Tommy's PregnancyHub

Taking your premature baby home

You may have been looking forward to taking your premature baby home, but when the time comes, you may feel a mixture of emotions.

Your baby will only leave hospital when they’re well enough. This may be when they’re feeding well and their body temperature and breathing are stable, rather than when they reach a certain age or weight.  

Getting ready to go home

It's natural to feel worried about looking after your premature baby at home. If you feel that you’re not ready yet, you can talk through your concerns with the healthcare team. They will help you to become more confident in caring for your baby in the baby unit. They will also agree a discharge plan with you. This may include what care your baby needs at home, where you can get support and what follow-up care your baby will receive. The team will give copies of the plan to you and any healthcare professionals who are involved in your baby’s care. 

If your baby needs medical equipment, such as breathing support, the healthcare team will: 

  • make sure you know how to use the equipment before you take your baby home
  • answer your questions about how to care for your baby
  • talk to you about how to prepare the equipment at home
  • teach you how to recognise and deal with emergencies, including details of who to contact
  • give you information on feeding, sleeping, dealing with illness and how to make follow-up appointments
  • tell you where you can get practical and emotional support.

Rooming in

The healthcare team may offer you transitional care or ‘rooming in’ if there is space on the baby unit or postnatal ward. This is where you stay in hospital with your baby overnight for 1 or 2 days.

The aim of this is to give you more confidence in caring for your baby independently while still having support from the hospital staff if you need it. It may be worth finding out if both parents can stay.

If you had twins or multiple babies

If you have twins or multiple babies, your healthcare team will try to make sure that the babies come home at the same time if they can. But it may be that one baby is ready to go home and another needs more care. This can be practically and emotionally difficult.

You may want to contact the Twins Trust who can provide more support to parents of multiple babies.

Preparing your home

As well as packing your hospital bag for labour, you’ll need a few things at home for after your baby is born. 
Here’s a list of things you’ll need:

Nappy changing

  • A few packs of newborn disposable or cloth nappies
  • Cotton wool
  • Changing mat
  • Barrier cream to prevent nappy rash
  • Muslin cloths

Bathing

  • Washing-up bowl or a baby bath
  • Towels

You don’t need to use soap, body wash or shampoo to bathe newborn babies, unless your health visitor advises you too. Plain water is safest for your baby’s skin at first. 

Clothes

  • At least 6 all-in-one sleepsuits/babygrows
  • At least 6 vests or bodysuits with poppers that close under the nappy
  • 2 cardigans (wool or cotton, rather than nylon)
  • A wool or cotton hat or a sun hat if it’s summer for going out (babies should not wear hats inside)
  • Mittens, socks or bootees

Many companies make baby clothes specifically for premature babies. Take a look online to see what’s available. 

Sleeping

  • Cot, crib, carrycot or moses basket with new mattress (in Scotland, the baby box comes with a mattress to use as a safe sleeping place for your baby) 
  • Fitted sheets to cover the mattress – you may need a few of these as you’ll be changing the sheets often
  • Light, cellular blankets or sleeping bags with a fitted neck that prevents the baby moving downwards into the bag – do not use duvets, pillows or cot bumpers for newborn babies because there is a risk of suffocation 

The Lullaby Trust has information about safe sleeping for premature babies

Breastfeeding

  • Nursing bras 
  • Breast pads
  • Nipple cream
  • Some women find nursing pillows useful, especially if they’ve had a caesarean section

Going out

  • Infant car seat (new or second-hand from someone you trust)
  • Pushchair with a fully reclining seat so your baby can lie flat – if you have a second-hand pram or buggy, make sure the wheels and brakes are in good working order
  • Shawl or blanket to wrap your baby in – this can also be useful if you want a cover for breastfeeding
  • Bag to put your essentials in while on the move, such as nappies

Keeping your home smoke-free 

Secondhand smoke is the smoke your baby breathes in when someone smokes near them. This is especially harmful for babies and children because they have less well-developed airways, lungs and immune systems. 

We know it is hard for some new parents to stay smoke free after having a baby, especially if other members of the household smoke. 

You're up to 4 times more likely to stop smoking successfully with NHS support.  

