The Care and Feeding of Preemies

by Amos Huron

Each year more than 530,000 U.S. children are born prematurely, and the large majority go home as happy, healthy babies.

Nevertheless, depending on how prematurely they were born, these infants have a greater risk of short- and long-term medical issues. Babies born prematurely have higher incidences of respiratory conditions and infections.

Any life-threatening problems have been addressed once a preemie is deemed ready to leave the hospital. The medical staff will have briefed the family on any specific health needs the child has.

While parents need to monitor their preemie’s health, doctors caution against overprotection. “We really want them to be treated like any other child,” says Dr. Marjorie Curtis-Cohen, MD, of Holy Redeemer Hospital in Meadowbrook, PA. “It’s a tough tight rope,” she says, but one that parents of preemies must be prepared to walk.

“Parents must be able to tell the difference between when their child is comfortable and when their child might be unhealthy,” says Dr. Miyre Kim, director of the High Risk Neo-Natal Follow Up Program at Virtua Health in Marlton, NJ.

What extra measures do experts suggest in the care and feeding of a preemie?

In-Home Health Care
Parents must be prepared to balance the preemie’s health with other needs. Babies born prematurely are more susceptible to infection, so parents need to limit how many people their child is exposed to. There’s no need to isolate a preemie, but avoid crowded situations where the baby is passed around, advises Dr. Curtis-Cohen. Preemies, like other babies, need to get out of the house when weather permits. Doctors agree that there must be no smoking in the home.

Parents of preemies should focus on physical activity. “It is important to provide good opportunities for children to develop skills,” says Dr. Kim, noting that children born prematurely tend to lag behind their peers in gross motor skills. Babies should be allowed to lie on their stomachs when awake. They should be encouraged to explore their environment much as any child would.

Doctors say stick to regular visits to pediatricians and, if needed, specialists. Should a physical or developmental issue be detected, early intervention is crucial, and is often available through state or county agencies at minimal cost.

Vaccinations are important, especially the RSV vaccine, as this respiratory ailment is particularly dangerous to preemies. Everyone in the house, as well as caretakers, should receive flu shots.

Feeding Your Preemie
Nutritionists agree that breast milk is the ideal diet for preemies, but some babies may need extra calories, which usually are added in supplements to pumped breast milk. Especially when being fed supplements, the baby’s weight must be monitored. Dr. Curtis-Cohen notes that overly rapid weight gain can set a child up for obesity problems later in life.

A major issue is having enough breast milk to sustain the hungry infant. While the child is in the hospital, a mother will have to begin pumping to establish this supply, a process that continues once the child goes home. “This takes a lot of work and dedication,” according to Brenda Waber, a dietician with Children’s Hospital of Philadelphia.

Because preemies often struggle to maintain a healthy weight, breast feeding especially benefits them. But it can help them later in life as well. Breast-milk-fed babies accept different food flavors more readily, and therefore tend to be more receptive to a varied, balanced diet when they are older, says Waber.

The Big Picture
As all parents know, adjusting to a new baby can be stressful, and parents of preemies are subject to additional strains. Take care of your own needs too, doctors advise. Get rest, exercise, relaxation and support. Your well-being will make you a stronger parent and help you to embrace the experience.

“Regardless of how complicated the care is, treat the baby as a baby,” says Dr. Kim. “Don’t lose sight of enjoying your child.”

Amos Huron is an editorial assistant for MetroKids.