3 Steps to Bringing Your Preemie Home: The Ultimate Guide

Mother and Father Taking preemie home

Without a doubt, the most asked question from preemie parents in every NICU, every day, everywhere, is "When will my baby come home?" It's the one major milestone that every single parent longs for, dreams of, obsesses over, and with good reason!

So would it surprise you to find out that when the big day finally comes, when weeks or months of waiting finally come to an end and it's time to take their sweet bundle of joy home, many parents feel utterly freaked out and totally unprepared?

Parenting in the NICU

If you have a baby in the NICU, does this sound familiar? Even though you can't stand to leave your baby and you can't wait to bring him home, do you feel as if you'll be unprepared when the day comes?

The truth is that the NICU is an overwhelming place. Parents, you are put in a very unnatural parenting role, sitting on the sidelines as nurses and doctors care for your baby, and it's easy to let all that time pass without really feeling like you're learning how to take care of your baby. You may watch everyone else take care of your baby, but the thought that you will be completely responsible for your baby can seem frightening. And no, unfortunately, you can't bring your favorite nurses home with you!

Over the years, I've learned several strategies about the best ways to prepare for the big day. By making the very most of your time in the NICU, your transition to life together at home can be easier and less scary with a little preparation.

I'll break down the suggestions into three major categories: getting your home ready, getting yourself ready, and getting your support team ready. There are lots of tips (the title isn't "the ultimate guide" for nothing!), but don't get overwhelmed. You probably won't need to know it all, and you can keep a checklist of what you need to know and buy if needed.

Step One: Getting Your Home Ready

Getting ready for your preemie is very much like getting ready for any baby, although there are a few important considerations to keep in mind. It's not rocket science to know that your little one may need littler stuff—preemie sized diapers, clothes, and blankets, for example—but I trust you've already realized that by now.  

What I want you to think about are the items you'll use at home that may keep your preemie safe, keep you feeling comfortable, and might not be on the top of every other must-have list. 

These are the items that every baby should have at home, and your preemie is no different. Just be sure they're the appropriate size.

  • Diapers & Wipes
  • Bottles: Unless you are 100 percent exclusively breastfeeding, you'll want enough bottles to get through a day at home. Even most breastfeeding mamas enjoy having a partner or friend feed the baby every once in a while, and most preemies take a combo of breast and bottle, at least in the beginning. Ask your NICU which types of bottles and nipples your baby will likely use.
  • Clothing that fits: Keep in mind, most preemies grow quickly, so don't go too crazy buying tons of preemie size clothes. They'll be in those newborn sizes in no time. 
  • Swaddle blankets and/or sleep sacks: You'll want to practice using them before the first day home, so ask if you can bring them to the NICU before discharge. It helps you feel comfortable using them, and it helps your baby get used to them ahead of time.
  • Somewhere to sleepEpic battles could be waged over who has the best answer to where your baby should sleep, but these guidelines from the American Academy of Pediatrics are a good place to start. Talking with your NICU about whether or not your preemie will need a special bed is important too. 
  • Formula: Only buy formula if your doctors recommend it. Wait until just before going home to buy any, so you know exactly which formula your baby is using.
  • Baby thermometer: Be sure it's appropriate for use on newborns. Many of the newer digital thermometers are designed for older babies and children.
  • Bathtub: It's perfectly fine to bathe your baby in any basin that is safe, but parents tend to prefer a bathtub designed specifically for babies. If you'll be using one of these, go ahead and pick one before you're already home.
  • Nasal aspirator: You don't want to be unprepared when the first runny nose hits, which it most certainly will. Bulb syringes work fine, but parents who have used the Nose Frida snot sucker (don't you love that name?) swear by it. Whatever you choose, you want to be sure to have something on hand to keep your little one's nose clear. 
  • Hand sanitizer: So every visitor has a quick and easy way to keep germs away from your little one. You might consider face masks, too, just in case someone shows up with questionable "allergies." Better safe than sorry.
  • Medication syringe: If your preemie is taking any medications at all, you'll want the equipment used to get that medicine into your baby, such as a medication pacifier or syringe. Ask your NICU for recommendations, and then keep reading because you'll not only need the equipment, but you'll need to practice using it, too. 

