Preterm Baby

Medically reviewed by Drugs.com. Last updated on Apr 2, 2024.

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What is a preterm baby?

A preterm, also known as premature or preemie, baby is born before 37 weeks of pregnancy. A full term pregnancy is 40 weeks. Preterm babies are at risk for health problems. This is because their organs are not fully developed. Preterm babies often need help to breathe, eat, gain weight, and maintain body temperature.

What are the types of preterm birth?

There are 3 types of preterm birth. The earlier a baby is born, the higher his or her risk for health problems.

• Moderate to late preterm: born between 32 and 37 weeks
• Very preterm: born between 28 and 32 weeks
• Extremely preterm: born before 28 weeks

What health problems is my baby at risk for?

Some examples of common health problems include the following:

• Breathing problems: Your baby's lungs may not be fully developed. He or she may not be strong enough to breathe on his or her own. Your baby may have pauses in breathing called apnea. This is common in a preemie. It usually gets better as the baby gets older.
• Heart problems: Your baby may have low blood pressure or patent ductus arteriosus (PDA). The ductus arteriosus is part of your baby's blood flow system during pregnancy. It usually closes soon after birth. If the ductus arteriosus stays open after birth, it may cause heart problems. Babies with apnea may also have episodes of a low heart rate.
• Blood problems: Your baby may have anemia, or low red blood cells. Red blood cells carry oxygen to organs and tissues. With anemia, your baby may have trouble with his or her oxygen levels. Your baby's skin and eyes may look yellow. This is called jaundice. Jaundice develops when a yellow-colored substance called bilirubin builds up in your baby's blood.
• Body temperature problems: Your baby does not have a lot of fat tissue. He or she loses body heat quickly and can have trouble staying warm.
• Feeding problems: Your baby may have trouble sucking and swallowing. Your baby may need to be fed temporarily through an NG tube. This is a long, thin tube inserted through the nose and down into the stomach. If your baby's digestive system is not developed, he or she may need to be fed through an IV. Your baby may also have reflux. This is when fluid moves backwards from the stomach into the esophagus.
• Digestive problems: Your baby's intestines may become injured or swollen. This may lead to an infection or a hole in your baby's intestines.
• Metabolism problems: Your baby's body may have trouble changing food into energy. He or she may have low blood sugar and have trouble keeping a stable level of blood sugar.
• Vision and hearing problems: Your baby may have retinopathy of prematurity (ROP). This means the part of the eye called the retina grows abnormal blood vessels. ROP decreases his or her vision and may require treatment. Your baby may also have a decrease in his or her ability to hear.
• Immune system problems: Your baby's immune system may not be fully developed. He or she may not be able to fight germs. This increases your baby's risk of developing an infection.

How will my baby be cared for after birth?

Your baby may be cared for in the neonatal intensive care unit (NICU) after he or she is born. He or she will be closely monitored, and treated, for problems. Your baby may need any of the following:

• An incubator or special lights will help your baby stay warm and treat jaundice.
• A monitor will record your baby's heart rate and oxygen levels. Your baby's blood pressure will also be monitored. You may see wires connected to your baby's chest and a wire attached to a sticker on his or her hand or foot.
• An IV may be used to give your baby fluids, medicine, or nutrition.
• Oxygen or a ventilator may be needed to help your baby breathe and support his or her oxygen levels. An oxygen mask may be placed over your baby's nose and mouth. Oxygen may instead be given through small tubes placed in his or her nostrils. This is called a nasal cannula. Increased oxygen pressure may be needed if your baby cannot breathe well on his or her own. An endotracheal tube may need to be inserted through your baby's mouth and into his or her lungs. It will be attached to a ventilator. This is a machine that will breathe for your baby until he or she can breathe on his or her own.
• Breast milk has the best nutrients for your baby. You may be able to pump your milk and give it to healthcare providers. If you cannot produce enough milk, donor milk or formula may be used. Your baby may have a feeding tube if he or she cannot suck and swallow. He or she may instead get nutrition through an IV.
• Blood tests may be needed to check for infection and monitor blood sugar levels. These tests may also give information about your baby's overall health. Blood tests will help healthcare providers decide what care your baby needs.
• Blood transfusions may be needed to increase the number of your baby's red blood cells. More red blood cells may help increase your baby's oxygen levels. This can help get him or her off a ventilator or oxygen. A blood transfusion may also increase his or her blood pressure and blood flow to his or her organs.
• Medicines may be given to treat heart or lung problems. Your baby may need medicine to increase his or her blood pressure. Medicine may also help him or her breathe more regularly or treat an infection. Premature babies may be given extra vitamins and iron.
• Surgery may be needed for certain congenital problems Congenital means your baby was born with the medical problem. Some examples include a hernia, intestine infection, or a body part that has not formed correctly.

