Having a Premature Baby
Having a Premature Baby in Luxembourg
- During pregnancy – coping with a ‘high risk’ pregnancy or a surprise early arrival
- Caring for you and your baby during pregnancy
- Your hospital
- Caring for your baby in hospital
- Coming home
- Practical help
- Your baby’s development
- Impact on family relationships
- Pregnant again?
- Coping with loss
- Further support & information for parents of a premature baby
During Pregnancy – Coping with a ‘High Risk’ Pregnancy or a Surprise Early Arrival
For some parents whose baby arrives early it is a big shock and things seem to happen very quickly. For other parents, perhaps an issue has been identified before or during early pregnancy which makes the pregnancy high risk. In this case parents will be used to regular monitoring appointments and are likely to be aware their baby will arrive early, although perhaps not be sure how early.
The medical definition of prematurity is a baby born before 37 weeks. This is also sometimes described as ‘preterm’. The following definitions are provided by the World Health Organisation:
However early your baby arrives, the experience of having a premature baby can be an emotional roller-coaster Common feelings at this time may include being numb, fear, sadness, anger, grief, anxiety and challenges communicating with your partner. Many parents, especially mums, also report feelings of guilt that their baby is having such a difficult start in life. It’s important to acknowledge that, in the vast majority of cases, there is nothing the mum or dad could have done differently. So, although the guilt is a common and normal human emotion, parents have nothing to feel guilty about. In fact, the causes of premature birth are not fully understood, even by the medical profession and often there is nothing that can be done to prevent it.
Babies are born early for many different reasons. Some of the most common ones include:
Infection – such as Bacterial Vaginosis or a Genital Tract Infection. Most women have increased vaginal discharge during pregnancy. This is completely normal and the discharge should be clear and white and not smell unpleasant. If you feel itchy or sore or your discharge is coloured or smells unpleasant speak to your doctor. Thrush is the most common vaginal infection during pregnancy and can be easily treated but it is important to get your Doctor’s advice to rule out anything more serious.
Uterine problems – such as a Short Cervix, Fibroids, a weak cervix or an unusually shaped cervix or uterus. If you are affected by one of these problems you were maybe aware of it before you even became pregnant, perhaps because of your gynaecological history or an issue that runs in your family. Speak to your doctor about what they recommend to support your healthy pregnancy.
Maternal medical problems – such as Diabetes or Pre-eclampsia. You can read one local mum’s story (link to Margaret’s article) of what happened when her baby arrived early because of a pre-eclampsia related condition.
Placental problems – such as Intrauterine Growth Restriction (where antenatal monitoring shows baby is not growing well) or problems with the placenta or umbilical cord meaning baby isn’t getting enough oxygen.
Multiple pregnancies – If you are expecting twins, triplets or more it is likely your babies will arrive early.
Other reasons some babies arrive early include:
An emergency like heavy bleeding during pregnancy
If it is identified that your baby is likely to arrive early you may well be offered a course of steroids (usually involving 2-4 injections in to your thigh, given over a 24-48 hour period). These steroids have been shown to help your baby’s development if he or she needs to arrive early.
Thankfully medical care in the Grand Duchy is of a very high standard. We will look at hospital facilities in more detail in our ‘Your hospital’ section below.
Caring for You and Your Baby during Pregnancy
If your pregnancy has been identified as high risk, pregnancy may be an anxious time for you. Share your concerns with your partner and your doctor. Some parents also feel more in control by researching their condition – just remember to check the reliability of sources, for example are they impartial and well researched? Sometimes making contact with others who have been through a similar experience can also be useful. UK Charity Bliss some useful advice on preparing yourself as well as a Message Board where you can connect with other families. Also see our list of suggested further support below.
Try to look after and nurture yourself, eating well, living healthily and doing some nice things for yourself such as getting your hair or nails done. Some mums also enjoy starting a baby book or box during pregnancy – a place to collect & keep your baby’s first mementos such as scan photos and maybe a picture of your ‘baby bump’.
