No more premature baby blues

Caring for preterm babies is not so different from caring for normal term babies but the pandemic can throw up challenges that need some navigating, writes Dr Sreenath Manikanti

If your baby was born preterm, you might feel excited about taking the baby home after a prolonged hospital stay and you might feel anxious to walk away from the safety of the hospital NICU. There’s however, no need to worry though as caring for preterm babies is not so different from caring for normal term babies. The doctors only discharge a baby born preterm if they are sure that the baby is healthy enough to leave.

The main requirements doctors check for before discharge are: Can the baby maintain its temperature in an open crib without a radiant warmer or incubator? Can the baby take all feedings by breastfeed and without supplemental tube feeds? Can the baby gain weight steadily? Most premature babies meet these criteria 3-5 weeks before their original due date.

• The correct temperature: You need to make sure that your baby is at a comfortable and safe temperature. The most effective way to do this is by adding layers of clothing or removing them when necessary. Try not to overload the bed with blankets as it can raise the temperature too high for the baby to handle. Buy a digital thermometer and maintain the baby’s axillary temperature between 36.5-37.4 C (97.7-99.4 F). The ideal room temperature for sleep is 20-24 C.

Helping your baby sleep: You can help your baby sleep better by setting the right environment, like cool temperature and dim lighting all in a quiet room. Preterm babies also get hungry more often in the night than term babies because the smaller the baby, the more often they need to feed.

Bathing your baby safely: The water should not be hot but warm instead. Aim for bath water temperature 100 F (38 C). Wash his/her hair with plain water only. Don’t add any liquid cleansers to the bathwater. Plain water is best for the baby’s skin in the first month. Give a sponge bath until the baby reaches an ideal weight of 2.5 kg. Avoid using any lotions or oils until your baby is at least a month old.

Prevention of Sudden Infant Death Syndrome (SIDS): This is a syndrome also known as cot death in which apparently healthy babies die in their sleep, usually within the first six months of life. Premature babies are at a slightly increased risk than term babies. It is still not known exactly what causes SIDS. The following measures help prevent SIDS:

• Never let your baby sleep on his stomach: This can harm the body and can cause breathing difficulties. It’s alright if he turns over by himself as his brain is mature enough to alert him to breathing dangers.

• Back-sleeping: This increases a baby’s access to fresh air and makes him less likely to get overheated (overheating is a major cause for SIDS).

• Side-sleeping isn’t safe either: Studies show that putting a baby down on his side rather than on his back doubles the risk of SIDS.

• Don’t add anything in the bed except a fitted sheet: Wait until your baby’s first birthday before adding any pillows or blankets as these can alter your baby’s breathing.

• Be careful while sleeping together: While sleeping in a bed, your baby could be suffocated by a pillow or a loose blanket. His/her air supply could be cut off if you or your spouse rolls onto him. Try to avoid co-sleeping until he becomes a little older.

• Breastfeed him as long as you can: Babies who are breastfed are more easily woken from sleep than formula-fed babies, which may be a reason babies who are breastfed are less likely to die from SIDS. Don’t smoke or drink alcohol if you are breastfeeding as it increases the risk of SIDS.

• Practice kangaroo care and continue breastfeeding: In a warm room at home, dress your baby only in a diaper and place the baby on your chest and turn the baby’s head to one side to enjoy skin-to-skin contact. Practice kangaroo care for as long as possible and as frequently as possible. Research has shown that kangaroo care in preterm babies enhances parent-infant bonding, promotes breastfeeding, stabilises the infant’s heart and respiratory rate, improves oxygenation, regulates body temperature and promotes growth.

• Prepare for an emergency: Now is the time to prepare for an emergency, before one arises. Find out the nearest hospital emergency and fastest route from your home. Be prepared to call for an ambulance if you believe your baby’s condition is critical. Save the NICU number for advice. It’s advisable for caretakers to receive BLS (Basic Life Support) Training before discharge.

(The author is a senior consultant neonatologist.)