If you want the science behind why all of this matters, why preemie physiology makes product choices more consequential, read our companion post: Why Preemies Absorb More of Everything. This post is purely practical: what to pack, what to buy, and what questions to ask your care team.
Clothing: What the NICU Actually Requires
Not every garment is appropriate for a NICU setting. Preemie clothing has functional requirements that conventional sizing doesn't account for, and some standard features, metal snaps, for instance, are outright contraindicated.
Here's what to look for when selecting clothing for a NICU stay:
- GOTS-certified organic cotton or bamboo: The closest-contact textile in your baby's environment. Conventional fabric can contain pesticide residues, formaldehyde-based wrinkle treatments, and synthetic dyes. GOTS certification verifies the supply chain from farm to finished garment.
- Plastic snaps, not metal: Metal snaps can heat up inside an incubator, causing thermal injury to fragile skin. Plastic snaps and Velcro closures are safe for both incubator use and X-ray imaging.
- Open-shoulder or side-snap designs: NICU equipment, ECG leads, pulse oximeters, temperature probes, needs to stay attached. Clothing with open shoulders or side snaps allows placement and access without undressing the baby entirely. Pulling garments over a preemie's head with active lines is both difficult and risky.
- Flat or external seams: Raised internal seams create pressure points on skin that may have very little protective barrier. Flat-felled or external seams eliminate this friction entirely.
- Footless designs for smaller preemies: Footless garments allow easier access for foot-based monitoring and make sizing less critical at very low birth weights.
Preemie clothing we carry
We've curated a small selection of GOTS-certified preemie clothing vetted for the criteria above. The L'ovedbaby Organic Snap Footie (Preemie/NB, 4–7 lbs) is GOTS-certified with nickel-free snaps, azo-free dyes, and fold-over mitten sleeves, one of the cleaner options available. The L'ovedbaby Organic Footed Overall is a softer, slightly roomier alternative in the same size range.
For basics at volume, preemies go through a lot of outfits, the Burt's Bees Baby Preemie Bodysuit 5-Pack is GOTS-certified with envelope necklines and snap closures, and it's a brand with a consistent track record on this site. Their Preemie Footed Pajamas follow the same standard. You can browse our full preemie clothing selection at Verdling's organic clothing page, filter by Preemie at the top.
Swaddles: Purpose-Built for Preemie Size
Standard newborn swaddles don't work for preemies. The proportions are wrong, and loose fabric in an incubator creates both a safety hazard and a monitoring challenge. The Mama Cheetah Organic Preemie Swaddle Sack 3-Pack is one of the few purpose-built options: 100% OEKO-TEX certified organic cotton, sized for XS (up to 7 lbs), with hook-and-loop wings that allow secure swaddling without loose fabric, and a two-way zipper for diaper changes. It's available in our bedding and sleep section, also filterable by Preemie.
Organic Oils: The Evidence Is Stronger Than You'd Expect
Preemie skin loses water rapidly, a condition called high transepidermal water loss, because the lipid barrier hasn't fully formed. Topical oils aren't just a comfort measure; clinical evidence suggests they can meaningfully improve outcomes.
The same trials also showed a 26% reduction in mortality in the sunflower seed oil group. The mechanism is straightforward: improving the skin barrier reduces the entry points for bacteria. The oil of choice matters, high-linoleate sunflower seed oil specifically supports ceramide synthesis, which is what the preemie's skin barrier is missing.
Coconut oil is the other evidence-backed option, with updated 2025 studies supporting its use for barrier improvement and weight gain in preterm infants. It's gentler and well-tolerated, though the sepsis reduction data is stronger for sunflower seed oil.
Oils to avoid: Olive oil and mustard oil, both commonly used in traditional infant massage, contain high levels of oleic acid, which disrupts the very lipid barrier you're trying to support. Pediatric dermatologists consistently flag these as contraindicated for newborn and preemie skin. Whatever oil you use should be fragrance-free and ideally certified organic.
Skincare and Hygiene: Fragrance-Free Is Non-Negotiable
Fragrances are complex chemical mixtures, a single "fragrance" ingredient on a label can represent dozens of compounds, some of which are known hormone disruptors and respiratory irritants. For a preemie with an immature respiratory system and a compromised skin barrier, fragrance exposure matters more than it would for a full-term infant.
Any wipes, lotions, cleansers, or balms brought into the NICU should be fragrance-free, dye-free, and preservative-minimal. Look for products with short ingredient lists. Parabens, phenoxyethanol, and formaldehyde releasers (DMDM hydantoin, diazolidinyl urea) have no business being on preemie skin.
What to Ask Your Care Team
Parents can't control the medical equipment their baby depends on, but they can ask informed questions. Some NICU facilities have already transitioned to DEHP-free and PVC-free alternatives for IV lines and feeding tubes. Many haven't. The conversation is worth having.
- Ask about DEHP-free lines: "Has the NICU transitioned to DEHP-free IV and feeding tube lines? If not, is it possible to request them for our baby?" Some hospitals have DEHP-free options available but don't use them by default.
- Screen your own supplies first: Any parent-provided items, wipes, balms, clothing, should be fragrance-free and certified organic before they enter the NICU. Don't assume the nursing staff will screen them.
- Ask about hand sanitizers and cleaning products: Many commercial hand sanitizers contain fragrance. If your baby's care team is using them immediately before handling your infant, it's reasonable to ask whether fragrance-free alternatives are available.
- Discuss oil massage if appropriate: Ask your neonatologist whether gentle massage with sunflower seed oil is appropriate for your baby's gestational age and clinical status. At many NICUs, developmentally supportive care including skin-to-skin contact and gentle touch is actively encouraged.
- Inquire about "BPA-free" equipment: Given what we know about bisphenol substitutes, "BPA-free" alone isn't sufficient. If your facility has access to certified bisphenol-free options, that's worth knowing.
NICU staff are allies, not gatekeepers. Most neonatologists and NICU nurses are aware of the environmental health research and are receptive to questions from informed parents. Frame your questions as wanting to understand what options exist, not as challenging their protocols, and you'll generally get a thoughtful response.
The Short Version
If you're preparing quickly and just need the essentials: GOTS-certified organic cotton clothing with plastic snaps and open-shoulder access, a purpose-built preemie swaddle, fragrance-free everything, high-linoleate sunflower seed oil if your neonatologist approves, and a polite conversation with your care team about DEHP-free line options.
For the research behind why all of this matters more for preemies than for full-term infants, read our companion piece: Why Preemies Absorb More of Everything.
This post contains affiliate links. See our affiliate disclosure. We are not medical professionals. Always consult your neonatologist or NICU care team before introducing any new product to your preemie's environment.