"Never trust a 35 weeker"

Specialties NICU

Published

What in the world does she mean????

I get asked that a lot.

35 week gestation premies (either newly born, or finally after 4-5 weeks of nicu stay) frequently act like they know what they're doing. They stay warm in an open crib, they've learned how to eat, they've even learned to breathe on a regular basis. They're gaining wt., and they're cuter than just about anything on the planet. Mom and dad are bonded, providing care, breastfeeding. (Well, maybe not dad.)

Don't trust them! and try not to let anyone send them home!

In a heartbeat, they can remember that they're only 35 wks, and, by rights, they don't have to know how to do any of the above. They can get cold, have residuals and have apnea of prematurity, get septic, even die.

As long as you remember they're not trustworthy, you won't completely relax around them.

Gompers, dawngloves, krvrn, and all the other experienced nicu nurses--what do you think?

I brought my daughter home (she was born @ 26 wks) when she was 35 wks, and all of 3 lb. 8 oz. I was 20 years old. She indeed turned blue the next day, and we rushed her to the ER where she was evaluated and sent home on a monitor for apnea. She continued to have episodes for more than a month. It was so scary seeing her blue!!

I will be interested in reading the above mentioned articles...

~J

Specializes in NICU.

I totally said this to my preceptor the other day - she laughed and laughed.

Specializes in NICU.

I'd read this thread quite a while ago, and again right before I started my NICU orientation, and lo and behold I've already experienced the truth to your statement.

Assigned back room for 35 and change week twins sectioned early because one of the twins was having problems. My preceptor and I were to be caring for the "healthy" twin. Hah! That'll teach me to never again believe it when they tell me that...

I am living proof that premies are fighters!! I have a fraternal twin (only 1 minute older than me) and we were 3 months premature. She weighed in at 1 pound 12 ounces, while I was 1 pound and 10 ounces. I stayed in the hospital for 9 months after I was born. I had heart surgery and needed an oygen with me 24/7 until I was about 2 years old. I was baptized twice and my parents planned two funerals for me. Well here I am today, a 23 year old pre nursing student who is thinking about working in the NICU and passing on my strength to all those premies who need hope and love.

Specializes in Pediatrics.

My son was born at 35 weeks and had to be intubated he was in the NICU for 17 long days. The first week we weren't even allowed to touch him. My niece was born at 35 weeks and was fine, her and her mom stayed in a couplet room for a week and that was it. I was so jealous.

p.s. he a huge 2 year old now, rough tumbly, you would never know he was early.

Specializes in NICU.
My son was born at 35 weeks and had to be intubated he was in the NICU for 17 long days. The first week we weren't even allowed to touch him. My niece was born at 35 weeks and was fine, her and her mom stayed in a couplet room for a week and that was it. I was so jealous.

p.s. he a huge 2 year old now, rough tumbly, you would never know he was early.

Yep, that's a boy for ya!

I'm sorry your son had such a rough start, but so happy to hear that he recovered with no long-term complications! :)

Specializes in OR, MS, Neuro, UC.

My 35 week baby aspirated mec, was addicted to MS (Mom with Lupus, severe during pregnancy) and was almost sent to the nursery...went limp and white; ended up on a jet vent and a canidate for ECMO. Babies problems were almost overlooked due to her size, 8lbs 5oz. Mom had gestational diabetes. Went home on O2 after a rally rough first week. Thank God for sharp NICU RN's.......

Specializes in NICU, case management.

In our NICU, we never discharge a baby until they have reached 40 weeks gestional age no matter how long they have been there. :cheers: I have seen 35 weekers with more problems than 28-30 weekers. It is a transitional stage and you just have wait and watch. You do not know what is going to happen.

Specializes in NICU.
In our NICU, we never discharge a baby until they have reached 40 weeks gestional age no matter how long they have been there. :cheers: I have seen 35 weekers with more problems than 28-30 weekers. It is a transitional stage and you just have wait and watch. You do not know what is going to happen.

Wow! Most of our kids are pushed out by their insurance companies as soon as they're PO AD LIB. There's no way we could keep them all until 40 weeks but it is a very good idea, I agree! We end up sending a lot of kids home on oxygen and apnea monitors, some with NG tubes if the parents want them home sooner. We have a home care program through our NICU with our own nurses doing the visits, so that helps.

I do think that we should at least keep them until 37 weeks, though.

Wow. You keep them until 40 weeks. That is amazing. Our situation is similar to Gompers. If they are PO feeding well, maintaining temp, and gaining weight consistently then they are out the door and the insurance companies are keeping a watchful eye on their progress and if they meet the criteria then they are asking when are they going home. I've never seen a baby go home on gavage feedings though unless PO feeding was not an option for the baby. I'm not sure at what gestational age we allow them to go home, but I think it is about 35 weeks and sometimes 34 weeks.

Our Neo docs on under a lot of pressure to discharge 34-35 weekers home with no monitor or O2. It is up to us to keep close tabs on our docs. We have to remind ourselves to document every event with As & Bs so they will need to follow NICU policy and place infant on caffiene, have parents have monotor/ O2 training and set up Ped appointments within 2 days of discharge. I agree this is the time that in utero they have slowed down on their breathing exercises and conserve energy so they can put on weight and add the brown fat they will need once they are delivered. They miss this part when they are delivered at less than 35 weeks and many docs forget that. Most go through this A&B if they are micro premies, premies and even near term infants. I guess it is up to us NICU nurses to keep reminding them of this and tell the insurance companies or Medicaid to learn more about premies. Let us do our job and they will have less re-admits and save money and lawsuits in the long run. PremieOne

WoW, I feel lucky to be here! I was born 2 months early "back in the day". I never knew that gestational age was so precarious. I am currently thinking about worrking NICU as a change and a new challenge.

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