How can I care for my baby at home?

Healthcare providers will teach you how to care for your baby before you take him or her home. Do the following to keep your baby safe and healthy at home:

• Prevent infection. Your baby will need several immunizations to decrease his or her risk for infections and diseases. Ask your healthcare provider how often your baby needs immunizations. Wash your hands before you touch your baby or anything your baby comes in contact with. Ask anyone who visits your baby to wash their hands. Do not take your baby to crowded places and keep him or her away from people who are sick. Do not let anyone smoke near your baby.
• Give your baby breast milk or infant formula with iron. Do this until at least 1 year of age, if possible. Introduce age-appropriate foods at 4 to 6 months of age.
  • You may need to feed your baby through his or her feeding tube. Ask how, and how often, to feed your baby through the tube. You may be able to pump your milk and give it to your baby through the feeding tube.
  • Feed your baby at least every 3 hours throughout the day and night. If you use formula, ask how to prepare it. Wash all bottles and supplies with hot water and soap. Let them air dry.
  • Hold your baby upright to feed him or her. Be sure your baby's upper body is higher than his or her lower body. Do not prop your baby's bottle on a pillow or other object.
  • Your baby may spit up after he or she eats. This is normal. Tell your healthcare provider if your baby spits up large amounts or continues to spit up throughout the day.
  • Your baby should have 6 to 8 wet diapers per day. This means that he or she is getting enough liquids.
• Give your baby medicine as directed. You should know when to give your baby medicine, how to give it, and what the dose is. You should also understand what the medicine is for, and what side effects to look for. Ask how to give your baby medicine if he or she has a feeding tube.
• Always place your baby to sleep on his or her back. This helps prevent sudden infant death syndrome (SIDS). Clear your baby's crib of toys and loose bedding. Put your baby to sleep on a firm surface. Allow your baby tummy-time as directed. Watch your baby at all times when he or she is on his or her tummy.
• Use medical equipment as directed.
  • Oxygen increases your baby's oxygen levels. Care for your baby's skin around the oxygen tubing as directed. Make sure the oxygen tank is full. Keep the oxygen tank away from open flames. Do not let anyone smoke near your baby.
  • A feeding tube and a syringe may be needed to feed your baby. Care for the feeding tube as directed. Clean your baby's skin around his or her feeding tube as directed. Wash all feeding supplies with hot water and soap. Let them air dry.
• Watch for your baby's progress. Your baby may take longer to reach milestones than full term babies. Ask a healthcare provider when your baby should reach certain milestones.

Call your local emergency number (911 in the US) for any of the following:

• Your baby stops breathing or you cannot feel his or her pulse.
• Your baby cannot be woken.
• Your baby's skin looks blue.

When should I call my baby's pediatrician?

• Your baby vomits more than 3 times in a day, or has trouble eating.
• Your baby is wheezing, breathing faster than normal, or grunting during feeding.
• Your baby's skin or eyes look yellow.
• Your baby has less than 4 wet diapers per day, or his or her head looks sunken in.
• Your baby's abdomen looks larger than usual and feels hard.
• Your baby cries more than usual or seems like he or she is in pain.
• Your baby has a fever higher than 100.4°F (38°C).
• Your baby has a rash.
• Your baby has white patches on his or her tongue or gums.
• You see a bulge or swelling around your baby's belly button or any part of his or her abdomen.
• Your baby's skin around his or her feeding tube or oxygen becomes red, swollen, or drains pus.
• You have questions or concerns about your baby's condition or care.

Care Agreement

You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's healthcare providers to decide what care you want for your baby. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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