MemorialCare - Your Guide to Postpartum and Newborn Care

ANGLE TOLERANCE SCREENING Babies born before 37 weeks (preterm) are at higher risk for breathing problems when they travel in a car seat. Before these babies can be discharged from the hospital, they will typically need to undergo a car seat angle tolerance screening (also called a car seat screening). Babies with certain medical conditions may also need to undergo this type of evaluation before discharge.

Feeding All babies need to be fed at least 8 or more times in 24 hours. Feed your baby when they show feeding cues and at least every 3 hours. Some late preterm babies feed well, and others do not. That’s why it’s vital to monitor your newborn’s feeding patterns and ask for help if you recognize a problem.

The AAP recommends that preterm babies and those with specific medical conditions go through car seat screening to determine if a special car seat carrier is needed before the baby can be discharged home.

What to know • Your baby may not wake up for feedings or give you feeding cues • If this happens, be sure to wake them for feedings every 3 hours • If your baby falls asleep during feedings, they may not get enough milk • To keep your baby awake while feeding, rub their back and the bottoms of their feet • Listen for swallowing sounds and keep track of your baby’s wet and dirty diapers If your late preterm baby doesn’t have a strong sucking motion, it can make it harder for them to take in enough milk. Try gently massaging your breast during every feeding to help your milk flow and make it easier for your baby to feed. To maintain a good milk supply, you may still need to pump your breasts after each feeding. Ask your lactation consultant to help you create a feeding plan that works for both you and your baby.

How screening is done • Completed in the hospital before your baby can be discharged • Done by a registered nurse or a Child Passenger Safety Technician (CPST) • Takes about 90 to 120 minutes to complete • Small sensor is wrapped around your baby’s wrist or foot to check blood oxygen level • Pads are placed on your baby’s chest to monitor breathing and heart rate • Nurse tracks your baby’s heart rate, respiratory rate, and oxygen levels during screening If your baby doesn’t pass • Car seat angle tolerance screening will be repeated once • If your baby doesn’t pass the second screening, their health care provider will be notified for further evaluation • In rare cases, a “car bed” that allows your baby to lie flat while traveling may be used until they can tolerate a semi reclined car safety seat CONTINUING CARE In the early weeks, late preterm infants will especially benefit from skin-to-skin contact, tummy time, and limiting visitors and noise to promote a calm, low-stress environment. You can also enhance your little one’s cognitive development by talking, reading books, and singing to them. As with all babies, you’ll learn more about their cues and preferences every day. Have confidence in your ability to provide the type of enriching environment your late preterm infant needs to flourish. Cognitive development Late preterm infants are at risk for subtle neurodevelopmental delays. Keeping all regularly scheduled appointments with your baby’s health care provider will help them track how well your baby is meeting physical and cognitive developmental milestones. If necessary, your baby’s health care provider may also make a referral to an outside resource who can provide support and help increase your baby’s progress toward meeting important milestones.

Call your baby’s health care provider immediately if your baby: • Is not feeding well or is missing feedings • Is hard to wake up for feeding • Has very few wet diapers or none in 6 hours • Has blood in the diaper • Has pale, cool skin Signs & Symptoms

EXTREME WARNING

Call 911 or go to the closest emergency room if your baby: • Is floppy or can’t be awakened • Has a seizure (jerky movements, eye rolling, staring) • Has blue, gray, or very pale skin

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Your Guide to Postpartum and Newborn Care