Quote from StressedDad2Be
I appreciate the numerous replies I've gotten on my original thread from the nursing professionals on this board. Thanks everyone. I'm very curious to hear some honest replies based on 1st hand experience to the following, hypothetical conversation.
You: So there's a mom that was just admitted with pre-term labor?
You: How many weeks?
Co-worker: She's X weeks along
You: Oh, that's not bad at all. We seldom have any problems with preemies born at X weeks, they almost always turn out perfectly fine and can go home with mom right away.
You: In fact, as long as they're at least Y weeks along they usually turn out just fine...although they may have a few minor bumps in the road the first week or two (with a short stay in the NICU just to be sure).
So, in your opinion, what is X and Y?
OK, Dad, this is not a hypothetical discussion at all! But since you have been so great about keeping us posted on your family's progress, I'll take the bait!
It is no coincidence that your hospital will electively deliver a 34 weeker, rather than insisting on a transport. That is roughly the age at which preemies, especially those who have endured long-term stressors in the womb, tend to do quite well. There are always exceptions, but most will require minimal (or no) respiratory support. Most will be able to tolerate some type of enteral feedings (oral or tube feedings) within a day or two of birth, and most will transition to an open crib quite readily. Also, 34 weeks is the age at which most general pediatricians and/or family practice physicians will feel comfortable managing the care of a "well" preemie without the back-up of a neonatologist or neonatal nurse practitioner. At 34 weeks, it is somewhat of a c**pshoot as to whether or not the baby will be ready to go home with mom. In order to be discharged, the baby needs to be able to maintain his/her temperature in an open crib, take all feedings by mouth, whether bottle or breast, and show no evidence of untreated apnea. Some babies can accomplish this with in mom's 2-3 day stay, some babies need more time.
By 36 weeks, the likelihood of respiratory difficulties, poor feeding, and apneic episodes decrease, but is not completely eliminated. A baby born at this age is more likely to be discharged with mom, but that is still not a given.
With any baby, preemie or full-term, follow-up after discharge is critically important. Preemies (except for my daughter who could have sucked the paint off a wall) tend to be sluggish feeders, even after discharge. Monitoring their weight and urinary output is important to ensure that they are feeding sufficiently to prevent dehydration and jaundice. Arranging for a home care nurse or early pediatrician appointment(s) is helpful in preventing re-admission for these problems.