A baby born between 37 and 41 weeks of pregnancy is termed as a full term baby. A baby born before 37 weeks is considered as a premature baby. While the mother’s age and certain medical conditions that they may be suffering from may keep certain pregnant women well prepared for the birth of a premature infant, sometimes the reasons for giving birth to a preemie will remain unknown.
Initial Days of a Preemie
Soon after birth, a preemie will usually get shifted to the neonatal intensive care unit, for extensive care that a baby at this stage will need. They will be placed on a hot bed with feeding tubes, intravenous lines, and lines attached to various monitoring systems and respiratory support systems.
The preemie will have no clothes on them except for a diaper. This is because the medical team tending to the baby will wait for their skin to fully develop and mature to a point where they are able to tolerate clothes on them. All of these will be a gut-wrenching sight for any newborn parent.
Survival Rates of Premature Babies
Premature infants will have very less body weight at birth. Body fat will be comparatively less, reducing their ability to retain body heat. Also, their organs would not have developed completely yet. The earlier the baby is born, lower will be their chances for survival.
Preemies born at 32 weeks of gestation and onwards generally will be able to survive, but will need some amount of medical assistance. However, infants born before this gestation period will have decreased survival rates.
Preemies born at 25 weeks of gestation will have 50% survival chance.
Preemies born at 24 weeks of gestation will have around 35%-40% survival chance.
Preemies born at 23 weeks of gestation will have 17%-20% survival chance.
Preemies born below this period of gestation generally will have 0% chance of survival.
Most often than not, babies born before 26 weeks of gestation will develop health complications, and in some it can cause severe disabilities.
Caring for a premature infant in a manner how kangaroos look after their newborns seem to have helped improve the health of many preemies in no time. Here, the mother will have to tuck their infant under their clothing, for a certain period of time on a daily basis. The skin-to-skin contact maintained between mother and child will help the baby in regulating their body temperatures much faster, will have more regular breathing episodes, will experience longer sleep periods, decreased periods of crying, rapid weight gain, and greater success at breastfeeding attempts.
Premature infants respond fittingly to the nurturing touch of their parents. During the initial days of a preemie’s life, touching them is kept minimal to avoid infecting and placing unnecessary strain on their otherwise fragile immune system. Once they become fairly stable, gently massaging or stroking their body, maintaining physical closeness will enhance their recovery process and be in a position to get discharged home sooner than expected.
Common Health Complications Encountered by Premature Babies
– Newborn preemies, because of their inadequate body fat and low birth weight, will have wrinkled, fragile and an extremely thin skin layer. Due to this, a preemie will need to be placed in an incubator to help them maintain good body heat and a relatively stable state of equilibrium.
– Preemies are likely to develop respiratory difficulties due to immature lungs. Introducing the substance called surfactant into their lungs will help correct this problem in most preemies. But, until their respiratory system develops completely, placing them on respiratory support will help in minimizing their breathing problems.
– Premature infants are unlikely to have developed good suck and swallow mechanisms. For this reason feedings are done via a gavage tube that will lead food materials into their tiny tummies directly.
These are the usual health problems that preemies face.Early preemies are prone to developing more complex health issues like the ones mentioned below.
– Preemies with extremely low birth weight face an increased risk of developing frequent respiratory problems, transient cessation of respiration, lower respiratory tract infections, asthma, etc. the main reason behind their repeated need for hospital readmissions even at later stages of their development.
– Vision problems like retinopathy of prematurity of a more aggressive nature, that may fail to respond to conventional treatment methods, is another health issue that preemies can come upon with. Also, hearing impairments, either central or peripheral, or even both are common among early preemies.
– As the gestational age of a preemie baby decreases, there is an increased risk of them developing impaired decision making skills, nerve impairments, and worsening muscular movements once they approach five years of age.
– Attention deficit hyperactivity disorder, overactive and impulsive behavior, in a constant state of confusion, and being disorganized are not uncommon in preemies at a later point in their life.
– Intrauterine growth restriction contributing to early birth of a baby can lead to an impaired brain development process resulting in complications like impaired motor functions, speech difficulties, or even cerebral palsy and autism.
– Emotional developmental problems, like lack of sensitivity to other’s feelings or rather lack of understanding other’s emotional signs are seen in preemies when they reach preschool age. This can later interfere with their social interaction as well as learning abilities.
Nurturing Premature Infants
Preemies will have excess nutritional needs, meaning they require increased calories, proteins, vitamins and minerals in their daily feeds. This is because they need to achieve rapid and consistent weight gain to keep up with the normal growth and developmental process. There is nothing that can replace natural breast milk, but preterm infants will lack this ability to suck and swallow from the breast nipple. These babies are often fitted with a gavage tube, through which breast milk can be introduced into their system. Preemie feedings should be done in small amounts but at timed intervals.
Once the baby begins to tolerate this, the breast milk will need to be fortified or formula feeds be given alternatively to increase their intake of proteins and minerals, which at this stage of their life, they will need in excess amounts.
While the baby is still on gavage feeds, once they reach 35 weeks of gestational age, the medical team will attempt at bottle feeding the preemie. By this time the preemie’s suck, swallow and breathing reflexes should have matured enough to be able to bottle feed. The mother will be asked to pump their breast milk which is transferred to the bottle and held close to the preemie’s mouth. While the baby may not accept it immediately, after a couple of trials, they will excel at this.
Some preemies may find it difficult to transition from bottle feeding to breast feeding, and some may never accomplish this. In that case, there will be a lot of pumping to be done by the mother to keep their preemie well satiated.
Baby feeding bottles come in food-grade plastic material, in various shapes and sizes. Choose a simple bottle that will be easy for handling by the baby, as well as easy to clean. Sterilizing the baby’s feeding bottles is never to be neglected.
– First, cleanse the bottle thoroughly and dip them in hot boiling water before beginning to use for feeding purposes.
– After every baby feed, again clean the bottle and its separate components under running water to get rid of any milk residue. Then wash with a mild soapy solution using a bottle brush, and rinse again with cold water.
– Following this, drop the feeding equipment in a pan filled with water and boil for approximately 10 minutes. Transfer them, using clean sterilized hands, onto clean towels, air dry them and store away until further use.
Frequent washing and cleaning of feeding bottles can be avoided by stocking several feeding bottles and different bottle teats that can be used alternatively.
How Soon will Developmental Milestones be Accomplished by Preemies?
In order to get a better understanding of how preemie children will typically develop, it is important to calculate the age of a preemie in an accurate manner. A preemie parent need not be perplexed about this. Here is what they have to know – that a preemie infant will have two ages – a developmental age and a corrected age.
For better interpretation, follow this – a preterm infant of 16 weeks of age, calculated from the day it was born (developmental age), and is born 6 weeks early, minus 6 from 16, and the age will be 10 weeks old (corrected age). Take this corrected age into consideration while noting down when their developmental milestones should be accomplished.
– At 8 weeks of age, a preemie will develop different cry tones for different needs, will move extremities actively, will make eye contact and be able to smile.
– At 16 weeks of age, the preemie will be able to take their hands to mouth, will try to locate familiar voices, can grasp and reach for objects.
– At 25 weeks of age, preemies will learn to roll from tummy to back, sit by themselves, transfer objects from one hand to another, and respond when being called to.
– At 36 weeks of age, a preemie can pick up objects, would have learnt to crawl, will babble and imitate sounds, can clap hands, and hold a bottle during feeds.
– By one year of age, preemies may be able to stand without support, may take their initial steps, and can combine actions with sounds.
A preemie parent, however, should remember that different children reach their developmental milestones at different ages, and any delay noted should not be a cause of worry.