Bringing a Preemie Home From the NICU: What I Wish I Knew

Bringing a preemie home from the NICU is the moment you have been waiting for since the day your baby was admitted. But when it finally happens, it can also feel completely surreal.

My daughter was born unexpectedly at 33 weeks and 1 day and spent just under two and a half weeks in the NICU. For most of that time, our entire focus was getting her strong enough to come home. Then suddenly, much faster than I expected, the nurses were telling us that discharge might actually happen.

I went from visiting my baby in the NICU to scrambling to order tiny pajamas, Ultra-Preemie nipples and preemie sleep sacks almost overnight. If your premature baby is getting ready to leave the NICU, here is what bringing our preemie home actually looked like, what we needed, what surprised me and what I wish I had known before discharge day.

Every premature baby is different, and discharge requirements and care plans vary by baby and NICU. This is our experience, not a substitute for the instructions you receive from your baby’s medical team.

How Did We Know Our Preemie Was Ready to Come Home?

For most of our NICU stay, feeding was the biggest thing keeping my daughter in the hospital. She had originally been fed through a tube and gradually learned how to coordinate sucking, swallowing and breathing while bottle-feeding. As she got stronger, she began finishing more of her bottles on her own.

Our NICU wanted her to consistently finish her bottles for a certain period of time before she could go home. She also had to pass a 90-minute car seat test before discharge.

I had somehow gotten it into my head that the car seat test would happen roughly three days before discharge, so I thought that would be our warning that it was time to get everything ready. Instead, it felt much more sudden. We went from waiting for her to hit her milestones to hearing that she might be able to go home the next day.

In general, premature babies need to demonstrate that they can safely handle important things like breathing, maintaining their temperature, feeding and growing before discharge, although exactly what that looks like depends on the baby and NICU.

I Was Not Nearly as Prepared for Discharge as I Thought I Would Be

Because my daughter had arrived seven weeks early, I simply wasn’t expecting to bring a baby home yet. Once we realized discharge was close, I started ordering everything I thought we would need.

I bought Dr. Brown’s bottles and Ultra-Preemie nipples, a few more double-zip preemie pajamas, preemie Halo sleep sacks and a small pack of preemie diapers. I went to the store for formula and wipes, we picked up her multivitamin and iron, and we got the SNOO ready in our bedroom. Thankfully, family members had already given us quite a few preemie clothes, so we weren’t starting completely from scratch.

Looking back, I wouldn’t recommend panic-buying an entirely separate preemie registry while your baby is still in the NICU. We actually needed far fewer specialized products than I initially imagined. But once your baby’s nurses start talking seriously about discharge, I would make sure you have your basic feeding supplies, a few clothes and diapers in the correct size, your baby’s prescribed medications or supplements, an appropriate car seat and a safe place for your baby to sleep.

I put together a separate guide of the preemie essentials we actually used at home because the list was much shorter than I expected.

Leaving the NICU Was Such a Huge Milestone

After almost two and a half weeks of walking into the NICU multiple times a day, it felt almost impossible to believe we were finally walking out with our baby. We hugged the nurses goodbye and took a photo before we left.

These were the people who had taken care of my daughter around the clock when I couldn’t, taught her how to eat and reassured us throughout one of the scariest experiences of our lives. Saying goodbye to them was emotional, but getting to leave with our baby was an incredible milestone.

Then we put her in the Doona and walked out of the hospital. She looked like a baby doll because she was so tiny.

We were incredibly excited, but we were also nervous. For weeks, she had been surrounded by nurses, monitors and medical equipment. Suddenly, she was coming home with us.

When we arrived, my son was waiting with my in-laws. He hadn’t been able to meet his little sister in the NICU, so watching him finally see her at home was one of my favorite parts of the entire experience. He was so excited.

The First Night Home With a Preemie

That first night was probably when the reality of leaving the NICU hit me the hardest. I barely slept because I was constantly checking to make sure she was breathing.

She slept in our room, and we had our Nanit monitor set up, so even though she was right there with us, I would still look at my phone in the middle of the night to see her. For weeks, there had always been someone watching her. If something changed in the NICU, a nurse knew about it. At home, that responsibility suddenly belonged to us.

Our NICU had specifically advised us that our daughter did not need a medical breathing or oxygen monitor at home. They explained their concern that unnecessary monitoring and false readings could create more anxiety and potentially lead to unnecessary trips to the emergency room.

