10 yrs old, she started having seizures. Turns out that she has a congenital birth defect that wasn’t discovered at birth. Cavernous Hemangiomas in her brain. She had brain surgery when she was 14 yrs old, and she still has to take medication to control her seizures. She’s 24 now and has 3 babies of her own, but we constantly worry about her still.

    Jennifer Swartvagher 3 years ago

    That had to have been so scary. I wish you and your daughter all the best.

Ariana is Still Growing 3 years ago

Well done! Every woman currently with a high risk pregnancy should save or print and post this! Every word is true. It was 22 years ago this month that I had my own preemies, only 5 weeks early, and only 1 week in the NICU, but every experience still occurred. Some words, like “whisked away” stay with you forever, giving birth, and then seeing the back of a doctor or nurse as your baby is being taken to another examining room, then to the NICU…it’s an empty feeling that can’t be described.
I would add to point #13, if you have the time and ability, don’t feel guilty if you go out to dinner or a movie, you need the down time and you’re not going to get it again for a long while.

    Jennifer Swartvagher 3 years ago

    Thank you. The time while your baby is in the NICU is so stressful, you need to unwind and take some time for yourself, even if it is just to go home to shower and nap.

shelly 3 years ago

NICU NURSES ARE THE BEST. I will remember everyone of them forever. Answered every question, every concern, every anxiety, every fear with compassion. Angels. They are the reason I have my daughter. She was a 24 week preemie. Whopping 18 ounces at birth. Yeast infection on skin, eyes still fused shut, and skin so thin you could watch the organs. Heartbreaking, yet amazing. 117 days in NICU, 3 eye surgeries, high blood pressure, home heart monitor, PT, OT. That was just her 1st year. Now at 10 yrs old, only glasses to see. You covered everything almost exactly as me. I never got breast milk (me–genetics) so she was formula the whole time. Held for the first time at 2 weeks old during her baptism. The hard part was watching all the other babies get to go home before us. The hardest…watching families loose their babies.

    Jennifer Swartvagher 3 years ago

    NICU nurses are some of the best people in this world. They cared for my son when I couldn’t.
    It was so hard watching other babies go home, but it showed me there was hope and that soon, it would be us.
    On Linus’ first day in the NICU, I was there while another family was saying goodbye to their baby. I was so sad for them.

      Shelly 3 years ago

      What I remember most about the nurses….they were happy. They all, everyone, loved their job. And that right there made walking into that room bearable.
      I watched at least 100 babies a month come and go. Some for short stays…just a day or 2… some for longer. While jealous as all get out that they got to go home I can never know the pain and heartache of leaving with no baby. Or like a mom I became friends with while we were both there loosing one twin. Extreme sorrow, fear, love, anger.

Mercy 3 years ago

My first baby was a preemie, born at 33 weeks. I thought the 10 days he spent in the NICU was long. Hats off to you for surviving over 3 months, and somehow keeping up with the rest of your kids.

    Jennifer Swartvagher 3 years ago

    Thank you. 10 days or 3 months, any NICU stay is hard. Glad to hear your son’s time in the NICU was short.

Nicole 3 years ago

I read this with tears in my eyes as I relived the time of my emergency c-section and my son in the nicu. How I wish I would have read this before. Thank you for writing this and helping prepare other mothers for the ‘what-ifs’ of pregnancy!

    Jennifer Swartvagher 3 years ago

    Thank you. Linus was an emergency c-section as well. I hope this post reaches all those moms with high-risk pregnancies as well as those who are not expecting any complications.

Heather Holter 3 years ago

I'm sorry you had to go through that. I had premature twins at 34 weeks and my sister did too (35 wks), and another sister had a premature baby (32 wks), but we were there much less time. 6, 20, and 26 days.

    Jennifer Swartvagher 3 years ago

    Thank you. I am always happy to hear about short and (hopefully) uneventful NICU stays.

SB 3 years ago

I was a preemie myself, born at 27 weeks (just over 2 pounds). I couldn’t go home for 3 months and was on a heart monitor for a year. I can only imagine the agony my mom went through- 19 years old with her first baby clinging to life. She must have been terrified. Every time my heart monitor would go off (I had apnea) her heart would stop. I technically died once, and the doctors spent an hour reviving me back while they transferred me to another hospital.

I am pregnant myself now with my first, and pray that I don’t have a preemie. But if I do, I am hopeful that my little one will pull through as I did, and as your son Linus did. Hats off to moms who go through this type of ordeal- and blessings be with them that their tiny miracles pull through!!!

    Jennifer Swartvagher 3 years ago

    Wow! You are a miracle. Good luck with your pregnancy. I wish you a happy and healthy 9 months.

thedoseofreality 3 years ago

What an incredibly helpful post for mothers and fathers out there. No one is expecting this to happen to them, so having this kind of advice would be crucial. Well done!-Ashley

    Jennifer Swartvagher 3 years ago

    Thank you. I always knew premature birth was a reality, but I never expected it to happen to me. I hope this post will bring comfort to a new parent in the NICU.

Andy 3 years ago

Thank you for this. While my son was not as early, at 36 weeks he needed almost two weeks in the NICU to let his lungs mature after I went into early labor. Although I had a hunch I wouldn’t make it to 40 weeks-I had his big sister at 37 weeks-it was still a nasty jolt to have my baby whisked away from me while I was on the operating table being stitched up from my c-section. My last night at the hospital was the worst-the baby in the room next door started crying, and I thought I was was going to go crazy, I wanted my boy so badly. Not to mention feeling as though I was leaving a piece of my heart behind when I was discharged over a week before he was. Thankfully we’re home now, and I’m one of the lucky ones who not only had a short NICU stay but whose baby, after two weeks of pumping, latched on and nursed correctly the first time he tried (I had exclusively pumped for my daughter due to her being low birth weight and not strong enough to latch-by the time she was strong enough she would only take a bottle).

    Jennifer Swartvagher 3 years ago

    I am happy to hear your boy had a short NICU stay and is home with you.

Debbie 3 years ago

Jennifer you have done a wonderful job explaining what to expect if your baby is premature. That has to be so hard not to be able to hold them and cuddle them.

My hat goes off to you and by the way I came from a family of 7 kids and I often wonder how my mother ever did it. Cooking for them is like having a family get together every meal.
Thanks again for sharing what to expect with a premature baby.

    Jennifer Swartvagher 3 years ago

    Thank you. During our NICU stay I would get sad thinking about all those lost cuddles, but I knew once he was discharged I would make up for all that lost time.

    I love having a large family. Kudos to your mom.


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