Caring for Premature Baby: What Parents Need to know

Premature baby is defined as baby born before 37 weeks of pregnancy is completed. There are subcategories of preterm birth, based on gestational age: extremely preterm (less than 28 weeks), very preterm (28 to 32 weeks), moderate to late preterm (32 to 37 weeks). While the normal baby born in 40 weeks of pregnancy. According to WHO, the rate of premature birth ranges from 5% to 18% of babies born in all over the world. In Pakistan it ranges 14% to 15.8% (ranks top 8 in the world), and in USA, it ranges from 11% to 13% of pregnancies.  

 How a premature baby look (Characteristics of Premature Baby) 

The weight of baby plays very important role, the normal birth weight is about 7 pounds while a premature baby weighs 2 to 5 pounds only.

The premature baby is visibly very small and weak, He/she is about 14 to 18 inches of length, too small to handle and feed. The head of preemie is disproportionately larger than a normal size. They have very fine, soft and feathery hair (lanugo) all over body.

They have jaundice (yellowing of skin and eyes). 

Due to lack of fat, their body temperature is low, especially immediately after birth in delivery room and Due to low weight they have sharper looking, less rounded features than a full term baby's feature. A premature baby is very weak, due to weakness, they lack of reflexes for sucking and swallowing which leads to many difficulties in feeding.

 Complications

Due to immature internal organs i.e. heart, lungs, brain, immune system. the body functions do not work properly. Premature baby may experience Breathing problem and heart may leads to heart murmur and heart failure. Other problems like temperature control problems, Gastrointestinal problems, blood, metabolism and immune system problems.

Long term problems: 1. Cerebral palsy 2. Impaired learning 3. Vission problems 4. Hearing problems 5. Dental problems 6. Behavioral and Psychological problems 7. Chronic health issues.

Causes of Premature Birth 

The cause of premature birth is not so common some factors which may have potential to give a premature birth are mentioned: 

- Diabetes - high blood pressure - heart disease or kidney disease. - infections (bleeding in first trimester), physical injury or trauma. 

-Age factor ( early pregnancies are very risky, normal age for pregnancy is 20 or higher) 

-previous premature birth. 

- prior multiple miscarriages and abortions 

- pregnant with multiples ( Almost 60 percent of twins, triplets, and other multiple deliveries result in preterm births. 

-Stress, improper nutrition, and less care during first trimester of pregnancy. 

Preventions 

-All medicines, multivitamins and guidelines are taken very carefully on time. 

-Do not miss any appointments of routine check up. 

-All check ups and scans should be carefully observed. 

- Stay away from infections. 

-Avoid intercourse during pregnancy or take precaution while having it. 

-be very conscious about nutrition, take protein, iron and calcium rich diet.

Premature Baby Care

Premature babies are not fully equipped to deal with life in this world. Their little bodies still with underdeveloped organs can't survive freely. Fortunately, medical technology has made it possible for premature babies to survive the first few days, weeks or months of life until they are strong enough to make it on their own. 

Use of NICU

Premature baby is placed in NICU (Neonatal intensive care unit). The NICU is known as 2nd tummy for premature baby, it provides very protective environment and used essentially for limited period. Therefore, it is wise to become as familiar with it as possible. 

The NICU is equipped with caring staff, monitoring and alarm systems, respiratory and resuscitation equipment, access to physicians in every pediatric specialty, 24-hour laboratory service. Various methods are adapted for respiratory assistance and feeding (depends on the premature newborn's individual needs). For breathing endotracheal tube or ventilator is used, which provide warm, humidified air and oxygen. Sometimes a clear plastic box known as oxygen hood is placed over head of baby for respiratory assistance. Another complication is nutrition for that different methods are applied for example IV lines in which nutrition is directly enters in blood stream while in umbilical catheter the nutrition is entered via umbilical cord to blood. Other methods like oral / nasal feeding are also used. Incubators are also used to keep babies warm and help protect them from germs and noise. A bright blue fluorescent light located over the baby’s incubator used to treat jaundice (yellowing of skin and eyes). Both the mother and father are encouraged by the NICU staff to interact with their baby.

 As a mother or father, you might not be aware of all the ways that you can interact with your baby. Here are some suggestions: 

-Touch your baby as much as possible. You can do this by using a gentle touch and stroking motions. 

-Talk to your baby. Your baby can recognize your voice(s) and be comforted by hearing from you. In addition to talking, you can read or sing to your baby. 

-Participate in your baby’s first bath. Depending on your baby’s progress, you may choose washcloths or sponges. 

-Take your baby’s temperature. 

Kangaroo Care technique

Kangaroo care is a technique where the premature baby is placed in an upright position on its mother’s bare chest allowing tummy

 to tummy contact that positions the baby between the mother’s breasts. The baby’s head is turned so that its ear is positioned above the mother’s heart. Many studies have shown that Kangaroo Care offers significant benefits. 

Kangaroo care has been shown to help premature newborns with: Body temperature 

– Studies have shown that a mother has thermal synchrony with her baby and that if her baby was cold, her body temperature would increase to warm up the baby and vice-versa. Breastfeeding 

– Kangaroo care allows easy access to the breast, and skin-to-skin contact increasing milk let-down. Increase weight gain 

– Kangaroo care allows the baby to fall into a deeper sleep allowing it to direct more energy to other bodily functions. Increased weight gain also means a shorter hospital stay. Increased intimacy and bonding. 

Reference: 

1.World Health Organization (November 2014). "Preterm birth Fact sheet who 

2. Wikipedia.org/wiki/preterm_birth 

3. American pregnancy.org 

4. healthy children.org 

5. Mayo clinic.org 

6.What are the risk factors for preterm labor and birth?". National Institutes of Health