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Info on Making Items for Preemies

The following information was posted to one of my e-mail lists. I e-mailed the member for permission to reprint the article and she graciously allowed me to share it with you all. I have organized it by topic and highlighted important information for your convenience but the words are hers. Also I have included additional information from Aunt B below Maureen’s article. Thanks to both ladies for their generosity in sharing this information. I should note that some of the opinions differ so you should check with the place to which you are donating if there is any question.

Please also note that while white is suggested here for blankies, I have made preemie hats in many colors for preemie efforts which have been readily received.

Crocheting for Preemies
©2007 Maureen Moniz

I can tell you from 20 + years of personal experience as a NICU nurse, the preemie items ARE CERTAINLY USED by the NICU nurses in any hospital.This is especially true of inner city hospitals that serve a low income population and therefore the parents may not have the means to purchase even little personal items for their baby. And they are used in vast quantities.

A preemie has a large head for its body size, and tremendous heat loss from its head, and consequently, the nurses try to keep their heads covered all the time. If a preemie has to"waste" calories by trying to maintain its temperature (or struggling to breathe independently), then there are no calories left for weight gain or lung development.

Each and every time a baby is taken out of its isolette and handed to a parent to be snuggled, there is a good chance that the little knitted/ crocheted hat will be knocked off its head (because most are too big for the smallest). Once on the floor, the parents can take it home and wash it, keep it, or do whatever, but it cannot be given back to the baby to wear due to the risk of pathogens and bacteria that are on the floor, on everyone’s shoes, no matter how clean the NICU is. And so the same baby may use several hats in any given day (Our floors were washed a minimum of 3 times a day, and STILL weekly cultures taken of the floors were scary. Infection control is an ongoing battle in any NICU.)

I can also say that the best yarn for these little hats is that baby yarn that everyone hates with the little silver thread going through it. It does not release fiber/fuzzies very readily, and therefore is permitted for use on a baby with a trach, or on a vent with CPAP.

Any fabric that has the potential to fray needs to have the raw edges bound in the most secure manner available. Whether this is a crocheted edge over a (single) turned down edge, or turning the hem over twice does not matter. I have seen tiny fingers and toes turn black from having the blood supply cut off after getting them tangled in fringe, button holes, open stitching in a beautifully crocheted blanket, etc. The nurses cannot be at every baby’s crib side at every minute, and it does not take long for a squirmy baby to get tangled up in thread of any kind. The finer the thread, the more present the danger.... worsted weight yarn (while not terribly appropriate for preemies), will usually only cause some swelling below the site of the entanglement. Sewing thread, unraveling fabric edges, and fine fringe, can actually cut through a baby’s delicate skin... the younger the gestational age of the baby, the more likely this is to happen as well.

Not to mention that even preemies will put anything in their mouths....if a baby is on a ventilator, there is no danger of them choking on a shred of thread. It is the babies that are not on ventilators who can experience a small shred getting stuck in their throats ..."

No wool yarn is permitted to be used (even a wool blend) in the presence of oxygen since there is a potential for static, and even a small "shock" can be dangerous in the presence of increased ambient oxygen. Plus, the younger the gestational age of the baby, the more likely skin reactions are to "foreign" materials. Some babies look like a rash head to toe just from contact with the "used a thousand times and really soft" receiving blankets that we used instead of sheets. Soft really is important to them.

If I may suggest, that we make some hats and blankets really, really small. (I know I may be preaching to the choir about this... sorry) The lower level of viability is a head circumference of 20.5 cm. That is roughly the size of a large egg at the widest part. Smaller than this, there is little likelihood that a child will survive, no matter how much effort is expended on its behalf.

Because some of these teenies are not the first but maybe the 4th or 5th pregnancy (and this is as far as they have been able to get), and even if the staff knows in the delivery room that this child probably won’t survive the night, we do everything possible to show these special parents that this child is every bit as much a person deserving of love and care as the 10 pounder in the next isolette. The parents will have noticed the birth weight of that 10 pounder may have been just a pound, but that was 6 months ago. And that gives them hope, even for the moment.

The less likely it looks that a child will survive the night, the more important it is for the nurses to have TEENY hats (egg sized and very stretchy, as you would see using a 2 x 2 rib), booties no bigger than a 1-1/4" sole, and blankets no bigger than about 10 x 12. As these babies are laying out on the warmers, the very fact that the clothes provided are NOT too big for their baby is comforting ...they have all walked past the warmers where there is baby using a 1/2 cotton ball and saran wrap for a diaper, or a blanket made of a sheet of saran wrap to trap the baby’s body heat. The parents just don’t realize that these babies are the same size as theirs, who happened to survive that first night.

