The first few days with your premature baby

Guest blog by Tommy’s Pregnancy Hub (with an additional exert from Harriet)

The first few days after giving birth to your premature baby can pass in a daze. Here’s what to expect…

Many women describe their early days with a new baby as having a dream-like quality. You are recovering from the birth, coping with a great deal of change - not to mention raging hormones - and may feel extremely tired.

If your baby is born prematurely, you have to cope with all of this without having had a chance to prepare yourself - either emotionally or practically. The birth may have come as a big shock, and you may also be coping with the realities of health problems for you or your baby.

Bonding with your premature baby

If your baby is in an incubator, you may find it harder than usual to bond with them - though this is not always the case. If you don't feel a connection with your baby at first, don't worry - just try to take each day as it comes.

You may worry because there may be a big difference between how you feel about your baby and how you think you 'should' feel about your baby.

If you are expecting to fall in love with them at first sight, you may feel very worried or guilty if you feel somewhat detached from the small creature lying in the incubator.

Try not to worry if you don't bond immediately. It takes many mothers some time to get to know and love their new baby - especially after a difficult birth. If your baby is in an incubator, then it may take you a little longer to connect with them, as so many other people need to be involved in their care. Kangaroo care can help with the bonding process and when your baby is stable this will probably be encouraged.

Read more about how to bond with your baby here.

The neonatal unit

The first time you see your baby in the baby unit, it may come as a big shock. The unit itself may seem like a space-age control room - very hot, with lots of flashing lights, beeping monitors and other mystifying pieces of equipment. Among all these are the incubators, each one containing a tiny baby.

Your tiny baby may be at the centre of a tangle of tubes, surrounded by equipment. Seeing them in this situation can be very distressing, and it is easy to feel very overwhelmed.

What your premature baby will look like

Your baby may also look quite different to what you had imagined. Newborn babies never look like the bouncing bundles that you see in the nappy adverts, but a baby born prematurely will be at an earlier stage of development. For example, they have very red skin, which may be covered in a fine down. Be reassured that these things are temporary. As your baby grows they will look more like the baby you had expected.

24-28 weeks

Weight: 1-3.5lb (450-1600g)

Length: 10-13in (25-33cm)

At this stage, your baby will be very thin, with fragile red skin covered with downy hair (lanugo). His head will look large, he will have soft skull bones, and a small face with a pointed chin and eyes fused shut.

29-34 weeks

Weight: 2-5.5lb (1-2.5kg)

Length: 12-14in (30-35cm)

Your baby will still be quite thin, and his skin will be slightly translucent and still covered in downy hair. In girls you may see tiny nipples. He may move quite vigorously and grasp your finger, and may be able to suck or lick, but he won't be ready to feed on his own.

35-37 weeks

Weight: 3.5-7lb (1.6-3.4kg)

Length: 15-18in (38-45cm)

By this stage, your baby will be much more robust and will look more like what you'd expect a term baby to look like. He may still be quite thin, with some hair, and he may still need extra help with feeding and breathing and staying warm.

Levels of care

Special care baby unit (SCBU) 

Also called the special care baby unit (SCBU, pronounced 'skaboo') or special care unit (SCU), these provide the most simple level of care for babies in their local area and stabilise a baby's condition before transferring him to another unit or provide emergency care if necessary. They may also provide some high-dependency services. They receive babies from other units once they are well enough to be cared for there.

Local neonatal unit (LNU)

Local neonatal units (LNUs) provide special care for babies in their local area, except for those who are very unwell and need complex or longer-term intensive care. The majority of babies over 27 weeks of gestation will usually receive their full care, including short periods of intensive care, within their LNU.

Neonatal intensive care units (NICU)

These specialist units have the facilities to care for critically ill premature babies. Babies will be transferred here from around the country to access the specialised expertise that they offer. They provide the whole range of medical neonatal care for their local population, along with additional care for babies and their families referred from the neonatal network.

Here’s what Harriet, new mama to a baby girl born 11 weeks premature, had to say:

“All NICU parents seem to have their photos of the incubator and the wires and the machines and the little knitted bonnets. Maybe even the first ever photo where the babies are put inside a plastic bag to keep them warm (apparently sandwich bags have been used when they've run out!)

Initially I was very selective which photos I let people see because I didn't want people to think of her as a poorly baby in a box. It took me a few days before I sent anyone a photo of her face.

It sounds impossible but you learn to blur out the wires and just focus on a little button nose or tiny fingernails, or in our case, absolutely huge hands and feet courtesy of her dad.

So, my advice if you know someone who has just had a preemie is don't ask for photos. They might not be ready to share just yet. And if you are one of the lucky ones to get a sneak peak into the NICU world, please be extra mindful of what you say; commenting on baby’s size or asking what the wires do puts a bit of a downer on the celebration of a new baby.”