Premature baby

Premature babies frequently arrive with unanticipated difficulties and feelings. These little fighters, who were born earlier than anticipated, have a special start in life and need extra care and attention. Parents could feel overburdened, unclear of what to anticipate, or uncertain of the best ways to assist their child.

Modern medicine and neonatal care have greatly increased the chances of survival for premature babies. But the trip can be an unpredictable one, full of both successes and setbacks. Familiarity with the requirements of an early baby can provide families hope and confidence during this fragile period.

This post will discuss what it means to give birth early, what kind of care these babies require, and how parents can be ready for and enjoy this unique experience. These facts can have a profound impact on anyone, whether you’re a new parent or helping a loved one.

Aspect	Details
Definition	A premature baby is born before 37 weeks of pregnancy, compared to the full term of 40 weeks.
Causes	Common causes include multiple pregnancies, infections, chronic health conditions, and complications with the placenta.
Common Challenges	Premature babies may face issues like breathing problems, low birth weight, and difficulty feeding.
Care Needs	They often require special care in a neonatal intensive care unit (NICU) and may need help with breathing, feeding, and maintaining body temperature.
Long-term Outlook	Many premature babies grow up healthy, though some may have developmental delays or health issues that need ongoing care.

What kind of child is considered premature?

Premature babies are defined by official medicine as those born at a gestational age of less than 37 weeks. These kids have less developed organs and lower growth and weight indicators.

Causes

• Neglect of medical supervision of pregnancy.
• Pregnant woman has bad habits.
• Insufficient or unbalanced nutrition of the woman during gestation.
• Age of the expectant mother or expectant father is less than 18 and more than 35 years.
• Pregnant woman works in harmful conditions.
• Low weight of the pregnant woman (less than 48 kg).
• Expectant mother lives in poor living conditions.
• Gestation in an unfavorable psychological environment.

• Past abortion.
• Multiple pregnancy.
• Occurrence of gestosis during pregnancy.
• Premature placental abruption.
• Short interval between births (less than two years have passed since the previous birth).
• Incompatibility of the baby"s and mother"s blood according to the Rh factor.
• Gynecological inflammatory diseases in the mother.
• Malformations of the female genitals.
• Extragenital diseases in pregnant women, such as hypertension, pyelonephritis or diabetes.
• Operations and injuries in the expectant mother.
• Acute infections during pregnancy.
• Genetic or chromosomal diseases in the fetus.
• Infection of the infant during intrauterine development.
• Severe malformations of the baby.

Classification of prematurity

The baby’s weight and length are among the physical characteristics that determine the baby’s degree of prematurity, along with the gestational age at which the baby was born. The prematurity levels are as follows:

• First – the baby is born at 36-37 weeks of pregnancy with a body weight from 2 to 2.5 kg and a body length from 41 to 45 cm.
• Second – the baby is born at 32 to 35 weeks, its body weight is less than 2 kg, but more than 1.5 kg, and the body length is from 36 to 40 cm.
• Third – the baby is born at 28-31 weeks of gestation with a weight from 1 to 1.5 kg and a length body from 30 to 35 cm.
• Fourth – the baby is born before 28 weeks of pregnancy with a weight less than one kilogram and a body length of less than 30 cm.

Here are the most peculiar and genuinely enchanted tales of premature babies surviving:

Signs

Appearance

Premature babies differ from babies born on time in the following ways:

• Thinner skin.
• Less subcutaneous fat or its absence.
• Larger head size in relation to the body.
• Large abdomen and low navel.
• Unclosed small fontanelle.
• Very soft auricles.
• Thin nails that may not completely cover the phalanges of the fingers.
• Open genital slit in baby girls.
• Testicles that have not yet descended into the scrotum in boys.
• Later loss of the umbilical cord stump.

The higher the degree of prematurity, the more prominent these signs are, and many of them may not be present in babies with the first or second degree.

Anatomical and physiological peculiarities

The degree of prematurity has an impact on how well the organ systems of a premature baby function because the shorter the fetus’s time in the mother’s womb, the less time its organs had to mature to a state that would enable it to adjust to life after birth more quickly.