I know our hospital had the loving attention of women all over who made plenty of hats and blankets suitable for babies about 3 lbs and larger, but it was the nurses who made the smaller hats, because the volunteer knitters did not know that we needed some to be even smaller, and even if we asked for some smaller, I think they did not believe we could possibly use them. It would be a tremendous blessing to NICUs everywhere to include some sets for the smallest of the small.

Finally, may I suggest that we steer clear of the traditional pink, blue, lavender, mint and yellow for these extremely teeny blankets and hats. A dying baby has AWFUL color, and the blue and lavender especially make the baby look even worse. Usually, the parents want to take pictures of their newborn, even if it is no longer alive, and the best made blanket in a traditional baby color blue makes those pictures ghastly. That is all they will have to show family and friends. Blankets that are made white, with a small trim of color that will indicate whether the child was a boy or a girl, truly enhance the baby’s appearance, and make the pictures easier for the parents in the weeks to come. (blankets and burial layettes that are used once the child has passed are lovely in the traditional baby colors ... It is only for the blankets used while the child is still alive that white is the preferred color)

Added 7-2011: Another reason that neutrals are so important is that many babies born with any number of “syndromes” do not survive (as the syndromes are incompatible with life once the baby is off the placental circuit), and one of the most unfortunate things about some of these syndromes is that they are unable to determine the sex of the child. Therefore a white, mint or even a pale yellow are preferable to the traditional in these cases. Of course, most preemies are born too early with perfectly intact "equipment", but in the other cases, why add to the parents’ heartbreak by giving a pink blanket to a child that "appears" to be a girl, and on autopsy a couple of days later, will be shown to be male or hermaphrodite?

I like to use Encore Colorspun as my go-to blanket color for these babies. I do not know what the color would be called as it is identified by a number. But it is a white yarn with tiny flecks of color ( pink/ blue/ green/ yellow/ lavender) spaced widely apart, and I think it covers all the bases ... male, female and/or other. It also is quite soft. Although I would not make a preemie garment in it, it is certainly great for 12-14" blankets.


Thanks to Maureen for providing this valuable information.

Here is another bit of info I posted a while back and have just found again. This information comes from Aunt B, a valued member of our crochet community who does a lot of charity work, particularly for the Native Americans of Pine Ridge. She gave me permission to share these tips suggested by a friend of hers who is a nurse:

Sweaters: Trying to stuff a tiny arm into an armhole of a sweater or other sweater like item is just not feasible. These items should be saved for newborns or preemies of a larger size ... like 5 or more lbs.

Booties: Tiny feet just can’t be shoved into a bootie with a cuff or frilly top. Booties should be open in the front and tie on.

Hats: Hats need to be very stretchy and soft with no brims, bows, ruffles, or other decorative item that could harm the baby’s delicate head.

Blankets and afghans: Blankets need to be soft and lightweight.

Materials: Worsted weight yarn should not be use for anything ... it is too rough and heavy. Use baby sport or fingering yarn. Pompadour should be avoided also because of the fine nylon strand running through it. This strand can break and act like a little needle to delicate skin.

Preparation: All items should be washed in mild soap with no fabric softener or softener sheets. Keep yarns and items away from pets and smoke. This is for the possibility of allergic reactions and washing doesn’t always remove all the pet dander or smoke scum.

Burial Items: If you are one who is willing to make burial items, please feel free to make these as pretty and frilly as you like. But, please bear in mind that the item needs to OPEN ALL THE WAY DOWN THE BACK. It probably will not be used if it isn’t.

For patterns, I suggest checking out Bev’s County Cottage preemie page.

My very favorite quick, easy, and tiny preemie hat is Teresa’s 10 Minute Crochet Preemie Hat. It can also be found at Bev’s Country Cottage - http://www.bevscountrycottage.com/teresa-hat.html

I have a few preemie size patterns in the section on wordless afghans which can be made in the appropriate colors for these babies.

Cotton and flannel fabric are also lightweight and can be used. A flannel blankie with a crocheted edging can make a quick blankie. You can purchase fabric with prepunched holes at Hemstitcher, you can punch the holes yourself, or you can purchase the Edgerydoo or skip stitch rotary blade attachment to punch evenly spaced holes.

Note that one article suggests the pompadour yarn as perfect and the other says not to use it at all. I would suggest asking the coordinator at your local hospital what they prefer.

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Crochet Cabana created October 1997 (domain name purchased March 2001)
Crochet Cabana’s Crafty Corral begun November 7, 2004.
The Crochet Cabana Blog begun May 2010.
Site update November 18, 2012.