What is prematurity?

Premature babies are born more than 5 to 8 weeks early (after less than 32-35 weeks of pregnancy). The earlier a baby is born, the more health problems the baby is likely to have. Premature babies may need to be cared for in the hospital until close to their due dates.

What is the cause?

The cause of premature birth is often not known. Sometimes a baby may need to be delivered early if you or your baby have a medical problem. It is common for twins or other multiple births to be born early.

What happens after the baby is born?

Because your baby is small and born early, she will be cared for in the Neonatal Intensive Care Unit (NICU) or Intensive Care Nursery (ICN) for a few days or several weeks. Many specialists will help care for your baby during her stay in the NICU.

Visit your baby as much as you can. Your presence helps your baby grow and get strong. Sometimes the baby is so sick at first that you may not be able to hold her until she is better. You can still hold your baby’s hand, touch, and talk to her. The older and more mature your baby is, the more you will be able to handle and care for her.

In the NICU, your baby will be in a special bed that keeps her warm by heating the air. She will be attached to a heart and breathing monitor while in the NICU. The monitor sounds an alarm if there is a big change in your baby’s heart rate, breathing rate, or level of oxygen.

What problems do premature babies have?

There are many problems that a preterm baby faces during the first weeks. Most problems of prematurity improve as your baby grows.

• Breathing problems. Your baby may need oxygen and a machine to help with breathing. She may also need medicines to help her lungs work better. Most children outgrow these lung problems during the first several months of life. Some children may continue to have problems with wheezing and infections, but usually get better as they get older.
• Feeding. At first your baby may be too weak or have too much trouble breathing to nurse or feed from a bottle. Your baby will be given IV fluids and nutrition right after birth. It may take several weeks before she is ready for breast milk or formula feedings. Because your premature baby cannot yet nurse, if you want to breastfeed, you will need to pump your breasts to provide breast milk for your infant. Breast milk helps protect her against infection and it is easily digested. Mothers of premature babies make special breast milk that is helpful to babies who are born early. Very premature babies do not know how to suck on a nipple. A tube may be placed into your baby’s stomach through her nose or mouth until she learns to suck on a nipple.
• Infection. Premature babies cannot protect themselves against infections very well because their defenses are weak. Once infected, your baby can get sick very quickly. If the healthcare provider suspects an infection, your baby will have blood tests and be treated with antibiotics.
• Bleeding in the brain. Very premature infants are at risk for bleeding in the brain. Ultrasound scans of your baby’s head will be done to check and follow-up for any sign of bleeding.
• Eye problems. In some premature babies, abnormal blood vessels may start to grow inside the eye. This may be a minor problem, but it could also be very serious. All premature babies will have their eyes checked soon after birth, and regularly as they grow up.
• Anemia. Every premature baby has too few red blood cells during the first 2 months of life. Most babies who are sick and often need blood tests, or who weigh less than 2 and a half pounds at birth, will need a blood transfusion to keep the blood count normal. You may be able to donate blood if your baby needs a transfusion. Talk with your healthcare provider about this.

What follow-up care does my child need?

If you need to have special equipment at home, the hospital will help you arrange for it. They will teach you how to care for your baby at home. Once home, your baby will need frequent feedings.

Most very premature babies grow up to be normal, healthy children. However, low-birth-weight babies are at greater risk for problems with learning, growth, or behavior than babies who are not premature. Physical therapy, occupational therapy, speech and swallow therapy and other programs may help to lessen the risk of problems. Premature babies also may need special medical care during the first year of life.

• Keep all appointments for checkups after your baby is home from the hospital. The pediatrician needs to make sure that your baby is gaining weight and developing well.
• Your baby should have her vision checked regularly after you go home from the hospital. As your child grows up, she may have eye muscle problems and may need glasses to correct this problem.
• Have your baby’s hearing tested at least once during the first year to make sure that she does not have hearing problems.
• Make sure that your baby gets childhood immunizations to protect against infection.
• It’s also a good idea for your family to learn infant cardiopulmonary resuscitation (CPR) before the baby goes home. Even if you never use CPR, it is best to be prepared.

Try not to be overprotective. You will see your baby quickly grow and get healthy and strong.