Babies born before their due date need special care, especially if they were very small at birth (less than 3 pounds).  Feeding premature babies is a unique challenge; it mainly depends on how early they were born, whether they have any medical issues and the severity of those issues.  It is also important to track how often your baby eats so you can share this information with healthcare providers and other caregivers.

Breast milk is ultimately the best source of nutrition for a new baby; it has proteins in it that can help fight infection and to promote growth.  If your baby was born before 34 weeks they often can’t feed from a bottle or breast due to the fact that they have trouble coordinating sucking, breathing and swallowing all at the same time.  However those born after 34 weeks may be able to feed from a bottle or the mother’s breast.

A good rule of thumb is to feed your premature baby 8 to 10 times per day and that will help prevent dehydration.  Six to 8 wet diapers a day is one indication that your baby is getting enough fluids.  If your head is now spinning with the “how many”, the “when” and the “how much” you may find it helpful to take a moment and track this information.  Premature babies tend to sleep more often than full-term ones but the duration is usually shorter.  In addition, with premature babies, sometimes you need to awaken them to feed them.

Soon after the birth of your premature baby start pumping if your baby is not able to breast feed.  Don’t be afraid to ask for help and do not hesitate to make sure those caring for you know your desire to breastfeed.   Once your milk supply is strong enough you can decrease how often you pump.  At 36 to 40 weeks, premature babies usually are able to suck and will most likely breast feed every 3 to 4 hours, but they may still need additional formula.  Once your baby is able to start nursing be prepared to nurse frequently and since they cannot take in much as milk at each feeding until they’re closer to term pump afterward to keep your milk supply up.  Some new mothers find it helpful to track this; either how often pumping occurs and how much, how much formula is given at each feeding and information on whether or not the baby was content, fussy or tired.

The video below shows you how to track breast and bottle feedings using the Babble Soft Baby Insights Day Tracker. These online tools are meant to help new parents easily track feedings and monitor baby’s fluid intake. There is also a feed tracking worksheet that you can print out to quickly write down feeding information to input later. By entering the feeding and intake data into Baby Insights, then parents can take advantage of the various graphs and reporting that is readily available and can help you identify patterns and monitor baby’s weekly intake or intake across multiple days. Parents of premature infants have found these charts and graphs especially helpful when meeting with baby’s pediatrician.

Image by Getty Images via @daylife

If you are concerned about your baby’s growth or development, you can monitor his feeding schedule and developmental changes using Babble Soft applications and share those reports with your pediatrician. A good doctor will understand that you are just a concerned parent and you want the best for your new baby!

The first 12 months of life are very important in the growth and development of your baby. Dramatic changes are taking place in all areas of their growth and development, sometimes it seems as if they are growing everyday, and they are. Most babies will double their birth weight by gaining an average of 0.5 oz to 1 oz every day for the first 6 months of life, and triple their birth weight between 9 to 12 months. By their first birthday, most babies have grown about 10 inches in length. Their head circumference normally increases 0.25 to 0.5 inches per month.
When you take your baby in for their well checkups the doctor or nurse will take three measurements:

Weight
Undress your baby completely, diaper and all. The doctor will place him on a scale to weigh him. The doctor or nurse will be able to tell you your baby’s weight in pounds to the closest ounce.

Length
While your baby is lying down he will be measured from the top of his head to the bottom of his heel. Some pediatricians use a device that has a headboard and a movable footboard so they can easily get accurate results.

Head circumference
In order to measure your baby’s head, the doctor will place a flexible measuring tape where his head has the largest circumference — just above their eyebrows and ears, and around the back of his head where it slopes up from his neck.

You may wonder why the doctor measures your baby’s head at every visit.  A baby’s brain growth is reflected by the size of his skull. If the head circumference is not increasing normally it could be an indication that the baby’s brain isn’t growing and developing as it should. If a baby’s head circumference grows too quickly, it may be a sign of a problem such as hydrocephalus, which is the buildup of fluid in the brain. Both conditions are rare but they are important to rule out.

Your baby’s pediatrician will use growth charts to evaluate and keep track of your baby’s physical growth. At each checkup, your baby’s length, weight, and head circumference will be measured and put into a chart of national averages for babies of the same age and sex. This will tell your pediatrician what percentile your child is in.

If the pediatrician tells you that your 3-month-old daughter is in the 90th percentile for weight, for example, that means 90 percent of the 3-month-old girls in the United States weigh the same or less than she does and 10 percent weigh more. If your baby was premature, their gestational age is used to plot their numbers on the growth chart.

If your baby was born 5 weeks early, her numbers will be compared with babies who are 5 weeks younger than your baby. Some pediatricians use “preemie” growth charts when measuring premature infants. Whichever growth chart is used your pediatrician will take into account that your baby was born preamturely.

