Preemie Clothes for in the NICU

Newborn baby 22 days early, only weighing 5 pounds

Tatjana Kaufmann / Moment Open / Getty Images

Preemies require special care that's personalized for each newborn. One common aspect of this care, however, is that preemies typically can't wear clothing at first due to their delicate skin and other issues. When parents can finally start dressing their little ones in adorable preemie clothes, it tends to be celebrated as a momentous milestone in the neonatal intensive care unit (NICU).

Clothing is avoided for most preemies because it may interfere with temperature regulation and access to any needed intravenous lines, says Karleen Sigvartsen, BSN, RNC-NIC, a neonatal intensive care unit nurse at Children's Hospital Colorado. Once these considerations are no longer an issue, preemies can typically start wearing soft, simple clothing.

Learn more about when preemies can start wearing clothing, what type of clothing is best, and other guidelines to follow for their wardrobes.

When Are Preemies Ready for Clothing?

When a preemie will be ready for clothing depends on many factors, says Lauren Long, BSN, RNC-NIC, a NICU nurse at Children's Hospital Colorado. "It's really patient-specific, depending on how sick the baby is," explains Long.

"General conditions for wearing clothing are stable respiratory support; the baby has been weaned off humidity in their isolette; weighs greater than 1400 grams (3 1/3 pounds); baby is gaining weight; baby’s gestational age at birth; and the current age of the infant," says Sigvartsen.

Your baby's NICU team is the best source for specific guidance on when your child might be able to start wearing clothes. Generally, you’ll be able to pull out your preemie clothes once the following milestones are met.

Skin Maturity

A preemie's skin is thin and almost transparent with very little body fat underneath it, making it prone to injury. Micro-preemies are born with even thinner skin. It may take a few weeks for their skin to be developed enough to wear even very tiny, soft preemie clothes.

"Preemies less than 32 weeks gestation are placed inside a warm isolette with extra humidity to help their skin develop and get used to the outside world. We avoid clothing or swaddling before this time since a humid environment causes cotton to become damp (and cold)," explains Long.

Overall Health

Your baby needs to be in stable condition in order to wear clothing. Until your baby’s cardiac, respiratory, and digestive systems are stable, their nurses and doctors will need to keep their chest bare so that it’s easy to see and assess how they are doing and provide care as needed.

"'Stable' looks different for every preemie, so that will be determined case-by-case. But ideally, when they are placed in an open crib (usually around 35 weeks), the infant can wear clothing," explains Long.

Access to Umbilical Lines or IVs

Preemies need to have their tummies bare until the umbilical lines (IV lines in their umbilical cord stumps) have been discontinued. Even stable babies may have umbilical lines. These must be removed before babies can wear preemie clothes.

Regular IV lines and PICC lines may make it hard to get preemie clothes onto your little one. Some preemie clothes are designed with special flaps that open to allow for IV lines, and some outfits can be modified for a baby's needs. "I have seen some crafty/creative people make patches in the onesie for the g-tube to come out of," says Sigvartsen.

Best Clothes for NICU Babies

Although it’s easy to find preemie sizes in stores and on websites, not all clothes will work for every premature baby. A baby’s size, condition, and medical equipment all play a role in what preemie clothes they can wear.

Additionally, says Long, "Preemie infants are not used to being touched, and putting on/taking off clothing can be very overstimulating." So, once they're ready for clothing, remember that simple is best. "Frilly dresses would be okay for a special holiday and photos, but we like clothing that is soft and keeps the baby warm," says Sigvartsen.

Preemie clothing should be soft and comfy. It's also important to choose items that are easy to put on and off. Cotton and other natural fibers tend to be gentle on the skin while also allowing for airflow. Also, while it's important to dress a preemie for warmth, be sure not to overdress them. They can overheat as easily as they can be too cold.

Hats

Hats are a must in the NICU, even for very small or very sick preemies. Covering the head helps babies stay warm, and preemie hats are an easy knitting or crocheting project. Plus, when overstimulation is an issue, hats and blankets may be allowed. "We encourage parents to focus on a hat or blanket we can wrap the baby in," says Long.

