Premature baby: coming home with a premature baby - Magicmaman.com
By familyShareSend by e-mail I certify that I do not send unwanted e-mailsThat's it! After difficult weeks in the hospital, you can finally go home with your newborn. Advice from our specialists to help a premature baby adapt.Adjustment time
Going home with a full-term baby is already very exciting and a bit scary. Am I going to find out why he's crying? Will he get enough milk? What if I can't organize myself? These are not the questions that are missing… Coming home with a premature baby – born before 37 weeks of amenorrhea (SA), i.e. before 8 months – is even worse! Of course, the parents are delighted to come home with their baby, but the anxiety is multiplied. "Throughout the duration of the hospitalization, we are on our nerves, because we are totally obsessed with the state of health of our child, says Charlotte Lavril, head of SOS Préma.com and mother of a little boy. born prematurely. Once at home, we suffer the backlash and we are exhausted! Not to mention that the doctors are no longer there to answer our questions. So there is a really painful adjustment period. »
When will my baby be able to leave the maternity ward?
Coming home with a premature baby depends on his state of health and his prematurity: it varies from baby to baby. other. All premature babies were born before 37 SA, but some are medium premature (born between 32 and 36 SA, in other words between 7 and 8 months of pregnancy), others are very premature (between 28 and 31 SA, i.e. approximately between 6 and 7 months) and others, finally, are very premature (before 28 weeks or six months of pregnancy). As a general rule, however, doctors take very specific criteria into account before letting a baby out of the maternity ward: he knows how to regulate his temperature on his own, so he no longer needs an incubator (or incubator). He manages to suckle and swallow (the probe therefore becomes useless), his weight curve progresses regularly. His heart rate is stabilized. Finally, it weighs between 1.8 and 2 kg. "Normally, all these conditions are met on the expected date of birth, within 2 weeks," says Dr. Jean-François Magny, pediatrician in neonatology at the Paris Institute of Puericulture.
Video of the day:What should you pay particular attention to before coming home with a premature baby?
When the doctors tell you that your baby will be able to go out and come home, you absolutely have to… think of yourself! Rest, try to relax because you are going to be very busy. It's time to recharge the batteries. Indeed, your baby will not sleep right away, his arrival in a new environment being a real stress. You will have to deal with his crying and be very available. In the meantime, get as much help as possible for everything related to logistics (shopping, tidying up the house, preparing food for you and your spouse). Do not hesitate to solicit girlfriends or grandparents! But be careful, frame things well: they are there to give you a hand, but once the baby is home, you will have to be left alone. You will need to meet all 3 and ask yourself. So choose very good friends or understanding grandparents who will not be offended when you kick them out! At the very beginning, your baby needs calm and chain visits are simply no.
Are there certain criteria for choosing a pediatrician?
There too, as far as possible, you have to anticipate and take care of it even before leaving the maternity ward. The medical team may be able to refer you to a pediatrician near you. Indeed, not all child care doctors know the particular follow-up that a premature baby requires and some make mistakes in terms of food diversification, specific milks, vaccinations, etc. Charlotte Lavril recommends building a small network before the baby comes out: choose a pediatrician who comes to your home if possible. A pharmacy that can also, when necessary, deliver medicines to the home. Contact the Maternal and Child Protection (PMI) who can send you a pediatrician once a week to make sure everything is fine. Good to know: once at home, you can also ask your questions by telephone to the neonatology department in which your baby was hospitalized. Some moms admit they haven't thought about it, but it's possible!
Does my premature baby need specific medical follow-up after going home?
Yes, apart from common childhood illnesses in an infant, to be seen with the liberal pediatrician, and possibly routine visits provided by the PMI, you will have to go to the neonatal unit every 2 or 4 months, this depends on hospitals after going home. The doctors thus follow the psychomotor development of your child and ensure that he grows up without worry. If he encounters motor skills or language learning problems, physiotherapy or speech therapy sessions are offered. The duration of this hospital follow-up can indeed go up to 6 years of the child, depending on the prematurity and the problems encountered.
