Key takeaways: Late preterm babies are born between 34 0/7 and 36 6/7 weeks. They’re at higher risk for feeding problems, low blood sugar, jaundice, temperature instability, and breathing issues. Close monitoring, feeding support, and early follow-up help.
Late preterm babies are often close in size to full-term babies, which can make them seem ready for everything. But their brains, lungs, and digestive systems are still maturing. They need extra attention.
Common Challenges
Feeding:
- Sleepy, tire quickly, and may have a weaker suck.
- May not wake for feeds on their own.
- Higher risk of poor weight gain and dehydration.
Jaundice:
- More likely to develop jaundice and to have higher bilirubin levels, and for longer.
Temperature:
- Less body fat and more difficulty staying warm.
Blood sugar:
- Higher risk of low blood sugar after birth.
Breathing:
- More likely to have breathing problems, including transient tachypnea and apnea (pauses in breathing).
Infection:
- More vulnerable to infections.
In the Hospital
- Blood sugar checks.
- Temperature monitoring and skin-to-skin.
- Feeding plans with close tracking.
- Bilirubin checks.
- A car seat test before discharge, recommended by the AAP for preterm babies.
Feeding a Late Preterm Baby
- Wake your baby to feed at least every 3 hours, or more often as advised.
- Watch for active feeding: sucking and swallowing, not just latching and sleeping.
- Breast compression can help keep milk flowing.
- Pump or hand express after feeds in the early days to protect your supply and give extra milk to your baby if needed.
- Feeding plans may include supplementation with expressed milk, donor milk, or formula.
- Work with a lactation consultant experienced with preterm babies.
After Discharge
- Follow-up visit within 1 to 2 days after discharge, often sooner than term babies.
- Frequent weight checks.
- Watch closely for jaundice, poor feeding, and dehydration.
- Use adjusted age for developmental milestones.
- Ask about RSV protection.
Call your baby’s doctor if your baby: feeds fewer than 8 times a day, has fewer wet diapers than expected, looks more yellow, is very sleepy or hard to wake, has a temperature below 97.5°F or of 100.4°F or higher, or has trouble breathing.
The Bottom Line
Late preterm babies may look ready, but they need extra support with feeding, warmth, and monitoring. Close follow-up helps them thrive.
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Sources
- Engle WA, Tomashek KM, Wallman C; Committee on Fetus and Newborn. “Late-preterm” infants: a population at risk. Pediatrics. 2007;120(6):1390-1401.
- Boies EG, Vaucher YE; Academy of Breastfeeding Medicine. ABM Clinical Protocol #10: Breastfeeding the late preterm (34-36 6/7 weeks of gestation) and early term infants (37-38 6/7 weeks of gestation), second revision 2016. Breastfeed Med. 2016;11(10):494-500.
- Kemper AR, Newman TB, Slaughter JL, et al. Clinical practice guideline revision: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2022;150(3):e2022058859.
- Bull MJ, Engle WA; Committee on Injury, Violence, and Poison Prevention; Committee on Fetus and Newborn. Safe transportation of preterm and low birth weight infants at hospital discharge. Pediatrics. 2009;123(5):1424-1429.
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
