Preemie Essentials: What You Actually Need for a Premature Baby

When my daughter was unexpectedly born at 33 weeks, I had nothing for a preemie. I had no preemie clothes, no preemie diapers and no special preemie supplies waiting at home.

One of the biggest things I learned from having a premature baby is that you don't need to panic and order an entirely new baby registry just because your baby came early. While your baby is in the NICU, the hospital has what they need, and when your baby is ready to come home, many of the things you'll use are exactly the same things you'd use for any newborn. Your preemie may just need smaller versions of them.

My daughter spent just under two and a half weeks in the NICU before coming home at just under 35 and a half weeks gestational age. By then, she was breathing independently, maintaining her temperature, taking her bottles and gaining weight. Once she came home, she was essentially a newborn who happened to be very small.

These are the preemie essentials we actually used, what our NICU sent home with us and what I learned you probably don't need to rush out and buy.

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1. Preemie Sleepers

This was probably the most obvious thing we needed that I hadn't purchased before she was born. My daughter weighed 4 pounds 2.5 ounces at birth, so the newborn clothes waiting at home were way too big.

My aunts quickly sent us preemie clothes, and I ended up with around five to seven preemie sleepers that I rotated through. For us, that was plenty. I received some short-sleeve preemie onesies too, but I barely used them because I preferred having her in a cozy footed sleeper with her arms and legs covered.

The style of sleeper mattered more than I expected, especially because we were waking her every three hours to eat after she came home. For nighttime, my favorites were double-zip sleepers and Magnetic Me preemie sleepers because I could quickly get to her diaper without dealing with a row of tiny snaps at 2 a.m.

I also had some adorable Little Me preemie sleepers with snaps. I loved those during the day, but they weren't my first choice for overnight. If I were buying preemie clothes again, I'd start with about five to seven footed sleepers rather than buying an entire wardrobe. Your baby may not be in preemie size for very long, and you can always order more if you need them.

Once she grew out of preemie sizing, I took the same less-is-more approach to how many newborn clothes you actually need.

2. A Small Supply of Preemie Diapers

The NICU provided all of my daughter's diapers while she was there and sent us home with a supply of preemie diapers too, which meant we didn't need a huge stash waiting at home. I'd take the same approach if I were doing it again: have some preemie diapers ready, but don't stockpile boxes of them.

Premature babies can grow quickly, and you don't necessarily know how long your baby will need that particular size. Our NICU also provided wipes and diaper cream, so we came home with enough supplies to get started. Once those ran out, we simply used our normal baby products. There was nothing particularly special or "preemie" about our diaper-changing setup other than the size of the diaper.

3. 4-Ounce Bottles

We used 4-ounce Dr. Brown's bottles when our daughter came home. I believe we started with a pack of four, which was enough for us initially. Because she was only taking around two ounces per feeding when she first came home, there was absolutely no reason for us to use larger bottles yet.

I also still use the smaller bottles for another reason: our daughter was prescribed supplements after leaving the NICU. Rather than putting her supplements into an entire bottle and risking her not finishing it, I put them into a small amount of formula in a 4-ounce bottle first. Once she finishes that, I give her the rest of her feeding.

Always follow your own baby's medical team's instructions for medications and supplements, but this has been another reason our smaller bottles have continued to be useful.

4. The Right Bottle Nipple for Your Preemie

This is one area where I would absolutely follow your NICU team's lead rather than ordering what you think your baby should use based on age. My daughter came home using a Dr. Brown's Ultra-Preemie nipple. She later moved from Ultra-Preemie to Preemie, then to a Transition nipple and eventually Size 1.

Before having a premature baby, I didn't realize how many nipple-flow options existed. For a preemie, nipple flow can be especially important because feeding requires coordinating sucking, swallowing and breathing, and premature babies may still be developing those skills. I share her full Ultra-Preemie → Preemie → Transition → Size 1 progression in how long babies use preemie nipples.

Our NICU nurses were incredible at teaching our daughter how to bottle-feed, so when she came home, I continued using the nipple flow that was working for her in the hospital. You don't need to guess. Ask the NICU which nipple and flow your baby is currently using before discharge, and have extras waiting at home.

5. The Formula or Feeding Supplies Recommended by Your NICU

My daughter initially received donor milk along with the colostrum I was able to provide. Because I had planned to formula-feed, she later transitioned to premature infant formula. When she came home, she was drinking Enfamil Premature 22-calorie formula.