Can I go out with him?
If there is no question of putting your child under a bell, remember that he is fragile. The immune system of "premas" is even more immature than full-term babies. So avoid crowded public places (shopping malls, subways, buses), very frequented by viruses and flee sick people. Choose a pram or a high stroller to protect it well. In addition, give up the shell seat in the car, and a fortiori at home: prefer the car nacelle to make it travel. Be aware that babies born prematurely are more likely to suffer from bronchiolitis, an inflammation of the small bronchi requiring hospitalization. Better to stay warm at home for the first few months!
How to arrange your bedroom?
Apart from the Cocoonababy, a very special mattress, the bedroom of a premature baby looks like that of any infant! It must be ventilated and cleaned regularly (your baby has fragile bronchial tubes), do not heat above 19°C and ban cigarette smoke throughout the house. Also be sure to sleep your toddler on their back and avoid duvets, blankets and pillows. Prefer pajamas and overpajamas.
And for vaccines?
The vaccination schedule must be respected according to his real age (date on which he was born) and not on his corrected age (date on which he should have been born) . It makes sense: your child is even more fragile than the others and it is out of the question to wait for the corrected age to protect him against illnesses that are far from benign. Please note that this rule has an exception: if your baby is very premature, he must be vaccinated during his hospitalization or when he reaches his 41st week (date on which he should have been born). Do not forget to ask the question to the neonatal service before going home. Finally, two vaccinations are even more important than for other children: pneumococcus (three doses one month apart between 2 and 6 months with a booster at 12 months) and influenza the first two winters. And parents should also get the flu shot.
Which mode of childcare should be chosen for a premature child?
Doctors recommend avoiding any group mode of childcare. Especially if your baby was born before 32 SA, if he had breathing difficulties, if you return to work before his first year and in the middle of winter. It is therefore preferable to keep your toddler away from the very present germs in nurseries, and to opt for the maternal assistant. But some mothers have told us that not all of them agree to take care of a premature baby, even in good health! It is therefore better to go about it as soon as possible… to find the pearl.
Do I have to breastfeed my baby?
Only you can make that decision! We cannot repeat it enough: breast milk is the best. But breastfeeding a hospitalized baby is not necessarily easy: you have to express your milk and bring it to the hospital (some infants cannot suckle the breast) and the atmosphere is more stressful than relaxing. . “I got there with a lot of willpower and because I had breastfed my first baby, it gave me confidence,” explains Charlotte Lavril. If you are breastfeeding your toddler, doctors recommend replacing two breast feedings with two bottles of special preterm vitamin-enriched milk in some cases to promote growth. If you are not breastfeeding, doctors will prescribe you special premature milk until your baby is 3 months old (in real age) or when he reaches 3 kg. Then, depending on the level of prematurity of your child and his weight, the pediatrician will directly prescribe a 2nd age milk, richer in iron and protein than the 1st age milk. On the diversification side, you have to go slowly. An exclusively milk diet until 5 or 6 months of real age is desirable because milk contains essential nutrients for its growth such as proteins, calcium, iron or folic acid.
Should a special pacifier be used for premature babies?
Neonatal teams generally recommend rubber pacifiers, more flexible than silicone, with a suction tip that is not too long so as not to be sickening the little drinker. But, as Dr. Jean-François Magny points out, this can vary from one baby to another and you should not hesitate to experiment. Normally, the neonatal service will be able to tell you what your baby's preferences are. In any case, remember to change your teat regularly because it lets the milk pass faster when it is too worn.
Is my premature baby more fragile on the digestive level?
Premature babies often suffer from gastroesophageal reflux, it's true. In most cases, these are banal rejections due to the immaturity of the digestive system. It is up to the doctor to decide whether it is only necessary to thicken the milk or whether additional examinations are necessary. Depending on the diagnosis, he may prescribe gastric dressings.
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