Caring for your premature baby at home

Your premature baby is home at last and now it's up to you to make sure they're fed, warm, washed and happy... Not to mention getting them to sleep at night!

In many ways, caring for your premature baby at home may not be so different from how you had imagined life with a new baby. You will have plenty of time to cuddle and play with them and watch them respond to everyday things they won't have experienced in the baby unit - a breeze, sunlight, the smell of a flower or your dinner in the oven.

Adjusting to life at home with your premature baby

Many families relish the return to the privacy and comfort of their own homes. You can start to care for your baby in your way, and it can feel as if 'real' family life can finally begin. However, it will also be a big adjustment for all of you. If your baby needs extra care - for example for breathing difficulties - you may feel very let down by general parenting books and websites, as they may not reflect your experience. However, they may still offer helpful advice with tips about feeding, sleeping routines and other aspects of life with a baby.

The correct temperature

You need to make sure that you keep your baby at a temperature that is comfortable and safe. The best way to do this is usually with layers - for example, a vest, a sleepsuit and blankets or a zip-up sleeping bag as necessary. You can easily add or remove an item depending on how warm or chilly the surroundings are.

If you're not sure how much you need to wrap your baby up, ask a member of the healthcare team. He may get cold very quickly - especially if left undressed, for example after having a bath - but high temperatures have been linked with cot death (see sudden infant death syndrome below), so it's equally important not to overload his cot with blankets.

Helping your baby sleep

Now that your baby is at home, you may find out that he didn't sleep as much as you thought at night when you weren't there! You can help your baby develop good 'sleep hygiene' by doing things such as providing a quiet, dimly lit environment at night time. In the early months, however, there's only so much that you can do, because babies get hungry. Also, the smaller the baby, the more often they need to feed. Developing a good night's sleep for you and the rest of your family may be a long-term project.

Sudden infant death syndrome (SIDS), also known as cot death

This is a syndrome in which apparently healthy babies die in their sleep, usually during the first six months of life. Premature babies are at higher risk for slightly longer than term babies. It's still not known exactly what causes SIDS, but we do know a number of things that help reduce it. Since the following guidelines were put in place in 1991, the number of cot deaths has reduced drastically.

Tips for reducing cot death

• Lie your baby on their back, unless your healthcare team has advised otherwise, with their feet at the bottom of the crib.
• Use lightweight blankets - never duvets or pillows, Keep bedding away from your baby's face, and tuck it in firmly.
• Make sure no one smokes in the house.
• Keep your baby in your room for the first six months, in their own crib.
• Never fall asleep with your baby on the sofa or in your bed, especially if you're very tired or have been using alcohol, drugs or medication, or if your baby was premature or small at birth.
• Make sure your baby rests well away from radiators or heaters and out of direct sunlight.
• Keep the room at 16-20^oC (61-68^oF), but ideally at 18^oC (64^oF).

Washing your premature baby

How often you wash your baby will depend on how premature they are and the condition of their skin. For most babies - whether premature or term - plain water is fine for the first few months of life. This includes at nappy changing - initially you should just use water and soft cotton wool.

Caring for dry skin

If your baby has dry skin, don't use any kind of moisturising product without asking your healthcare team for advice. You can gradually start introducing gentle baby products and wipes as your baby becomes older and their skin more robust.

Top and tail: When you wash your baby, use only water. You don't need to give them a bath every day, it is usually enough just to 'top and tail' – using cotton-wool balls soaked with tepid water to wash their bottom, face and neck.

Snuggle him dry: When your baby's skin is wet they will become cold very easily. Each time they get damp and dries off, they will lose some body heat. Always wash them in a warm, draught-free place, and have a towel close by to wrap them in and dry them afterwards.

The following organisations can give you more information about the topics covered in this section.