During the first months after being discharged from the hospital parents may feel insecure and need professional support as they are facing a variety of problems ranging from feeding difficulties, sleeping problems and supervision by home monitoring to caring for their child's development. Primary contact should be the local paediatrician who carries out the usual screening tests and vaccinations for all children. Aftercare by nurses specialized in paediatric care or midwives is helpful.

All preterm babies should be followed up closely on a neurological and psychological developmental basis to be able to intervene on time  – e.g. with the help of physiotherapy, ergo-therapy or early intervention. Some hospitals offer special consultation hours for preterm babies or refer these children to a social pediatric center or another early intervention center.

The main aim of advice and support is that the parents regain their own balance, their confidence and competence after the critical time of birth and hospital stay and that they support building up an individually adapted form of parent-child interaction - regardless of any possible development problems.

An important means of support and encouragement after discharge can be the exchange with other concerned parents in self-help groups. Local parents' groups can be found with the help of the federal or national association. You will find a link to the national preterm birth associations in your country at European National Parents' Organisations. If you are looking for direct help and advice please feel welcome to get in touch with the respective group.

Respiratory Syncytial Virus (RSV)

Respiratory Syncytial Virus (RSV) affects many babies during the winter months, causing cold-like symptoms. It may also cause breathing difficulties if the lungs are affected.

If your baby was born too early, he is exposed to a higher risk of lung infections. If he was born with a congenital heart problem, RSV infections can lead to other more serious illnesses. Therefore, hygiene is very important to prevent RSV. Regular and thorough hand washing and keeping surfaces, toys and bedding clean can help to prevent RSV. If your baby feels ill, try to keep him away from public places. RSV spreads more frequently in the period of October to March. If indicated, immunization of former preterm infants with chronic lung problems is recommended. Please do not hesitate discuss this issue with your pediatrician.

Please click here for more information on RSV.

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Home Monitoring

Monitoring at Home - a good feeling of security

After discharge parents are frequently faced with a variety of new tasks and challenges, which are especially in case of ill children often accompanied with worry, insecurity and fear about the child, so that a normal everyday life is hard to cope with.

Home monitors are able to reliably support worried parents.These monitors are specially designed to monitor oxygen saturation, respiration, heart rate or pulse rate of at-risk children of all age groups in both and  have found wide acceptance in clinics, during transport or at home, including in the care for preterm infants and small children. They help parents keeping an eye on their child when travelling home in a car seat after discharge, during the first days and weeks at home or in situations where intensive supervision and care are of high importance. The monitors can be used in a wide range of applications.

Indications for home monitoring may include:

  • SIDS-Siblings (Sudden Infant Death Syndrom siblings)
  • Preterm infants, born before 33rd week of gestation
  • Low-birth-weight infants
  • Infants after ALTE (Appearant Life Threatening Event)
  • Infants with instable respiration or threatening arrhythmias
  • Preterm infants with significant apneas at the time of hospital dismission or needing oxygen at home
  • Infants with tracheostoma
  • Children with artificial respiration
  • Children with conspicuous polysomnogram
  • Children with drug addicted parents

The monitors generate an acoustic and visual alarm when no respiration or movement is detected for a preset time, i.e. central apnea, or when the measured oxygen saturation or heart/pulse rate violates the limits set by the operator. Ideally, monitors combine apnea alarms with heart rate- and oxygen saturation-alarms so that the number of false alarms can drastically be reduced.

A timely alarm by a home monitor can lead to adequate medical intervention.

Please contact your NICU/ PICU team or your paediatrician to check the individual nessesity for home monitoring as well as for individual handling instructions.

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Sudden infant death syndrome (SIDS)

The Sudden Infant Death Syndrome (SIDS) also known as „cot death” or „crib death”, is the sudden and unexpected death of an apparently healthy baby.  It is the leading cause of death among infants in the age from 1 month to 1 year and happens twice as often during childhood period than death on the road accidents. It occurs without a recognizable cause during sleep, affects mainly babies in the first year of life regardless of social classes. Despite worldwide research, the causes of Sudden Infant Death are not yet clarified. Also, there are no ways to predict the Sudden Infant Death syndrome. Prevention campaigns have been trying for some years to counteract infant death; in fact the death rate was reduced by more than 50 %.

Reduce risk
Through intensive research, risk factors could be identified (e.g. low weight at birth, frequent extreme paleness or blueness of the face, unusually long pauses in breathing, climbing up of gastric acid to the larynx, severe anemia, etc.). Parents and the baby's environment can reduce certain risk factors; some factors can even be totally avoided

Observe the following recommendations and thus reduce the risk for Sudden Infant Death: 

  • Ensure a smoke-free environment for the baby, even during pregnancy
  • Place your baby on the back to sleep from the very beginning
  • Use “baby sleeping bags” or sleep sacks instead of blankets. Protect your baby from overheating and from bedding covering its face
  • Place your baby within reach of the parents’ bed but in its own crib
  • Breastfeed your baby, if possible for half a year without adding any additional food, because breast milk is the best for your baby during the first six months

Place your baby on the back only to sleepInternational research clearly shows that sleeping on the stomach (prone position) significantly increases the risk of Sudden Infant Death.

