There are a few developmental milestones a premature baby in the NICU will need to be meet before they can go home. Each NICU may differ in what is required for discharge so be sure you ask what goals need to be reached. Having an idea of where you baby stands and what milestones have already been reached can be reassuring, even if it’s just to know they are gaining weight.
The length of time a premature baby stays in the NICU varies, usually they will stay in the NICU until about the time of their actual due date, some may have a shorter stay while others may need to stay longer. Each baby is different and health issues can be a factor.
When having twins each infant may also be different one may need some time in the NICU while the other doesn’t at all or can go home earlier.
These are milestones that must be reached before your little ones can go home, remembering there may be other factors in the decision of discharge. You will need to talk this over with your health care providers.
Breathing on their own – Most premature babies will need extra oxygen once born, some for only a short time and others for longer. Breathing unassisted is often one of the first milestones reached by preemies.
Your baby’s vitals including having a good heart rate, blood pressure and oxygen levels will be monitored. Their heart rate and breathing patters will be observed for the common condition found in premature babies called apnea of prematurity. Commonly known as the As and Bs or apnea and bradycardia.
Apnea is when breathing stops which lasts between 15 and 20 seconds, this can cause a drop in the baby’s blood oxygen levels and bradycardia. Bs or Bradycardia is when the heart rate has slowed down to less than 80 beats per minute. The As and Bs will often happen together, sometimes referred to as ‘spells’ and is very treatable when closely monitored. Babies will usually grow out of it when they reach the gestational age of about 35 weeks. Sometimes an apnea monitor may be sent home with you.
All babies will lose some weight after birth, which is absolutely normal. Every NICU will differ and some may have a minimum weight required before you can take your infant home. The most important thing is they are continually gaining weight.
Preemie babies are often not strong enough to breast or bottle feed to begin with. The suck swallow breathe reflex is not established until about the 32nd week of gestation. Reaching the developmental milestone of successfully eating by mouth is usually achieved around the gestational age of 37 weeks, while others may take longer due to additional health issues.
An isolette (incubator) or other special bed may be used to help keep your baby warm and snug. Kangaroo care is another great way to warm your little one. This preemie developmental milestone of being able to keep warm on their own is very important and most babies who weigh over 4 pounds are able to do this.
When you are all discharged and at home, it is important to understand that preemies are not going to reach their twin baby milestones at the same rate as full term babies. This is when you use their adjusted age to determine the developmental stage.
Premature babies will often need a bit of extra help to reach their milestones from rolling to crawling, walking to talking. You may be able to receive an extra service where professionals will help you and your infant in reaching their goals.