Sleep Patterns

Premature babies often have irregular sleep patterns compared to full-term infants. Their nervous systems are still maturing, which can affect their ability to establish consistent sleep-wake cycles. Parents should expect more frequent wakings and shorter sleep periods initially.

• Expect 15-18 hours of total sleep in 24 hours

• Sleep periods may last only 2-3 hours at a time

• Watch for signs of over-tiredness, such as facial grimacing or turning away

• Keep a sleep log to identify emerging patterns

• Remember that sleep patterns will normalize gradually as baby matures

Grunting Due to Weak Stomach Muscles

Premature babies commonly grunt during bowel movements due to underdeveloped abdominal muscles. This grunting is typically normal and occurs because they're learning to coordinate the muscles needed for passing stool.

• Normal grunting usually occurs during active bowel movements

• May be accompanied by facial reddening and straining

• Should not be accompanied by severe distress or persistent crying

• Will improve as abdominal muscles strengthen

• Consider gentle tummy massages to aid digestion

Promoting Baby's Sleep (and Yours)

Creating consistent routines and optimal conditions can help both preemie and parents get better sleep. Understanding your baby's unique needs is key to establishing healthy sleep habits.

• Maintain a consistent bedtime routine

• Use blackout curtains during sleep periods

• Consider white noise to mask household sounds

• Watch for early tired signs rather than waiting for overtiredness

• Accept help from family members for night feedings when possible

• Practice safe co-sleeping guidelines if recommended by your healthcare provider

Creating a Safe Sleep Environment

Preemies need extra attention to their sleep environment due to their increased vulnerability. Following safe sleep guidelines is crucial for reducing the risk of SIDS, which preemies are at higher risk for.

• Always place baby on their back to sleep

• Use a firm mattress with fitted sheet only

• Keep room temperature between 68-72°F (20-22°C)

• Remove all soft objects from the sleep area

• Consider using a sleep sack instead of blankets

• Place crib away from windows and cords

Head Shape and Plagiocephaly

Premature babies are at increased risk for developing flat spots on their heads (plagiocephaly) due to their softer skull bones and decreased muscle strength.

• Alternate head position during sleep while maintaining back sleeping

• Implement supervised tummy time during wake periods

• Use different holding positions during feeding and carrying

• Consider physical therapy if recommended

• Monitor head shape during regular pediatric visits

• Limit time in car seats and swings when not traveling

Torticollis

Torticollis, a condition where neck muscles are tight on one side, is more common in preemies. Early recognition and intervention can prevent long-term complications.

• Watch for consistent head turning to one side

• Notice if baby has difficulty turning head both ways

• Learn neck stretching exercises from your healthcare provider

• Incorporate stretches into daily routines like diaper changes

• Position toys to encourage head turning to both sides

• Seek professional evaluation if concerned

Massage for Babies

Gentle massage can benefit premature babies by promoting growth, improving sleep, and enhancing bonding. Always get clearance from your healthcare provider before starting massage.

• Use gentle, slow strokes

• Watch baby's cues for overstimulation

• Start with short sessions (5-10 minutes)

• Use appropriate hypoallergenic oil if desired

• Learn proper techniques from a qualified instructor

• Stop if baby shows signs of stress

Giving Medications

Administering medications to preemies requires extra precision and care due to their small size and specific needs.

• Double-check all dosing instructions

• Use preemie-specific measuring tools

• Keep detailed medication logs

• Store medications safely and check expiration dates

• Never adjust doses without medical advice

• Learn proper administration techniques from your healthcare team

Sterilizing Bottles, Nipples, and Water

Preemies have immature immune systems, making proper sterilization crucial for preventing infections.

• Sterilize all feeding equipment until at least 6 months corrected age

• Use appropriate sterilization methods (boiling, steam, or chemical)

• Store sterilized items properly

• Use cooled, previously boiled water for formula preparation

• Clean and sanitize preparation areas

• Replace bottles and nipples regularly

Drooling Near Four Months Corrected Age

Increased drooling around four months corrected age is a normal developmental milestone, though it may cause skin irritation.

• Use soft bibs to protect clothing and skin

• Change wet bibs frequently

• Keep skin clean and dry

• Watch for signs of skin irritation

• Consider protective barrier creams

• Remember this is a temporary phase

Teething and Premature Babies

Teething in preemies typically follows their corrected age rather than chronological age, though individual variations exist.

• Expect first teeth around 4-7 months corrected age

• Use appropriate teething relief methods

• Monitor for fever or excessive fussiness

• Offer safe teething toys

• Maintain good oral hygiene

• Consult pediatric dentist when first teeth appear

Remember to always consult with your healthcare team about specific concerns, as each premature baby has unique needs and considerations.