Those are the basics. When your baby has been in the NICU, however, you may find that you're interested in some of the following items. Ask your NICU about them if you have questions. Some extra gadgets that many preemie parents love include:

  • Baby monitor: These range from simple to complex, but most parents love having a way to see and hear their babies when they are in separate rooms. These are different from medical grade home monitors, which come only with your doctor's orders. These home monitors allow you to hear and see your little one, and they offer parents great peace of mind.
  • Rock-n-play: So many preemie parents swear by these. They make it easy to keep baby's head slightly elevated, which can help with reflux, and it keeps them gently moving, which a traditional crib or bassinette can't do. 
  • Baby swing: My favorite, by far, is the mamaroo. Some babies have gotten used to particular swings at the NICU, so you may want to buy something similar. 
  • Sling, wrap, or skin-to-skin shirt: Even though your baby is much bigger now, there are still benefits to spending time skin-to-skin. Wraps and slings and shirts designed for this purpose are really wonderful ways to continue the practice with a bigger baby. The best way to transition to using one is to start using the wrap or shirt you like while baby is still in the NICU. That way, it's a familiar sensation to your baby, something he or she is already used to. 
  • Hands-free pumping bra: You should have this already, don't wait if you're pumping for your preemie. Pumping is a reality for most preemie moms, and these bras are lifesavers. And don't forget the bags for storing milk—you won't have the freebies from the NICU anymore.
  • Baby mobile: This is another item that can be great to have early, because you can play the sounds while your baby is still in the NICU, and then those same sounds will be comforting and familiar for your baby when you are home together. 

Once you have everything you need—a safe space for baby to sleep and the supplies you'll need to get through the first few days or weeks—you're ready to turn your attention to getting yourself ready.

Step Two: Getting Yourself Ready

Here's something you may not have thought of before: parents of healthy full-term babies try to learn about baby care by hanging out with friends who have babies, or by attending classes, maybe reading books. But they don't have their own baby to practice with. They don't have any idea what their baby will actually like or dislike. 

So, if there's one thing to appreciate about the NICU, it's that you have the opportunity to learn about your baby, your actual, very own baby, before taking him or her home. Lucky you! 

I can't begin to tell you how many parents don't take the time to really learn their baby while they're still in the NICU, for all sorts of reasons, good and bad. Maybe it's NICU staff who keep parents at a distance, or maybe it's a feeling that the nurses are better at it and should be the ones doing all the cares. Maybe it's simply impossible to spend much time at the NICU when you have other children at home.

The best way to be ready for your baby at home is to dedicate some time to caring for your baby while still in the NICU. Holding your baby is great, and changing diapers is great too, but I'm going to walk you through a bunch of ways you can get to know your baby even better. Then when you go home, you'll be confident and in charge, like the super boss parent you've always dreamed you would be!

You'll want to learn:

