What to Expect When You Have an Extremely Premature Infant

Extremely Premature Infant

A premature birth is one in which the baby is born before 37 weeks of gestation and it’s more common than you might imagine. An estimated 9.6 percent of all babies born in the U.S. are born prematurely. As previously reported in The Pulse, premature babies have a better chance of surviving with fewer health complications now than they did 20 years ago (read about it here). However, the closer a baby is born to the due date, the more likely that baby can survive independently, without medical intervention, and the less likely the baby is to have complications.

There are many reasons that labor may start early. Pregnancy complications, such as preeclampsia, health factors such as diabetes and/or lifestyle factors, such as smoking while pregnant, are a few factors that may increase the likelihood of preterm labor. Premature delivery is also more common in women carrying twins or triplets.

Sometimes babies are born extremely prematurely, which requires long-term medical intervention, because the baby is not yet ready to survive independently. Extremely premature infants may have to stay in the hospital’s neonatal intensive care unit (NICU)  for weeks and even months.

Premature babies are susceptible to breathing problems such as apnea or respiratory distress syndrome. They have fragile blood vessels that may break or not have closed properly. They are prone to jaundice, anemia and vulnerable to infections.

While early labor does pose health risks for babies, the good news is that, thanks to medical interventions, many extremely premature babies do grow up to be healthy children.

If your baby is born prematurely, medical intervention will start directly after birth. For the first few hours after birth doctors will focus on keeping the baby warm, place the baby on a breathing machine and provide blood transfusions and possibly medication such as antibiotics to ward off infections.

Neonatologists, the doctors who care for newborns, may keep the baby on a breathing machine for a week or more and monitor developments closely. A premature newborn will need intravenous nutrition and if you planned to breastfeed you can use a breastpump to store milk for the baby.

By about the second week of life, doctors will have examined the baby’s brain using an ultrasound similar to the ones given during pregnancy to monitor any problems with blood vessels.

Since the newborn is being fed intravenously through the stomach, the baby will be closely monitored for infections and prescribed antibiotics should an infection occur. Sometimes premature infants may require surgery.

Once your baby is 34 weeks old and gaining weight steadily, it may be time to move out of the NICU into a special care nursery. Even so, the baby will still be monitored closely and may still need assistance breathing.

After weeks of visiting a baby in the NICU, parents may long to bring the baby home but it’s important to be patient, as a premature baby needs to be monitored by medical professionals.

Usually babies can be discharged if they weigh at least 4 pounds, can keep warm on their own without an incubator, is gaining weight steadily, can breastfeed or be bottle fed and can breathe on her own. Some babies are ready to go home by 37 weeks, but each case is unique.

Before taking your baby home, you may want to take a class in caring for a preemie. A preemie care class can prepare new parents for what to expect during the baby’s first weeks at home. For example, a premature baby is more vulnerable to germs, so it’s wise to keep visitors away during the first weeks. A preemie gets tired faster and may require some special equipment, such as an apnea monitor to measure her breathing.

For the first year your baby will weigh less than others born at the same time and she will probably not meet the developmental milestones of babies born at the same time. When noting developmental milestones it’s important to start counting from the baby’s original due date.

The closer to term a mother carries a baby the better it is for the baby’s health and development, so if you suspect you are going into early labor, call your doctor and go to the hospital right away. There may be ways to stop or slow preterm labor.

Joan MacDonald
Joan Vos MacDonald has written about health and fitness for newspapers, magazines and websites. She is a member of the National Association of Science Writers and the author of two books on health-related topics, "Tobacco and Nicotine Dangers," for young adults, and "High Fit Home," a design book about fitness and architecture. She lives in upstate New York near her children and grandchildren.

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