A Guide to Understanding NICU Progress for Premature Babies

Giving birth to a preemie is a joyous yet difficult journey; you are thrilled that your child is receiving care in a NICU, but the prospect of leaving the hospital without a baby in your arms is terrifying. Many parents do not have the schedule flexibility to remain at the baby’s side throughout their time in the hospital, and they feel torn and anxious about what types of experiences their little one is going through while they are absent.

The following information will hopefully give new parents of premature babies some idea of what their baby is experiencing, how development is occurring at various stages and what issues might present themselves as a result of premature birth. Use this information as a guide to help you make better decisions about treatment for your precious one. Before you know it, it will be time to bring your baby home.

Babies Born at Less than 28 Weeks’ Gestation

Today’s extremely premature baby has a much better survival rate than preemies of the past. With 80 percent survival rate, this baby has some challenges ahead, but things look good. Because their respiratory system isn’t fully developed, these babies may have difficulty breathing on their own. Initially, they may need the help of a respirator until they get the hang of it. Sucking and swallowing reflexes don’t kick in until around 34 weeks’ gestation, so most early nutritional needs are delivered intravenously.

Almost all of these babies have an extremely low birth weight, meaning they’ll need to gain some extra pounds before it is considered safe for them to go home. Other issues they might encounter during this time are respiratory distress, hypoglycemia, hypothermia, jaundice and urinary tract infections. Generally speaking, the earlier a child is delivered, the longer they will need to stay in the hospital in preparation for life in the outside world.

Babies Born between 28 and 31 Weeks

Survival rate for these little angels comes in at 95 percent. Their biggest challenges are breathing difficulties and respiratory infections, as the lungs are one of the last systems to develop fully in utero. They may need the assistance of a respirator for a short time and they may run into issues with tube feeding.

Their immune systems are still developing, so they are at greater risk for developing infections than their counterparts who are born full term. Not to worry though, most of these babies go home on or around their original due date, provided they don’t experience too many complications during their time in the NICU, so you’ll have them safely home in your arms before you know it.

Babies Born between 32 and 36 Weeks

These moderate to late preterm babies have spent a fair amount of time getting ready for the outside world, so their survival rate tends to be 99 percent or higher. They tend to have fewer problems with respiration. If any assistance is needed, it tends to be hours or days in the NICU and then they are off and running on their own.

While feeding through a tube is common in the first hours after birth, it isn’t long before these hungry children will take a nipple. They are eager to learn and master their sucking and swallowing reflexes, so there is usually a steep learning curve as they respond to their bodies’ cries for food. If there are no significant health issues with the baby, he can go home almost immediately, although there is an extensive examination process that ensures the baby will be able to continue basic functions, such as eating and breathing, independently after leaving the hospital. If anything is brought into question, a short hospital stay of a few days to a few weeks is common to make sure everything checks out.

Babies Born between 37 and 38 Weeks

Years ago, babies that were born at 37 weeks were considered “full term,” although standards have changed the definition of full term to define babies that are born between 39 and 40 weeks’ gestation. Children at this gestational age have very few developmental issues and are able to go home quite quickly after birth. Some issues with low birth weight may need to be monitored, but this, too, quickly rectifies itself as mom and baby learn the subtle nuances of feeding and pumping.

Going Home

Regardless of gestational age, there are certain milestones that must be reached in order for the baby to establish independence and be able to go home. They include:

• Breathing on their own
• Feeding from breast or bottle
• Maintaining a stable weight
• Gaining weight steadily
• Having no unresolved acute medical conditions that require care

Rest assured, parents. With the proper care and a little time, your child will meet these milestones for independence and be able to accompany you on the exciting journey home together. Your NICU environment is the right place for your little preemie to be. Attentive around-the-clock care from caring and professional nursing staff and doctors who specialize in treatment of preterm babies ensures that your precious one is in good hands.