Your NICU Baby at Home: Care Instructions
Learn how to care for your baby when going home from the NICU.
Feeding
For the first few months of life, your baby will need only breastmilk or formula.
Always mix the formula following the directions on the can, or the directions given to you by your baby’s doctor.
Feed your infant as instructed by your baby’s doctor.
“On demand” feedings are generally about every 2 to 3 hours for most formula-fed babies. Breastfed babies may nurse more often, about every 1 ½ to 2 ½ hours.
Babies less than 5 pounds should not go longer than 3 hours between feedings.
As babies grow and get bigger, they may go 4 to 5 hours between feedings.
Pour about the amount of formula or expressed breastmilk that your baby will take for one feeding in each bottle. Throw away any formula or breastmilk left over in that bottle after each feeding.
Never “prop” your baby’s bottle. Always hold your baby during a feeding. This can strengthen your bond with your baby and will help prevent choking, ear infections, and tooth decay.
Nipple sizes and types for bottles are different to match how your baby is growing and help with any special needs they may have. Ask your baby’s doctor what bottle nipple is right for your baby.
Diapering
Keeping your baby clean and dry will help prevent the chance of diaper rash.
Your baby should wet at least 6 diapers a day.
Bowel movements vary from baby to baby. Your baby may have a bowel movement a few times a day or only once every few days.
Avoid using baby powder in the diaper area.
Always roll the top edge of the diaper below the umbilical cord if it is still attached.
Bathing
Always bathe your baby in a comfortable, safe place.
Gather all of your supplies before starting the bath.
Never leave your baby alone near the water—not even for a few seconds! If you must leave the room during a bath, always take your baby with you.
You may give your baby a "tub" bath when the umbilical cord falls off. Until that time, sponge baths are recommended to keep the umbilical cord dry.
Use a mild or a moisturizing soap.
Always check the water temperature before starting the bath. The water should feel warm, not hot. Test the water temperature with the inside of your elbow or wrist. The American Academy of Pediatrics advises keeping your hot water heater set at no higher than 120°F (48°C).
Stimulation
Remember that your baby has the same senses that you have: sight, hearing, smell, taste, touch, and movement.
Each time you stimulate your baby’s senses they have a new chance to learn about the world. To help your baby learn:
Talk to your baby often. Use "baby talk." The higher pitch, slower speech, and emphasis on certain words help get your baby's attention.
Show your baby new and interesting things. Point out pictures in your home. Go for walks outside. Talk about the things you see.
Give your baby different things to look at.
Read, smile, sing, and play music for your baby.
Hold, rock, and carry your baby as much as possible.
Ask your baby’s doctor about letting your baby use a pacifier. It is usually best to wait until breastfeeding is well established before you offer a pacifier.
Respond to your baby's cries right away. They will learn to trust you and will cry less. Crying is your baby's way to tell you that they are hungry or uncomfortable. You are not spoiling your baby by quickly responding to their needs.
Safety
For any emergency, call 911.
Learn child and infant CPR.
Infants should ride in a rear-facing car safety seat. In rare situations, a baby may need to use a car bed.
Some premature and high-risk babies may need extra monitoring in the car. You may need to watch them while in the car to make sure they do not have difficulty with breathing or turn a blue color.
Babies should always sleep on their back unless instructed otherwise by their doctor.
Use a safe sleep surface. Babies should sleep on a firm, flat mattress with a fitted sheet. Don't use one that is at an angle or inclined. Safe examples are a crib or bassinet.
Keep loose blankets, pillows, stuffed toys, bumpers and other soft items out of the sleep space. Don’t use infant sleep positioners or weighted blankets, or other weighted objects.
The American Academy of Pediatrics advises that babies sleep in the same room as their parents. The baby should be close to their parents' bed, but in a separate crib or bassinet. This is advised for at least the first 6 months.
Don't put your baby to sleep in a bed, couch, or chair with another adult or child. Don't fall asleep with your baby. Bed sharing is also not advised for twins or other multiples. Infants who sleep in the same bed as adults or other children are at a higher risk of SIDS (sudden infant death syndrome) and can accidentally suffocate.
Sitting devices like car seats, strollers, swings, infant carriers, and slings are not recommended for regular sleep. If a baby falls asleep in one of these devices, they should be moved to a safe, flat surface like a crib as soon as possible.
Dress your baby in a sleep sack or pajamas for warmth while sleeping.
When awake and supervised during play, you may put your baby on their stomach on a firm surface for “tummy time.”
Never leave your baby unattended on any elevated surfaces, such as a changing table, couch, or bed. Even at this young age, they can extend their body and fall over the edge.
Never leave your baby alone in the house, yard, or car. While you are in the home, you may leave your baby in a safe sleep area inside the home.
Signs of a problem
Contact the doctor or seek immediate medical care if your baby:
Has a rectal temperature of less than 97.5 °F (36.4 °C) or more than 100.4 °F (38 °C), or as advised by the doctor
Has fewer than 6 wet diapers a day
Has frequent, thin, watery stool (diarrhea)
Has hard, dry, formed stool (constipation)
Is vomiting
Has drainage from their eyes, ears, and/or nose
Refuses feedings, spits up often, or breathes too fast when feeding
Has difficulty feeding or is too sleepy to finish a feeding
Shows signs of pain, such as continuous crying or irritability that cannot be calmed
Sweats a lot
Has a diaper rash that gets worse or does not go away after a couple days of treatment
Call 911 anytime you think your child may need emergency care. For example, call if:
Your child stops breathing or becomes unconscious.
Your baby has trouble breathing or has blue or gray skin, lips, gums, or nail beds.