Care of the late pre-term baby

Care of late pre-term baby

A late pre-term or near-term infant is a baby born early, between 34 and 36 completed weeks gestation. Although late pre-term infants are usually significantly larger than very premature newborns, they are still premature and have their own unique health considerations.

Recent studies show that babies born just three to six weeks early are at a greater risk for potentially serious health problems than full-term newborns. It's important for parents to be alert for the special situations or needs that may arise because their baby is just a few weeks early. The late pre-term baby may not show any sign of problems until after the first day or two of life. Their organ systems are immature and behavior (i.e., feeding patterns) may be more unpredictable.

What to know and watch for

Feedings

  • Late pre-term infants tend to feed slower and may need to be fed more often than full-term babies.
  • A late pre-term infant may not be able to take as much breast milk or formula as a full-term infant.
  • Frequent feedings are essential to prevent jaundice, especially the first several days.
  • Contact your pediatrician if your baby refuses feedings, even for less than a day.
  • Some late pre-term infants may have problems initiating or maintaining breastfeeding; lactation support is available to assist with a feeding plan.

Sleeping

  • Late pre-term infants may be sleepier than most full-term infants and may sleep through needed feedings.
  • Always awaken the baby to eat after two or three hours of sleep.
  • All infants, including late pre-term infants, should be placed on their backs to sleep.

Breathing

  • Late pre-term infants may be at greater risk for respiratory distress.
  • Signs to watch for:
  • Baby turning color (blue) especially in the face or around the mouth.
  • Nostrils flaring.
  • Fast breathing pattern.
  • Dial 911 for respiratory distress, then call your pediatrician.

Temperature

  • Late pre-term infants, like all preemies, have less body fat and may be less able to regulate their own body temperature than full-term infants.
  • Room temperature should be warm enough to maintain the baby's normal temperature. 
  • The baby should wear a hat. Like all newborns, late pre-term babies should be kept from drafts.
  • A good rule of thumb is to dress your baby in one more layer than you're wearing.

Jaundice

  • Late pre-term infants may be more likely to develop jaundice, a symptom of a condition called hyperbilirubinemia that can lead to severe nervous system damage if not identified and treated early.
  • Screening is completed during hospital stay before discharge.
  • Infants should follow up as directed by the pediatrician within 24-48 hours of discharge or sooner if skin becomes yellow or if your baby is not feeding well.
  • Late pre-term infants have immature immune systems and may be more likely to develop infections, and watched-for signs of infection such as fever or difficulty breathing.

Download the printable version of this page (PDF).