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Premature Babies

Premature babies are tiny bundles of joy that require a little extra care. Read on to know more about them.
When the first baby laughed for the first time, the laugh broke into a thousand pieces and they all went skipping about, and that was the beginning of fairies. And now when every new baby is born its first laugh becomes a fairy. So there ought to be one fairy for every boy or girl.
---James Matthew Barrie

Premature babies are those children who are born before the 37th week of pregnancy. It is because of this reason that premature babies or preemies weigh much less than full-term babies and may suffer from health problems. Preemies require special medical attention and care. This is provided to them in a neonatal intensive care unit, or NICU. Premature babies are kept in the NICU until their organ systems can work on their own.

What are some of the causes of preterm delivery?

There are many causes that are responsible for preterm deliveries. At times it is caused by the mother's lifestyle choices made during pregnancy such as smoking, drinking, using drugs, eating poorly and exposure to physical stress. Of course there are times when the causes are way past the mother's control. In this case we would need to take into consideration causes like hormonal imbalance, a structural abnormality of the uterus, a chronic illness or an infection. Preterm delivery also happens when the mother is above 35 years of age or less than 19.

What are a premature baby's basic needs?

Warmth

Since premature babies lack the body fat that is required to maintain their body temperature, it is important to keep them warm. This is achieved with the use incubators or radiant warmers. Radiant heaters are warmed open beds that run on electricity. These are used when the medical staff needs to care for the baby frequently. On the other hand incubators completely surround an infant, keeping him/her warm as well as decreasing the chance of infection and limiting water loss.

Nutrition

Preemies have special nutritional needs because their digestive systems are immature and also because they grow at a faster rate compared to full-term babies. They cannot be directly fed from the breast or bottle because they are at risk of developing necrotizing enterocolitis, which is an intestinal infection that is unique to premature babies. To avoid this problem, they are fed breast milk pumped through a tube that goes from the baby's nose or mouth into the stomach.

Since the needs of premature babies are different from full-term babies, special fortifiers may also be added to the breast milk or the formula (if breastfeeding is not desired).

What are the common health problems most premature babies face?

Premature babies face a number of problems because their internal organs are not fully ready to function on their own. Some of the common health problems are:

Hyperbilirubinemia

This is a common treatable condition that affects about 80% of premature babies. Those preemies affected by hyperbilirubinemia have high levels of bilirubin, which is a compound that causes them to develop jaundice, a yellow discoloration of the skin and the whites of the eyes. Preemies are monitored for jaundice and treated quickly before the bilirubin reaches dangerous levels. To help them eliminate bilirubin, jaundiced babies are placed under special lights.

Apnea

This health problem is caused by immaturity in the area of the brain that controls the drive to breathe. This problem results in an apnea spell in which a baby stops breathing, there is a decrease in heart rate and the skin turns pale, blue or purple. Gentle stimulation of the baby to restart breathing is how apnea is treated. In case apnea occurs frequently, the baby may be given medication and/or a nasal device that blows a steady stream of air into the airways.

Anemia

This is another health problem that affects premature babies and is because of the lack of number of red blood cells that are necessary to carry enough oxygen to the body. They develop this problem because babies do not make many new blood cells in the first few weeks. Another reason is that the red blood cells that are present have a shorter life as compared to an adult's. Frequent blood samples make it difficult for the red blood cells to replenish too. Premature babies, who weigh less than 1,000 grams, require blood cell transfusions.

Low Blood Pressure

This is a common complication that may occur and can be because of an infection, fluid/blood loss or medications administered to the mother before delivery. To treat low blood pressure fluid intake is increased and medications prescribed.

Respiratory Distress Syndrome (RDS)

An immediate problem most premature babies have is respiratory distress syndrome. The main cause of this is the lack of an important substance called surfactant that their immature lungs are not able to produce. Luckily, RDS can be treated and most babies do quite well. Most pregnant women who are going in for premature delivery can be administered medication that will hasten the production of surfactant in the baby's lung and help to prevent RDS. Artificial surfactant can then be given (if required) immediately after birth and several times later.
By Rachna Gupta
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