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Most pregnancies last about 40 weeks. Babies born between 37 and 42 weeks of pregnancy are called “full term.” Babies born between 34 and 36 full weeks of pregnancy are called “late preterm” babies. Your baby may look and act like a baby born on its due date, but he is not fully mature and he may have trouble in many ways. The list below gives some of the reasons your baby needs extra care and attention.
At 35 to 37 weeks in your pregnancy, your baby’s brain is only 75 to 80% developed and needs to grow more. He might have trouble timing his sucking, swallowing, and breathing or keeping his body temperature normal. He might not be able to respond to people, noises, and activities in the same way that a full term baby does. Too much stimulation may stress your baby. This stimulation may happen from things that you think are routine such as talking, rocking, a noisy room, or some types of music. Your baby may tell you he’s stressed by spreading his fingers into “a stop” (palm out and flat) or putting his hand in front of his face. He may cry more, and you may have trouble settling him. Because his brain is growing, he may sleep a lot and not be as alert as a baby born at full term.
When a baby is born early, his lungs may not be fully developed. He might have some problems with his breathing and it might be too fast or too slow. Your baby’s bed should be a firm surface, without blankets, comforters, pillows, or stuffed animals. Always place your baby on the back for sleep to prevent Sudden Infant Death Syndrome (SIDS).
Babies begin to store fat in the last few weeks of pregnancy. A baby uses these fat stores for energy to eat and to stay warm. Since your baby was born early, he has less fat stores, so it’s important that he feeds every 3 hours. You may need to wake him and keep him awake while you’re feeding him. Good feeding builds his fat stores and helps his brain develop.
Your late preterm baby may be very sleepy. Wake him to feed every 3 hours, if he doesn’t wake on his own. The hospital or public health nurses can teach you how to help him stay awake and have a good feed. Your doctor will tell you when you can let your baby sleep longer than 3 hours.
If you’re breastfeeding, you may pump or hand express milk after your baby is done feeding. This will help with your breast milk supply. The more milk taken from the breast, the more milk you will make. This expressed breast milk can be fed back to your baby. If you are formula feeding, choose a formula with iron and omega 3.
Most babies lose a little weight after birth. Because late preterm babies have trouble feeding, your baby may lose more weight, but he should be back to his birth weight by 2 weeks of age. He should have at least 4 heavy wet diapers and 2 to 4 bowel movements (poops) every day. If he’s formula feeding, he should have 4 heavy wet diapers and at least 1 bowel movement (poop) a day. You’ll know he’s feeding well if he’s gaining weight.
Because your baby has a small amount of fat (energy stores), it’s hard for him to keep his blood sugar at normal levels. Feeding often can help.
Late preterm babies can have trouble keeping their body temperature normal because their brains are not fully developed and they have less body fat. Take your baby’s temperature in the armpit. A normal temperature is between 36.3ºC and 37.5ºC. If your baby needs help keeping his temperature normal, putting your baby on your bare chest (skin to skin) with a blanket covering you both may help. Keep your baby away from drafts. A good rule is to dress your baby in one more layer than you’re wearing. If your baby’s temperature is low or high, it may be a sign that he’s not well.
A baby born early has a less mature liver and is more likely to have jaundice than a baby born at full term. Jaundice can lead to serious problems with the brain if it isn’t treated. Signs of jaundice are: yellowing of the skin, yellowing of the whites of the eyes, sleepiness and poor feeding. Make sure you tell your baby’s doctor if you see any of these signs. A blood test can tell if your baby has jaundice. Your baby will be checked for jaundice before he leaves the hospital. He should be seen by a public health nurse or doctor within 24 to 48 hours of being at home. Feeding your baby at least every 3 hours helps to prevent jaundice.
The immune system helps the body fight infection. In the last weeks of pregnancy, proteins that help immunity move from the mother to the baby. A late preterm baby may be born before this happens. It’s especially important to breastfeed a late preterm baby because breast milk can help your baby develop immunity. Try to give as much breastmilk as possible. Signs that your baby may have an infection are: a high fever of greater than 37.5ºC, a low temperature of less than 36.3°C, trouble breathing, poor feeding, or trouble waking up.
You can help protect your baby from infections by asking everyone to wash their hands before touching or holding your baby. Limit visitors and outings when your baby is very young. During fall and winter, everyone in your house should get an influenza (flu) shot.
Holding your baby next to your body (skin to skin) has many benefits. It helps keep your baby’s temperature normal. It also helps your baby to have good oxygen levels, and heart and breathing rates. Babies who are held skin-to-skin cry less. Mothers who hold their baby skin-to-skin have better milk production. It’s important that you stay awake during breastfeeding or skin to skin time so that your baby doesn’t slip off your chest and fall. Try chewing gum to stay awake.
Call 911 anytime you think your baby may need emergency care. For example, if your baby has trouble breathing.
Call your doctor or public health nurse, or seek immediate medical care if:
To see this information online and learn more, visit MyHealth.Alberta.ca/health/pages/conditions.aspx?Hwid=custom.ab_newborncare_latepreterminfant_inst.
For 24/7 nurse advice and general health information call Health Link at 811.
Current as of: March 14, 2019
Author: Maternal, Newborn, Child and Youth Strategic Clinical Network, Alberta Health Services
Care instructions may be adapted by your healthcare provider. If you have questions about a medical condition or this instruction, talk with your doctor or appropriate healthcare provider.