Premature babies can have different nutritional requirements than full-term babies and may need additional calories, protein, vitamins or minerals to support their growth. The specific feeding plan will depend on your baby, so this isn't an area where I'd simply buy whatever another preemie parent used. Ask your NICU exactly what you should have at home.

Our NICU sent us home with as many of the little ready-to-feed two-ounce formula bottles as they could, which was amazing. Those tiny bottles were especially convenient during the first middle-of-the-night feeds because instead of mixing formula at 2 a.m., I could open one, pour it into her bottle and feed her.

Once we needed to purchase more formula ourselves, we bought it at Target. One lesson I now tell every formula-feeding parent is to check the expiration date when you buy formula. We once purchased formula that had already expired. Thankfully, my husband noticed before we used it, and now checking the date is automatic for us.

6. A Preemie-Size Swaddle or Sleep Sack

This was one thing I hadn't considered before bringing home such a tiny baby because our standard newborn sleep setup didn't necessarily fit her yet. The hospital had used Halo Velcro swaddles, so we purchased a similar Halo option to use when she came home.

Eventually she grew into the sleep products we had already purchased for a newborn, but initially we needed something that fit her much smaller body appropriately. This is another reason I wouldn't buy tons of preemie-specific sleep products in advance. See what your baby is using successfully in the NICU, ask what the team recommends for home and buy what you need from there.

For any baby, premature or full-term, the sleep space itself should follow current safe-sleep recommendations. Make sure you have an appropriate safe sleep space ready before your baby comes home and follow your baby's medical team's recommendations.

7. Your Normal Newborn Essentials

This is probably the most important thing I learned: you don't necessarily need "preemie" versions of everything. Once my daughter came home, we used the same basic newborn supplies we had used with my son, including wipes, diaper cream, burp cloths, bottles, a bottle brush, baby soap, a thermometer, a diaper caddy and plenty of extra sleepers.

The NICU even sent us home with a bottle brush and some of the baby soap they had been using. Once those were gone, we switched to the same products we already used at home. She didn't need special preemie skincare products or an entirely different bathing routine. She was a baby who just happened to be much smaller than the average newborn. Our Newborn Essentials article covers all of our must-haves during the first 3 months.

8. Any Vitamins, Iron or Medications Prescribed at Discharge

Our daughter came home with an iron supplement and a multivitamin. She has continued taking them, with her dosage adjusted over time by her medical team.

This isn't something I'd recommend purchasing based on a preemie essentials list online because your baby's needs may be completely different. Before discharge, make sure you understand exactly what your baby has been prescribed, how much to give, how often to give it and whether you need any syringes or other supplies to administer it.

9. Your Infant Car Seat

You don't necessarily need a special "preemie car seat," but you do need to make sure your car seat is appropriate for your baby's size and follow your NICU's instructions. We used our Doona and did not purchase a special aftermarket insert or positioning product.

Before discharge, we brought the Doona into the NICU and our daughter completed a 90-minute car seat test while the team monitored her. Once she passed, that was one of the final boxes checked before we could bring her home.

I'd bring your car seat to the hospital before you think you'll need it and ask your NICU when they want it. Our discharge happened much faster than I expected, so having the car seat ready is one thing I'd definitely recommend doing before you have a confirmed discharge date.

What Our NICU Sent Home With Us

I was genuinely surprised by how much our NICU gave us. They sent us home with preemie diapers, wipes, diaper cream, ready-to-feed formula, pacifiers, baby soap, a bottle brush and some of the other supplies that had already been opened for our daughter.

Our NICU couldn't reuse certain opened supplies that had already been at our daughter's station, so the nurses encouraged us to take them home. We absolutely did, and it gave us a nice starter supply while we figured out what we actually needed.

Of course, every hospital and NICU is different, so don't assume yours will provide the same things. But I also wouldn't panic-buy everything while your baby is still admitted. Ask your nurses what the hospital provides and what you'll actually need to have waiting at home.

What I Didn't Buy for My Preemie

This list is almost as important as the essentials list because I didn't buy special preemie skincare, special bathing products, a special car-seat insert or an entirely different collection of baby gear. We also didn't use an at-home breathing or oxygen monitor.

