Follow up

All babies, whether born preterm or term, need to have regular visits with a paediatrician for check-ups and immunisations. Preterm babies will probably need to have more regular and thorough follow-up visits beyond what is usually recommended for babies. The purpose of follow-up visits lies in the surveillance of the baby’s progress in growth and development and looking out for potential problems as early as possible.

In general, follow-up visits are scheduled at 4, 8, 12, 18, 24 and 36 weeks corrected age in the baby’s first year, meaning the age if the baby had been born at the expected time.

Usually these visits are there for assessing and tracking the baby’s growth and discussing feedings and sleeping patterns. The developmental level of the baby regarding sensors and the baby’s physical state is evaluated, as well as checks for jaundice are performed. The doctor will also provide the recommended immunisations for the baby. Any questions parents may have about the baby’s health are discussed.

Some countries offer structured preventive early intervention programmes for very preterm infants such as the ToP programme in the Netherlands. It is funded by the Dutch health insurance, consequently every very preterm infant and parent can get this support after discharge. Parents should always take the chance to consult the health care team before going home about specialised care programmes.

Last but not least follow-up practices or clinics are also forums for exchange with doctors and other parents on their baby’s behavior and on recommendations what to do about it.

Parents are often faced with an ‘information flood’ which can be challenging for them to absorb. Information is often new and specific, and parents – commonly worried about their preterm baby – may be overwhelmed.

 

 

In the following are some tips to help to get the most out of follow-up appointments:

  • Starting a file

 

It can be very helpful to write down the advice given in a file. This will support parents to run a commentary on the baby’s progress which they ca refer to later. In connection with immunisations and vaccinations the GP or paediatrician will record all vaccinations given to the baby in an international immunisation card. It is important and helpful to keep the record for future medical treatment of the baby to track the vaccination history.

  • Asking questions

 

Even if parents may suspect their questions to be amateurish, no health care professional will expect parents to understand the various possible health conditions entirely. It is better to ask twice than to leave a visit with uncertainties.

  • Managing appointments continuously but not too tightly

 

Sometimes, follow-up appointments for preterm babies can mount up and families may have more than one fixed date in a week. They can take up a lot of time and be very tiring, especially if families have to travel long distances. If it becomes difficult to manage the number of appointments, asking the health visitor to re-organise some of them, if possible, is a reasonable move in order to keep everyday life manageable.