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WHAT YOU NEED TO KNOW:
What is a preterm baby?
A preterm baby is born before 37 weeks of pregnancy. A preterm baby is also known as a preemie or premature baby. Premature babies are at risk for several health problems because they are not ready to leave the womb. These problems may be short-term or long-term.
What short-term health problems is my baby at risk for?
Short-term problems usually get better on their own or with treatment before the baby leaves the hospital. Some short-term problems may develop into long-term problems. Your baby may have any of the following.
- Breathing problems may happen. Preterm babies may be born before their lungs have started making surfactant. Surfactant is the liquid that helps your baby's lungs stay expanded when he or she takes a deep breath. He or she may not be strong enough to breathe on his or her own and may need help to breathe. Your baby may have periods of apnea, or no breathing. This is normal in a preemie. It usually gets better as the baby gets older.
- Heart problems may happen. Your baby may have a patent ductus arteriosus. The ductus arteriosus is a blood vessel that brings oxygen and blood to your baby during pregnancy. After he or she is born, it is should close, and your baby should get oxygen by breathing. A ductus arteriosus that stays open after birth may cause heart failure in your baby. Babies with apnea may also have episodes of a low heart rate. It may be treated with medicine.
- Feeding problems are common in preterm babies. A preemie may have a hard time sucking and swallowing. He or she may need to be fed through a tube that is inserted into his or her stomach or intestines. Some preemies cannot be fed through their stomach or intestines. This happens because their digestive system is not developed, or they are too sick. These babies may be fed through an IV until they are well enough to get nutrition into their stomach. Your baby may also have reflux, or the movement of fluid backwards from his or her stomach and into his or her esophagus. This is very common in preemies, and usually does not need treatment.
- Digestive problems may happen. Your baby's intestines may become injured or swollen. This may lead to an infection or a hole in your baby's intestines. Your baby may need surgery to fix the hole.
- Eye and hearing problems may happen. Most eye problems get better on their own. Your baby may have a decrease in his or her vision or hearing.
- Jaundice happens when bilirubin builds up in your baby's blood. Bilirubin is a yellow liquid that gets into the blood when red blood cells get broken down. The liver usually helps the body get rid of bilirubin. A preemie's liver has trouble getting rid of bilirubin. This may cause your baby's eyes and skin to look yellow.
- Low red blood cell counts , also known as anemia, may happen. A preemie cannot make red blood cells quickly. Red blood cells carry oxygen to organs and tissues. If your baby is anemic, he or she may also have trouble with his or her oxygen levels.
- Control of body temperature is difficult for a premature baby. He or she may have problems staying warm because he or she does not have enough fat tissue.
- Infection is a greater risk for a preterm baby. His or her immune system is not fully developed and he or she cannot fight germs. His or her blood may also lack antibodies that help prevent infections. He or she may develop infections anywhere in his or her body.
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. He or she may need any of the following:
- An incubator or special lights will help your baby stay warm and get rid of 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. Healthcare providers will always be near your baby. If his or her monitor alarms they may gently tap him or her. This may make him or her breathe better and increase his or her heart rate.
- 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 increase the oxygen levels in his or her blood. Your baby may get oxygen through a mask placed over his or her nose and mouth or through small tubes placed in his or her nostrils. If he or she cannot breathe well on his or her own, pressure will be given through the tubes in his or her nose to help keep his or her airways open. If he or she needs more help to breathe, an endotracheal tube may be inserted through his or her mouth and into his or her lungs. It will be attached to a ventilator, or a machine that will breathe for him or her until he or she can breathe on his or her own.
- A feeding tube or IV nutrition will help your baby grow stronger. You may be able to pump your milk and give it to healthcare providers. They can add protein, calcium, and other nutrients to your breast milk and give it to your baby through his or her feeding tube. If you cannot produce enough milk, your baby can be given formula or breast milk from a donor bank.
- Blood tests and glucose checks 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 and get him or her off a ventilator or oxygen. A blood transfusion may also increase his or her blood pressure and the 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, or to help him or her breathe more regularly. Medicine may also be given to help treat an infection or other problems. Premature babies may be given extra vitamins and iron.
- Surgery may be needed to fix any problems that do not get better on their own or with other treatments.
How can I care for my baby at home?
Your baby may leave the hospital when he or she can breathe on his or her own, stay warm without extra heat, and is gaining weight steadily. Spend time with your baby in the hospital as much as possible before he or she goes home. Learn about equipment, medicines, and how to feed your baby. 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 by keeping your home clean. 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. Breastfeed or give your baby your milk in a bottle as much as possible. Your milk will help protect your baby from infections and other illnesses.
- Feed your baby as directed. Only give your baby breast milk or formula with iron for the first 6 months of his or her life.
- You may need to feed your baby through his or her feeding tube. Ask your healthcare provider how often to feed your baby through his or her tube. You may be able to pump your milk and give it to your baby through his or her feeding tube.
- Feed your baby at least every 3 hours throughout the day and night. Instead you may need to give your baby formula. Ask your healthcare provider how to prepare your baby's formula. Wash all bottles and nipples 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.
- 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 your healthcare provider how to give your baby medicine if he or she has a feeding tube. Your baby may need vitamins, iron, or other medicines to help him or her grow and stay healthy.
- Always place your baby to sleep on his or her back to prevent sudden infant death syndrome (SIDS). Clear your baby's crib of toys and loose bedding. Put your baby to sleep on a hard or 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. Most babies do not need medical equipment at home. Your baby may need any of the following:
- 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.
- An apnea monitor monitors your baby's heart rate and breathing. Your healthcare provider will show you what to do if the monitor alarms. You may need to gently tap your baby if he or she stops breathing. This will make him or her breathe and increase his or her heart rate. You should learn infant CPR before your baby leaves the hospital.
- A feeding tube and a syringe may be needed to feed your baby. A feeding tube may be needed if your baby cannot get enough food by bottle or breast feeding. Care for the feeding tube as directed. Use a syringe to give him or her breast milk or formula through his or her feeding tube. 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 so that you know that your baby is growing and developing as he or she should. Your baby will reach certain milestones such as crawling, smiling, holding up his or her head, and speaking, at different ages. Preemie babies may take longer to reach milestones than babies born on time. Ask your 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 AgreementYou 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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