Familiarising yourself with the facilities at the hospital where you are giving birth can also be reassuring. All pregnant women are entitled to a tour of their maternity unit, accompanied by their birth partner. You may organise this tour directly with your hospital, or if your prefer to ensure an English speaking tour, you can arrange one through the Well Baby Clinic. You can arrange this at any point during your pregnancy and this is a good opportunity to ask any questions you may have about the hospital’s facilities. If your pregnancy is high risk then speak to your Doctor directly about any questions or concerns you have about the facilities for you and your baby during and after the birth.
Both the Central hospitals in Luxembourg have excellent facilities. The Maternité Grande-Duchesse Charlotte has a specialist MIC Unit (Maternal Intensive Care) to support very high-risk pregnancies. This unit is located right next to the delivery room. The Maternite is also on the same site as the KannerKlinik which provides Neonatal Intensive care as well as parent and baby rooms to help support the transition from hospital to home, once your baby is well enough to come home. The Maternite has held the Baby Friendly award since 2000, meaning it is committed to supporting all mothers to breastfeed if they wish to.
The Clinique Bohler is also experienced in monitoring high-risk pregnancies and can offer screening and regular out-patient monitoring appointments as well as a dedicated 12 bed in-patient ward for women with high-risk pregnancies. It has a Neonatology department, especially to look after babies, born after 32 weeks, who need extra care due to arriving early, having a low birth weight, needing monitoring or being poorly.
The hospital you give birth at will depend on the hospital your gynaecologist is registered to. However, if your baby arrives before 32 weeks then you will automatically be transferred to the Maternité who specialise in looking after babies who arrive very early.
If your baby needs special care in hospital, the medical equipment and environment of the Neonatal ward can seem scary and daunting to parents at first. Ask your doctors and the nurses on the ward any questions you have – they are there to look after your baby and help you.
UK charity Bliss offer an on-line tour of a typical Neonatal Unit to help familiarise you with some of the sights and sounds you can expect. You may also find it interesting to read the story of one Luxembourg family and their experience of an unexpected early arrival.
Although the most common reason babies are admitted to a neonatal unit is being born prematurely, there are many different reasons why babies may need special care.Some of the most common reasons include:
Caring for your Baby in Hospital
Caring for your newborn baby is an experience that most new parents anticipate with excitement and maybe a touch of nerves. Caring for your baby is a practical way to help parents bond and develop a relationship with their baby. Although it can be a steep learning curve for ALL new parents, for parents of a premature baby, it can seem even more scary and potentially fraught.
It is common to experience feelings of grief, anger or dislocation from your current experience and to mourn the fact that you did not have the birth, healthy baby or romantic experience of the early days that you had hoped for. Acknowledging your feelings with others who have been through a similar experience can help. See below for a list of support organisations and helplines here in Luxembourg. Bliss, the UK charity also offer a helpline & UK parenting charity NCT offer a shared experiences helpline.
The arrival of a premature baby is also acknowledged to be a time of huge stress for new parents. Try and be kind to yourself and each other, for example:
- Acknowledging you may both respond to your feelings differently and this is probably one of the most stressful and upsetting challenges you have faced together
- Listening to each other and talking to others who are close to you about your feelings
- Congratulating yourselves for the birth of your new baby and giving yourselves permission to celebrate the new member of the family
- Giving yourself permission to take care of yourself and each other and any other children you have
- Mum expressing breast milk if you are able and not putting pressure on yourself to produce more, rather celebrating every drop
- Talking to, stroking and cuddling your baby
- Getting as involved in your baby’s care as you are able to
To begin with it can be understandably scary and daunting caring for a premature baby particularly if your baby is very poorly, very early or very small. Couple this with the wealth of special equipment in the Neonatal Unit and it is likely things will feel bewildering at first. However, the staff at the unit should encourage and support you to get involved in your baby’s care are soon as possible.
Once you feel able to take the information in, if you have a question then ask the staff who are not only there to care for your baby but also to help you, as parent, do the same. It can help to familiarise yourself with the equipment in the ward and any technical medical terms that relate to your baby’s condition. The UK Charity Bliss provide a helpful glossary of terms as well as an online tour of a Neonatal Unit. One of the things parents commonly share as being initially scary is all the noise, machines, wires and particularly alarms. It can help to understand what the alarms or for and to recognise how they are helping your baby or the other babies on the ward.
