What do you know about premature babies? The question itself may seem easy to answer: We've all heard about babies that need special care because they come to life before they are expected to.
Well, if we scratch under the surface, there's a lot more to consider regarding premature babies or preemies, and that's what we'll try to do in this post.
Are you ready to 'visit' a neonatal intensive-care unit (NICU)? Please, come on in!
What is a premature baby?
First and foremost, you have to know that premature babies are those who are born before the 37th week of pregnancy. Remember that pregnancies normally last an average of 40 weeks, so a preterm birth occurs more than three weeks before the little one is due. And, of course, that entails consequences, as the newborn won't be ready to survive on his own outside of the womb yet. Luckily, scientific progress allows us to overcome such a difficulty.
Characteristics and levels of premature babies
Depending on how early they are born, preemies are divided into different categories:
- Late preterm: it's the most common one, and it happens when babies are born between 34 and 36 weeks of pregnancy. Boys tend to be 46cm, weight 2.5kg and have a head circumference of 32cm. Girls: 45cm (length), 2.4 kg (weight) and 31.5cm (Head c.).
- Moderately preterm: when they are born between 32 and 34 weeks of pregnancy. Boys tend to be 42cm, weight 1.8kg and have a head circumference of 29.5cm. Girls: 42cm (length), 1.7 kg (weight) and 29cm (Head c.).
- Very preterm: when they are born before 32 weeks of pregnancy. Boys tend to be 36.5cm, weight 1.1kg and have a head circumference of 26cm. Girls: 36cm (length), 1kg (weight) and 25cm (Head c.).
- Extremely preterm: when they are born at or before 25 weeks pregnant. Boys tend to be 31cm, weight 0.65kg and have a head circumference of 22cm. Girls: 32cm (length), 0.60kg (weight) and 21cm (Head c.).
Premature babies: Needs... and special needs
When dealing with premature babies, there's something you need to keep in mind: the earlier they are born, the higher the risk of further complications. If newborns already need a lot of attention under normal circumstances, just imagine how much additional help a preemie may require. For a start, he may be born without enough body fat to maintain his body temperature, and that's why he may have to be placed in an incubator that can keep him warm and prevent infections. These electric 'baby beds' adapt to the little one's temperature, which is measured by a tiny thermometer stuck to his skin.
Regarding baby's feeding, it's important to pinpoint that premature babies can't be directly breast or bottle-fed unless they are born after 32 to 34 weeks of pregnancy. They also need to be fed in small amounts at a time to prevent the risk of contracting a gastrointestinal infection called necrotising enterocolitis (NEC), which is the second most common cause of mortality among preemies. Almost all premature babies are given calcium and phosphorus supplements, either through a special formula or by adding them to breast milk whenever it's necessary.
Problems and complications of premature babies
Depending on how early your child is born, he may have to face common short-term problems typical of premature babies. These include:
- Breathing problems: if the baby's respiratory system isn't fully developed, like when his lungs aren't able to expand and contract due to the lack of a substance named surfactant, he may suffer from neonatal respiratory distress syndrome. Apneas, pauses in the breathing, can also affect preemies.
- Heart problems: low blood pressure and patent ductus arteriosus (PDA) are related to premature births as well. When left untreated, the latter can lead to heart failure.
- Brain haemorrhages: some preemies suffer from mild brain haemorrhages that can be easily treated, but there are times when the blood accumulates in the brain, causing hydrocephalus, which requires surgery.
- Gastrointestinal problems: as pointed out earlier, premature baby development can provoke gastrointestinal problems, such as necrotising enterocolitis (NEC).
- Temperature problems: when the newborn lacks the necessary body fat to regulate his body temperature properly, complications like hypothermia may arise.
- Blood problems: anaemia and infant jaundice (yellow discoloration in the baby's skin and eyes, due to an excess of bilirubin), are common blood problems among premature babies.
Future development in premature babies
Once your baby leaves the neonatal intensive-care unit (NICU), and as time goes by, he'll have to be checked regularly by your paediatrician, like any other child of his age. However, he'll need to undergo visual and hearing tests, along with other medical evaluation focused on his nervous system, motor skills development, like sitting or walking, and muscle tone. In these follow-up appointments, the doctor will also check your baby's speech development and behaviour, since it's pretty common that premature babies need special help from speech therapists or physiotherapists as they grow.
Yet again, it's hard to predict aspects like premature babies survival rates or how premature birth is going to affect your child in the long run. Just so you know, premature babies may suffer from long-term complications, such as impaired cognitive skills, vision and hearing problems, dental problems, behavioural issues, like attention-deficit/hyperactivity disorder, and certain chronic health conditions, like asthma.
Keep in mind that premature babies can be slower in reaching baby milestones as well: in order to monitor them, you should take into account the date they were supposed to born.
What you can do
Most women have a bad time coping with premature births, and it's understandable. The excitement of giving birth gets partially overshadowed by your baby's health and his special needs. As some of these newborns have to spend some time in the incubators, mums usually worry and feel frustrated, because they can do nothing but leave their little ones in the hands of professionals. Yet, there are things they can do indeed to make the best of the situation. Here's some advice:
- Find out as much information as you can about your preemie's condition, so that you can handle the situation better.
- Be aware of any change in your baby's condition. If you notice any, contact the medical staff right away.
- Learn how to express milk from your breasts and try to pump six to eight times everyday.
- If possible, spend time with your little one... don't be afraid of hurting him, because after all, he needs his mummy too!
It's normal for you to focus on your little one right now, but you can't forget about yourself. You just gave birth and you need to heal as well! Be aware of your emotions and try to be positive. When you can't, accept help from others and seek support by talking to other people under the same circumstances, like other NICU parents. Remember that you first need to recover, both physically and emotionally, to take care of your preemie in the best way possible.
One in 10 to 15 newborns are premature babies, and most of them turn out to be ok. Having a premature birth may not be ideal, or what you were dreaming of, but luckily there are ways to support your premature baby development up to healthy standards.