Every expecting parent naturally hopes that their baby will be born healthy and full-term. Unfortunately, about seven per cent of babies are still born prematurely. However, 9 out of 10 premature babies go on to lead perfectly normal, healthy lives.
A normal pregnancy lasts nine months, or about 38 to 42 weeks. Newborns are considered to be premature if they are born before they are 37 weeks old. Premature babies are even more vulnerable than full-term babies and need to be treated with special care. These tiny, frail creatures are often born with problems, as many of their organs and systems are not fully developed.
Problems associated with premature babies:
The common health problems associated with premature babies are:
• Respiratory distress syndrome. Premature babies have difficulty in gas exchange as a result of protein and fluid collection within the small air sacs and the collapse of the sacs themselves.
• Difficulty in feeding because of weakness.
• Greater likelihood of contracting jaundice and increased vulnerability to its effects.
• More susceptible to infection.
• Congenital defects, including those that affect the heart.
• Danger of bleeding in the brain leading to the development of hydrocephalus (dilatation of the fluid-filled cavities or ventricles in the brain).
• Persistent ductus arteriosus (PDA), which is a blood vessel near the heart that normally closes after birth, but which can stay open, especially in premature babies. Many times, a PDA needs to be closed, either with medications or if that doesn't work, then with surgery.
• Periventricular leukomalacia (PVL), which is a sign of brain damage.
• Necrotizing enterocolitis (NEC), an inflammation of the intestines. Treatments, depending on how severe it is, can include antibiotics, intravenous nutrition and sometimes surgery.
• Retinopathy of Prematurity (ROP), abnormal blood vessels in the eyes of premature babies.
• Apnea and Bradycardia (A & Bs) or apnea of prematurity, which occurs when their immature respiratory and nervous system cause them to stop breathing for short periods of time and for their heart rate to drop. This is treated with stimulation, medications, CPAP, oxygen and/or by being on a ventilator, depending upon the frequency and duration of apnea.
• Anemia or low blood counts, which sometimes require blood transfusions.
• Bronchopulmonary dysplasia (BPD) or chronic lung disease (CLD).
• Premature babies are also at increased risk for inguinal hernias and hydroceles.
These babies are very fragile and must be treated gingerly when it comes to taking care of them. Sometimes the solution can lead to a further problem. There have been cases of a baby's lung been blown out or scarred as a result of over-inflation of the lung by a respirator. There are cases of oxygen therapy causing blindness or impaired vision in these premature babies.
The smaller and less mature the premature baby is at birth, the greater will be its problems in the long run. These babies are at the high risk of cerebral palsy, mental retardation, learning disorders, and vision, speech and hearing problems.
Risk Factors of Premature Babies:
There are various risk factors that help to predict which pregnancies are at risk for premature delivery. But in most of the cases, there are no causes found.
However, the risk factors that may increase the chances of having a premature baby include:
• Delivery of a previous premature baby
• Multiple gestation pregnancies, such as twins, triplets, etc.
• Placental abruptions
• Placenta previa
• Infections during pregnancy, especially if they spread to the uterus or placenta
• High blood pressure
• Preeclampsia, which causes maternal high blood pressure, proteinuria (spilling protein in the urine), and swelling.
• Maternal smoking or use of illicit drugs.
• Maternal malnutrition, especially if it leads to poor weight gain during pregnancy.
• Fibroids, an abnormally shaped uterus and cervical incompetence.
• Becoming pregnant while being treated for infertility, having a previous abortion in the 2nd trimester, and not having prenatal care.
• Problems with the fetus can also lead to a premature delivery, including infections, poor growth and certain birth defects.
Special Care for Premature Babies:
Premature babies are put straight into intensive care after delivery. They are usually kept in incubators in Neonatal Intensive Care Unit (NICU). They require round-the-clock nursing. They are fed intravenously and sometimes put on the respirator to help them breathe if necessary. Their vital signs like blood pressure, heart rate, breathing and pulse are closely monitored. Premature babies are kept in intensive care till the doctors are of the opinion that they are out of danger. Even after they have been discharged from the hospital, these babies are required to visit the hospital for periodic evaluations from pediatricians, neonatologists, ophthalmologists and psychologists to check any problems that may crop in the developing bud.
Babies who are born prematurely (before the due date) need special care during their first 2 years, especially if they were very small at birth (less than 3 pounds).
Nutrition and Growth of Premature Babies:
Consult the doctor about feeding the premature baby. The baby may be recommended vitamins, iron and a special formula in case of bottle-fed. Vitamins are often given to premature babies to help them grow and stay healthy. The baby also may require extra iron because premature babies often do not have as much iron stored in their bodies as full-term babies. The baby may be required to take the iron drops for more than a year or still longer.
A premature baby may not grow at the same rate as a full-term baby for the first 2 years. Premature babies are usually smaller during this time. They usually catch up with full-term babies in time. It is advised to keep a record of all the milestones achieved by the baby and consult the doctor regarding the same.
Initially, most premature babies need 8 to 10 feedings a day. There should not be a gap of more than 4 hours between the successive feedings. 6 to 8 wet diapers a day show that the baby is getting enough breast milk or formula. Premature babies often spit up after a feeding. This is normal.
Switching to Solid Foods:
Most doctors advise giving a premature baby solid food at 4 to 6 months after the baby's original due date (not the birth date). Premature babies are not as developed at birth as full-term babies are, so it may take them longer to develop their swallowing ability.
Premature Baby’s Eye and Vision:
Crossed eyes or strabismus are more common in premature babies than in full-term babies. Often, this problem goes away on its own as the baby grows and develops.
Some premature babies may also have the eye problem “retinopathy of prematurity (ROP)”. However, ROP can be treated to prevent vision loss.
Premature babies are also more likely than full-term babies to have hearing problems. The baby's hearing capacity can be checked by making noises behind or to the side of the baby. If the baby doesn't turn his or her head, or jump at a loud noise, contact the doctor immediately.
Premature Baby’s Immunizations:
Immunizations or vaccines or shots are given to premature babies at the same ages they are given to full-term babies. The premature baby may need a flu shot when she or he reaches 6 months of age because they might get sicker with the flu than full-term babies. Flu shots to the entire family can help protect the baby from catching the flu from someone in the family.