The nurses at your hospital should support you to become involved in your babies care as your baby is stable enough. Try and get as involved as possible to help build your confidence as a new parent. Read one local mum’s account of her experience and how hospital staff supported her and her partner to care for their baby.
There are many things you can do to care for your baby while they are in hospital. The specifics will depend on your baby’s age and how they are doing. Some common ways to care for your baby whilst in the Neonatal Unit include:
- Expressing milk
- Mouth care
- Feeding your baby
- Touch through comfort holding or stroking
- Kangaroo care
- Nappy changing
- Talking and singing to your baby
When your baby is ready to come home will depend on their health, how they are feeding and how they are gaining weight. If you have any questions about your baby, speak to the staff, the nurses are there 24/7 and a Paediatrician will visit your baby every day.
The announcement that your baby is ready to come home may be met with mixed emotions. It may be the news you have been longing to hear and yet hearing the news may also fill you anxiety and uncertainty about whether you are ready and how you will manage to care for your baby at home.
Depending on your hospital you may be offered the option to room-in with your baby in a special parent and baby room where you are 100% responsible for your baby’s care whilst still knowing you have the hospital staff nearby to call on if you need to.
It is likely you will meet a few different Paediatricians during your baby’s stay in hospital and this can be a helpful way to get to know the Paediatrician you would like to use once leave hospital. Personal recommendations from other parents whose opinion you rate is also a good way to decide on your family Paediatrician. It is helpful to be set up with a Paediatrician and have arranged your first home visit from a Sage Femme Liberale (Community Midwife) before you leave the hospital. Make sure your Doctor has given you a carnet (or prescription) for your Midwife appointments. This can help ease the transition from hospital to home.
Little things can make a big difference in the early months after your new baby’s arrival. One of the things that mums can find helpful is to find clothes small enough for their new baby. Here in Luxembourg, specific brands which cater for premature babies include:
- Baby Club at C&A (from 46cm+)
- JackyB (from 44cm+)
- Sanetta, H&M and Petit Bateau (these labels and French brands in particular, have smaller sizes for newborns from 50cm+)
Your Baby’s Development
For many new parents, it is tempting to compare their baby’s development with that of their peers. As all babies are unique, it can be counterproductive to compare your baby with others whatever your baby’s due and actual arrival dates. For parents of a premature baby, however, it is particularly unhelpful to compare your baby with others born around a similar time, for example the babies of other mums in your antenatal class. Babies who arrive early are generally expected to reach their developmental milestones in line with their expected due date. This is sometimes called ‘corrected age’. The majority of babies catch up their peers within the pre-school years but some babies may need a little extra support.
Your baby will receive regular appointments to keep an eye on their development and if you have any questions or concerns it is always worth speaking to your Doctor for reassurance. At 30 months all babies in the Grand Duchy are invited to a Bilan 30 check-up which focusses on hearing and speech development and provides the opportunity to get further support with speech & language development if needed.
Generally premature babies will be ready to being weaning (being introduced to solid foods) around 6 months after their birth date, like their friends who arrived closer to their actual due date. However, this will depend on your baby and their needs and your Paediatrician will be able to provide you with advice tailored to your baby’s requirements. For help in spotting your baby’s readiness for solid food, take a look at A consensus statement on weaning preterm infants (2011).
Advice on all aspects of infant feeding including introducing solids can also be provided by Ligue Medico-Sociale who provide regular workshops in French and German at locations across Luxembourg. Well Baby Clinic also offer advice, in English, at their drop in groups as well as an Introducing Solids workshop.
Service de Rééducation Précoce (SRP)
If your baby’s arrived early, you may also be referred to a service called Service de Rééducation Précoce (SRP) once your newborn has reached sufficient weight and maturity to have left the care of the hospital. The SRP provides global care (which can also be provided in English) for babies and children up to the age of 4, covering:
You can contact them directly or ask to be referred by your doctor if you have any concerns about your baby’s development. Their multi-disciplinary team is composed exclusively of specialists with extensive experience of work with infants – including physiotherapists; ergotherapists; speech therapists; psychologists; and doctors – who can support you in optimising your baby’s physical and psychological growth in the early years.
