Caring for your premature baby at home

In many ways, caring for your premature baby at home may not be very different from how you had imagined life with a new baby. You will have plenty of time to cuddle and play with your baby and watch them respond to everyday things they won't have experienced in the baby unit. Here are a few things to keep in mind.

Before your baby leaves the baby unit, the healthcare team will help you learn how to care for your baby at home. This may include:

• keeping your baby at a comfortable temperature – see below
• sleeping – see below
• washing – see below
• feeding 
• preventing infection
• recognising and dealing with illness
• breathing support.

What should my baby’s temperature be?

Your baby’s body temperature should be between 36.6°C and 37.2°C.  

You do not need to take your baby’s temperature regularly. But check their temperature if they feel hotter than usual, they are sweaty, they look or feel unwell, or if you have any other concerns. 

The healthcare team will show you how to check their temperature at home. You may want to buy a digital thermometer suitable for babies. 

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 (see below).  

Although the baby unit is very warm, your baby will now be able to cope with lower temperatures. Aim to keep the room temperature at 16–20°C.  It can be difficult to judge the temperature in the room, so you could try using a room thermometer. Some baby monitors also show the room temperature. 

The best way to keep your baby’s temperature at a comfortable and safe level is by dressing them in layers, such as a vest, sleepsuit, blankets or zip-up sleeping bag. You can add or remove an item depending on how warm or cold it is. But it’s important to know that babies shouldn’t wear a hat indoors as it can make them overheat.

Contact your GP or call 111 if your baby’s temperature is very high or low or if they also have other signs of illness, such as a rash.  

How can I help my baby sleep?

Newborn babies spend most of their time sleeping. Some premature babies may have more disturbed sleep patterns than babies born at full-term. But it’s normal for all babies to wake up regularly during the night for feeds, whether they are fed with breast milk or formula.  

A newborn baby doesn’t have much of a sleep pattern and doesn’t know the difference between night and day. Showing your baby the difference between night and day can help them learn to settle at night. For example, you could dim the lights and keep noise to a minimum during the night. Find out more about your baby’s sleeping patterns. 

You can also read about how to cope with sleepless nights.

Sudden infant death syndrome (SIDS) 

Rarely, babies can die suddenly and unexpectedly of an unknown cause. This is called sudden infant death syndrome (SIDS) or sudden unexplained death of an infant (SUDI). The chance of a baby dying from SIDS is low but premature babies are more at risk than full-term babies. 

The cause of SIDS isn’t known but there are some things you can do to help reduce the risk. For example, we know that placing babies to sleep on their backs has greatly reduced the number of cases of SIDS. It’s also important not to fall sleep on a bed, sofa or armchair with your baby.
 
Speak to your midwife, health visitor or the baby unit team if you’re worried about your baby’s risk of SIDS. 

How can I reduce the risk of SIDS?     

• Lie your baby on their back to sleep with their feet at the bottom of the cot, Moses basket or pram, unless you have been advised differently by your healthcare team. 
• Use lightweight blankets, tucked in firmly. Make sure they only reach your baby’s shoulders and can’t cover their head. Never use duvets, pillows or cot bumpers.
• Use a firm, flat, waterproof mattress for your baby to sleep on.
• Keep your baby’s cot or Moses basket in your bedroom for the first 6 months. 
• Avoid co-sleeping with your premature baby. Never fall asleep with your baby on a sofa, armchair or bed, especially if you're very tired or have been using alcohol, drugs or medication. If you feel yourself getting tired, place your baby safely in their cot or Moses basket.
• Make sure your baby doesn’t get too hot or cold. Keep their cot away from radiators or heaters and out of direct sunlight. The room temperature should be 16–20oC. 
• Make sure no one smokes in the house. Find out more about smoking after pregnancy. 
• Breastfeed your baby if you can.
• Do not put your baby in a hat indoors. Babies can’t regulate their own temperature and this can make them overheat. 

The Lullaby Trust has more information on safer sleep advice for premature and low-weight babies. 

Your baby’s sleeping position

Some babies who were born very prematurely may have been sleeping on their fronts for medical reasons in hospital. But now they are at home, you should put them to sleep on their back. Babies may find it hard to get used to a new sleeping position at first but keep putting your baby onto their back. You can speak to your health visitor, the community healthcare team or midwife if you have any questions about this. 

You should not place your baby on their front for sleeping or use any type of equipment such as sleep positioners or rolled up blankets to keep them in one position when you get home. This is unless you have been told to do so by your baby’s doctor or paediatrician because of a medical condition. 

Babies who need to be given oxygen at home should be sleeping on their backs. You may have been told to increase the amount of oxygen if they are on their back instead of their front but this is still the safest way for them to sleep. 

How do I care for my baby’s skin?

Bathing your baby

Once your baby’s temperature and health are stable, they can have their first bath.  The healthcare team will show you how to care for your baby’s skin before you leave the baby unit.

How often you wash your baby will depend on how premature they are and the condition of their skin. To avoid irritating their skin, limit baths and hair washes to no more than 2 or 3 times a week. In between baths, you can ‘top and tail’ using cotton wool soaked in tepid water to wash your baby’s face, neck and bottom. 

Plain water is best for washing your baby’s delicate skin. If you need to use soap, the baby unit team can help you find one that is safe to use.  

The water should be warm, not hot. Check it with your wrist or elbow and mix it well so there are no hot patches. 

Snuggling them dry

Babies get cold easily when they’re wet. To help keep your baby warm, wash them in a warm, draught-free place and have a towel in easy reach to dry and wrap them in afterwards.

Changing your baby’s nappy

Keeping your baby’s bottom clean and dry can help reduce nappy rash. You only need water and cotton wool when you’re changing your baby’s nappy. You can gently pat the area dry or leave your baby’s nappy off for a while.  

If you are worried about nappy rash, you could use a thin layer of barrier ointment to protect your baby’s skin against moisture. Talk to your health visitor if your baby’s skin is broken.

Caring for dry skin

If your baby has dry skin, it’s important not to use any kind of moisturising product without asking your healthcare team for advice. Oils and lotions can increase the risk of infection and your baby’s skin should improve itself over time.  

First aid for parents

Your unit may offer to train you up in techniques to resuscitate your baby or to cope with choking. If you would like to develop these skills further, ask your healthcare team, contact your local branch of the British Red Cross or search online for private courses.

Your health visitor may also know if there are any local courses in your area.

Bonding with your baby

Some parents bond with their baby immediately, while others find it takes more time. We have put together some ideas for how to spend quality time with the newest member of your family.

Find out more about bonding with your baby.