Fortunately, Becky had plenty of practice caring for Caleb and Claudia (each weighed just a little over a pound at birth) during their 15 weeks in the hospital, and she could rely on her parenting skills -- even when half asleep. “We had such a long stay in the special care nursery, and they taught us everything. In some ways, it was easier than taking home a full-term baby you hardly know.”

Learning to care for your preemie baby before you leave the hospital will certainly make homecoming a little less stressful; so will knowing what to expect that first year. Here are some answers to questions often asked by preemie parents soon after homecoming:

What follow-up care does my baby need?
During Caleb and Claudia’s first year at home, Becky visited doctors’ offices once or twice a week, sometimes more, to check on the twins’ health and development. “Although it’s not a rule for every preemie, many are at higher risk for growth, nutrition and developmental problems, and they need close monitoring for at least the first year,” says Judy C. Bernbaum, MD, director of neonatal follow-up program at Children’s Hospital of Philadelphia.

Depending on your baby’s medical needs, you may need to schedule follow-up appointments with an ophthalmologist (eyes), audiologist (ears), cardiologist (heart), neurologist (brain) and/or others. Your preterm baby should also qualify for an evaluation to determine if he or she is eligible for government-funded early intervention services (often called 0 to 3 programs). Consult your pediatrician, social worker, local Child Find office or your state’s department of education. “To help children reach their highest potential, problems must be identified early,” Dr. Bernbaum stresses.

How can I keep my baby out of the hospital?
Preterm infants are rehospitalized up to 50 percent more than full-term babies, most often because of a respiratory infection (both Claudia and Caleb were rehospitalized for a virus within a month after homecoming). “It’s very important for parents to know the signs of respiratory distress and seek medical attention when needed,” Dr. Bernbaum says. Signs of respiratory distress include: an increased rate of breathing; difficulty breathing; wheezing; retractions (chest or rib area “caves in” when breathing); a change in color from pink to gray, or a blue tone around the lips; inability to sleep and/or drink or eat.

Preventative care can help reduce the chance of illness; avoid crowds of people and young children who may be carrying germs and practice good handwashing. Immunizations should be given on the same schedule as full-term children, and ask your doctor about preventative treatments during flu and virus seasons.

Is my baby eating and growing enough?
Becky nursed Claudia and Caleb about every two to three hours for the first few weeks after homecoming. It’s not unusual for preemies to need such frequent feedings for good growth, according to Dr. Bernbaum. Your pediatrician may also recommend supplementing your breastmilk with a slightly higher-calorie formula, or if bottle-feeding, giving a formula designed specially for preemies.

During your baby’s first year, your pediatrician will look for continuous weight gain, indicating good growth. Some premature babies are at risk for feeding difficulties, says Dr. Bernbaum, so be sure to discuss any concerns with your doctor or a developmental expert.

When will my baby “catch up?"
“You should not expect your 6-month-old preemie to function like a 6-month-old full-term baby,” Dr. Bernbaum says. Instead, when evaluating developmental milestones, use your preemie’s “corrected age” (the age your baby would be if born on his or her due date). Healthcare experts will evaluate your child by corrected age for two to three years (some preemies take even longer to catch up to their peers).

Try not to get frustrated if your baby doesn’t follow typical child development books, even by corrected age, says Dr. Bernbaum. “It’s more important to look for progress over time, and if you have any concerns, talk to your pediatrician or a developmental expert.”

Caleb and Claudia are now 14 months old, and “life is beginning to seem more normal,” Becky says. The twins aren’t catching as many colds, and there are fewer follow-up appointments. Though Becky wouldn’t want to relive that first year, she says there is a positive side to having a baby born early. “We get to enjoy our children as small infants for a longer time than full-term parents do.”