You shouldn’t worry needlessly about these percentages because each child is different and will develop at his own pace. These measurements are used as a general guide to help you and your pediatrician assess your baby’s growth and development. The important thing is that your baby’s growth is progressing. This helps your doctor make sure that your baby is gaining weight as they should with no big drops in weight. The pediatrician will also keep an eye on their weight to make sure it isn’t excessive for their height, an indicator of potential weight problems down the road.
If your baby’s percentile changes significantly the doctor will want to figure out why and make sure they do not have a serious medical condition. Since a minor illness or a change in your baby’s eating patterns might result in a smaller drop the pediatrician may just want to follow your baby’s growth more closely for a while.

If your baby hasn’t been sick but his weight gain is slowing relative to the growth curve he’s been on, your pediatrician may suggest increased or more frequent feedings or may prescribe vitamins. You may be asked to come in for more frequent visits to make sure that your baby starts gaining weight again.

When a new mom leaves her infant in the care of a nanny or newborn care specialist, what are her concerns? What does she want to know?

 

How can a nanny help her feel more connected to her baby and help her deal with possible feelings of guilt over leaving her baby? 

A new mom’s perspective

As a new mom, I was so concerned about leaving my baby with anyone else … even my husband! When I returned, I wanted to know when he ate, if he slept, and practically everything he did. Now that I have two kids, I still ask their teachers and care providers what they did during the day. It’s so comforting to have an idea of how their day went. I sent our son to a home care on a part-time basis when he was a baby. I felt frustrated by the vague answers I received when I asked about the details of his day; but I bit my tongue, felt guilty, and walked away wondering what I had missed. 

It was difficult to leave my son with someone else and thereafter, leave my daughter – but I wanted to work. My career is very important to me and I knew I would be a better mom if I was able to pursue my passion. However, I still wanted to stay connected to my babies. It would have been a pleasure to receive an email, a text message, a picture, or even have the ability to log in to a website to see how my babies were doing. It would have made my life so much easier if I was assured that although they might have cried a bit when left them, they were eating well, sleeping well, learning and having fun. 

I was still breastfeeding when I returned to work, and I made every attempt to time my pumping sessions so that I could nurse my babies when I picked them up. If I arrived only to find out they had just been fed, I would have to go home and pump instead of feed them, making me feel very disappointed.  On the other hand, it was nice having breastfeeding support and knowing that I had expressed enough milk for them while I was away made me feel more connected to them. 

What moms want to know

In the “old days,” moms had no choice but to stay at home.  They could get advice and make decisions based on one-on-one face time with baby, family members, and friends. Nowadays, moms rely on their nannies to communicate their baby’s daily activities, issues, fussy periods, smiles, and schedules. When moms are not present, having the opportunity to review their baby’s activities at a glance in a daily journal or report is not only powerful, it helps them and their nanny make better baby care decisions. It is also a great way to provide records for their pediatricians, which can aid in making medical decisions. Here are more examples that illustrate the importance of keeping a daily journal: 

• A new mom misses important milestones. While she is at work, baby shows off her biggest smile or makes a first attempt at crawling. Imagine a caregiver who captures the moment via a picture, includes a milestone caption, and emails it to the mom. What a way to brighten her day. Although the mom is not present physically, she can take delight in knowing that the true “first” was captured.

• An infant spits up often but with no discernible pattern. Both the mom and nanny are busy and jot down handwritten notes, which might be stained or misplaced by the next day! Maintaining an online daily record of the baby’s feedings (with corresponding spit-up times) can help to establish a pattern of feeding times and a correlation between the feeding quantity and spit-up periods. The mom can forward the reports to the doctor to aid in a decision regarding whether her baby needs medicine for acid reflux or if there is a need to simply change the baby’s feeding schedule.

• A baby has difficulty sleeping. Mom (or dad) puts the baby down in a specific manner and in a specific place during the weekends. The nanny arrives and puts the baby down in a different manner, thus she witnesses a different outcome. The baby appears confused, which results in additional stress for both the nanny and family. One solution is to review online reports that are designed to track a baby’s sleep patterns and reveal how the baby was put to sleep. The reports can serve as physical proof that specific baby sleep positions or methods work better than others for the baby. The reports can also give parents the assurance that their baby is okay, and shifting their behavior or the nanny’s behavior can make life easier for everyone.

• A baby needs regular medications. Administering medications is a critical part of providing childcare. Therefore, it is beneficial to have a central place where medicine doses are recorded. This procedure can allow both the mom and nanny to ensure medicine doses, reactions, and duration are properly recorded and timed. Proper daily record keeping can help to avoid accidental overdoses and ensure a dose is not missed.

• The nanny runs out of expressed breast milk for baby. If the mom keeps daily pumping records and both the nanny and mom keep daily bottle-feeding records, Mom can adjust her breastfeeding and pumping schedule to ensure there is enough expressed milk for her baby.

There are many more sound reasons to keep daily records. However, the most important reasons in my opinion, are for the health and well-being of the baby, and improved communication between the nanny and family. Although moms today have many more opportunities than they did in the past, they also have more decisions to make and more balls to juggle. Keeping daily records of an infant’s activities helps nannies and moms make better baby care decisions – and it helps moms feel more connected to their baby. A happy mom means a happier baby!

By Aruni Gunasegaram, President and Founder of Babble Soft
Written for the International Nanny Association Spring 2008 newsletter