  • How to change your baby's diaper. If you let the nurses know that you want to do as many diaper changes as you can when you're there, you're sure to get good at it in no time. Then that's one less thing to stress you out when you take your baby home.
  • How to feed your baby. For some preemies, this is no big deal, and for others it is nearly impossible to get them to safely and efficiently get all the milk they need to keep growing. Whichever is the case for your baby, you should be at the NICU practicing all of the different types of feeding you'll do—breast, bottle, syringe, supplemental nursing system, whatever. You should ask to practice as much as possible, and get all of the help you can while you're there. See the lactation consultants if you're breastfeeding or see the occupational therapists or speech language pathologists if your baby has complicated feedings. And practice, practice, practice. 
  • How to take your baby's temperature, and know what is normal for your baby.
  • How to bathe your baby. Let your nurses know that you want to practice bathing, and ask them to save bath time for you so that you can get the practice you need. All nurses have different ideas about the ideal way to bathe a baby, so be willing to try lots of different ways to see just what you and your baby like best. 
  • How to swaddle your baby. Again, nurses have different styles, so try learning from lots of different people and you're sure to find a few ways that work well for you. Again, the only way to get good at it is to practice.
  • How to mix your baby's formula or fortified milk. Many preemies need to have extra calories in their diet, and that means parents have to know how to mix up the milk that they'll be feeding their baby. Don't wait until the last day to learn how to do this. Ask to help out with mixing up your baby's milk early on, and you'll soon become comfortable with the job.
  • How to give medications. If your baby will need any medications, such as multi-vitamins or reflux meds, be sure you have the nurses show you a few different ways to give them to your baby and then practice it yourself. 
  • How to soothe your baby. Sometimes it's hard to have other people telling you what your baby likes when she's upset because you'd probably rather be figuring that out on your own, in the comfort of your own home. But NICU nurses have tons of experience helping upset babies, and some of them are sure to have figured out some things that work well with your sweet little one. Take the suggestions and use them as needed. 
  • How to massage your baby. If you are lucky enough to have someone on staff who can teach you ways to massage your preemie, do it! Parents pay big bucks sometimes to have specialists teach them this, but you may have access to great teachers in your NICU. 
  • Find out if you'll need special equipment at home, and get the training you need. Some babies need special equipment such as oxygen and feeding tubes, and will have home health care providers. If your baby will need any of these, try to find out as soon as possible. And start practicing with them as soon as possible! Do not wait until the last day or two to get comfortable with the equipment. Without a doubt, there will be goofs and confusions with any kind of home equipment and it's better to work through those while you still have the NICU staff right there to help.
  • Infant CPR. Most parents, thankfully, will never need to use CPR skills, but it is a good feeling to know that you would know what to do in the event of an emergency. If your hospital does not have any CPR training available, ask them where you could take a class. 
  • Rooming In. Some hospitals allow rooming in, which is when parents stay at the hospital overnight or for several days, practicing complete independent care of their baby while still in the safety of the hospital setting. It's great to do if it's available. 

Step Three: Getting your Support Team Ready

Support will be different for every family, but it is vitally important.

For you, your support team may simply be your wife or husband. Or your support team may be your husband, your parents, and a couple of close friends. For others, support may be an entire church community, support group friends, grandparents, aunts, uncles and more. 

No one way is better than the other. But it is important to know who will be supporting you at home, and help understand how they, too, can get ready for the day you take your baby home. 

  • Share this article with your spouse or partner. Help him or her understand what's at stake, and how much they can do to help make this transition easier. 
  • Figure out who your support team is. Then stop and think about how that team can help you. Will you have enough support, or would it make sense to reach out to a close friend or relative to ask for a little help? If so, do it now rather than later when you may be too tired or overwhelmed to think to ask for help. 
  • Think about what you would really like, in terms of support. Do you want someone to give you a break once a day so you can take a walk? Do you want help with laundry or meals? Do you want someone to talk to, or peace and quiet for naps while they help with household work? Friends and family members usually want to help but they often don't know what to do, so help them help you by telling them just what you want. You'll be glad you did. 
  • Consider a support group. The NICU and prematurity are seriously scary life events, and it stresses parents out, a lot. Taking your baby home from the NICU may seem like you're entering "normal" baby times, but surrounding yourself with other parents of "normal" babies may leave you depressed and feeling alone because those parents won't appreciate the scary world you've been living in. Consider connecting with other preemie moms and dads to help you feel appreciated and understood. Research shows it is incredibly helpful. 
  • Choose a pediatrician wisely. If you still haven't chosen a pediatrician, try to find one who has some experience with babies similar to yours. It is perfectly acceptable to ask to meet potential doctors and ask them about their experience caring for preemies. They are going to be a huge part of your support team after going home, so you want one you care trust and connect with. 
  • Find out which specialists you will be seeing. You will likely see specialists like physical therapists, speech therapists, lactation consultants, and more after you take your preemie home. They, too, will play a vital role on your support team so make sure you know all of your resources after you leave the hospital and clearly keep track of all follow-up appointments. 
  • Give your family a clear understanding of what visits will be like. Friends and family are naturally super excited to finally get to meet your little one and spend time together. They may not have any idea just what an emotional wreck you have been and will still be. They probably really want to help and just need your guidance to show them how to be great supporters. For starters, you certainly can't have any visitors who are sick. Be sure to tell them this. If you need time to bond and don't want visitors for a month, that's alright. Tell them. 

I hope this list of ideas helps you feel a bit more prepared when the joyful day arrives and you get to take your sweet preemie home. Nothing will erase the anxiety you will likely feel, but being prepared does make it a whole lot smoother. Good luck, and go get ready for the best day ever!

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