How Preemies Differ from Full Term Newborns

Studies show that there are differences between preemies and their full-term peers and birth and beyond, but you don’t really need to dive deep into the research to know that. Every parent of a preemie knows that preemies march to the beat of their own drums, in and out of the NICU.

These differences are pretty obvious from the beginning, even in later-term preemies. Babies born prematurely commonly have:

  • Less muscle tone
  • Low birth weights
  • Poorer reflexes
  • Poorer stress response
  • Breathing difficulties
  • Feeding difficulties
  • Shorter periods of alertness
  • Greater difficulty tracking objects and people
  • Thinner skin
  • Digestion issues
  • Problems regulating temperature
  • Jaundice

Some babies, especially those born very early, will also have physical issues that make them seem very different from other newborns. For instance, many still have fused eyelids, ears that lack cartilage (so fold easily), and no obvious nipples. Their skin can be red and raw and tear like wet paper. Inside, their hearts and blood vessels and intestines may be prone to problems.

The big overarching goal of NICU care is to help preemies grow strong enough so they can make the transition home. But a parallel goal is giving these babies the tools they need to catch up to their full-term counterparts in as many areas as possible, which is why hospitals employ feeding specialists and occupational therapists. Here are some of the issues that tend to stick around:     

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Preemie Parent Tips: 8 Ways to Take a Break When You’re a NICU Parent

Parenting in the NICU is exhausting – physically, mentally, and emotionally. It takes a huge toll on your body and your spirit, and that’s true even when your journey is a relatively easy one. If you’re coping with the effects of extreme prematurity or your preemie is sick, you’re facing an even longer, tougher road.

Taking a break can seem ridiculous. Your preemie needs you! And so that’s why I’m not going to suggest you go out to dinner, skip a NICU visit, or go away for the weekend. Some parents of preemies find that doing these things makes it easier – but for many others, the idea of not being at a preemie’s bedside feels too scary to contemplate. There’s no right or wrong answer. Taking a day for yourself when your preemie is in the NICU is actually pretty healthy, but if you’d rather not? That’s okay, too.

Obviously there are situations where spending every waking moment in the NICU is not an option. Many parents of preemies (myself included) have to work. Lots also have older children at home who need care. And if daily responsibilities drive when you can and can’t be in the NICU, that’s okay, too.

But if you have a tough time stepping out of the NICU and don’t have obligations forcing you to take a break, here are some ideas to help you unwind when staying home from the hospital isn’t an option:

Have a conversation with the NICU staff that isn’t about premature birth or your preemie. The longer your preemie is in the hospital, the deeper your relationship with their care team (which includes everyone from specialists to doctors and nurses to social workers and even the maintenance staff) will become. It’s comforting to put names to these faces and to know something about them that isn’t related to your situation. You may learn that you actually have lots in common with the people taking care of your baby!

Read out loud to your preemie. No matter how early or how fragile your baby is, you can read your favorite books to them. And if you dislike Goodnight Moon (or don’t yet have a copy), it doesn’t matter. Read Harry Potter or YOUR favorite books. Your baby will be soothed by the sound of your voice and chances are you’ll be comforted by the interaction. Reading to your preemie every day is one way to feel like an engaged parent when you feel helpless and you’re surrounded by reminders of your baby’s premature birth.

Or catch up on your own reading – just for pleasure. Spending as much time as possible at your preemie’s bedside is fulfilling but also monotonous. After all, one of the most important things a preemie can do is sleep! Bring a book or all those magazines you haven’t had a chance to thumb through and escape the NICU in your imagination between feedings. Just make sure what you’re reading is uplifting or thrilling enough to take your mind off the bings and bongs of the NICU.

Decorate your preemie’s room or bedside. If you suspect your baby will be in the NICU for an extended period of time, making it feel more like home is a great idea. Make sure you know your NICU’s rules about items brought in from home first, and then do what you can to have a little bit of the nursery you’d have at home right there in the hospital. If you feel calmer at your baby’s bedside, chances are they will benefit.

Start writing a journal or poems or even a book. While journaling is an effective way to process the many emotions you feel about your baby’s premature birth, writing can also take your mind off your current circumstances for a little while. If you’ve ever had a book idea floating around in your head, now is as good a time as any to start writing!

