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.


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  1. says

    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.

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  2. Andy says

    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).

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  3. SB says

    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!!!

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  4. Nicole says

    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!

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  5. says

    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.

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  6. shelly says

    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.

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    • says

      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.

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      • Shelly says

        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.

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  7. says

    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.

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  8. Anna says

    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.

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