Our NICU specifically advised us against adding a consumer breathing monitor because they didn't believe our daughter medically needed one and were concerned that false readings could create unnecessary alarm. That doesn't mean another premature baby won't need monitoring at home. Some premature babies may be discharged with medically necessary equipment, and that's something your baby's medical team will discuss with you.

The important distinction is that I would follow your baby's medical team rather than assuming every preemie needs additional monitoring simply because they were born early.

Don't Panic-Buy a Whole Preemie Registry

If your baby unexpectedly came early and you're sitting in a hospital room thinking, "I have nothing for a preemie," you don't need everything today. Your baby has what they need in the NICU right now.

Our hospital provided diapers, wipes, feeding supplies, formula, pacifiers and everything else necessary to care for our daughter while she was admitted. That gave us time to figure out what she actually needed rather than trying to predict it before she was born.

The things I really needed to buy were mostly smaller versions of ordinary newborn products: preemie sleepers, preemie diapers, the appropriate nipple flow and a smaller swaddle. Everything else looked surprisingly similar to caring for any newborn.

But Don't Wait Until Discharge Day Either

Here's where we made a mistake: we assumed we'd get plenty of warning before our daughter came home. I pictured someone telling us several days in advance that she was probably going to be discharged.

That's not what happened. As she started hitting her milestones, things moved quickly, and suddenly we were hearing, "It looks like she might go home tomorrow." We started frantically ordering things on Amazon, and we also hadn't expected her to be discharged on a weekend, but she came home on a Sunday.

My advice is not to panic-buy the day your baby enters the NICU, but once your baby starts getting closer to discharge, get the basics ready. Have a few appropriately sized sleepers, diapers, bottles, the nipple flow your baby is currently using, the feeding supplies your medical team recommends, a safe sleep space, your infant car seat and a basic diaper caddy.

You don't need to know the exact discharge date to quietly get those things in place.

How Many Preemie Clothes Do You Actually Need?

For us, about five to seven preemie sleepers were enough. I wouldn't personally buy 15 or 20 preemie outfits before knowing how long your baby will be in that size.

I preferred footed sleepers over short-sleeve onesies, and I especially liked magnetic or double-zip styles for overnight feedings. If your baby ends up staying in preemie size longer, you can always add more.

Do You Need Special Products for a Preemie?

Maybe, but not necessarily. Some premature babies go home with much more complex medical needs than my daughter did and may need oxygen, monitoring equipment, specialized feeding equipment or additional medications.

Our daughter did not. By the time she was discharged, she was breathing independently, maintaining her temperature, taking bottles and gaining weight, so our list of actual "preemie essentials" was remarkably short.

Talk to your NICU team before buying specialized equipment. They know your baby's medical history and can tell you what you'll actually need at home.

My Preemie Essentials Checklist

If I were preparing to bring my daughter home again, I'd have about five to seven preemie sleepers, a small supply of preemie diapers, wipes and diaper cream, four 4-ounce bottles, extra nipples in the exact flow she was using in the NICU, and whatever formula or feeding supplies her medical team recommended.

I'd also have a properly fitting swaddle or sleep sack, burp cloths, bottle-cleaning supplies, a thermometer, basic baby bath supplies, a safe sleep space and our infant car seat ready. Finally, I'd make sure we had picked up any medications, vitamins or supplements prescribed at discharge and understood exactly how to give them.

That's really it. Your baby's individual list may be longer or shorter depending on why they were born early and what support they still need when they're ready to leave the hospital.

The Biggest Thing I Learned About Preemie Essentials

Before having a premature baby, I think the word "preemie" made me assume everything about caring for her would be different. The NICU part was different, the feeding journey was different and her size was definitely different, but once she was medically ready to come home, so much of caring for her looked like caring for any other newborn.

She needed to eat, have her diaper changed, sleep somewhere safe and be held and loved. She also spit up on her clothes and went through plenty of diapers, just like any other newborn.

If your baby arrived earlier than expected, you don't need to build an entirely new baby registry overnight. Start with what your NICU tells you your baby specifically needs, add a few basics in the right size and then wait and see. You can always buy more as you figure out what works for your baby.

A Note From Me

This article is based on my experience bringing home my daughter after she was born at 33 weeks and 1 day and spent just under two and a half weeks in the NICU. Premature babies can have very different medical, nutritional and developmental needs, so always follow your NICU team's and pediatrician's recommendations about feeding, medications, sleep, monitoring and any other equipment your baby may need at home.