Premature Infant

When premature births cannot be prevented by medical intervention, the mother is shifted to neonatal intensive care unit (NICU) with special facilities. Premature infants are also called preterm infants or preemies. The chances of babies born at less than 25 weeks are very slim. Health complications of a premature infant and developmental impact are directly related to the gestation period. If the infant is born closer to the estimated date of confinement, higher the chances of survival. The probable health problems may also be few.

As premature infants are born early without completing the full gestation period, the infant weighs much lesser than full-term babies. Premature infants tend to be afflicted by various health problems, as the organs did not have sufficient time to develop. Premature infants require special medical care until the organ systems have developed sufficiently; enough to sustain life without medical support.

Premature infant care

While most premies that are born between 32 to 37 weeks do well with good care, the premature infants born before 26 weeks stand a risk of developing long-term disabilities such as mental retardation, hearing loss and cerebral palsy. In the NICU, the premature infant is places in a warm enclosed bed (isolette). These incubators made of transparent plastic keep the premature infant warm, limit water loss and reduce chances of infection.

The nutritional needs of premature infants are special since their digestive systems are immature. Tube feeding or intravenous feeding is done till the premie can suck and swallow. Breast milk can be pumped and fed to the premie through a tube as it contains proteins that fight infection and promote growth. A premature infant may need a ventilator to aid breathing.

A premature infant may require being in the prenatal intensive unit for few weeks or months. The first six weeks are considered crucial. The premature baby’s early life is highly unpredictable. The doctor will recommend discharge from hospital and the infant will be sent home if certain criteria are met.

• If the premature infant can maintain body temperature in an open crib for a minimum of 24 - 48 hours
  
  
• If the infant can take all feeds by bottle or breast and supplemental tube feedings are not required
  
  
• If the infant shows signs of steady weight gain.
  

Typical health problems of preemie

Apnea: This means that the premature baby may have a spell of stopped breathing where the heart rate decreases and the skin turns bluish.

Respiratory distress: A premature infant suffers breathing difficulties on account of the immature lungs.

Anemia: A premature baby lacks sufficient numbers of red blood cells and may need red blood cell transfusion. Besides, the life span of an infant’s RBC is shorter.

Risk of infection: A premature infant is at high risk to infections as any body part can get easily infected.

Hyperbilirubinemia: This is a condition where the infant develops jaundice. It is essential to bring this under control as it can lead to brain damage if the bilirubin rises to excess levels.

Premature infant care at home

Premature infants need special attention at home. The mother has an important role to play and needs to commit more time during the early days of preemie’s life. The support and co-operation of all the family members can only benefit the premature infant. Taking the infant to a group day-care home or center is not recommended during the first year. With special care, a premature infant can grow up to be a normal, healthy individual.

Limit visitors: A premature infant is prone to illness as the immunity level is low. The body is not equipped to fight infections unlike full-grown babies. As a precautionary measure, it is best to restrict visitors. Adults or children with colds or flu should not be allowed near the infant. Maintain a high degree of cleanliness. For the first three months, taking the infant out of home should be avoided.

Frequent feedings: A minimum of 8 to 10 feedings will be required per day. The infant must be fed slowly. The risk of developing a gastrointestinal disease called Necrotizing Enterocolitis is high. In order to avoid dehydration, the interval between feedings should not exceed 4 hours. Check if the infant is spitting up each time after a feed. Excess spitting may deter weight gain. It is best to contact the doctor and seek advice.

Sound sleep: Premature infants sleep more hours per day as compared to full-term babies. Select a firm mattress and ensure that the infant is put to bed on its back and not on stomach to reduce risk of sudden infant death syndrome (SIDS).

Emergency preparation: Even after coming home, the doctor may recommend using extra equipment like oxygen or apnea monitor for some time. The mother as well as an additional member of the family should know how to operate them prior to coming home. It also helps to know about the essentials of emergency care and post doctor’s instructions at prominent places at home.

Immunizations: The schedule followed for immunizations is the same as that of a full-term baby. Maintain the schedule, every immunization is important. The doctor will also undertake physical examination, weigh the premature infant. With proper care, the infant will become medically stable and healthy in all other aspects.