The Preterm Baby (Premature Infant)
Many causes of preterm birth remain unknown; however, there are several identified risk factors that can contribute to its occurrence.
Causes
A preterm infant (baby) is one born before the 37th week of pregnancy, which is three weeks earlier than the expected due date. These babies often face medical challenges and require special care, including a stay in the neonatal intensive care unit. Newborns born between 25 and 29 weeks of pregnancy may also need to be fed intravenously or through a feeding tube.
Risk Factors
- Previous preterm birth.
- Age of the mother.
- Multiple pregnancies (twins or more).
- Conception via in vitro fertilization.
- History of multiple miscarriages (spontaneous or induced).
- Complications with the uterus, cervix, or placenta.
- Maternal chronic diseases (such as high blood pressure or diabetes).
- Smoking and substance abuse.
- Psychological stress.
- Infections.
- Significant weight loss or gain before pregnancy.
- Short interval between pregnancies (less than six months).
Short-term health problems in preterm infants
- Breathing difficulties.
- Heart complications.
- Digestive system issues.
- Anaemia.
- Intraventricular Haemorrhage.
- Inflammations.
- Neonatal jaundice.
Short-Term and Long-Term Health Problems in Preterm Infants
- Late preterm: Babies born between the 34th and 6+36 weeks of pregnancy.
- Moderate Preterm: Babies born between the 32nd and 6+33 week of pregnancy.
- Very Preterm: Babies born between the 28th and 6+31 week of pregnancy.
- Extremely Preterm: Babies born less than 28th week of pregnancy.
Categorization of the Preterm Baby
- Maintain an appropriate and stable temperature for the infant's environment.
- Prioritize breastfeeding, if possible.
- Ensure the infant sleeps in a calm, quiet environment.
- Have the infant sleep in their own bed, not in the same bed as an adult.
- Protect the infant from direct sunlight exposure.
- Pay careful attention to the infant's hygiene.
- Avoid using any moisturizing products on the infant without a doctor's advice.
- Seek medical consultation promptly when necessary.
Caring for Preterm Infants After Hospital Discharge
Parents of preterm infants often encounter unique challenges, and emotional support during this time is vital. Encouraging parents to visit and spend as much time as possible with their infant in care is important. However, they may face difficulties such as:
- Being unable to hold their infant for safety reasons.
- The distressing possibility that their infant might face life-threatening complications, as preterm infants have a higher risk of sudden infant death syndrome (SIDS).
Some Challenges Faced by Parents of Preterm Infants
While it's not always possible to prevent preterm birth due to some unknown causes, there are measures that can be taken to reduce its risk:
- Regularly attend obstetrics and gynecology appointments during pregnancy to monitor the health of both mother and fetus.
- Avoid strenuous activities and prolonged standing during pregnancy, as these can increase the risk of preterm birth.
- Minimize risk factors associated with preterm birth, such as smoking and substance abuse.
Protection: Long-term health problems in preterm infants
- Growth and motor development issues.
- Vision and hearing impairments.
- Dental problems.
- Speech and language delays.
- Cerebral Palsy.
- Behavioural or psychological issues.
- Chronic health conditions, such as asthma.
When can a preterm infant be discharged from the hospital?
The infant can be discharged once they can breathe unassisted, feed either through breastfeeding or bottle-feeding, and maintain steady weight gain.
Common Questions
The American Academy of Pediatrics recommends the following to reduce the risk of death in infants from birth to one year old:
- Breastfeed the infant for at least the first six months.
- Ensure the infant receives all recommended vaccinations on schedule.
- Always place the infant on their back for sleeping or napping. However, when awake, supervised tummy time is encouraged to strengthen abdominal muscles and prevent head flattening.
- Use a firm mattress with a tight-fitting sheet, avoiding gaps between the mattress and the bed's edges.
- Avoid bed-sharing between parents and the infant.
- Prevent overheating by avoiding excessive clothing and not covering the infant’s face or head.
- Position the infant's bed in safe areas, away from potential hazards like wires or cords.
