By Dr. Sushanth Shivaswamy, Senior Consultant – Neonatology and Paediatrics, Kinder Women’s Hospital and Fertility Centre Bengaluru
Preemies are special. They arrive well ahead of time and need special care and attention. Although during birth they have the characteristics of a fetus that is physically not ready to leave the womb yet, with proper neonatal care, they can grow up to be perfectly normal human beings. They usually are low birth weight (2.5 kgs or less) and are born before 37 weeks of pregnancy. But an infant born before the 35 weeks has higher chances of health complications, require intensive care and treatment, and are kept in the Neonatal Intensive Care Units for continued and expert care, monitoring and observation.
Premature babies, often diagnosed with certain health problems, are treated by Neonatologists to ensure no further deterioration of their health condition. Few of the most common health problems that we see in preemies include:
When bilirubin builds up in the baby’s blood, the baby is diagnosed with jaundice and is the most common disorder found in preterm infants. The skin turns yellow and is treated by keeping the undressed baby under special lights while covering its eyes.
Respiratory Distress Syndrome (RDS) is a breathing disorder that occurs due to the baby’s immature lungs. Since the lungs often lack surfactant that helps in keeping the lungs expanded, artificial surfactants are used, and the babies are kept on CPAP or ventilator support to help them breathe better. It also helps in maintaining the adequate oxygen levels in the blood. At times, these babies may also need oxygen treatment and stay on supportive oxygen therapy for prolonged periods (days to weeks).
Apnea is common among preterm babies and is characterized by a temporary pause in breathing for about 15 seconds. Bradycardia is a condition associated with drop in the heart rate. Thankfully, most of the preterm babies outgrow this condition by the time they are ready to go back home.
Chronic Lung Disease/Bronchopulmonary Dysplasia (BPD) happens when the preterm babies need oxygen support and therapy for weeks and even months until their lungs grow and mature to help them breathe on their own.
Retinopathy of Prematurity (ROP) is a condition of the eyes when the retina is not found to be completely developed. While in some cases, the child may not require any treatment, in some others, laser surgery and other forms of treatment are used. Such treatments are done by pediatric ophthalmologist or any Retina specialist.
Few other conditions seen in premature babies are infections, feeding issues, heart murmurs and anemia or low red blood cell count.
Note for the parents
It might not be the best arrival that parents wish for their child, however, it is their top-most priority to keep the baby safe instead of getting stressed. A premature baby is kept in a special care nursery room and cannot be breastfed or held as and when we wish to. This can be a stressful experience for many parents and must be dealt with care.
Stay close to your baby as much as possible, even if it is the special care room. After the doctor finds that the baby does not require external support for its organs, the parents can be permitted to touch the baby and do skin to skin touch (kangaroo mother care) as well. Even if the mother is discharged from the hospital, come and visit the child as often as you can. In the meantime, take adequate rest and prepare for the child’s homecoming.
Since breastfeeding may not be recommended for the baby yet and are intravenously fed with fluids through intravenous lines or feeding tubes, it is important to have patience and let the child be fed using the best possible techniques deemed appropriate for the time period. Undoubtedly, breast milk has the best nutritional value that can enhance the child’s immune system. It is advisable to use a breast pump to ensure adequate milk for the baby once the baby is recovering.
Wait for the doctors to confirm to touch, hold and cradle the baby. Follow their instructions to keep the baby safe and secure, ways to create an infection-free environment at home and in nurturing the child to help maintain required body temperature, steady weight gain and to establish early breast feeding.