• Premature babies breathe more frequently, than full-term babies, which is due to the narrow upper respiratory tract, a more pliable chest, and a higher position of the diaphragm. In addition, the baby"s lungs are not mature enough, which causes frequent pneumonia and apnea attacks.
• Due to premature birth, the baby"s circulatory system may not be fully formed. The result is various cardiac pathologies that worsen the baby"s condition. And since the vascular walls are more fragile and permeable, the baby often experiences hemorrhages.
• The brain, even with deep prematurity, is fully formed, but the conduction pathways in the last stages of pregnancy are still developing, therefore, in prematurely born children nerve impulses are poorly conducted to different tissues. If the baby"s nervous system is damaged, its motor activity will be reduced, as well as muscle tone. Reflexes in such a child may be depressed or absent altogether, tremors are often observed.

• The mechanisms that regulate the production and expenditure of heat in the body are poorly developed in a premature baby. Prematurely born babies lose heat faster, and it is produced in their body with great difficulty. In addition, due to underdeveloped and non-functioning sweat glands, babies can easily overheat.
• The digestive tract of a premature baby also functions worse than that of babies born on time. First of all, this is due to insufficient production of enzymes and gastric juice, as well as dysbiosis of the intestinal microflora. In addition, the motor function of the gastrointestinal tract suffers due to impaired conduction of nerve impulses, which leads to a slowdown in the movement of food through the intestines.
• In the bones of premature babies after birth, mineralization processes continue, which is the reason for additional calcium administration to babies. Such babies have an increased tendency to develop rickets and pelvic joint dysplasia.
• Due to immature kidney function, a premature baby quickly develops signs of dehydration or edema, if the baby is not cared for adequately.
• The endocrine system does not function properly in prematurity, which is why hormones are secreted in insufficient quantities, and the glands are quickly depleted.

Consequences of prematurity and viability

Premature babies’ chances of survival are influenced by their gestational age and the factors that led to their birth. If babies born at 23 weeks only survive 20–40% of the time, then babies born at 24-26 weeks survive 50–70% of the time, and babies whose development period is longer than 27 weeks survive more than 90% of the time.

Premature babies put on weight quickly and grow longer than expected. In these measures, many of them catch up to their full-term peers in 1-2 years, but some babies’ differences from their peers don’t even out until they are 5–6 years old.

Prematurity causes anemia to develop more quickly. Premature babies are more likely to experience sepsis and purulent infections of the intestines, meninges, or bones. Premature babies are more likely to experience neurological disorders, issues with vision or hearing, recurrent acute respiratory viral infections, and genital issues later in life.

Premature babies have more severe and persistent jaundice. This physiological condition—caused primarily by the breakdown of fetal hemoglobin—usually goes away by three weeks of life, but in many premature babies, treatment is necessary. Phototherapy is the main treatment for this condition.

Extreme prematurity

This is the moniker for infants under one kilogram. Less than 5% of preterm births result in them being born, and they frequently need artificial and medical support to breathe. The percentage of disability and the likelihood of different complications in these babies is very high, even if they are breastfed.

Deep prematurity

Babies with a body weight of between one and 1.5 kg at premature birth are observed to have this condition. Such babies require oxygen therapy, mechanical ventilation, feeding via a tube and vein, and other procedures to be delivered. The baby is given amino acids, glucose, hormonal agents, and other substances to help him grow and develop more quickly.

7 months

Although most babies born at this stage of pregnancy weigh 1.5–2 kg, they are not able to function on their own. The infants receive the required medical attention, are placed in incubators with the ideal humidity and temperature, and are given medication support. The infant is moved to a heated crib after gaining up to 1.7 kg of weight. The baby doesn’t need thermal support after gaining up to 2 kg of weight.

8 months

By now, babies can breathe on their own, weigh between two and three kilograms, and can suckle. Babies are kept under observation in the hospital for a while due to their higher risk of apnea episodes. If complications do not arise and the baby’s weight quickly returns to normal, the new parents can take their baby home.

The following video describes the post-birth life and development of premature babies in contemporary perinatal centers:

Dispensary

Pediatricians must keep a close eye on prematurely discharged babies at home.

In the first month following discharge, measurements and exams are conducted once a week; after that, they happen every two weeks until the patient is six months old, and then once a month until the patient is a year old. A surgeon, neurologist, cardiologist, orthopedist, ophthalmologist, and, once the child is older than a year, a psychiatrist and speech therapist will examine him or her.