Your midwife, health visitor or GP can give your details of your local NHS stop smoking service. You can also visit the Smokefree website or call the NHS smoking helpline on 0300 123 1044.

Find out more about smoking after pregnancy.

Room temperature

Premature babies are less able to control their body temperature than full-term babies.  If their environment is too cold, they can lose heat very quickly. If it is too hot, babies can overheat, which increases the risk of sudden infant death syndrome.  

Although the baby unit is very warm, your baby will now be able to cope with lower temperatures. Try to keep the room temperature at 16–20°C. 

It can be difficult to judge the temperature in the room, so use a room thermometer in the rooms where your baby sleeps. In Scotland, a room thermometer is included in the baby box.  (ref as before)

Remember that the safest place for your baby to sleep is in a cot in the same room as you for the first 6 months. This will also help judge the temperature of the room they are sleeping in.  

Travelling home

If you’re travelling by car or van, your baby will need to travel in a car seat. Premature babies are more at risk of breathing problems when they are in car seats so the healthcare team in some units may do a ‘car seat challenge’. This is where your baby sits in their car seat on the baby unit, while the healthcare team check for any breathing problems or changes in your baby’s heart rate. If there are any problems, they may change your baby’s position in the seat or suggest a ‘car bed’, which allows your baby to lie flat. 

The Lullaby Trust recommends that you remove any hats or outdoor clothing before putting your baby in the car. It is also recommended that you avoid travelling in cars with premature and young babies for long distances. Ideally, another adult should travel in the back of the car with your baby, or if you’re travelling alone you should use a mirror to keep an eye on your baby. 

The Royal Society for the Prevention of Accidents (RoSPA) has released a suite of new resources and practical advice for parents and professionals on how best to transport premature and low birth weight babies. Visit www.childcarseats.org.uk

At home

Remember that even though you are at home, you are not alone. Once you are home, the community team will offer you support. A member of the baby unit team may also visit you if your baby still needs medical care.  

We have lots of information about how to look after your baby at home

 

EFCNI, Hüning BM et al. (2018) European Standards of Care for Newborn Health: Transition from hospital to home. European Foundation for the Care of Newborn Infants. https://newborn-health-standards.org/transition-hospital-home/

NICE (2017) Developmental follow-up of children and young people born preterm. NICE guideline 72. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ng72/chapter/Recommendations
  
NICE (2019) Specialist neonatal respiratory care for babies born preterm. NICE guideline 124. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ng124

BAPM (2017) Neonatal Transitional Care: A Framework for Practice. British Association of Perinatal Medicine. https://www.bapm.org/resources/24-neonatal-transitional-care-a-framework-for-practice-2017

NHS. 10 Self-help tips to stop smoking. https://www.nhs.uk/live-well/quit-smoking/10-self-help-tips-to-stop-smoking/ (Page last reviewed: 25 October 2018. Next review due: 25 October 2021)

EFCNI, van Leeuwen M et al. (2018) European Standards of Care for Newborn Health: Temperature management in newborn infants. European Foundation for the Care of Newborn Infants. https://newborn-health-standards.org/temperature-management-infants/

Campbell D, Dolby L (2018) Physical Examination of the Newborn at a Glance. Wiley Blackwell, Oxford.
  
NHS inform (April 2020) Baby box. https://www.nhsinform.scot/ready-steady-baby/pregnancy/preparing-for-parenthood/baby-box

NHS. Reduce the risk of sudden infant death syndrome. https://www.nhs.uk/conditions/baby/caring-for-a-newborn/reduce-the-risk-of-sudden-infant-death-syndrome/ (Page last reviewed: 17 September 2018. Next review due: 17 September 2021)
  
Smith VC (2013) Neonatal intensive care unit discharge preparation, family readiness and infant outcomes: connecting the dots. Journal of Perinatology 2013; 33: 415–421.
  
The Lullaby Trust (2019) Car seat factsheet. https://www.lullabytrust.org.uk/wp-content/uploads/9-car-seat-factsheet-2019.pdf

EFCNI, Damhuis G et al. (2018) European Standards of Care for Newborn Health: Case management and transition to home. European Foundation for the Care of Newborn Infants. https://newborn-health-standards.org/case-management-transition-home/