Monitoring
As with every newborn, follow-up of the premature infant is necessary to evaluate growth, development, or worsening of disease, and for the education and reassurance of parents.[162]
Immediately after discharge from the hospital, the infant will need to be followed by a medical professional who is qualified in the care of a premature infant. A follow-up visit with a healthcare professional should be conducted within 48 hours of discharge to ensure that the baby and its parents are adjusting well to being at home. Any parental concerns should be addressed at this visit, and weight gain should be assessed.[163] Home visiting enhances parent-infant interactions.[164]
Pre-discharge kangaroo care (in which the infant is held skin-to-skin by an adult), peer counselling, in-home breast milk intake measurement, and post-discharge lactation support have been shown to improve breastfeeding outcomes among preterm infants, and maternal satisfaction improved with post-discharge interventions.[59][165]
The importance of follow-up care for an extremely or severely premature infant after hospital discharge is critical.[166] In particular, ophthalmology evaluation, appropriate neuroimaging, monthly palivizumab administration for the prevention of respiratory syncytial virus infections, occupational therapy/physiotherapy (OT/PT) with early intervention as necessary, and monitoring of growth and achievement of milestones helps these infants to thrive.
Growth and developmental follow-up for moderately premature and near term infants with a primary care physician and OT/PT facilitates early diagnosis and treatment of any problems that arise.
As preterm infants are less likely to complete their recommended infant vaccinations than term infants, medical professionals caring for these infants should ensure they are offered immunisations appropriately.[167]
Coordination of all speciality services (ophthalmology, pulmonology, OT/PT, and neurodevelopmental assessment) is necessary. Specialised clinics exist where many of these specialties can be consulted during a single visit, reducing the burden of appointment scheduling and attendance for carers. Follow-up visits are frequent during the first years of life in order to reduce the impact of the sequelae of prematurity.
Family support is very important to help family members cope with prematurity-related sequelae.
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