Premature Infant Care

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1 Premature Infant Care Introduction A premature baby is born before the 37th week of pregnancy. Premature babies are also called preemies. Premature babies may have health problems because their organs did not have enough time to develop. These babies need special medical care until their organ systems can work on their own. This reference summary will teach you how to care for your premature baby, both in the Neonatal Intensive Care Unit, or NICU, and at home. Premature Babies The earlier a premature baby is born, the greater the chances of health problems. This is because the earlier a baby is born, the less time the baby s organs have to develop. A normal pregnancy, or full term pregnancy, lasts weeks. If the baby is born at or before 20 weeks of gestation, or pregnancy, the baby is very unlikely to survive. Severely premature babies have a high risk of death. A fetus reaches viability at 23 weeks. This means there is a possibility of survival outside the uterus. However, the chances of survival are only 20% at this stage of growth. At 25 weeks gestation, a fetus has a 50% chance of survival. An infant born prematurely may have to spend days, weeks, or even months in the NICU at the hospital. The period of time spent in the NICU depends on how premature the birth is as well as the health of the baby. 1

2 Babies born prematurely are also at an increased risk of health problems later in life. They may have delays in development when compared to a child of the same age that was born at term. Children who are born prematurely have higher rates of cerebral palsy, sensory issues, learning disabilities and respiratory illnesses compared to children born at term. Cerebral palsy describes a group of disorders that involve the brain and the nervous system. Cerebral palsy can affect basic functions such as movement, learning, hearing, seeing, and thinking. Premature Complications Not all premature babies face the same health problems. However, there are some common health problems that many premature babies face after birth. In general, many premature babies have trouble staying warm. Often their bodies are so small that they do not have the energy or body fat to control their temperature. This is why premature babies are usually kept in warmers. Premature babies also may have problems with their blood pressure. Their blood pressure may be too high or too low. They may also have a slower heart rate due to low oxygen levels. Many premature babies have trouble breathing after birth. Often this is because the lungs did not have time to fully develop. Preemies with trouble breathing may need the help of a breathing machine, or ventilator, until their lungs mature. Often babies don t make many new red blood cells after birth and their blood cells die out quicker. This can cause anemia. Anemia is a condition in which the number of red blood cells is below normal. Anemia can affect blood pressure and heart rate in preemies. It can also cause apnea. Apnea is a condition in which breathing repeatedly pauses for a brief period of about 20 seconds. Premature babies born at or before 30 weeks will usually develop apnea. This is because the part of the brain that controls breathing is not fully developed until after 30 weeks. 2

3 Sometimes premature babies have trouble feeding. Feeding requires a lot of energy. Babies born prematurely may be unable to feed on their own. Also, sometimes the digestive tract in a preemie is not developed enough to handle food. An IV line or tube can provide nourishment for these babies. Premature babies may also have reflux. Reflux is when the acid from the stomach backs up into the esophagus. This can cause the esophagus to become irritated. Usually the muscular ring between the esophagus and stomach prevents reflux. However, preemies often have poor muscle tone. Infections are another possible complication faced by preemies. Usually the skin and mucous membranes protect the body from germs that cause infection. However, these are not fully developed in premature babies. Jaundice causes a newborn s skin to look yellow. It is a common complication for newborn babies. A yellow substance called bilirubin is what makes a baby with jaundice have a yellow color. It collects in the skin because the baby s liver has trouble removing it from the body. NICU The neonatal intensive care unit, or NICU, is a place for sick newborns. Often these newborns are premature. How long a premature baby stays in the NICU depends on his or her health. Generally, a baby stays in the NICU until his or her organs have matured and are working without assistance. The NICU has special equipment to care for sick newborns. The staff is also trained to handle many of the special health problems faced by babies born prematurely. Often a premature baby is kept in an incubator, or isolette. An incubator completely surrounds the baby. This provides a stable environment that keeps the baby warm and prevents infection. Some premature babies may instead be kept in warmers. Warmers do not completely surround the baby like an incubator does. This is more convenient if the baby needs frequent care from NICU staff. Incubator 3

4 Your baby will likely receive medicines as a part of his or her care in the NICU. Various medical tests are also common. These tests will make sure the treatments are working. Do not be afraid to ask questions or to ask for help. If you are curious what the machines are used for, ask. The staff in the NICU can explain. The staff in the NICU will be able to help you learn about how to care for your preemie. How much you are able to help depends on your baby s health. If your baby is very premature, you may have to wait to hold your baby until he or she is stable. Other times you may be encouraged to hold your baby as much as you want. If you want to hold your baby, you may need help working around any tubing or wires from monitors. However, it is important to spend time with your baby in the NICU so you can bond with him or her. Even if you cannot hold your baby yet, you may still be able to touch him or her. Stroking your baby s hand or head and talking to your baby can help you bond. Babies that are very premature may not respond well to being touched. Your healthcare provider may suggest limiting contact. However, you can still sit next to your baby and talk to him or her. Although you may want to spend a lot of time with your baby, premature babies get tired easily. It is important to let them sleep undisturbed. Ask the NICU staff about your preemie s needs. Home Care Caring for a premature baby doesn t stop when you leave the NICU. Home care is also important to consider. Special care may be required for your preemie s first two years of life. Make sure you follow all of the instructions your baby s healthcare provider has given you. 4

5 Preemies often have more check-ups than full-term babies. These appointments are very important and help the healthcare provider monitor your baby s growth. Your premature baby may need a special diet to help him or her grow. This may include a special formula or vitamins. It is common for premature babies to spit up after a feeding. However, you should talk to your healthcare provider if your baby doesn t seem to be growing or gaining weight. Often premature babies do not grow or develop at the same rate as full-term babies. Your healthcare provider can tell you if this is normal or something to be concerned about. Premature babies also sleep more than full-term babies. However, they wake up more often and sleep for shorter periods of time. Problems with sight and hearing are also common in premature babies. Talk to your healthcare provider if you notice these problems. Sometimes a preemie will grow out of this and not need treatment. Make sure your baby gets his or her immunizations. Immunizations are vaccines or shots that help prevent certain illnesses. Premature babies get immunizations at the same time as full-term babies. Summary A premature baby is born before the 37th week of pregnancy. Premature babies are also called preemies. Premature babies may have health problems because their organs did not have enough time to develop. Premature babies need special medical care until their organ systems can work on their own. The neonatal intensive care unit, or NICU, is a place for sick newborns. Often these newborns are premature. How long a premature baby stays in the NICU depends on his or her health. 5

6 Caring for a premature baby doesn t stop when you leave the NICU. Special care may be required for your preemie s first two years of life. Ask your healthcare provider if you have any questions about the health of your preemie. Catching health problems early often makes treatment easier. 6