How an Early Arrival Affects Baby’s Health

Premature babies, defined as infants born before 37 weeks gestation, are born before their bodies and organ systems have completely matured. These babies are often small, with low birthweight (less than 2,500 grams or 5.5 pounds), and they may need help breathing, eating, fighting infection, and staying warm. Very premature babies, those born before 28 weeks, are especially vulnerable. Many of their organs may not be ready for life outside the mother’s uterus and may be too immature to function well.

Health Problems for Premature Babies

Some of the problems premature babies may experience include:

• Temperature instability—the inability to stay warm due to low body fat

• Respiratory:

  • Hyaline membrane disease/respiratory distress syndrome—a condition in which the air sacs cannot stay open due to lack of surfactant in the lungs

  • Chronic lung disease/bronchopulmonary dysplasia—long-term respiratory problems caused by injury to the lung tissue

  • Air leaking out of the normal lung spaces into other tissues

  • Incomplete lung development

  • Apnea (stopping breathing)—occurs in about half of babies born at or before 30 weeks

• Cardiovascular:

  • Patent ductus arteriosus (PDA)—a heart condition that causes blood to divert away from the lungs

  • Too low or too high blood pressure

  • Low heart rate—often occurs with apnea

• Blood and metabolic:

  • Anemia—may require blood transfusion

  • Jaundice—due to immaturity of liver and gastrointestinal function

  • Too low or too high levels of minerals and other substances in the blood such as calcium and glucose (sugar)

  • Immature kidney function

• Gastrointestinal:

  • Difficulty feeding—many are unable to coordinate suck and swallow before 35 weeks gestation

  • Poor digestion

  • Necrotizing enterocolitis (NEC)—a serious disease of the intestine common in premature babies

• Neurologic:

  • Intraventricular hemorrhage—bleeding in the brain

  • Periventricular leukomalacia—softening of tissues of the brain around the ventricles (the spaces in the brain containing cerebrospinal fluid)

  • Poor muscle tone

  • Seizures—may be due to bleeding in the brain

  • Retinopathy of prematurity—abnormal growth of the blood vessels in a baby’s eye

• Infections—Premature infants are more susceptible to infection and may require antibiotics.

Premature babies can have long-term health problems as well. Generally, the more premature the baby, the more serious and long lasting are the health problems.

How Are Premature Babies Treated?

Specific treatment for prematurity will be determined by your baby’s physician based on:

• Your baby’s gestational age, overall health, and medical history

• Extent of the disease

• Tolerance for specific medications, procedures, or therapies

• Expectations for the course of the disease

• Your opinion or preference

Premature babies usually need care in a special nursery called the neonatal intensive care unit (NICU). The NICU combines advanced technology and trained health professionals to provide specialized care for the tiniest patients. The NICU team is led by a neonatologist, who is a pediatrician with additional training in the care of sick and premature babies.

Care of premature babies may also include:

• Temperature-controlled beds

• Monitoring of temperature, blood pressure, heart and breathing rates, and oxygen levels

• Giving extra oxygen by a mask or with a breathing machine

• Mechanical ventilators (breathing machines) to do the work of breathing for the baby

• Intravenous (IV) fluids—when feedings cannot be given, or for medications

• Placement of catheters (small tube) into the umbilical cord to give fluids and medications and to draw blood

• X-rays (for diagnosing problems and checking tube placement)

• Special feedings of breast milk or formula, sometimes with a tube into the stomach if a baby cannot suck. Breast milk has many advantages for premature babies as it contains immunities from the mother and many important nutrients.

• Medications and other treatments for complications, such as antibiotics

• Kangaroo care—a method of caring for premature babies using skin-to-skin contact with the parent to provide contact and aid parent-infant attachment. Studies have found that babies who “kangaroo” may have shorter stays in the NICU.