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Normally the premature premature baby remains in the neonatal ICU until he is able to breathe alone, has more than 2 g and has the suction reflex developed. Thus, the length of stay in the hospital can vary from one baby to another.
After this period, the premature baby can go home with the parents and can be treated similarly to full-term babies. However, if the baby has some kind of health problem, parents should adapt care according to the doctor's instructions.
What tests does the premature baby need to do
During hospitalization in the neonatal ICU, the premature baby will undergo constant tests to ensure that it is developing properly and to diagnose problems early, which when treated, can be definitively cured. Thus, the examinations usually include:
- Heel prick test: a small prick is made on the preterm's heel to draw blood and test for the presence of some health problems such as phenylketonuria or cystic fibrosis;
- Hearing tests: are performed in the first 2 days after birth to assess whether there are developmental problems in the baby's ears;
- Blood tests: they are done during the ICU stay to assess the oxygen levels in the blood, helping to diagnose problems in the lungs or heart, for example;
- Vision exams: they are done right after the preterm's birth to assess the presence of problems such as retinopathy or strabismus of the retina and must be done up to 9 weeks after birth to ensure that the eye is developing correctly;
- Ultrasound exams: they are done when the pediatrician suspects changes in the heart, lungs or other organs to diagnose the problem and start the appropriate treatment.
In addition to these tests, the premature baby is also physically assessed every day, the most important parameters being weight, head size and height.
When to vaccinate the premature baby
The premature baby's vaccination program should only be started when the baby is over 2Kg and, therefore, the BCG vaccine should be postponed until the baby reaches that weight.
However, in cases where the mother has hepatitis B, the pediatrician may decide to have the vaccination before the baby reaches 2 kg. In these cases, the vaccine should be divided into 4 doses instead of 3, with the second and third doses doses should be taken one month apart and the fourth, six months after the second.
See more details of the baby's vaccination schedule.
How to care for your premature baby at home
Caring for a premature baby at home can be challenging for parents, especially when the baby has a respiratory or developmental problem. However, most care is similar to that of full-term babies, the most important of which are related to breathing, risk of infection and feeding.
1. How to avoid breathing problems
During the first 6 months of life there is a high risk of respiratory problems, especially in premature babies, as the lungs are still developing. One of the most common problems is sudden death syndrome, which is caused by asphyxiation during sleep. To reduce this risk, you should:
- Always lay the baby on its back, touching the baby's feet against the bottom of the crib;
- Use light sheets and blankets in the baby's crib;
- Avoid using a pillow in the baby's crib;
- Keep the baby's crib in the parent's room until at least 6 months of age;
- Do not fall asleep with the baby in bed or on the sofa;
- Avoid having heaters or air conditioning near the baby's crib.
In addition, if the baby has some type of respiratory problem, it is important to follow the instructions provided in the maternity ward by the pediatrician or nurses, which may include nebulization or administering nose drops, for example.
2. How to ensure the correct temperature
The premature baby has more difficulty keeping his body temperature under control and, therefore, he can get cold quickly after bathing or become very hot when he has a lot of clothes, for example.
Thus, it is recommended to keep the house at a temperature between 20 and 22º C and to dress the baby with several layers of clothes, so that one can be removed when the room temperature gets warmer or add another layer of clothes, when the day gets colder.
3. How to decrease the risk of infections
Premature babies have a poorly developed immune system and, therefore, in the first months of age they have an increased risk of infection. However, there are some precautions that help to decrease the chances of infections arising, which include:
- Wash your hands after changing diapers, before preparing food and after going to the bathroom;
- Ask visitors to wash their hands before being in contact with the premature baby;
- Try to avoid too many visits to the baby during the first 3 months;
- Avoid going with the baby to places with a lot of people, such as shopping centers or parks, for the first 3 months;
- Keep pets away from the baby for the first few weeks.
So the best environment to avoid infections is to stay at home, as it is an easier environment to control. However, if it is necessary to leave, preference should be given to places with fewer people or at times that are more empty.
4. How should the food be
In order to properly feed the premature baby at home, parents usually receive teaching at the maternity hospital, as it is common for the baby to not be able to breastfeed alone on the mother's breast, needing to be fed through a small tube in a technique called relactation. See how the contact is made.
However, when the baby is already able to hold the mother's breast, it can be fed directly from the breast and, for this, it is important to develop a correct technique to help the baby breastfeed and prevent the development of problems in the mother's breast.