Step outside while your preemie is napping. If you’re lucky, the neighborhood around your NICU has a few spots worth strolling. But if not know that many hospitals have meditation gardens or walking paths, so why not ask at the info desk if yours is one of them? Once your baby is settled, take a quick walk. If you’re worried about being gone too long, set an alarm for 20 minutes. You’ll return refreshed and ready to share some of your renewed energy with your preemie.

Get some work done at your baby’s bedside or in the waiting area. While no parent wants to be working in the NICU, our parental leave policies in the US make it so doing some remote work might be in your best interests. Many hospitals now have free wi-fi. Just make sure to ask whether devices are allowed inside the unit before firing up your laptop.

Play games online. Assuming your NICU allows you to bring electronic devices into the unit, mobile gaming can be a distraction and a social activity all in one. Let friends know you are looking for gaming buddies and what times you’ll be playing, and you can take a break without ever leaving your preemie’s bedside.

Remember that there’s no right or wrong way to unwind. Some parents feel comfortable getting away, some parents feel most comfortable spending as much time as possible in the NICU. But even if you fall into the second group, it’s good to reconnect with things you find comforting. Taking time to care for yourself doesn’t have to mean taking time away from your preemie.

Adjusting to Your New Reality After Premature Birth

Adjusting to life with a new baby is always challenging, but adjusting to life after premature birth can be a lot harder. You may not realize how much premature birth will impact your life at first because your preemie is new to the NICU. Once you’re discharged, you’ll be spending a lot of time (and energy) going back and forth to the hospital while still recovering from the delivery, and the days can pass you by in a total blur. If your preemie was very early or has significant health issues, you’ll probably be totally focused on them.

Bottom line: It’s hard to think about yourself at all when your preemie is new to the world and struggling.

Eventually, though, the NICU becomes more familiar and life after premature birth becomes your new normal. As feelings of fear subside, feelings of grief and anger can emerge. All the stress you weren’t giving yourself space to feel hits you like a wall and suddenly you’re anxious, depressed, and unbelievably tired. Maybe you’ve burned through the parental leave you had available and you need to go back to work. Or you have older children at home. Finding a balance between being there for your preemie and being on top of your responsibilities can seem impossible.

Caring for yourself? Who has time for that!

Many people decide that seeking help from a counselor or a therapist is helpful after premature birth since there are so many feelings to unpack (and so little mental space to do it in). Premature birth is traumatic in so many ways, and if you’re mired in guilt or anxiety or coping with PTSD it’s a lot harder to adjust to life with a preemie in the NICU or at home. Your emotions following premature birth may be unpredictable and you may experience lots of ups and downs. Letting yourself feel whatever you’re feeling is okay, even your emotions are different from what the people around you expect you to be feeling.

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Continuous and Multiple Waves: The Many Emotions of Preterm Birth

The title of this post came from a study conducted in 2014 that found that mothers in particular have strong, varied, and long-term reactions to preterm birth. While most of us are personally and acutely aware of that fact, it was nice that the study’s conclusion recommended that more attention be paid to preemie parents’ mental and emotional health.

The world probably doesn’t need more studies proving that parents who are coping with preterm birth will have strong emotional reactions to their circumstances. Preterm birth is traumatic and everything that follows is frightening. What we’d like to see are more studies addressing the huge range of feelings parents have about prematurity and an investigation of the types of support that are effective at helping them work through those feelings.

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18 Things You Might Not Know About Premature Birth

For many moms, the first signs of premature labor are obvious contractions. But for some, premature labor began with nothing more than a general “off” feeling or minor flu-like symptoms.

Mothers who deliver their babies early produce milk that’s perfectly designed to nourish premature babies. A preemie mom’s milk will have extra minerals, fat, and protein, along with leukocytes and antibodies to protect their preemies from infection.

Half of all neurological disabilities in children are related to reterm birth.

The first line of treatment for incidents of apnea of prematurity (where breathing stops for more than 15 seconds) is often stimulation of the preemie’s skin by patting or rubbing – both of which can help a baby begin breathing again.

Umbilical and inguinal hernias occur more often in preterm infants. Umbilical hernias are usually self-resolving but inguinal hernias require surgery.

