A baby is born with a need to be loved – and never outgrows it. – Frank A. Clark
Babies are loved from the moment they are conceived and the time they spend in their mothers’ bodies is something most Moms wish would just fly by so that they can meet their darlings! However, those nine to ten months are extremely crucial for the baby, giving him enough time to develop so that he’s able to survive in the cold hard world outside. But what happens when the baby isn’t ready, but needs to come out for some reason or the other? While a premature delivery may seem to cut short the mother’s waiting period, it poses a fresh set of problems for both mother and child, with prematurity now being among the top reasons for infant deaths worldwide. For this reason, there is now global awareness on prematurity, and several organizations have decided to observe November 17 as World Prematurity Day.
What is a Premature Baby?
A premature baby or preterm baby or preemie is a baby who is born at less than 37 weeks of gestational age. (T he normal gestational age is 40 weeks) Such births can occur for a variety of reasons, including chronic illnesses in the mother like diabetes, hypertension, over or under weight or other lifestyle issues like smoking or drugs. Any sudden trauma can also result in a premature birth, as can pregnancies that include multiples. A mother who has had a previous preterm birth has a higher chance of subsequent preterm births as well.
As far as possible, doctors try to prevent labor till the pregnancy reaches 39 weeks, by which time the baby is more stable. Yet, in some cases, they may have no option but to deliver the baby early to protect the mother and/or child.
Risks of being born Premature
When a baby is born before 37 weeks, he misses out on some crucial developmental stages of many of his organs, especially his lungs. As a result, a preemie is generally unable to breathe or feed on his own and requires the support of specialized medical devices and care in a neonatal intensive care unit, also called a NICU. Here are some other health risks of being born premature:
- Cerebral Palsy
- Brain Hemorrhage
- Thyroid problems
- Learning Disabilities
- Chronic respiratory issues
- Increased susceptibility to infections
The shorter the time the baby spends inside the womb, the higher are his chances of developing one or more of these risks. However, with all the latest scientific advancements, several preemies do not encounter any of these and grow up to be normal, intelligent children. Yet, this is only possible with a lot of care along with sufficient medical help and support.
Main Challenges in Caring for a Preemie
While the exact health challenges will vary from baby to baby based on his gestational age, the most common challenges that preemies face are breathing on their own, being able to feed and staying clear of infections. While in the hospital, the staff will take care of these issues along with specialized devices. Most babies are kept attached to a ventilator till they are strong enough to breath on their own. Most preemies born before 34 weeks have trouble sucking, so they are usually fed from a tube. However, when your baby is strong enough, you will be able to carry him home with you. While this is a relief in some ways, it can also be scary, now that you and your family will have to care for the baby without round-the-clock medical help. However, you can still make your baby’s homecoming an enjoyable and memorable occasion by considering a few important points when caring for your premature baby.
Things to Consider when Caring for a Premature Baby
1. Bringing Home your Premature Baby
It’s quite likely that your delivery was unexpected and you didn’t get enough time to prepare for your baby’s arrival. Before you leave the hospital, have someone clean the house completely, since your baby is very vulnerable to infections right now. Have an area for the baby setup in your room if the nursery isn’t ready. This is recommended since your preemie needs a lot more close contact with his mother. Arrange for alternative stays for pets and avoid having too many people when the baby comes home. Avoid soft toys that can collect dust or anything that has strong smells or loud music since a preemie is extra sensitive to all these.
2. Handling a Premature Baby
Since your baby has missed out on valuable time inside your body, you can make up for it now by keeping him close to you for as long as possible. Many experts recommend a ‘kangaroo care’ system, where the baby is kept close to the mother, inside her shirt for skin to skin contact (see image above). This system has shown to encourage breastfeeding, while keeping the baby warm, comfortable and stress free, while improving her overall health. Keep bottles of sanitizer everywhere so that anyone who’s handling the baby can clean their hands first. When putting baby to sleep, put her down on her back, to avoid the possibility of SIDS (Sudden Infant Death Syndrome). If any of your friends or family members smoke, ask them to stay away from the baby till he’s stable.
3. Feeding a Premature Baby
Mothers of premature babies start producing milk right after delivery, just like mothers of full term babies. Initially, you might have to pump when your baby is being fed through a tube, but once he’s strong enough to suck, it is recommended that you try breastfeeding. While there are special formulas for preemies, they can be hard to get and still can’t match the benefits of breast milk.
Breastfeeding takes time even for strong, full term babies, but with preemies, it can be a much longer process. The baby first starts rooting, then slowly reaches for the breast with his mouth, and may start licking or sucking for just a few seconds. Soon he will learn to latch on correctly and suck with more strength. However, a preemie’s stomach can only hold a little at a time and he’ll need to be fed every few hours to keep up his strength. Sucking from the breast requires more effort in the initial stages and a bottle may cause nipple confusion, so many preemies are fed pumped breast milk from a small spoon. If he wets about 5 diapers a day and his urine doesn’t seem concentrated, he’s probably getting enough to eat.
4. Washing and Cleaning a Premature Baby
Washing a premature baby may seem daunting, but initially, only very basic washing is required. For the first several weeks, only water and soft cotton wool will do, and you don’t need to actually soak him – just using a little water to clean around the neck and the diaper area is sufficient. You’ll need to clean after every diaper change, though a bath isn’t necessary every day. If you’d like to use baby products, talk to your doctor first. He’ll be able to tell you if your baby’s skin is ready for external products and which brands are suitable. Preemies get cold fast, so they need to be wrapped in a towel right after their bath.
5. Shopping for a Premature Baby
Preemies are usually much smaller than full term babies and have less body fat, so finding clothes and diapers that fit can be challenging. In India, there are very few manufacturers for products specially for preemies, but you can find quite a few essentials online, including imported varieties. Otherwise go for the smallest size available and try them out – if your baby is not too premature,they might just fit. As for clothes, make sure they don’t have any snags or zippers – snaps are the easiest to manage. Avoid soft toys, rattles and other noisy paraphernalia for a while and entertain your baby by talking and singing to him.
Tips for Parents of a Preemie
Being a new parent is not easy, but when you have the added challenges of a preterm baby, it can feel like you have no time to rest. Since preemies need to be fed very frequently, the mother’s sleep can be seriously compromised which can further worse conditions like postpartum depression. While it’s not a good idea to have too many people around a preemie, by no means should the mother be left alone to fend for herself and her new baby. It is advised to have someone else to take over the household chores so that the new parents can focus on their family, especially if there are older children to consider or if the preemies are multiples.
There are many extra restrictions and considerations when caring for a premature baby, and it can seem frustrating and exhausting. However, all these precautions in the early stages will pay off as you watch your tiny baby get stronger and healthier and soon you won’t believe that the bouncing child in front of you was once a tiny, helpless little baby!