Caring for Your Preemieby Katlyn Joy | January 9, 2012 8:00 AM
A baby that arrives too soon, before 37 weeks, is considered premature. A full term baby is between 38 and 42 weeks. Premature infants require special attention and care, and how much generally depends on just how early baby arrives and how small the baby is.
What Causes Preterm Birth?
A number of factors can be involved in baby's early arrival including:
- Multiple pregnancy such as twins or more
- Older mothers such as those over 35
- Younger mothers such as those under 16
- African Americans regardless of socioeconomic status
- No or little prenatal care
- Low socioeconomic status
- Mother's use of tobacco, alcohol or drugs
- Conditions such as kidney or heart disease, diabetes, hypertension, infection, pre-eclampsia, or placenta previa
- Poor nutrition
- Cervical or uterine problems
At the Hospital
After birth most preemies will start life at a NICU or neonatal intensive care unit. These specialized care units are equipped to handle the special challenges of infants born too soon.
Common problems of newly born preemies include neonatal respiratory distress, apnea, low muscle tone, feeding difficulties, problems regulating body temperature, jaundice, anemia, low blood sugar, infection and bleeding into the brain in extreme cases.
Your baby will be watched closely for any of these problems. Tests are routinely performed on preemies such as blood gas analysis, blood tests to monitor levels of glucose and bilirubin in the case of jaundice and calcium. Chest x-rays may also be done. The infant's heart activity and respiration will also be monitored.
Babies will be placed in an incubator to monitor the vital signs and to help regulate body heat. Those born before 34 weeks of pregnancy will routinely have digestive problems so it's to be expected that a flexible feeding tube will be inserted into the nose or mouth and run to the stomach. This is a temporary procedure to help baby get adequate nutrition until the baby's own digestive system is ready to operate on its own.
Those suffering with respiratory problems may have oxygen delivered through a small tube in the nose, via an oxygen hood, or by respirator in more serious cases.
Ask your child's doctors about all procedures, explanations of your child's situation and what you can do to help. Spend time with your baby as much as you can, particularly skin to skin time which is vital for preemie babies. If you want to nurse baby, go ahead and pump and freeze baby's milk and let your baby's doctor know you have a milk supply established for baby.
In most cases, babies are released from the hospital once they can regulate their temperature adequately, feed through bottle or breast and is steadily gaining weight.
Bringing Baby Home
- Have a good carseat installed properly to bring baby home. Limit baby's time in the carseat to an hour or less.
- Learn infant CPR and first aid and make sure you know how to properly operate any specialized equipment such as an apnea monitor.
- Make sure your child is on the best formula and is taking any required vitamins or supplements.
- Ensure that baby is feeding well. You'll want to aim for about 10 feedings a day, and wait no more than 4 hours at any time.
- Count the wet diapers. Babies will spit up, especially preemies so one good way to see that baby is getting enough to eat is to look for at least several wet diapers a day.
- Delay solids until doctor advises, but this is often 4 to 6 months after the original due date not the birth date of baby.
- Avoid all soft bedding in the crib and make sure baby sleeps on a firm, tight fitting mattress.
- Keep baby in the same room as you sleep. This seems to help regulate baby's breathing during sleeping periods.
- Always put baby to sleep on the back.
- Keep baby's immunizations up to date.
- Watch baby's weight gain.
- Know the signs of infection in baby and don't delay in seeking medical attention if you are concerned.
- Get baby's vision and hearing checked. Premature infants are at risk for retinopathy of prematurity or ROP. This causes problems in the growth of the eye's blood vessels. Hearing problems in preemies can also be affected. Keeping a watchful eye for such problems is key.
- Get some help! Don't go it alone. Have support people in your life and take needed breaks. You can't care for someone else if you don't take proper care of yourself.
With medical advances and improved developmental practices with preemies, the future is bright. Some 90 percent of preemies born at 28 weeks to 37 weeks survive. While the long term effects of prematurity can include mental or physical development delays or disability, medical challenges and growth delays proper early intervention can greatly improve or alleviate many problems.
Follow up with a prematurity clinic with physical or speech therapy will be advised in many cases. Some programs have home visits with developmental specialists to help parents of preemies. Take advantage of any such programs to give your little one the best chances of success and health.
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