Severe cases of neonatal hyperbilirubinemia (aka jaundice) can actually result in brain damage! Phototherapy can seem a bit silly but it’s really vital for the preemies who need it.

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Kangaroo Care Is Good for Preemie Parents, Too

kangaroo care benefitsWhen you’re new to premature birth, everything is scary. Just looking at your preemie (and all their medical accessories) can be frightening. And the thought of holding a preemie? Terrifying! But at the same time, most new parents are desperate to hold their babies because they instinctively know that physical contact is a vital part of bonding.

You probably know that the first time a NICU nurse hands you your preemie can be a transformative experience for your baby. Kangaroo care (holding a preemie skin to skin) is especially beneficial for preterm infants.

What you might not know is that holding a preemie can change parents’ lives, too! Here are just some of the ways kangaroo care is beneficial for moms and dads:

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8 Things You SHOULD Say to Parents of Preemies

So many people have written variations of posts outlining various things not to say to parents of preemies, and that’s important. We know there is a lot of unintentional insensitivity toward preemie parents. People say some strange things to parents of preemies both in and out of the NICU, and it’s not hard to understand why.

The trials, joys, and sorrows of having a preemie are unique, and prematurity’s rollercoaster ride is something that most people will, thankfully, never experience. It’s not hard to imagine that most folks who say awkward and seemingly rude things to parents of micro-preemies and later-term preemies, too, are simply trying to find something, anything to say to express sympathy, empathy, or their condolences.

What to Say to Parents ofPreemies

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Preemie Moms Share the Signs of Premature Labor

Everyone’s prematurity story is different and that got us thinking about how those stories begin. What are the most common signs of premature labor – like what were the very first symptoms of labor that preemie moms in our community experienced. We polled our Facebook community to find out what symptoms they experienced before going into premature labor. As many of us know, those signs and symptoms aren’t always the ones our doctors told us to look out for!

Here are some of the symptoms preemie moms experienced before giving birth prematurely. Which sound familiar to you? Which did you experience?

No fetal movement (turned out my water had broken around 22weeks), and swollen feet (developed preeclampsia after birth). I demanded an ultrasound, and she was born later that day at 23weeks. -Laura

Low groin pains/pressure. Dr said it sounded like a UTI. My water broke 4 days later due to incompetent cervix at only 22 weeks. -Amanda

Back pain! Unbearable back pain! It turns out that it was back labor and my contractions weren’t even showing up on the monitor because they were all in my back, not uterus! -Jennifer

For days before my daughter was born I felt pressured bottom of my belly -Rachel

It might sound strange, but I just knew. I didn’t expect him to come at 31 weeks, but two days before, I was on the phone with my mother in law saying “he’s not going to last until April!” I can’t remember anything specific physically though. -Emily

It felt like my son was stretching into my hip, it was a really deep pressure in my right hip. I told the nurse about it at my 26 week appointment, 2 days before he was born, and she literally laughed and told me that my body was just making room for the growing baby. -Angela

I’ve had 2 preterm births and both times I could only describe the way I felt as “blah” No symptoms at all, other than that feeling. It was like everything including my emotions were stuck in neutral. Delivered both times within 24 hours of starting to feel that way. -Brianna

I thought it was constipation and gas pains. Apparently it was super low contractions. – Sarah

woke up with bad headache light head. vomiting swollen feet and hands.. my doctor told me to take sinus med. I said no it not sinus problem. – Emily

Spotting throughout. Multiple trips to ER. OB said one week before the birth “it’s in Gods hands”. I fired her on the spot. No suggested bed rest, no meds. Then cramping. Finally got another OB appt when I spiked a fever the following Monday. All my amniotic fluid had leaked. – Sia

At my ultrasound 4 days before I gave birth my daughters head was so low they couldn’t measure it on the ultrasound. I told them it felt like I had a bowling ball between my legs. They blew it off and refused to do an internal ultrasound to check my cervix. 4 days later my twins were born at 28w 2d. – Melissa

Sudden change from frequent kicking and movement to barely discernable activity. I had morning sickness up until then and it went away. My eyesight changed and I remember thinking I must need glasses. Even though I felt much better than I had in months, there was this nagging feeling that something was wrong. – Pat

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