Please complete this hypothetical, preemie discussion:

MarySunshine · Mar 1, 2005

I think X=36 and Y=35, but there may be more experienced nurses who disagree or have something to add. Just like the first time a baby walks can vary widely between children, so can the developmental milestones a premie/newborn go through. Also, sometimes the gestational ages are not precisely accurate. We could be +/- a week or so in our estimate! One 35 weeker may be able to go home right away, while another may need a NICU stay.

Keep in mind that premies several weeks younger than 35weeks usually go home healthy after a NICU stay. 35 weeks just seems to be a sortof cutoff in the NICU -- maybe they'll be ready to go home, maybe not. Is everything okay with the family Dad2be? :)

Jolie, BSN · Mar 1, 2005

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?
Co-worker: Yes
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.

Good luck!

BETSRN · Mar 1, 2005

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?
Co-worker: Yes
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?

You can never tell.......... That's why I suggested before that you just talk with your wife's HCP's and NOT take what is speculated on this board as the be all and end all.

Mimi2RN, ASN, RN · Mar 1, 2005

There are other things involved, r/t mom's health. Is she PIH? On mag sulfate? Has she been given beta methasone? Is she PROM? GBS pos or neg, and has she been treated?

34-36 weekers can be wonderful, or very sick. As others have said, a 36 weeker can stay in the room with mom, or have to be on a vent. You won't know until baby delivers, and then it's up to the baby and the doc.

ShannonC · Mar 2, 2005

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?
Co-worker: Yes
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?

From my experience, what I have seen in my particular hospital,my "X" here is 34 weeks and my "Y" is 33. To me that fits the bill--33 weekers almost always turn out fine, albeit with a short stay in the NICU. Most of our 34 weekers are in the NICU for only a day or so. I had a 34 week/1 day baby last weekend who was in the NICU for all of 3 hours. And then I have my own personal experience with my own children who were 34 weekers who went home with me right away when I was discharged.

Of course, I feel obliged to say, StressedDadtoBe, that (and you know this of course) we can't ever be certain until baby is out. Sadly, there are some cases where even 36 weekers(or more) have trouble. But, from my experience, we barely blink anymore at 34-35 weeks.

dansamy · Mar 2, 2005

My own 3 were 30w, 33w and 34w2d. My 30 weeker stayed exactly 4 weeks in Special Care. 33 weeker stayed 3 weeks. And my bouncing, big baby (4lb12oz - my biggest!) born at 34 weeks & 2 days stayed for 12 days.

SmilingBluEyes · Mar 2, 2005

NO sense gathering 'stats" here; that is simply borrowing trouble. Each kiddo is different. I have seen 36 weekers give us fits for weeks (blood sugar and breathing problems usually). I have seen 34 weekers do GREAT and go right to breast and home in a few days w/o any special care.

Each kid and situation is different. You are risking making yourself go nuts with hypotheticals. No professional here can predict how your baby will do when born. No hypothetical conversation will change any outcome for you. It depends on too many variables.

I tell you what. Just pray and hope for the best and be thankful the pregnancy went as far as it has. That is the best thing you can do...oh and pamper your wife a bit. That would be helpful as well as smart. Good luck; you are so close!

BETSRN · Mar 2, 2005

NO sense gathering 'stats" here; that is simply borrowing trouble. Each kiddo is different. I have seen 36 weekers give us fits for weeks (blood sugar and breathing problems usually). I have seen 34 weekers do GREAT and go right to breast and home in a few days w/o any special care.
Each kid and situation is different. You are risking making yourself go nuts with hypotheticals. No professional here can predict how your baby will do when born. No hypothetical conversation will change any outcome for you. It depends on too many variables.
I tell you what. Just pray and hope for the best and be thankful the pregnancy went as far as it has. That is the best thing you can do...oh and pamper your wife a bit. That would be helpful as well as smart. Good luck; you are so close!

I have to agree with Smilin'. She said just what I said yesterday. You are not going to get any information from any of us that is going to pertain to your little opne. Each baby is different as is each pregnancy! please stop stressing by posting here and just wait it out.

ShannonC · Mar 2, 2005

I have to agree with Smilin'. She said just what I said yesterday. You are not going to get any information from any of us that is going to pertain to your little opne. Each baby is different as is each pregnancy! please stop stressing by posting here and just wait it out.

I think I have a soft spot for this Dad, because I remember being sort of in his and his wife's shoes. This is the scenario: you read the hard stats, you get all informed, but then you want to just hear from real life people... he seems like a smart enough fellow to know that the best we can offer is anecdotal info, but sometimes it's just really nice to have a "real person" behind the stats. Or maybe I'm totally wrong :) (been known to happen). But BetsRN has a point--there IS something to be said for letting go of the stats and just peacefully waiting... MUCH easier said than done though!

SmilingBluEyes · Mar 2, 2005

Shannon, we all have a soft spot. I am only trying to help. I don't see this going anywhere beneficial or helpful for him. I can relate to the stress a wee bit; I had a preemie who also had a birth defect requiring surgery before he was 4 months old. But I still say playing hypothetical games won't help him. May stress him out even more.

To the OP I still say focus on your wife, her health and needs and your own. You cannot control this situation, don't try. Just handle things as they come; Let things run their course. And please let us know how things go when the baby does come.

prmenrs, RN · Mar 2, 2005

I agree with Smilin'. As hard as it may be, you have to wait it out. We're all here, waiting and praying with you, so don't feel alone.

It's also important to remember that you and your wife did not do anything to cause this, neither of you need to feel guilt in this situation. I frequently see families who want to know why this happened. There will probably not be an answer to that question. Nobody caused it, sometimes things just happen.

We'll be waiting to hear back from you! God Bless!