Version July 2025
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What are discharge instructions? —
Discharge instructions are information about how to take care of yourself and your child after getting medical care.
What does it mean when a baby is born premature? —
A baby born before 37 weeks of pregnancy (3 or more weeks before the due date) is called "premature" or "preterm." Pregnancy normally lasts about 40 weeks, counting from the first day of your last period. Premature babies are sometimes called "preemies" for short.
Babies who are born closer to their due date can look like full-term babies. ("Full-term" babies are born after 40 weeks of pregnancy.) They might have fewer problems than babies who are born earlier. But all premature babies are at risk for certain problems.
Premature babies often need extra medical care after birth. They might stay in the neonatal intensive care unit, or "NICU." This is a part of the hospital for babies who need special care. The medical staff will decide when it is safe for you to take your baby home.
How do I care for my baby at home? —
Ask the doctor or nurse what you should do when you go home. Make sure you understand exactly what you need to do to care for your baby. Ask questions if there is anything you do not understand.
Before going home, make sure you have a plan for:
●Travel – If you need to travel by car, make sure you have an infant car seat. You should also make sure it is installed correctly. Babies should ride in a rear-facing car seat in the back of the car. Many people choose an infant "bucket" seat that clicks into a base that stays in the car. The other option is a "convertible" car seat. These can be installed rear-facing, then switched to forward-facing when the child is older. The car seat straps should be adjusted to your baby's size (figure 1).
●Feeding – Know when and how to feed your baby. Breast milk has many benefits for premature babies. Most newborns need to eat about 8 to 12 times a day (at least every few hours). Some babies do not wake up on their own to eat. It is OK to wake up your baby to feed them. Some premature babies need more calories or special formula. Some might need to get milk or formula through a feeding tube after they go home. If so, your baby's doctor or nurse will give you more instructions and show you how to use the feeding tube.
●Sleep – Always put your baby on their back on a flat surface to sleep. They should sleep in a crib, cradle, or bassinet without any pillows, blankets, or other objects in it (figure 2). The mattress should be firm, not soft. If you want your baby to sleep near you, put the crib or bassinet near your bed (figure 3). Do not put them to sleep in a car seat or swing.
●Keeping your baby safe – Know how to do CPR on a baby. Most people never need to use it, but it's good to be prepared if there is ever an emergency. Your baby's doctor can give you more information about how to learn CPR. You can also help protect them from infections while their immune system is still developing. Anyone who holds or touches your newborn should wash their hands first.
If anyone in your house smokes, it is very important that they quit. Smoking around a baby exposes them to secondhand smoke. This can lead to health problems, such as asthma and infections. If you need help quitting, talk with your doctor or nurse. There are treatments that can help.
●Supplies and medicine – Make sure you have all the supplies you need. Some premature babies need special equipment. If your baby needs to take medicine, make sure you know how and when to give it.
●Soothing and comforting – You can try "skin-to-skin" contact while you are both resting (figure 4). This is when you hold your baby on your bare chest while they are wearing only a diaper (and sometimes a hat). The baby should be covered with your shirt or a blanket to keep them warm. You can also soothe your baby by dimming the lights or gently touching their head, feet, or back.
●Support – Get help and support when you can. It can be challenging to care for a premature baby. It can help to join a support group and connect with other parents and caregivers of premature babies.
Talk to your baby's doctor or nurse if you are struggling. They can give you resources for things like financial help and emotional support.
What follow-up care does my baby need? —
The doctor or nurse will tell you when to make a follow-up appointment. Make sure you know when and where to go.
Most premature babies should see a doctor or nurse within a few days of going home. Some might need frequent follow-up visits for the first few months. At these visits:
●The doctor or nurse will weigh and measure your baby. This is to make sure they are growing as expected.
●They will also make sure your baby gets all the vaccines they need. Vaccines are especially important for babies who were born premature. This is because premature babies are at higher risk of infections than other babies, and vaccines help prevent infections.
During these follow-up visits, ask your baby's doctor or nurse any questions you have about vaccines or your baby's health. They will also refer you to specialists or other services as needed.
When should I call the doctor? —
Get medical care right away if your baby:
●Is not eating normally
●Is unusually sleepy or hard to wake
●Has severe or worsening jaundice (when the skin or white part of the eye turns yellow)
●Seems to be working harder than normal to breathe
●Turns blue or gray in the face, skin, lips, fingernails, or toenails
●Seems weak or floppy
●Has a fever of 100.4°F (38°C) or higher
●Does not have a wet diaper for 8 hours or longer
●Does not have a bowel movement for 4 days or longer
●Spits up a lot, or spits up blood
●Has blood in their diaper
●Cries for longer than 2 hours without stopping
●Has redness or oozing around the umbilical cord stump
You should also call for advice if you:
●Have questions about how to care for your baby
●Are having trouble feeding or caring for your baby
●Feel depressed or are having trouble coping
Patient education: When a baby is born premature (The Basics)
Patient education: What to expect in the NICU (The Basics)
Patient education: Caring for your newborn (The Basics)
Patient education: Car seat safety for premature babies (The Basics)
Patient education: Benefits of breast milk for premature babies (The Basics)
Patient education: Breastfeeding (The Basics)
Patient education: Enteral (tube) feeding (The Basics)
Patient education: Safe sleep for babies (The Basics)
Patient education: CPR for children (The Basics)
Patient education: Depression during and after pregnancy (The Basics)
