Premature Baby: An Unexpected Early Surprise

by Dr. Sudha. B | Nov 17, 2022 | Pediatrics

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Every couple anticipates the joy of welcoming the newest member of the family. However, among all the festivities and preparations, the parents’ greatest concern is the foetus’s health. Even if everything goes perfectly from the beginning, it’s still possible that the baby will arrive far earlier than expected. These babies are termed as premature or preterm babies.

Each year, over 15 million preterm births occur worldwide. When a baby is born three or more weeks before his expected due date, he is considered premature. Premature birth happens before the 37th week of pregnancy. Depending on whether a baby is born early or late preterm newborns are classified as late preterm (births between 34 and 36 weeks), moderately preterm (births between 32 and 34 weeks), very preterm (births between 30 to 32 weeks), and extreme preterms (born before 28 weeks of completed pregnancy). Extreme premature babies face numerous health challenges.

Complications

Arriving earlier than anticipated can result in a number of issues for the babies. The infant has an increased risk of difficulties at birth, some of which may be noticeable right away and others of which may emerge later in life. Premature babies are more prone to a number of both short-term and long-term health problems, such as:

Short-term complications

Premature birth problems in the initial weeks could include:

Partially developed organs: Premature infants have partially developed organs such the lungs, heart, brain, and intestines, which can cause breathing issues, bronchopulmonary dysplasia, apnea, patent ductus arteriosus (PDA) and hypotension, intraventricular haemorrhage in the brain, necrotizing enterocolitis (NEC), and other problems.
Temperature regulation issues: Premature babies typically have lower body temperatures than a full-term baby because they have less body fat stored. They are unable to produce enough heat to keep themselves warm. Breathing issues and hypoglycemia (low body sugar) can result from hypothermia (abnormally low body temperatures). Incubators or warmers are used to keep the body temperature stable.
Blood disorders: Jaundice (excess bilirubin in the blood causing yellow colouring in the skin and eyes) and anaemia (low RBC count) are two conditions that are common in premature babies.
Metabolic issues: Premature babies struggle to convert stored glucose into its active forms, which results in a slower release of energy and hypoglycemia. This eventually leads to a slow metabolism.
Immune system problems: Premature babies frequently have weak immune systems, which increases their risk of infection. Infection in a premature newborn can swiftly spread to the bloodstream, resulting in sepsis, another bloodstream infection.

Long-term complications

In the long term, premature birth may lead to the following complications:

Cerebral palsy (a disorder of movement)
Impaired learning
Vision problems
Hearing problems
Dental problems
Behavioural and psychological problems
Chronic health issues (like asthma, feeding problems, and sudden infant death syndrome (SIDS))

Several things to remember when caring for premature babies

Compared to full-term babies, premature babies require special care and consideration. Premature babies will most likely require a prolonged hospital stay in the hospital’s dedicated nursery unit. The newborn may have certain short-term or long-term health difficulties that need continuous care and monitoring in order to help the child adjust to life beyond the safe confines of the womb. In such cases, the NICU stays for these small babies must be prolonged, and they may also require additional special care and attention at home even after being released from the hospital.

Here are some tips for caring for a premature infant at home:

Temperature:

It is crucial to keep the infant warm because his low body temperature (hypothermia) could cause breathing problems. A premature newborn suffering from hypothermia uses the majority of the milk’s energy to keep himself warm. It is critical to keep the infant warm to avoid these and other issues like breathing difficulties. Some techniques for keeping a baby warm include:

- An additional layer of clothes, socks, mittens, and caps can be beneficial.
- The ideal room temperature should be kept at roughly 27 degrees celsius.
- The baby should not be bathed until he weighs 2.5 kg; daily sponging with lukewarm water is adequate to keep the newborn clean.
- Kangaroo mother care, which involves bringing the baby closer to the mother’s chest to allow skin-to-skin contact between the mother and the baby, can help keep the infant warm and aid with preterm weight gain.

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Feeding:

Babies’ digestive systems may not be fully developed if they are born prematurely. As a result, many of these little babies have trouble feeding. These babies frequently have difficulties latching, sucking, and swallowing breast milk. In such instances, it is recommended that the babies be given expressed milk using paladai. It is recommended that at least eight feeds be given per day, with no more than three hours between them. Parents can also use milk fortifiers and multivitamin drops as prescribed by their doctor.

Sleep:

Sleep is essential for the formation of a premature baby’s five senses, neurological systems, and the structural growth of the brain. It is crucial to ensure the baby is in the supine position and is laying on a firm mattress without any pillows.

Protect the baby from infections:

Premature infants have relatively low immunity, making them more susceptible to infections. When touching the baby, it’s crucial to practise good hygiene practices like routine hand washing and sanitizer use. Parents should limit visitors and stay away from gatherings. Anyone suffering from an infection should keep a safe distance from babies. It is crucial to remember that even a simple peck on the baby’s face poses a danger to his life. Such inadvertent errors should be avoided at all costs.

Developmentally supportive care:

Developmentally supportive care is essential for lowering stress and fostering growth in the premature newborn. The fundamental idea behind developmentally supportive care is to stimulate the early-developing sensations of touch, smell, and taste while safeguarding the later-developing senses of hearing and vision. The growth and development of the baby will be aided by behaviours such as gentle handling, reduced noise levels, avoiding bright lights, and dimming the lights at night.

Regular follow-ups:

Regular assessments of the baby’s growth and development are strictly necessary. It’s crucial to stay in touch with the baby’s paediatrician. In order to monitor the infant’s growth throughout time, the paediatrician will do examinations such as hearing tests, newborn screening, a checkup for retinopathy of prematurity, a vision evaluation, and a neurodevelopmental assessment. Parents must make sure that they don’t skip any vaccination visits.

Dealing with the obstacles of preterm neonatal development is quite difficult for new parents. Your life can be completely upended by a preemie newborn. Even though it may seem like the most difficult thing in the world at times and you may want to cry while caring for a newborn, it will all be worth it in the end. The experience on the rollercoaster will stick in your memory the most. Your current struggles for the betterment of your baby’s health will pay off in the future. For the sake of the baby’s wellbeing, you should simply pay attention to and heed the advice of a licensed medical practitioner. Just trust your doctor and embrace your preemie.