Care Recommendations for Late Preterm Infants

Temperature Management

The American College of Obstetricians and Gynecologists recommends maintaining body temperature between 36.5°C and 37.5°C after birth through admission and stabilization 1
For late preterm infants, room temperature should be maintained at 23°C to maintain normal temperature, as recommended by the American Heart Association 2, 3
Implementing skin-to-skin care with a parent immediately after birth is recommended for temperature regulation in infants at low risk of needing resuscitation, according to the American Heart Association 3, 4
Monitoring for hypothermia is crucial, as it is associated with increased neonatal morbidity and mortality, as stated by the American Journal of Obstetrics and Gynecology 1

The American Academy of Pediatrics recommends that late preterm infants have decreased breastfeeding rates compared to term infants due to maternal delayed lactation onset, infant immaturity, decreased effective milk emptying, and mother-infant separation 5, 6
Inadequate human milk intake in the first days can lead to longer hospital stays and higher readmission rates, as reported by the American Academy of Pediatrics 5, 6
When supplementation is necessary, the American Academy of Pediatrics recommends using expressed maternal milk or pasteurized donor human milk, as formula supplementation has been associated with increased exclusive formula feeding at discharge 5, 6

Skin-to-skin care has been shown to reduce hypoglycemia risk, with 273 fewer infants/1000 being hypoglycemic when skin-to-skin care is used, according to the American Heart Association 2, 3
The American Academy of Pediatrics recommends considering intravenous glucose infusion when necessary to avoid hypoglycemia 7

The American Academy of Pediatrics recommends monitoring closely for hyperbilirubinemia, as late preterm infants are at increased risk 5, 6
Breastfeeding 9-10 times per day is associated with lower bilirubin concentrations, as reported by the American Academy of Pediatrics 5, 6
Colostrum feedings increase stooling, which increases bilirubin excretion, according to the American Academy of Pediatrics 5, 6

The American Heart Association recommends delayed cord clamping for at least 60 seconds for late preterm infants, which facilitates postnatal cardiovascular transition, increases hemoglobin and hematocrit, and improves iron status 8

The American Academy of Pediatrics recommends administering intramuscular vitamin K1 (0.5-1.0 mg) on the first day of life to reduce vitamin K deficiency bleeding risk 5, 6
Providing vitamin D supplementation (400 IU/day) is recommended for infants consuming less than 28 ounces of commercial infant formula per day, according to the American Academy of Pediatrics 5, 6

The American College of Obstetricians and Gynecologists recommends a single course of antenatal corticosteroids for pregnant patients with singleton pregnancies between 34 0/7 and 36 6/7 weeks who are at high risk of preterm birth within 7 days 9
Antenatal corticosteroid administration in the late preterm period decreases respiratory morbidity, as stated by the American College of Obstetricians and Gynecologists 9
The American College of Obstetricians and Gynecologists recommends avoiding antenatal corticosteroids in pregnant patients with pregestational diabetes mellitus due to the risk of worsening neonatal hypoglycemia 9