That advice was specific to our daughter. Some premature babies do go home with oxygen, medical monitors or other equipment, and those families should follow their NICU team’s discharge plan.

The good news is that the intense anxiety of that first night didn’t last forever. Once we got into a routine, caring for her at home became much less scary than I had imagined.

Feeding Our Preemie at Home

Feeding was still a major part of our routine after discharge. Our daughter was very sleepy, so we had to wake her every three hours to eat, including overnight.

She was taking around two ounces at a time and continued drinking the 22-calorie premature infant formula recommended by her medical team. My husband and I alternated overnight feeds. Because she was eating such small amounts, we started with 4-ounce bottles and didn't need larger bottles yet.

We had planned to have a night nurse, but because our daughter arrived so much earlier than expected, our original night nurse wasn’t available yet. We eventually found someone who could cover until she was, but that first night was just us.

We prepared her formula according to its instructions and continued using the Ultra-Preemie nipple she had been using when she left the NICU. Her nipple flow changed over time as she became a stronger and more efficient eater. She eventually progressed through several nipple flows as she became a stronger eater, which I break down in my guide to how long babies use preemie nipples.

One thing I learned throughout this experience is how much feeding can change with a premature baby. What worked in the NICU, what worked during her first weeks at home and what worked a month or two later were all slightly different.

We Didn’t Have to Recreate the NICU at Home

This was one of the most reassuring surprises for me. In the NICU, everything was tracked.

I remember saving diapers so the nurses could weigh them, which helped the medical team monitor her urine output and fluid balance. Her feeds and weight were also closely monitored. I assumed we might have to continue some version of that once we got home, but we didn’t.

We weren’t told to weigh every diaper, record every feeding in an app or weigh our daughter ourselves. We simply needed to make sure she was eating as instructed and having wet diapers.

Our team actually encouraged us not to weigh her at home. Weight can fluctuate depending on when and how you measure it, and they didn’t want us becoming unnecessarily anxious over small changes. Instead, we let the pediatrician monitor her growth at her appointments.

That was a helpful mental shift for me. We weren’t bringing the NICU home with us. We were bringing our baby home.

Our First Pediatrician Appointment After the NICU

We saw our pediatrician within a couple of days of discharge, and weight gain was probably the thing I cared about most. After watching every ounce matter in the NICU, I wanted reassurance that she was continuing to grow once we were responsible for all of her feeds.

We had another weight check a couple of weeks later and then gradually moved into a more typical pediatric appointment schedule. Those appointments became reassuring checkpoints for me.

Rather than trying to measure and evaluate everything myself at home, I could let our pediatrician follow her growth and development and ask questions whenever something concerned me.

Medications and Vitamins After NICU Discharge

Our daughter came home taking an iron supplement and a multivitamin. We initially picked them up from the pharmacy and later were able to order them online. Those were the only medications or supplements we had to give her at home.

Her dosages have changed as she has grown, so this is definitely an area where I would follow your own pediatrician or NICU team’s instructions rather than another parent’s routine.

One little trick that worked for us was putting her vitamins in about an ounce of formula first. That way, I knew she had finished the portion containing the supplement before giving her the rest of the bottle.

Managing Germs and Visitors With a Preemie

One of my biggest concerns after bringing our daughter home was germs, especially because we also had an older child in school. Unfortunately, some of my family came down with a stomach bug right around the time she was discharged.

As disappointing as it was, they waited to visit until they were healthy. My in-laws were able to be there and help us, which was incredibly nice.

With my son, we tried to be practical rather than make his new sister completely off-limits. He was so excited to finally meet her, but because he was going to school every day, we were conscious of everything he could potentially bring home. We had him touch her toes instead of constantly touching her hands or face.

Your own NICU or pediatrician may give you different recommendations based on your baby’s health, gestational age, time of year and medical history, so this is another area where I would ask what precautions they specifically recommend for your baby.

Was Bringing a Preemie Home Harder Than Bringing Home a Full-Term Baby?

This was probably my biggest surprise: once we settled in, it wasn’t as different as I expected.

She was smaller. She was sleepier. We had to wake her to eat, pay close attention to feeding and continue the specific nutrition and supplements her doctors recommended. But she was still a baby.