The back position (supine position) has proven to be the safest sleeping position. There is no evidence that a baby placed on its back is more likely to choke on fluids it brings up! Even a small baby already has protective reflexes, which work well in the back position. Put your baby to sleep only on its back. When it is awake and is being watched, encourage your baby to lie on its tummy to play, in order to train its neck, shoulders and arms. As soon as your baby is tired, please place it back in supine position.

Until a few years ago, the side position (lateral position) was recommended in many countries as an alternative to the prone position. However, further research has shown that the risk of Sudden Infant Death increases in the lateral position by up to 6 times. Therefore, avoid the side position for your baby as a sleeping position.

In the supine position, your baby’s head is always a little inclined to the side. If you notice that your baby develops a favorite side for his head, put your child in turn to the head or foot end of the bed and change the position of the light. This helps to prevent a unilateral flattening of the head and is good training for the different muscles and tendons in the neck area.

Protect your baby from overheating and from bedding covering its face
Keep your baby warm – but not hot!

  • The ideal temperature for babies to sleep at is at 16 ° -18 ° C. Ensure adequate ventilation of the bedroom and the rest of the apartment (2-3 periods of airing with wide-open windows for about 10 minutes, then close the window again).
  • The baby bed should not be placed directly next to the heater and should not be directly exposed to the sun.
  • Because of the risk of heat accumulation or respiratory disability, you should not use pillows, covers, sleep positioners, bumper pads, stuffed animals, fluffy bedding in the crib, as well as long heavens or mosquito nets over the beds and baby cots waterproof material in all. Soft mattresses and heavy covering are associated with the risk for SIDS.
  • A hot water bottle, a heating pad, a warm grains- or cherry-stone-pillow should not be used in a baby cot either.
  • Your baby can best give off excess heat on the face and the exposed head. Therefore, while at home, please do not use a hat for your baby.
  • At home, your baby does not need more clothing than yourself. To sleep, he needs only diapers, underwear and pajamas and even less at high temperature (e.g. in summer).
  • Outside, your baby needs more clothes at low temperatures.
    However, you should always check whether your baby is not dressed too warm, that is, whether it is sweating noticeably. This also applies for car trips, bus rides, visits to department stores, etc.
  • Do not hesitate to dress your baby according to the circumstances, even if it has just fallen asleep! The best way to check whether your baby is too hot or too cold is by placing your hand on the back of its neck, for hands and feet of babies are often cool and therefore not sufficient for this analysis.

All information applies even if your baby is sick (e.g. has a feverish cold). Even in this case, your baby needs fewer clothes, never more. Hot water bottles and heating pads are also unnecessary for your baby.                

To sleep, use a sleeping bag and no blanket

Baby sleeping bags have many advantages compared to duvets:

  • Your child is always properly covered, even if he kicks and moves.
  • Baby sleeping bags are available for different room temperatures and different sizes for premature babies and newborns, so that your baby does not have to feel cold nor does it have to sweat.
  • With the right sleeping bag, the risk of overheating and bedding covering his face is much smaller. Unlike blankets, your baby cannot pull a sleeping bag over his head, mouth and nose. A newborn infant is already capable of slipping under the covers; older babies can pull the blanket over their head or crawl underneath it. Both increase the risk of overheating and the risk of rebreathing exhaled air of their own.
  • In a sleeping bag, which opens at the bottom you, can change the diaper or undress the baby completely without waking the baby. It may remain in his comfortable surroundings.
  • With a sleeping bag, it is more difficult for the baby to turn into the riskier prone position.
  • You should always pay attention to the right size of the sleeping bag! (Body minus head length plus 10-15 cm for kicking and growing).
  • Also make sure that the neck is so small that the child's head cannot slip through. The armholes should not be too large either.
  • When your baby is too cold, add warmer clothes. You must avoid the combination of sleeping bag and blanket!       

Place your baby within reach of the parents’ bed but in its own crib

Let your child sleep in the parents' bedroom during the first two years of life, but in his own bed with a firm, non-polluting, air-permeable mattress. The sounds and movements of the parents positively stimulate your baby. You do not spoil your child in doing so. It needs your vicinity. For breastfeeding as well, it is advantageous if the cot is standing next to the parents’ bed.

However, do not let your baby sleep in the same bed with you in order to avoid overheating and bedding covering the baby's face.

Waterbeds, strollers and bags are not a suitable place for babies to sleep.

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Breastfeed your baby, if possible for at least six months

Breast milk is the best food for your baby during the first six months. Its composure gives the baby a natural protection against allergies and infections. In addition, breastfeeding reduces the risk of Sudden Infant Death.

Each baby has its own feeding rhythm. The intervals between meals vary in time from baby to baby. The nutrition is sufficient if your baby is growing steadily in weight! Please contact your local pediatrician or your midwife to discuss the best time to introduce supplementary food to your baby.

In case of breastfeeding problems, please talk to your lactation consultant, your midwife or your doctor. Please do not stop breastfeeding if you cannot stop smoking. However, make sure you have a smoke-free time at least two hours before each feeding.

Please click here for more information on nutrition.

Consult a doctor

Further information
Make sure your baby has regular check-ups and of course, consult your local pediatrician if you are worried or if the baby has a fever and feels sick.

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