Despite the many advancements in prenatal care and medical technology, babies continue to be born before their expected delivery date. A baby is considered premature in Washington state when born at 37 weeks gestation or earlier. Many premature babies need to spend some time in the neonatal intensive care unit, or NICU, to receive specialized care and attention in those early days. There can be complex medical issues that may require many months of support in the hospital. Concerns can range from poor feeding and weight gain to heart and lung development complications.

At some point, the day arrives when the baby is ready to be discharged home with their family. While this is a day to be celebrated and is often filled with hope and joy, many caregivers leave with a sense of uncertainty and even fear. All the close support and guidance provided by a trained and informed care team does not follow the family home. This is when the next part of the journey can begin – home-based support through the Encompass Early Supports for Infants and Toddlers program, or ESIT. When a family arrives home with a premature baby, there can continue to be multiple concerns. Babies that have spent time in the NICU are at an increased risk for feeding struggles, poor growth, and developmental delay. And the babies are not the only ones at risk. Caregivers have been shown to be at a higher risk for depression, anxiety, and other mental health conditions. When this occurs, the relationship between the infant and the caregiver can be stressed and negatively impacted in other ways.

Even when a baby has not exhibited any immediate concerns by being born early, it is standard practice to have follow-up assessments completed due to the increased risk of delays. Once a family contacts us or is referred by a medical provider, the timeline for receiving an evaluation and subsequent therapy is fast-tracked. The infant and their caregiver are quickly matched with a team of providers with specialized training in NICU-to-home transitions and care. These knowledgeable professionals provide ESIT services in the comfort of the home environment to support the infant and the caregivers to increase positive social-emotional development, attachment, and developmental and medical outcomes.  Nutrition support, occupational and physical therapy, feeding therapy, speech and language therapy, caregiver mental health screening and referral, as well as vision and hearing services, are all part of the support tailored to each family’s unique needs. As the child gets older, services can support preschool readiness skills, and peer interaction and socialization. Family resource coordination is also a vital service every family receives that offers practical and helpful resources and can assist families in advocating for what they need.

Research has shown that preterm infants are often not referred to early intervention programs upon discharge from the NICU. This is concerning given that prematurity is accompanied by an increased risk for developmental challenges before age 3, as well as early onset of a variety of health issues later in life such as hypertension, cardiovascular events, diabetes, chronic pulmonary disease, pregnancy complications, and osteoporosis. Therefore, it’s important that caregivers consider contacting their local early intervention program for a developmental evaluation in the first couple of months of the infant’s life. It is also common for parents to contact the program before discharge from the hospital so that services can begin promptly when returning home. ESIT can support a child until they turn 3 years old and helps families make the transition to school-based services and/or outpatient therapy.

The Encompass ESIT program serves the greater Snoqualmie Valley region, including North Bend, Snoqualmie, Fall City, Carnation, Duvall, Issaquah, Sammamish, and Renton. Email us at ESIT@encompassnw.org or call 425-888-3347.

To locate the ESIT program that serves the area closest to you, contact Within Reach at info@withinreachwa.org or call 1-800-322-2588.

*Co-authored by ESIT South Team Supervisor Kim Hall, MS, OTR/L, and Encompass Family Resource Coordinator Sarah Johnson, RDN, CD.