What We Didn’t Know About Preemie Babies

Parenthood, Twins / Tuesday, September 4th, 2018

We heard it time and time again after P and C were born: “Forget everything you know about newborns.” 

Whether it was how to hold them, feed them, or clothe them, what we thought we knew was wrong. Whenever we thought we’d figured something out, something else would take us by surprise.

Each time, we would hear a NICU nurse say those six words—forget everything you know about newborns.

The nurses weren’t trying to make us feel inferior or like we didn’t have a clue about our own children. They just gently reminded us that preemie babies are different. They’re special. They need more care and help, but they fight like no small being has ever fought before.

My husband and I, our families, and our friends learned a lot about preemies when P and C made their grand entrance into the world. We were in love with them and amazed at their determination to learn and survive, but also surprised by how much we didn’t know.

I want to share some interesting facts about preemie babies that don’t necessarily apply to full-term babies, because you just never know who might need to forget everything they know about newborns.

They had to learn how to eat.

Most babies are born instinctively knowing how to suck, swallow, and breathe when they eat. Preemie babies don’t always enter the world knowing how to do those things, so they have to learn.

Thankfully our girls didn’t take long to figure it out, but we still had our fair share of feeding tubes, drool, and spitup during their 12-day NICU stay.

In the first few days, each meal involved constant coaxing of the bottle, gently rubbing the girls cheeks to stimulate a rooting reflex, and delivering what couldn’t be taken with a bottle through a feeding tube that went into their noses and down to their stomachs.

It was sad to watch them struggle to eat and constantly pull on their feeding tubes, but we had a small army of people who’d started praying for our girls before they were born. During those NICU days, we saw prayer after prayer answered as P and C grew stronger and learned to eat on their own (no more feeding tubes!).

They ate in a different position.

When they ate, we couldn’t hold them the traditional way that you would think of to bottle-feed a baby. Instead, we would lie them on their sides on our legs and rest their tiny heads in our hand. We held the bottles horizontal to the floor, so they were literally eating sideways instead of leaned back in a cradle position.

The NICU nurses explained that because they were still learning the rhythm of suck-swallow-breathe, this position was best to prevent choking.

If they were eating in a cradled position and took in too much milk and tried to take a breath, they would breathe in the milk and choke. In side-lying position, if they sucked in too much milk and couldn’t swallow it all before taking a breath, it would pool in their cheek and they could swallow it after their breath.

The side-lying position also mimics breastfeeding more closely. Although I ended up exclusively bottle-feeding P and C, it would have been extremely helpful for them to be used to eating in a side-lying position if I had nursed.

They needed special clothes and diapers.

If you’ve ever shopped for baby clothes, you’ve undoubtedly seen the traditional sizes of newborn, 0-3mo, 3-6mo, 6-9mo, and more. Have you ever noticed the size P? The P stands for preemie, and the clothes are extra tiny for super small humans.

When P and C were born, they were actually so little that they only wore diapers for several days and they were constantly swaddled. When we did start clothing them, preemie outfits hung off them. They were so small!

At less than 4 pounds each, their little bodies got lost in newborn diapers, too. Instead, they wore preemie-small diapers—yes, there are different sizes of preemie diapers! Who knew? The nurses showed us the smallest diapers you can order, micro-preemie, and we gasped out loud when we saw how small they were.

It was no picnic to find diapers that fit once we were able to take the girls home. We could only find preemie-small diapers on Amazon and at Walmart, so we really had to plan ahead when we were running low.

They came home in specific car seats.

At the hospital where P and C were born, the staff like to do a car seat check before you take your babies home from the NICU. We had car seats we absolutely loved (they are so light and cozy), and we were super disappointed to learn that the weight limit started at 5 pounds.

Since P and C weighed only 4 pounds when it was time to bring them home, we had to buy a new set of car seats. Of course, no one could legally stop us from using the car seats we already had, but we wanted to do the safest thing for the girls.

We ended up using the new car seats to bring P and C home and to take them to their first doctor appointment, and then the girls were over 5 pounds and we switched to our original ones.

If you are trying to bring an extra-small human home, you might want to double-check the weight limits on your car seat!

They had two different ages: chronological and adjusted.

This was one of the most interesting preemie facts we learned.

Because P and C were born at 35 weeks and 1 day (every day counts!), the doctors looked at them developmentally as being younger than they actually were. I’ll explain.

When P and C were 2 months old chronologically, they were actually 3 weeks adjusted. This is because 40 weeks (the length of a full-term pregnancy) minus 35 weeks and 1 day (when P and C were born) equals 4 weeks and 6 days, rounded up to 5 weeks.

So when they were 2 months old, they were only expected to act like 3-week-olds.

When they were 6 months old, they were only expected to act like they were about 5 months old.

When they turned 1 year old, they were expected to act about 11 months old.

You get the idea.

We were told that doctors would look at developmental milestones based on their adjusted age, not their chronological age, until their second birthday. By age 2, most preemies have caught up to their peers in terms of developmental milestones.

We are super blessed to have P and C act more and more like their chronological age every day, so we haven’t really seen developmental setbacks. Even if we did, it wouldn’t be especially concerning if we looked at their adjusted age instead.

You can’t put anyone in a figurative box, including preemie babies. While the five points I mentioned might have applied to our twins, that doesn’t necessarily mean they’ll apply to every preemie baby.

All babies are blessings, but preemies are born fighters. I’m amazed every day at what P and C are able to do, and I’m so thankful God chose Spencer and me to be their parents!

Hello! I am a work-at-home mom to twin girls and a canine. I’m learning what life looks like when you surrender to God. Passionate about parenthood, marriage, and all things coffee!