Q: My four and a half months old baby was born premature at the end of 28th week. His birth weight was 1.35 kg, and at the time of discharge from the hospital he was 1.1 kg. He was in NICU for almost 45 days. Currently, he weighs around 3.65 kg. I have the following queries:

1. How do we see whether he is growing fine and gaining enough weight? Please suggest a growth chart that can be referred for preterm babies?
2. What other precautions need to be taken for a premature baby, especially during changing seasons?
3. His sleeping hours keep on changing. At times, he gets up after half an hour. How do we make sure that he gets proper sleep?
4. He cries while urinating. Is it to do with some kidney problem?
5. Shall we use mosquito repellent in his room and shall we use fans for him?

A:Preterm babies continue to grow slow during NICU stay and even beyond discharge. Many of these babies may catch up in growth later during childhood; some may take 8 - 10 years to catch up. During first two years of life their growth should be checked as per their corrected age and can be plotted on WHO growth charts, which are available on the net. Extremely preterm babies may be more prone to respiratory infections. Give all the vaccinations at appropriate time and keep the child away from any person who is suffering from any form of infection. Sleep patterns may be very variable and there is no way we can regularise the sleep pattern. Many babies may cry before passing urine and after they have passed urine they may cry because they are wet. However, if he is very uncomfortable while passing urine, get his urine examination done and if required ultrasound of the abdomen for kidneys If there are mosquitoes in the room, protect him from them, either use nets or may use mild repellent cream.