Becoming a new parent can be a stressful time, but it can be even more stressful for parents of premature babies. It becomes a time of uncertainty, worry, and confusion. For some parents, having a better understanding of what’s happening can help. We’ve put together a brief guide on what you need to know about premature babies to help you feel more prepared for the possibilities ahead.
A premature baby is one that has been born 3 weeks or more before the due date. A full term pregnancy is 40 weeks, so a baby born at 37 weeks or less is premature. Premature babies fall into different categories:
- Late Preterm – 34-36 weeks
- Moderate Preterm – 32-34 weeks
- Very Preterm – 25-32 weeks
- Extremely Preterm – Before 25 weeks of pregnancy
A baby’s weight at birth is part of how premature babies are assessed. A little one’s birth weight can impact the care they receive and can even impact any medical complications. As with birth terms, birth weights are also broken down into categories.
- Low birth weight – Under 5 pounds 8 ounces
- Very low birth weight – Under 3 pounds 5 ounces
- Extremely low birth weight – Under 2 pounds 3 ounces
- Micro birth weight – Under 1 pound 12 ounces
Essentially, it depends on ‘how premature’ the baby is. In some cases, a late preterm baby will look like a full term baby, but maybe a little smaller. Babies born at 32 weeks or earlier are usually less developed, and can seem very small, fragile, and bird-like. They may seem to have a very large head in comparison to the rest of the body. They may have jaundice, so can have yellowish skin, and mottling. The skin may also be very thin, and you may be able to see the blood vessels under the skin. Premature babies may also have a hairy back and shoulders. Babies have a blanket of tiny hairs on their bodies called lanugo. These are usually shed before birth, but many premature babies are born with them.
As the little one grows, and gets older, most physical differences will correct themselves, and they will catch up to their full term peers.
Premature babies can sometimes behave a little differently to a full-term baby. Firstly, they may cry much quieter, more like a whimper than a cry, because the respiratory system isn’t yet fully developed. Some will also have laboured breathing, or sleep apnoea, due to an immature respiratory system.
Many babies will need to spend some time in an incubator, as they won’t have enough body fat to help keep them warm. They may also seem much more sleepy than a full-term baby. They don’t sleep in the same way either. Premature babies sleep for around 22 hours per day, but usually only for an hour at a time. They also don’t get good quality sleep, so spending most of the time seeming drowsy and tired.
Some premature babies won’t have developed a suck reflex, and in those cases a nasogastric, or NG tube may need to be inserted. Also, the sucking reflex isn’t the only reflex that may be absent. Other reflexes may not be there either as the little one’s muscles and nerves are not fully developed.
Premature babies are very vulnerable to germs, and are prone to infections, and illness. It’s incredibly important to limit a premature baby’s exposure to people, places, and sources of germs, until a more robust immune system has developed.
Premature babies can have a few health problems, but it’s important to remember that many of these conditions respond very well to treatment, and may not have a lasting impact.
- Breathing issues – An underdeveloped respiratory system can cause some short term breathing issues. Some premature babies develop apnoea, when they stop breathing for a short period of time. Others can develop a lung disorder called bronchopulmonary dysplasia, which causes laboured, rapid, or noisy breathing. This will usually correct itself as the baby grows.
- Low body temperature – As premature babies have little or no body fat, they tend to get cold very easily. Special attention has to be given to keep premature babies comfortably warm.
- Heart issues – Low blood pressure is a particular concern, as well as some other problems as the baby’s heart isn’t quite fully developed. Most cases respond well to medical treatment.
- GI problems – Premature babies don’t have a fully developed gastrointestinal tract, and this can lead to problems in the bowel. Premature babies should only have breast milk, or a specially formulated formula designed for premature babies.
- Jaundice – Jaundice is quite a common problem for babies. It’s caused by too much bilirubin in the blood, which creates a yellow tone to the skin and eyes.
- Hypoglycaemia – Premature babies may not be able to store and convert the glucose in their bodies, which can cause low blood sugar.
- Infections – They don’t have a fully developed immune system which means they are at risk of infection, and infection may affect them more severely than a full-term baby.
Some premature babies can have some health complications that cause longer term problems. Some will sort themselves out as the baby grows, and others may need more medical intervention at a later date.
- Delayed learning – They tend to hit developmental milestones later than their peers of the same age.
- Vision issues – There can be some damage to the retinas after premature birth. It may affect the vision.
- Hearing loss – They tend to have a higher risk of hearing loss.
- Dental issues – Premature babies tend to have their teeth erupt later than full-term babies, and the teeth may be misaligned and discoloured.
- Behavioural issues – Some studies have found that premature babies may be more prone to psychological issues, and developmental delays in later life than full term babies.
- Chronic conditions – Other issues that they can face are chronic conditions like asthma.
Remember that your doctor and midwife will be there every step of the way, so if you do encounter any of these issues with your little one, you will be well supported. If you have any questions about any of the things discussed above, consult your doctor for further advice.