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Preemies
How premature = no daycare?
Hello again ladies 
Please forgive yet another question from this lurker. I'm coming in again for your knowledge and experience and so appreciate you putting up with me!
I've read that, often, doctors recommend that preemies *not* be put into daycare for a certain period of time due to germs and etc. Are there any general "rules" on this? You know, like a 32 weeker shouldn't be in group daycare for at least 6 months or something? (Yeah, right, as if anything's that exact!) I'm just looking for some general guidelines, understanding of course that the time of year plays into it too.
Since our MFM has said that I definitely will be induced early due to my history (just hopefully not *very* early!) I'm trying to figure out what childcare avenues to look in to. Is it even worth finding a daycare?
Thanks!
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Re: How premature = no daycare?
I definately don't think there is a standard based on any fact; it really seems to be just the opinion of your doctors. Preemies born before 34 weeks are more prone to infection since 34 weeks is the point at which antibodies are passed from mother to baby (although breast feeding helps, of course). And preemies born with respiratory distress are obviously more prone to complications from illnesses, since they have weaker lungs to begin with.
My 32 weeker (who needed CPAP at birth) had a serious illness at 6 weeks (GBS/sepsis/bacterial meningitis) and our doctors never said anything about keeping him out of daycare. The only thing we were told was to completely quarantine him until he was 4 months old and then to avoid unnecessary trips or lots of visitors until the end of RSV season (April here, so he was 9 months old). We put him in daycare when he was 4.5 months old and he never got sick until RSV season ended (that same month in fact).
We were lucky enough to find a daycare for medically fragile children (the kids have a full range of medical issues, from bad food allergies to prematurity to severe cognitive and physical disabilities). They take a lot of precautions to prevent the spread of infection and all the kids are assessed by a nurse in the morning (they listen to their lungs, etc) so any illnesses are usually caught fairly quickly. Marino has viral triggered asthma so even the smallest cold can throw him into respiratory distress, so its been great to have him in a place where they "get it." He'll start regular preschool in the fall (at 26 months) and I already have some anxiety about that.
My DD was born at 32w, and the doctor would really like her to be kept out of daycare until the end of RSV season (she's not eligible for any more Synagis, dangit). There are two things I'd keep in mind.
1. Daycare may be the least expensive childcare option. When I was working, I was pretty well paid, but if I had legally hired a nanny, I would have basically had to hand her my paycheck. I hate making childcare decisions on the basis of money - my kids are so much more important than money! - but there are financial limits to what we can do.
2. Even if you decide that your child shouldn't be in daycare immediately, it's worth doing some research if you think you might want to use it later. Many daycares have waiting lists. Do this research now so that you don't lose options just because you didn't get yourself on the list far enough ahead.
I also have a 30 weeker and the NICU also recommended no daycare for 1 year. We are financially only able to postpone daycare till he is 6 mos (actual) though.
Our DS is a 26-weeker and required a lot of respitory support in the NICU - they said no daycare for 1 year (actually wrote a doctor's order to get us out of our contract and to our non-refundable money back) and if we can help it, for 2 years.
I think it would be dependent on more than just gestational age at birth...but I would definitely talk to your doctor about this. You might not get a black and white answer either!
My son was a 27 weeker with a moderate amount of breathing problems - very short time on the vent, forever (it seemed) on CPAP and the nasal cannula. He came home in August 2008 and was not on oxygen or any monitors. Our pediatrician, our neonatologists, and all the NICU nurses were adamant about keeping him out of daycare for the first year and until age 2 if we could make it work.
I would definitely still go look at daycares and get on waiting lists. You never know what might happen.
my daughter was 27 weeks, on a vent for 2 weeks, cpap FOREVER, and is now home on oxygen. (at 4 months adjusted.)
they told me that i should stay home from work for as long as we could afford. (we had planned for that anyway, so it wasn't a big transition for us financially. i most people depend on 2 incomes nowdays.) and out of daycare for at least a year, and for 2 if we could help it. they told me to spend as much time with her as i could because i'm the best therapist/advocate that she has... and with her problems she needs lots of appointments.. (several a week now that she's in physical therapy), plus synagis, and a pulmonologist, etc. etc.. they said that the time that i spend with her working on her development would be beneficial in the long run. the head neo said she's seen kids with bull-headed parents come out of the nicu thinking that they'd probably never walk- and the intervention on the parents' part made all the difference.
if they have a daycare for special needs kids, or preemies, that would be AWESOME! that is a fabulous idea, i wish there were more of those out there. but even a daycare that is willing to help with developmental things (like for instance, my daughter needs practice on belly time, or sitting etc. really simple stuff.) and be considerate of immunity issues... that would be great.
good luck!