Premature babies: care, corrected age and coming home

• ✓Care depends on the baby's gestational age, weight and health.
• ✓Parents can take part in many aspects of care during the hospital stay.
• ✓Corrected age helps provide a clearer assessment of some aspects of the baby's development.
• ✓Always follow the advice of the team caring for the baby.

When a baby is born before 37 weeks, some organs continue to mature outside the womb. The baby may therefore need help with breathing, maintaining their temperature or feeding.

Gestational age at birth helps guide care, but on its own it does not predict how the baby will progress. Birth weight, health and any complications that arise during the hospital stay also matter.

In the neonatal unit, the incubator provides a stable environment, monitors track the baby's vital signs and a feeding tube delivers milk when the baby cannot yet complete feeds by mouth. The team should explain what each piece of equipment is for and what changes they are observing.

Parents can talk to the baby, touch them, change their nappy or take part in feeds, depending on the baby's condition. Skin-to-skin contact or kangaroo care is also part of their care when the team says it is safe.

Rules on access, hygiene and participation vary between units. Families can ask which aspects of care they can help with and when.

A premature baby may feed at the breast, from a bottle or through a tube that carries milk to the stomach. A feeding tube is used when the baby still finds it difficult to coordinate sucking, swallowing and breathing.

The amount, frequency and method of feeding should be set by the professionals who know the baby. If the family wants to start or continue breastfeeding, they can ask the unit for support.

Corrected age adjusts chronological age to account for the weeks remaining until the pregnancy would have reached 40 weeks. It is used as a guide when assessing some aspects of the baby's development during the first few years.

The formula is: corrected age = chronological age - number of weeks early. For example, a baby born at 32 weeks was born eight weeks early. At 16 weeks old, their corrected age is 8 weeks.

Before your baby is discharged, ask for these six details in writing. For help preparing your home and the essentials for their return, you can also read about the first days at home with your baby.

1. Feeding: how and how often to feed the baby.
2. Medication: what to give the baby and how to administer it.
3. Follow-up appointments: which appointments are scheduled and where they will take place.
4. When to seek advice: which signs require medical assessment.
5. Contact details: which number or service to contact if you have a question.
6. Special instructions: vaccinations, tests or specific care for your baby.

Hygiene and visitors

Wash your hands before touching the baby and postpone visits from anyone with a fever, cough or symptoms of infection. Limit the number and length of visits if the team advises you to do so.

Safe sleep

The baby should sleep on their back on a firm, clear surface, without pillows, cot bumpers or soft toys. Avoid tobacco smoke and too many layers of clothing or bedding. The guide to baby sleep and night waking provides more detail on this general advice; the neonatal team's guidance still takes priority.

Contact a healthcare professional if the baby:

• ✗Has difficulty breathing, has long pauses in their breathing or looks blue or very pale.
• ✗Persistently refuses feeds or vomits repeatedly.
• ✗Is much sleepier or more irritable than usual, or has a fever.
• ✗Has fewer wet nappies than usual or shows signs of dehydration.
• ✗Is not their usual self and their carer notices a worrying change.

If in doubt, it is better to call than to wait.

If fear, guilt or exhaustion become difficult to manage, consider seeking professional help or talking to other families who have been through a similar experience.

Friends and relatives can help by respecting visiting arrangements, avoiding comparisons and taking on specific tasks, such as preparing meals, doing the shopping or looking after other children.

Sources: World Health Organization: Preterm birth and Recommendations for care of the preterm or low birth weight newborn.