A premature baby is one that is born at less than 37 full weeks and is not yet mature enough to cope easily. They are ill-prepared for life outside of their mother’s uterus.
This occurs to approximately 1 in 18 babies. In today’s modern world, the chances for a premature baby to survive and thrive are vastly improved but it is still a worry to new parents.
Premature babies have weak muscle tone and do not move much. They may have calcium and iron deficiencies as well as low blood sugar levels. They are often prone to jaundice and score a very low rating on the Apgar scale. For these premature babies, living outside the uterus is an enormous challenge and they face many health risks.
Many premature babies experience breathing difficulties as the lungs are still very immature. The lungs are the last organ in the body to mature and early birth results in under development. Surfactant, a substance produced in the lungs to prevent them from collapsing inwards, is often lacking and is most common in babies born before 28 weeks. This is known as respiratory distress syndrome or commonly referred to as RDS. Baby’s breathing can also stop for a short period of time. This is known as apnoea and is not uncommon. Breathing is controlled by a part of the brain called the respiratory centre, which is immature in premature babies. Oxygen can be administered to assist with the breathing either by means of a face mask or the insertion of a small tube directly into the windpipe.
Their risk of infection is greater than that of a full-term baby. This is due to an underdeveloped immune system and a body that is too weak to defend itself.
Due to lack of strength to suck, most prem babies require an alternative means to feeding depending on their condition. Intravenous feeding would be necessary for ill or very premature babies who cannot swallow or digest food. Subsequent feeds may be through a naso-gastric feeding tube which passes through the nose and directly into the stomach. This may appear unpleasant but the tube is very soft and narrow making it a comfortable way to feed baby. As they progress and the sucking and swallowing reflexes develop adequately, they are able to have a combination of breast or bottle, with tube feeding supplementing the balance. Premature babies burn calories more quickly therefore requiring more frequent feeds than full term babies.
Their temperature control is inefficient and they have less insulation as they are so tiny and lack body fat underneath the skin. They may be placed in an incubator which is thermostatically controlled to maintain their body temperature.
Having survived all these hardships, it is comforting to note that most premature babies have no long-term health problems.