What is a Micro Preemie and What Should You Know?

What should you know as the mama of a micro preemie?

We take a look at the care these tiniest of premature babies need in their first months.

With about 1 in 10 babies being born prematurely (before the 37th week of pregnancy) in the US each year, many women share the experience of being mamas to preemie babies.

But if your baby is born at 26 weeks premature or less, your teeny-tiny peanut becomes known as a micro preemie.

Because they’ve made such an early entrance into the world, your micro preemie baby will need extra care in the neonatal intensive care unit (NICU), until their little body is ready to go it alone.

As the new mama of a micro preemie baby, we know this is an anxious time for you as you watch and wait.

So let’s talk about these very special babies and what you can expect during their first few months.

In this article: 📝

What is the difference between a preemie and a micro preemie?

Both “preemie” and “micro preemie” are names used for premature babies—that is, babies born before a pregnancy reaches 37 weeks.

So what is a micro preemie?

Micro preemies are premature infants who are:

• Born before 26 weeks, and/or
• Weigh less than 28oz (1lb 12 oz) at birth
  As well as being tiny when they’re born—some can fit into the palm of your hand—micro preemie babies look very delicate.

Their skin is so thin that you can see all their veins underneath, and it may even be gelatinous.

Unfortunately, because your 26 week old baby has had less time to develop in the uterus than other early arrivals, they have a higher risk of health complications.

That means that once you’ve given birth, your baby will need to be cared for in the neonatal intensive care unit (NICU), probably for a few months.

What medical treatment does a micro preemie need?

In the NICU, your micro preemie baby will be placed in an incubator (box-like enclosure that simulates a controlled environment) to keep them warm, as they’re not able to regulate their own body temperature straight away.

They will also be:

• Given help to breathe through a ventilator, as their lungs aren’t fully developed yet
• Fed through an intravenous line (IV) if their digestive system isn’t ready to absorb nutrients. This is usually until they reach about 34 or 35 weeks old. Once ready, they’ll be given milk through a feeding tube.
• Monitored to check their breathing rate, oxygen levels, and blood pressure. Nurses and doctors will also be watching out for heart murmurs which are common in premature babies.
  They might also need extra medical treatment for any other health issues that arise.

For example, micro preemies are at higher risk of infections, such as sepsis, which are treated using antibiotics.

The NICU team will also be on the lookout for problems in your baby’s organs, which may need medication or surgery to treat.

Micro preemies survival rates

Thanks to the amazing medical care in NICUs, micro preemie survival rates are better than they have ever been.

Sadly, a micro preemie born at 21 weeks is unlikely to survive, but the prospects for a baby born at 22 weeks are a little better, with a 10% survival rate.

At 24 weeks, though, we see a huge improvement, with a survival rate of around 60%. And at 27 weeks it’s up to 89%.

What long-term problems do micro preemies have?

It’s not the easiest start for premature babies, but for micro preemies, their early birth may have a lasting impact beyond those first critical weeks.

Because of their shortened development time, these little fighters have a higher risk for chronic respiratory, cardiac, and endocrine system disorders.

But studies (like the one above) do indicate that significant lifestyle modifications can help.

Having awareness is the first step, so here are the most common long-term conditions associated with premature births:

• Asthma
• Poorer lung function
• Chronic kidney disease
• Hypertension
• Increased risk of heart failure
• Diabetes
• Metabolic syndrome
• Osteoporosis
  Preterm infants have also been shown to exhibit a wide range of neurological conditions cognitive difficulties, autism, mood disorders, and difficulty interacting with others.

But it’s by being equipped with this information that we can hope to provide an enriching, empowering future for these little heroes.

What’s more, you may be able to give your tiny gift a fighting chance with specialized early developmental interventions.

Being there for your micro preemie in the NICU

When your micro preemie baby is in the NICU, you might not be able to touch them at first, if their skin is too delicate – but you can speak or sing to them.

Just hearing your voice will reassure and comfort them.

In time, you’ll be able to place your hands into the incubator and begin building that soothing contact.

And, once your doctor is confident they are strong enough, you’ll have the joy of that very first cuddle!

Kangaroo care (where you and your baby have skin-to-skin contact) is also a beautiful way to spend time with your preemie when they’re ready for it.

Of course, you can also bring in little outfits for them (special micro preemie clothes are available, and are designed to be easy-opening for medical care).

And, eventually, you’ll be able to practice changing those tiny micro preemie diapers.

Just because your baby is in hospital, this doesn’t stop you from showering them in mama-love.

Taking your micro preemie home

It’s a joyful day when you finally get to take your micro preemie baby home with you.

They’re usually ready for this once they reach certain milestones like staying warm and breathing on their own, they're breast or bottle-feeding, and any serious illnesses have resolved.

And there are a few extra steps you can take to give yourself full confidence, like:

• Taking a course in premature infant care: This can include infant CPR, learning how to use monitoring equipment, asking your baby’s medical team for notes and advice.
• Set up scheduled checkups with your baby care provider
• Brush up on micro preemie nutrition: You can discuss with your pediatrician how feedings will look like for your baby or maybe enlist a specialized nutritionist.
• Take extra precautions: Knowing how to take care of baby’s health is important for every parent but your little peanut is different. Make sure everyone is on the same page when it comes to illness and contact ahead of time. At best it will keep your anxieties low.
• Practice compassion. This goes for your entire unit. Coming home is exciting but scary and a huge learning experience. There is nothing to prepare you for what’s in store so best to be patient with yourself as you adjust to this brand new chapter.
  Heading home is an amazing moment, but you might still be wondering what’s next for your baby.

As for the big question: do micro preemies catch up with other babies in terms of development?

The good news is: Yes!

Most preemies and micro preemies go on to hit those classic baby milestones (walking, talking, etc.) they just need a little extra time to get there.

In the meantime, look after yourself too.

All those months at the NICU aren’t easy.

If you need support, you can always reach out to the micro preemie mamas on Peanut.

Whatever helps, mama. 💛