6 Things I Didn’t Know About Preemies Until I Had One

The author Laurie Sage holds her preemie daughter in the NICU
Image Source: Laurie Sage

“I’m going to tell you what my father told me: Your baby will be early and small.”

Those were the words my mother said to me at some point in my second trimester, when the fear of pushing a human out of me began to set in. I was 18 days early and 5 lbs., 12 oz. when I was born, and she and her sister were both just as early and a bit smaller. It was assumed that my daughter too would follow suit, but what actually transpired took us all by surprise. She was a preemie — arriving a whole seven weeks early, weighing in at 4 lbs., 7 oz., and measuring 18 inches long.

They say you’re never really prepared for a baby, but you really don’t know unprepared until you have a preemie. Of course, no one expects it to happen, but when it does, it flips your world upside down. My husband I are the poster children of parents who were unprepared for a preemie. Not only did we not take any birthing classes, the nursery wasn’t set up (my baby shower ended just hours before my water broke!), and we hadn’t even settled on a name.

But we were lucky. Our daughter — who we eventually decided to name Sloane — didn’t need any assistance eating or breathing, and spent only 10 days in the NICU. Mommy and Daddy on the other hand were exhausted, scared, and adapting to the brand new world of having a preemie. We entered the NICU knowing nothing, and walked out extremely knowledgeable, thanks to the most amazing doctors and nurses.

Here are six things we learned in those first 10 days:

1. It’s not clear when you can take them home.

Having a preemie shatters your childbirth dreams. Your partner doesn’t get to cut the umbilical cord, your baby isn’t put directly on your chest after delivery, you’re not in the same room as them during your hospital stay, and worst of all, you have no idea when you can take that bundle of joy home.

When I finally made it down to the NICU to see Sloane, the nurse told us that we wouldn’t be able to take her home until closer to her due date.

I. Was. Crushed.

During morning rounds, I asked the doctor every single day when she will be able to come home. “It’s only been two days,” the doctor told me after the second time I probed him. My jaw hit the floor. It felt like it was two weeks! As the days went by, it became apparent that she wouldn’t need to be there so long, and we were lucky enough to have her home after 10 days. But that’s not always the case for preemie families.

2. Babies need to pass a car seat test before they can leave the NICU.

Gone are the days when babies need to be at least 5 lbs. before they can come home. Now they need to prove they can gain weight, hold their body temperature, and pass a car seat test. The car seat test has completely scarred me: Car seats will forever petrify me, and I’m convinced they are hazardous in a way. I mean, my baby had to take a test to make sure it was safe for her to even leave the hospital.

The car seat test is where the baby sits in it for 90 minutes, while hooked up to monitors. Their heart rate can’t drop below a certain point, and if it does, you have to wait another 24 hours and try again. Luckily, Sloane passed on the first try, and we took her home at 4 lbs., 3 oz.

Laurie Sage's preemie daughter smiles while wearing a tutu
Image Source: Laurie Sage

3. Premature babies have two ages: Actual age and adjusted age.

We learned quickly that although Sloane was born on June 12, her milestones were to be measured up against her due date, August 1 — AKA her adjusted age. We recently went for her four-month check-up and our doctor told us, with a smile, that she’s doing everything a 2-month-old should be doing. While hearing that our precious 4-month-old is functioning as a 2-month-old is a little unsettling, it’s something we are slowly coming around to.

4. You will hear the phrase, “She’s not supposed to be here yet,” ad nauseum.

Since preemies function at their adjusted age, the nurses, doctors, nurse practitioners, lactation consultants, and everyone else in the medical field will tell you that the reason she’s not doing something yet is because “she’s not supposed to be here yet!” She falls asleep during tummy time? “She’s not supposed to be here yet!” She sleeps all day? “She’s not supposed to be here yet!”  She falls asleep on the breast? Remember: “She’s not supposed to be here yet!”

5. They use energy differently than full-term babies.

At every shift change, the new nurse on duty would take Sloane’s vitals, one of them being her body temperature. She needed to maintain a body temperature no less than 97.7° F.

One night, she was too low. With two new parents hovering over her, the nurse on duty took it a few more times in different areas, and even used a different thermometer. She was still too low.

As I was getting ready to start breastfeeding, the nurse stopped me and explained that since her body temperature was too low we would have to “hold the feed” until she could get her body temperature up. To say that my husband and I freaked out over this news is an understatement. We couldn’t believe they were not going to feed our little girl — who mind you, was losing weight at this point.

The nurse kindly called the doctor in to further explain to us that preterm babies use their energy differently. She wouldn’t be getting nutrients from the feed as she would be using the energy to get warm as opposed to consuming calories. We felt better, but were not completely at ease, at least not until her temperature went back up and we were able to feed her.

6. Two words: Triple feeding.

When it was decided that I would be breastfeeding Sloane, I was told that I would be triple feeding every three hours until around her due date. Triple feeding is when you breastfeed, bottle feed expressed milk, and pump. This is to make sure she’s getting enough food and to keep your supply up.

Let me give it to you straight: Triple feeding is EXHAUSTING! The first few days it would take so long that I would only have a half-hour before I’d have to start the process all over again. It took long because she’d fall asleep at the breast, then bottle feeding was a struggle. Eventually, I worked out a system with my husband: he bottle fed while I pumped. That extra time I got back was nice to spend with my daughter and family.

And there you have it — everything I didn’t know about preemies, but learned in a 10-day crash course in the NICU. I may have felt wildly unprepared to deliver my baby — and so might you — but in the end, left that hospital more grateful for her than I ever could have imagined.

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