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Problems of the Premature Baby

Problems experienced by babies born more than 3 weeks earlier than their expected birth date

  • Present from birth
  • Gender, genetics, and lifestyle are not significant factors

Pregnancy usually lasts about 40 weeks. Babies born before 37 weeks of pregnancy (see Premature labour) are called premature, and these babies may have problems because of their small size and immaturity. The severity of these problems will depend on how far the pregnancy has progressed and the baby’s weight at birth. With specialist care, babies born as early as 23 weeks now have a chance of survival.

What are the problems?

All premature babies lose heat easily because they are smaller than full-term babies and have thin skin and little fat. In addition, respiratory problems may occur because the lungs are immature and may not produce enough surfactant, a chemical that is required for the lungs to function properly. This problem is known as respiratory distress syndrome. Temporary cessation of breathing is a common problem due to immaturity of the brain. Premature babies are also particularly vulnerable to injury and infection. The trauma of birth, lack of oxygen, and infection can all affect the developing brain. In very premature babies (born before 28 weeks), tiny blood vessels in the brain may rupture and bleed. There are usually no lasting problems, but specific learning disabilities and problems with movement and posture (see Cerebral palsy) may occur.

About 8 in 10 premature babies are affected by neonatal jaundice, due to immaturity of the liver. In this condition, there is yellowing of the skin and the whites of the eyes.

What might be done?

The doctor will assess your baby’s condition at birth and start treatment if necessary. A baby who is only a few weeks premature may not need specialist care. However, you will be advised to feed your baby frequently and to make sure that he or she is kept warm.

Other premature babies may be looked after in a special care baby unit and are placed in an incubator so that their environment can be carefully controlled. They may also be given fluids and fed intravenously or through a tube that is passed through the nose and into the stomach. A premature baby may need to spend several weeks or months in the unit, and parents will be encouraged to take part in the baby’s care. Tests may also be performed, such as ultrasound scanning of the brain and chest X-rays, to look for abnormalities that may require treatment.

If your baby has respiratory distress syndrome, mechanical ventilation may be necessary, and surfactant will probably be given directly into the airways to help the lungs to function. A ventilated baby may be given sedatives to make him or her more comfortable. However, the high levels of oxygen that are sometimes needed to treat respiratory problems in premature babies may be associated with damage to the retina (the light-sensitive layer at the back of the eye), resulting in visual impairment.

A baby who has jaundice may have treatment with a specific wavelength of fluorescent light (see Phototherapy). Antibiotics may also be given to treat or prevent infection.

When your baby leaves hospital, the doctor will continue to give you advice and support. Your baby may be given a vision test to look for retinal damage (see Vision tests in children) and also a hearing test (see Hearing tests in children) to check for any hearing loss. The growth and development of your baby will also be carefully monitored.

What is the prognosis?

The success of treatment depends on how early the baby was born and the weight at birth. About 4 in 10 babies born at 23–24 weeks survive, but they may have long-term problems, such as visual impairment, lung disorders, or cerebral palsy. Most babies born after 30 weeks develop normally with no long-term health problems. Premature babies are more susceptible to sudden infant death syndrome.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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