When a Baby Arrives Too Soon: What Parents Should Know About Premature Birth

Most families spend nine months getting ready for a baby's arrival. Nurseries get painted, names get argued over, hospital bags get packed weeks in advance. So when a baby decides to arrive early — sometimes months early — those carefully laid plans can fall apart in the space of a few hours.

Instead of swaddling their newborn and heading home, parents suddenly find themselves standing next to an incubator in a Neonatal Intensive Care Unit (NICU), surrounded by wires, monitors and machines they've never seen before. As a neonatologist, the question I hear most often in those first moments is achingly simple: Will my baby be okay?

I wish I could give a one-line answer every time. I can't. But here's the good news — neonatal care has come an incredibly long way, and even babies born extremely early today have a real shot at healthy, happy childhoods that would have seemed unlikely just a generation ago.

Why are premature babies so different?

Technically, any baby born before 37 completed weeks of pregnancy is called premature. But there's a world of difference between a baby born at 35 weeks and one born at 25 or 26 weeks.

In extremely premature babies, many organs are still very much under construction. The lungs often aren't ready to work on their own. Keeping body temperature steady is a real struggle. Feeding takes time and patience, because the coordination a baby needs to suck and swallow simply hasn't developed yet.

These tiny babies are also far more vulnerable to infections, and their brain, eyes, heart and intestines need to be watched closely.

This is exactly why premature babies need more than just "keeping an eye on them." They need dedicated, specialised NICU care from the very first breath.

The first few hours matter—a lot

For a very premature baby, good care doesn't start after birth. It starts before it.

Whenever we know a premature delivery is likely, the obstetric and neonatal teams talk to each other early and often. Giving antenatal steroids when needed, choosing the right place for delivery, and making sure an experienced neonatal team is standing by at birth — all of this can shape how the baby's first days unfold.

Once the baby arrives, the priorities are simple to list but demanding to execute: keep the baby warm, help them breathe if they need it, keep oxygen levels and blood sugar steady, guard against infection, and start nutrition at the right time.

For a baby who weighs only 600 or 700 grams, even the smallest details can make a real difference.

Whenever it's possible, a mother at risk of an extremely premature delivery should be moved, before the birth, to a hospital equipped to handle such a delicate case. It's almost always safer to transport a stable mother than a critically ill newborn.

NICU care is a journey, not a single treatment

One of the questions parents ask me most is, "How many days will my baby be in the NICU?"

Honestly, for very premature babies, we're usually talking about weeks, not days.

And it's rarely a straight road. A baby might have several good days, then pick up an infection or need a bit more breathing support again. Feeding might be going smoothly, then need to slow down for a while. The weighing scale might not budge for days before finally starting to climb.

These ups and downs are hard on parents—I've watched it happen more times than I can count, and it never gets easier to witness.

That's why, in the NICU, we learn to celebrate every small win: coming off the ventilator, reaching full milk feeds, crossing the one-kilogram mark, moving from an incubator to a cot, the first successful breastfeed, and finally breathing on their own without any oxygen support.

Every single one of these milestones is a step closer to home.

Parents are part of the care team—not just visitors

Modern neonatal critical care isn't only about machines and monitors.

A mother's own milk is precious for a premature baby—nothing replicates it. Kangaroo Mother Care, where the baby rests skin-to-skin on a parent's chest, helps regulate temperature, supports breastfeeding, and builds that early bond, and we encourage it the moment the baby's condition allows.

I always tell parents, "You are not visitors here." You are part of your baby's care team.

As the baby grows stronger, we actively encourage parents to get more involved—holding their baby, doing Kangaroo Mother Care, taking part in feeds. It matters for the baby, and honestly, it matters just as much for the parents.

What happens after discharge?

Going home is one of the happiest days for any NICU family. But newborn care doesn't stop at the hospital door.

Babies born very early need structured, ongoing follow-up. Growth, nutrition, hearing, vision, and overall development all need to be tracked carefully.

We assess premature babies using their "corrected age" during the early years—their age is counted from their due date, not their birth date. This matters, because comparing them directly with full-term babies can create needless worry for parents.

If there's one thing I'd want every parent to remember, it's this: every premature baby's journey is their own. Progress should be measured against your own child's growth, not against a neighbor's baby, a cousin's baby, or a chart in a book.

From fragile beginnings to energetic childhoods

One of the most rewarding parts of my work is meeting these children again, months or years down the line.

A baby we once watched anxiously for every single breath walks into the clinic on their own two feet. Parents who once hesitated to even touch their tiny baby are now struggling to keep up with a toddler who won't sit still. It's one of the best parts of this job.

Those visits are a reminder of just how far neonatal medicine has come.

Premature birth remains a genuine challenge, and no outcome can ever be promised. But timely delivery at the right centre, experienced NICU and newborn care, the right technology, breast milk, Kangaroo Mother Care, and close developmental follow-up have changed what's possible for so many premature babies and the families who love them.

When a baby arrives too soon, the journey may look nothing like what the family had imagined. It can mean weeks of uncertainty and many small, uneven steps.

But sometimes, it's those very small steps that carry a family the furthest.

About the Author

Dr. Sachin Sakharkar is widely regarded as one of the best neonatologists in Thane, with over 13 years of experience in NICU and newborn care. He specialises in the care of premature babies, neonatal critical care, and complex newborn conditions.

To book a consultation, visit his profile: Dr. Sachin Sakharkar — Doctor Profile

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