Taking Care of Premature Babies

A full term pregnancy is of about 40 weeks.  In past babies born anywhere between 37-42 weeks were considered  full term babies. Then the doctors realized that each week inside the womb is important for your baby’s  development and in 2013 ACOG and SMFM updated the definitions for term pregnancies. Early term is when your baby is born between 37-38 weeks, full term is when your baby is born between 39 -40 weeks, late term is when your baby is born between 41- 42 weeks and post term is when your baby is born after 42 weeks.

Babies born before 37 weeks are considered premature babies. They are further categorized as extremely preterm babies born before 28 weeks, very preterm babies born between 28-32 weeks, moderately preterm babies born between 32-34 weeks and late preterm babies born between 34-37 weeks. With the advancement of medical field babies born at as early as 23 weeks may also survive with intensive medical care however chances are a little low. As per Quint Boenker Preemie Survival Foundation and March of Dimes the likelihood of survival for a baby born prematurely is 17 % at 23 weeks, 39% at 24 weeks, 50% at 25 weeks, 80% at 26 weeks, 90% at 27 weeks, 90-95 % at 28-31 weeks, 95% at 32-33 weeks and very likely at or above 34 weeks.

All newborns need to be taken care of but preterm babies  need special care as some of their body parts are still underdeveloped such as lungs, digestive system, immune system, nervous system and skin depending upon how early the baby is born. Premature deliveries should be done in presence of personal trained in resuscitation to ensure that baby makes smooth transition from life inside the womb to the outer world. The team ensures that the baby is warm, breathing and his heart is pumping. Then as per the need of the baby he is sent to Neonatal Intensive Care Unit (NICU) for specialized care.

Care at NICU :

The care at NICU is based on needs of an individual baby based on the gestation, weight and other circumstances.  The following care may be given to your preemie baby in NICU :

Thermoregulation :   Premature babies are unable to maintain their temperature due to lack of brown fat and subcantaneous tissue, rapid heat loss from head, inability to shiver for production of heat etc. Thus premature babies are kept under radiant warmers or incubators depending upon the need.

Life Support : The lungs of premature babies may not be fully developed. Sometimes C-PAP ( Continuous Positive Airway Pressure) method is used for babies who can breathe on their own but need help getting air into their lungs. Some babies may need life support ventilator till the lungs mature and the support is withdrawn gradually when the baby can breathe on it’s own. Very often an artificial lung maturing chemical is administered into the lungs. A few babies may have chronic lung disease and may need ventilator for long time but since lungs continue to grow in first years of life this disease is cured eventually.

Feeding :  The premature babies, depending upon how mature they are at the time of birth, may need help in feeding. A baby can suck and swallow usually around 34 weeks and if the baby is born before that he may be fed by intravenous lines, catheter or oral and nasal feeding depending upon need. Once stable all babies are started on milk feeds in small quantities and the quantity is gradually increased . Breastmilk is preferred due to its various benefits.

Treatment of other problems: Other problems may include jaundice, heart problems, brain problems etc. All of these are resolved as per circumstances.

The babies are ready to go home when they are off life support , are feeding on their own, are maintaining their body temperature and all the care that they need can be provided at home. They achieve all this generally around 34-35 gestation weeks.

Care at home

Even after taking premature  babies home special care is needed. They are prone to infection and diseases due to weak immune system. Following things should be taken care :

Hygiene:  Maintain proper hygiene in the house specifically around your little one. Wash hands before handling your baby and advise others also to do so. Avoid bringing baby in close contact with someone having cold or flu to protect baby from catching the same.

Feeding : Give feed to baby after every 2-3 hours. If the baby is sleeping do not wake him up to feed as sleep is also very important for development of a healthy baby. But take care the gap between feeds should not be more than 4 hours in any case. Give breastmilk preferably as it helps in building immunity in babies.

Maintain Temperature Around Baby : Usually the temperature in neonatal care unit is 22 to 27 degree Celsius. Maintain this temperature immediately after bringing him home. Slowly we can reduce the temperature to 18 to 21 degree Celsius.

Kangaroo Care : Kangaroo care is skin to skin contact between baby and parents usually mothers. Your baby ( wearing only a diaper) should be placed on your chest (also bare to allow skin to skin contact) for sometime. Cover your baby’s back with blanket for warmth. It is similar to a kangaroo holding her baby in pouch. The benefits of Kangaroo care for baby are stabilized heart rate, improved breathing pattern, temperature maintenance, rapid weight gain, decreased crying, increased breastmilk supply, peaceful sleep and helps in good bonding

Giving massage : Give gentle massages to your baby once doctor has permitted the same. Let the skin of baby develop fully before starting massage. Massages help in promoting sleep, weight gain, boosts his immunity, improves circulation and digestion.

Give lots and lots of cuddles, hugs and kisses to your baby and enjoy this time with your little one. Please remember that premature babies achieve their milestones a little late as compared to full term babies but they will catch-up soon. So do not fret they are fine in your capable hands.  I hope these tips help you in taking care of your baby and ease your mind. Do not forget to share to help others.

Apoorva Yadav Kamboj.

Thanks to the Sources : www.verywellfamily.com, www.fmri.in, americanpregnancy.org, momabc.net, my.clevelandclinic.org, raisingchildren.net.au.