Diaper Covers

Typically, even the smallest and sickest NICU patients can wear a colorful cover over the diaper. This item is often the first piece of clothing a preemie can wear.

Booties

Although it can be hard to keep booties on tiny feet, they are adorable and can often be worn by even very small babies with complex medical conditions. They have the added advantage of helping to keep your baby warm, as well as looking cute.

Bodysuits

Bodysuits, which are also called onesies, are simple garments that may either be short or long-sleeved. "While still in the NICU, short-sleeve or long-sleeve onesies with buttons or snaps are recommended," says Signartsen. They also may or may not include fabric covering the legs.

"We also prefer that the baby wears something that he or she can be placed on to dress in—not something that goes over the head," says Long.

Sleepers

One-piece pajamas with long sleeves and feet are wonderful for babies who are transitioning from a warm incubator to an open crib. "Footed jammies with snaps are the most preferred items of clothing to wear," says Long. Sleepers are easiest to use when they snap up the front, as monitor cords can be threaded out between the snaps. Zippers are harder to work with.

How to Wash Preemie Clothes

Preemies have sensitive skin and delicate respiratory systems, and strong odors or harsh chemicals may cause allergic reactions. So, it's important to take precautions when washing their clothing:

  • Always wash preemie clothes before wearing them to remove dust and ensure cleanliness.
  • Do not use fabric softeners and dryer sheets.
  • Use a detergent that is perfume- and dye-free.
  • Wash clothing in warm or hot water, in a smoke-free environment.

Benefits of Clothing in the NICU

Not only do preemies look adorable in tiny preemie clothes, but there are actually some specific benefits to dressing preemies.

Better Thermoregulation

Clothing improves a baby's thermoregulation. Babies stay warm better when they are dressed (outside of an isolette) because they don’t lose heat as easily from drafts or from cold surfaces.

Improved Bonding

Moms and dads tend to feel more comfortable around their babies when their babies are wearing clothes like a "real baby" instead of a NICU patient. They may feel more confident and at ease getting involved with their baby’s care by changing diapers, taking temperatures, and holding babies close when they are dressed.

Less Family Stress

Parents of preemies who wear clothes tend to feel less stress around their babies. They interact more effectively with their babies because they worry less about medical conditions and focus more on the baby.

A Word From Verywell

Dressing a new baby in adorable, tiny clothing is something many expecting parents eagerly await. For the parents of preemies, this experience is often delayed. Many preemies need to stay in an incubator until their condition stabilizes and their body develops enough to be ready for clothing. Once your preemie meets certain NICU health care milestones, they'll be ready to don the soft, sweet outfits you've got at the ready.

6 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Pediatrics. Caring for your premature baby: what parents need to know.

  2. Skrzetuska E, Puszkarz AK, Pycio Z, Krucińska I. Assessment of the impact of clothing structures for premature babies on biophysical propertiesMaterials (Basel). 2021;14(15):4229. doi:10.3390/ma14154229

  3. American Academy of Pediatrics. Tips for dressing your baby.

  4. American Academy of Pediatrics. Cleaning baby clothes.

  5. Pineda R, Bender J, Hall B, Shabosky L, Annecca A, Smith J. Parent participation in the neonatal intensive care unit: Predictors and relationships to neurobehavior and developmental outcomesEarly Hum Dev. 2018;117:32-38. doi:10.1016/j.earlhumdev.2017.12.008

  6. Ionio C, Colombo C, Brazzoduro V, et al. Mothers and fathers in NICU: the impact of preterm birth on parental distressEur J Psychol. 2016;12(4):604-621. doi:10.5964/ejop.v12i4.1093

By Cheryl Bird, RN, BSN
Cheryl Bird, RN, BSN, is a registered nurse in a tertiary level neonatal intensive care unit at Mary Washington Hospital in Fredericksburg, Virginia.