Impact on Family Relationships
The transition to parenthood is commonly acknowledged to put pressure on all couple relationships. For parents of a premature baby this pressure can be intensified by the stress and anxiety of caring for a small or poorly baby. Try and be kind to one another and accept that you may both react very differently to the situation.
Even once your baby is home, you may need extra help coming to terms with what has happened to you and your family. If so speak with your Doctor or contact one of the support organisations listed below.
Parents of premature babies, both mums and dads, are potentially at higher risk of experiencing Postnatal Depression. The challenges of feeding and caring for a premature baby coupled with the potential initial difficulties getting out and about to typical mum and baby groups can lead to stress, anxiety and isolation. If you feel like you may be affected, talk to your partner, Midwife or Doctor or contact one of the support organisations suggested in our Postnatal Depression article.
Welcoming a new baby to the family is a time of exciting but unsettling transition for any sibling but when their new brother or sister arrives early it can be a difficult time. Don’t feel guilty about making time to care for your older child as well as visiting and caring for your new baby. It can help to try and involve the older sibling with their new brother or sister as much as possible, encouraging visits and giving them chance to ask questions and talk about any worries they may have.
If you are pregnant again then congratulations! It is common for parents who have experienced one baby arriving early to be anxious during subsequent pregnancies. It may be helpful to talk to your Gynaecologist about any concerns before you get pregnant. Well Baby Clinic are now also offering Early Pregnancy Workshops which offer a chance to learn more about staying healthy during pregnancy and to ask any questions you may have.
Coping with Loss
If you are reading this section because you are bereaved, we wish you our deepest sympathy for your loss. There are a number of organisations in Luxembourg who offer support through groups, helplines or counselling. Please see our Loss and Bereavement page in our Special Needs section for more information. Passage have also produced a Grief Support in Luxembourg Factsheet which is available to download on the same page. See below for a list of further support organisations outside of Luxembourg. Our article, Coping with loss during pregnancy will also be available soon.
Further Support & Information for Parents of a Premature Baby
Support organisations in Luxembourg:
- Your Doctor and the hospital where you are giving birth
- Sage Femmes Liberales – Community midwives who can visit you in your own home. Ask your Doctor for a ‘carnet’ or prescription for Midwife visits before you leave hospital
- Initiative Leuwensufank – Initiative Leuwensufank also offer a Baby hotline you can contact with any questions or concerns: (+352) 36 05 98, Monday to Friday 9:00-11:30am or email: email@example.com
- La Leche League – For breast feeding support groups and advice via phone and email
- Well Baby Clinic – Offer drop-in groups run by qualified Health Professionals were you can get advice and get your baby weighed as well as a range of social groups, baby massage and first aid and postnatal exercise with baby
- Ligue Medico Sociale – A government child health scheme that offers monthly drop in sessions and training to parents and access to advice from trained Health Professionals. Enquire at your Commune for local meetings.
- Online Help offered by Kanner Jugend Telefon – An email support service, available in English, aiming to support parents by providing access to trained counsellors.
- SOS Preema – Luxembourg group which is part of a French parent-led organisation to support families of premature babies. Their SOS Preema Facebook page can offer additional support, but you will need to join the group in advance.
Support organisations outside Luxembourg:
- Bliss Family Services Helpline – UK Charity supporting families of babies born too soon, too small, too sick. Helpline number: 0500 618140 & email: firstname.lastname@example.org
- NCT Shared Experiences Helpline – Offered by UK’s largest parenting charity.
- Bliss Family Information Booklets – The UK Charity supporting families of babies born too soon, too small, too sick offers a wide range of booklets to support parents which can be downloaded online or ordered online to be delivered by post to a Luxembourg address.
- Tommys – Our online midwife, is a UK charity funding research and information for parents coping with premature birth, miscarriage and stillbirth.
- Life’s Little Treasures Foundation – Australia’s leading charity dedicated to providing support and information for families of children born premature or sick.
- 24 Weeks Plus – A UK-based parent-ed organisation providing support and information for parents of preemie babies.