As a second-time mom, I already knew how to change a diaper, make a bottle, soothe a newborn, survive broken sleep and generally take care of a baby. Once I realized I didn’t need to recreate the NICU in my house, everything started to feel much more normal.

If you’re bringing home your first baby, there may naturally be a bigger learning curve because you’re figuring out newborn life at the same time you’re navigating life after the NICU. But for me, one of the most comforting realizations was that my premature baby didn’t require an entirely different version of motherhood.

She was smaller and had some additional needs, but so much of caring for her was simply caring for a newborn.

What I Wish I Knew Before Bringing My Preemie Home

I wish someone had told me that discharge could happen faster than I expected. I would have had a small collection of essentials ready earlier: a few preemie sleepers, diapers, the bottles and nipples she was currently using, her formula, a sleep sack that fit, her medications or supplements, a safe sleep space and the car seat ready to go.

I wouldn’t have bought much more than that. We didn't need an entirely different collection of baby gear simply because she was premature.

I also wish I had known how quickly home would begin to feel normal. The first night, I was terrified to stop watching her. I kept checking that she was breathing and couldn’t imagine how I was supposed to go from having an entire NICU team watching her to simply going to sleep.

But then we fed her, changed her and put her back to sleep. Three hours later, we got up and did it again. Slowly, we developed a routine and I became more confident caring for her without a nurse standing a few feet away.

If Your Preemie Is Coming Home Tomorrow

If another NICU mom told me today that her baby was unexpectedly being discharged tomorrow and she was panicking, I would remind her that her medical team has been working toward this moment too. They have been watching your baby closely and will determine when your baby is medically ready to leave the NICU.

Ask every question you have before you leave. Make sure you understand your baby’s feeding plan, medications or supplements, follow-up appointments and anything your medical team wants you to watch for. Have the basic supplies ready, but don’t convince yourself that you need to buy an entirely different house full of baby products just because your baby was born early.

Most importantly, give yourself a little time to adjust. Bringing our daughter home felt enormous because of everything it had taken to get there, but once she was home, our life slowly stopped revolving around the NICU.

We weren’t taking care of a NICU patient anymore. We were taking care of our daughter.

Frequently Asked Questions About Bringing a Preemie Home From the NICU

When can a preemie come home from the NICU?

There isn’t one gestational age or weight that determines when every premature baby can go home. Discharge depends on the individual baby and may include being able to breathe without hospital support, maintain body temperature, feed successfully and demonstrate appropriate growth. Your baby’s NICU team will determine when your baby is medically ready for discharge.

What do you need when bringing a preemie home?

For us, the most useful items were preemie sleepers, a small supply of preemie diapers, 4-ounce bottles, the nipple flow she was already using, her prescribed formula, appropriately sized sleepwear or sleep sacks and the iron and multivitamin recommended by her medical team. We didn’t need an entirely separate collection of specialized preemie baby gear.

Do you have to wake a preemie to eat?

We did. Our daughter was very sleepy after coming home and our medical team had us wake her every three hours for bottles. Feeding recommendations depend on your baby’s age, growth and medical history, so follow the schedule your NICU or pediatrician gives you rather than another baby’s schedule.

Do you need to weigh a preemie at home?

We didn’t. In fact, our team discouraged us from weighing our daughter ourselves because normal differences in timing and technique could make the number fluctuate and create unnecessary anxiety. Her pediatrician monitored her weight after discharge. Some babies may need closer monitoring, so ask your baby’s medical team what they recommend.

Does a preemie need a breathing monitor at home?

Not necessarily. Our NICU specifically told us our daughter did not need a medical breathing or oxygen monitor at home. Some premature babies do go home with prescribed monitoring, oxygen or other medical equipment, so this decision should be made by your baby’s medical team.

How soon does a preemie see the pediatrician after NICU discharge?

Our daughter had her first pediatrician appointment within a couple of days of leaving the NICU, with additional follow-up for her weight. Your NICU should give you a follow-up plan before discharge based on your baby’s individual needs.

A Note From Me

This article shares my personal experience bringing my daughter home after she was born at 33 weeks and spent just under two and a half weeks in the NICU. Every premature baby has a different medical history and discharge plan.

Always follow the feeding, sleep, medication, monitoring and follow-up instructions provided by your baby’s NICU team and pediatrician.