Babies who are born too early or too small at birth
(weighing less than 2.5 kg or 5½ lbs) will
need some form of special care to enable them to catch
up. Other possible situations demanding special attention
include health risks such as babies with severe respiratory
issues, jaundice that requires an exchange transfusion
and babies lacking in oxygen or had undergone fetal
distress. The most likely form of treatment and attention
will be provided through special care baby unit or
SCBU and neonatal intensive care unit or NICU if the
baby is very premature or ill (born at 24-25 weeks
and weighing 450g can be helped to thrive in a NICU).
Overall about 7% of babies are born premature.
The
Categories
Preterm babies
Preterm babies are babies who
are born before term and are not equipped to live
in the outside world. Depending on how premature
he is, he will need special care in the hospital
premises. Newborns are said to be premature if they
are born before 37 weeks of age. Chances for survival
increases for a baby born after 24-25 weeks of gestation
but they will require intensive care for some time;
babies born before week 23 aren't mature enough
to make it. While premature babies face difficulties
initially, a good percentage grow up to be completely
normal or with moderate problems.
Small-for-dates babies
Small-for-dates babies are babies who weigh less
than expected for the age. Usually full-term, a
small for date baby is small sized at birth and
therefore needs to be handled with care.
Health issues
Health issues can become a problem with a premature
baby born before 37 weeks that would not normally
afflict a full term infant. One such situation is
jaundice. Underdeveloped organs can affect breathing;
create problems with body temperature and feeding.
Baby will be more prone to infections and, lack
in essential minerals such as calcium and iron.
Why the Special Care
Key areas that need close supervision are:
Temperature Control. A premature or small-for-dates
baby is more vulnerable to feeling cold since her
body has too little or no body fat for insulation.
The arrangement will be to place her in an incubator
with warmed, humidified air or oxygen creating the
effect of an artificial womb.
Feeding. A very premature baby
will not be able to ingest milk so the substitute
will be a special solution of sugar, salts and potassium.
Once she is able to feed, she will either be fed
with her mother's expressed breast milk or special
infant formula. Thin soft tubes inserted through
the nose will used for feeding.
Breathing. Before 27 weeks, a baby's
lungs are not mature enough to allow the transfer
of oxygen into her system. The nervous system is
not matured enough and hence baby's breathing mechanism
can be affected. She will need assistance to breathe
with the help of a ventilator.
Premature Baby Care at
a glance..
• Special care babies will be placed in an incubator
which has special doors on the top; nurses will attend
to the baby whenever necessary e.g. for feeding etc.
The incubators are carefully controlled to provide
the correct temperature, oxygen levels and humidity
all in the bid to allow baby to develop and thrive
well.
• A premature baby may need to be on a ventilator
since his lungs are not fully matured. Ventilators
help air into your baby's lungs.
• Scanners are used to help visualize the inside
of your baby's skull. Any bleeding that may develop
can be diagnosed as well as to keep tabs on future
long term problems.
• Since infections have mainly responsible for
a premature birth, antibiotics and IV fluids are routine
for babies these little; these will be administered
either through an IV or umbilical central line.
• Babies may be placed in a special bed with
a radiant warmer to help maintain body temperatures
• Baby will probably be placed on a cardio-respiratory
monitor with a pulse oximeter to measure the oxygen
in his blood.
• Electrodes placed on the baby's chest will
monitor his heartbeat. A stethoscope is used to record
the baby's heart rate as well.
• He will have a feeding tube attached in his
nose or mouth that goes down to his stomach if he
is mature enough to feed; babies between weeks 32-34
won't be able to breastfeed or bottlefeed so will
rely on the tube for his feeds. Breast milk can be
expressed and stored in the SCBU until baby is capable
to have it
• Most premature babies are discharged around
the date they were originally due. For example, a
baby born at 26 weeks will have a three month stay
in the hospital.
• Generally the baby will need to be gaining
weight, breathing well on his own and feeding to be
able to check out from the SCBU. Following that his
progress will be assessed regularly by the doctors.
Your Baby needs You
Time. Your baby needs you to spend
as much time as you can with him, the same love and
attention a full term baby is given.
Touch. Establish skin contact by
touching and caressing your baby through the portholes
of the incubator whenever you can. Touching and stroking
your baby will help him to make good progress in his
growth and development. She is already familiar with
your voice and your touch will help further.
Breastmilk. If possible, express
breast milk and have it stored in the SCBU. Research
shows that colostrum and milk of a mother whose child
is preterm contain more of certain nutrients than
those found in mothers of full term babies. This makes
up for the missing nutrients a preterm baby would
have missed out which he should have received in the
uterus.
Involvement. Get involved in taking
care of your baby; learn from nurses on how to feed,
wash and change baby. This will intensify bonding
and prepare you in caring for him.
The final word
Having left the womb earlier, premature infants will
start off at a different point. For example if she
was born 2 months or 8 weeks before term, then at
6 months she will display social skills of a 4 month
old. These differences become less obvious with time
and by the time your child turns 2 years old, there
will be little or no difference between your baby
and one born at term.