Further Information – Useful Links
Coping with a ‘high risk’ pregnancy or a surprise early arrival & caring for you and your baby during pregnancy
Bliss: UK Charity for parents of early or poorly babies explains some common reasons babies may arrive early or need special care.
NHS Choices: UK health service web site explains common reasons babies need special care.
NCT: UK’s largest parenting charity explores emotions during pregnancy.
Royal College of Obstetricians & Gynaecologists: The UK professional governing body which also provides a range of informational leaflets for patients.
NHS: UK Health service web site explores the impact of type 1, type 2 and gestational diabetes.
Multiple pregnancies (twins triplets and more)
TAMBA: UK charity providing support and information for parents expecting more than one baby.
Pre-eclampsia & HELLP Syndrome
Action on Pre-eclampsia: Essential information.
NHS Choices: Information on pre-eclampsia symptoms.
HELLP Syndrome: Factsheet on HELLP, which is the medical term for one of the most serious complications of pre-eclampsia.
Maternité Grande-Duchesse Charlotte: The newly-built Maternité (to replace the old) is part of the CHL group of hospitals and boasts a MIC Unit (Maternal Intensive Care).
KannerKliniK: 24/7 Children’s clinic (adjacent to the new Maternité hospital) also provides Neonatal Intensive care.
The Clinique Bohler: This Kirchberg hospital is the largest maternity centre in the Grand Duchy, with up to 2700 deliveries a year.
Centre Hospitalier Emile Mayrisch: Hospital based in Esch-sur-Alzette, the south-west of Luxembourg.
Centre Hospitalier du Nord (CHDN): Hospital based in Ettelbruck.
Bliss: An online tour of a NICU.
NHS Choices: Information for parents on special care, ill or premature babies.
Caring for & feeding your baby
Comfort Holding and Kangaroo Care: Advice for parents on how to provide positive, reassuring touch to premature newborns.
Small Wonders: Programme and online DVD to help support putting parents at the heart of their baby’s care.
Feeding a Premature Baby: Information on every aspect of your baby’s feeding including tube feeding, expressing and bottle feeding.
Tube Feeding: Information on a specific form of feeding premature and sick babies.
Tommys: Pregnancy information and research.
NHS Choices: Information on breastfeeding a premature baby.
Kelly Mom: Popular source of reliable breastfeeding advice.
Words for life: UK literacy charity shares tips for talking and singing to your premature baby.
Bliss: Checklist of things to be comfortable with before your baby comes home from hospital.
Safe Sleep: Guidance from UK Charity Lullaby Trust.
Your baby’s development
Bilan 30: Speech and auditory testing for all children in the Grand Duchy at 30 months.
Birth to Five Timeline: An interactive resource from the NHS to highlight typical developmental milestones from birth to 5.
Bliss: UK Charity supporting parents of premature babies in all aspects of their journey.
Impact on family relationships
Tommys: UK charity funding research and information for parents coping with premature birth, miscarriage and stillbirth.
One Plus One: A UK charity which supports couples to maintain healthy relationships.
Couple Connection: An online resource for couples wanting to work through challenges.
Preemie Help: Online premature birth resource offers some practical tips on coping with common sibling concerns.
Bliss: Information on the next pregnancy following the birth of a premature baby.
Tommys: Your online midwife, offers guidance on what you can do to reduce your risk of premature birth.
Coping with loss*
Bliss: Support, including after bereavement, for the family of a premature baby.
Child Death Helpline: For anyone affected by the death of a child of any age from any cause.
Lullaby Trust: UK charity promoting safe sleep messages and supporting bereaved families.
SANDS: Support after neonatal death or stillbirth.
* If you are reading this section because you are bereaved we wish you our deepest sympathy. Our article, Coping with loss during pregnancy will also be available soon.
Grief Support for the English-speaking Community in Luxembourg – a Passage factsheet with information on counselling and support services available In Luxembourg (in English) to help cope with loss and bereavement. The document contains hyperlinks to resource websites and the necessary contact emails. Click to download.
Article by: Kate Ensor, who is a coordinator for Passage and a postnatal group facilitator & childbirth educator at the Well Baby Clinic of Luxembourg.
Last updated: Monday 12th October, 2015