At what weight are they discharged?

After the baby’s weight has increased to at least 2 kg, the mother typically brings the newborn home. Additionally, the baby’s improved thermoregulation, lack of complications, and needlessness for heart and respiratory support are all crucial for discharge.

Features of care

Premature babies need special attention. With the assistance of neonatologists and pediatricians, they receive nursing care in phases—first in the maternity hospital, then in the hospital, and finally at home under the guidance of experts. The key elements of baby care are as follows:

• Ensure optimal temperature and humidity in the room.
• Conduct rational treatment.
• Ensure adequate feeding.
• Ensure contact with the mother using the "kangaroo" method.
• After discharge, limit contact with strangers.
• Bathe and walk with the baby after the doctor"s permission.
• Do gymnastics with the baby and take massage courses after the pediatrician’s permission.

The following are some suggestions made in the video to help premature babies avoid developmental issues:

What to do if there are alarming symptoms?

The mother should definitely seek medical attention if something worries her. A specialist is required in the following situations:

• The child"s reluctance to suckle or eat from a bottle.
• Attacks of vomiting.
• Prolonged jaundice.
• Constant loud crying.
• Respiratory arrest.
• Severe pallor.
• A child"s painful reaction to sounds, looks or touches at the age of over 1.5 months.
• Absence of a reciprocal look at the age of over 2 months.

Vaccination: when to vaccinate?

A premature baby can only be vaccinated once its body weight has increased and it is strong enough.

In maternity hospitals, children under 2 kg are not eligible for the BCG vaccination. It can be delayed for six to twelve months if there are contraindications, and it is recommended when weight gain reaches 2500 g. The pediatrician should decide when to introduce additional vaccinations, keeping the baby’s growth and well-being in mind.

Premature babies are those born before 37 weeks of pregnancy and frequently have special difficulties, such as underdeveloped organs and a greater need for medical attention. Many premature babies now live healthy lives thanks to advancements in healthcare, but thriving requires early intervention, appropriate care, and support from family and medical professionals.

Opinion E. Komarovsky

It is well known that the well-liked pediatrician advises against overheating infants during their first year of life. Komarovsky always emphasizes the importance of regular ventilation, raising the nursery’s air humidity to between 50 and 70 percent, and keeping the temperature there no higher than +22°C.

But his advice varies dramatically when it comes to premature babies. Komarovsky agrees with his colleagues that since these babies’ thermoregulation is still developing, it is imperative that the room temperature be raised to a minimum of +25°C as soon as the baby is released.

All extreme experiments (in this case, lowering the air temperature to the indicators recommended by Komarovsky for full-term babies) are forbidden until the baby gains weight up to 3000 g and its age is not 9 months after conception.

Advice to parents

• You should not look for those to blame for the fact that the baby was born prematurely, it is better focus on current problems and help the baby adapt to a new life, supporting other family members.
• Try to communicate more with the baby as soon as the doctor allows you to pick up the baby. Remember the high need of premature babies for close physical contact with their parents. This will help the baby gain weight faster and accelerate mental development.
• Take photos and keep a diary of the baby"s life. In the future, this will be an interesting family value.
• Remember that each baby develops individually, therefore, do not compare a prematurely born baby with other premature babies, or with babies born on time.
• Ask doctors about all the points of interest, ask them to clarify the terms and explain what diagnoses have been given to the baby. This will help you organize the regime, care and activities with a growing baby after discharge.

Although raising a premature baby can be difficult, these babies can thrive with the right support and care. Every action, including eating and receiving medical care, is vital to their development. Given that every baby develops at a different rate, parents should exercise patience and trust in the process.

It’s critical to rely on the knowledge of medical specialists and to ask for help when necessary. It will be easier to create a caring and encouraging environment for your baby to grow strong and healthy if you are aware of their specific needs.

Recall that you are not traveling alone. Making connections with other parents who have gone through similar experiences can be consoling and reassuring, boosting your confidence as you tend to your child.

Video on the topic

PREMATURE CHILDREN. What are the chances of a child "maturing"

Features of the development of premature babies

Development of a premature baby in the first year of life

Adult premature babies

How to assess the psychomotor development of a premature baby. Advice to parents – Union of Pediatricians of Russia

👶 How to care for a premature baby, features. Premature baby how to care. 12+