BABY COME EARLY !

A MANAGEMENT PLAN FOR DEALING WITH PREMATURE BABIES

A baby is said to be pre-term, premature of a preemie when born three weeks (or more) before the due date. For the new parents, it is a shock to realize that the frail, thin bundle with a lot of body hair (lanugo), who looks more like a foetus, is actually their baby. Preemies have translucent skin, soft ear cartilage, wrinkled features and a weak cry. A few (depending on their gestational age and body weight) may have problems with breathing, feeding and temperature regulation.

Most of their organs are immature. They need to complete that part of their development, which would have otherwise happened in the secure environment of their mother’s womb.

Neonatal intensive care units (NICUs) are designed to provide care to preemies; they receive round-the-clock monitoring by trained doctors and nurses.

IN THE HOSPITAL

In a NICU, the baby is kept under very hygienic conditions in an incubator that is warm and adjusted to provide the body temperature needed. Most of the early feeds are given through a tube as premature babies lack the sucking reflex or are too weak to do so,

Preemies are given a special high-fat, low-birth weight formula that helps them gain weigh faster. If the baby has breathing problems, oxygen therapy is initially used, but if the problem does not settle, a ventilator may be used.

There is also a continuous monitoring of the heart, blood pressure and blood sugar levels according to a famous of India. “Neonatology has witnessed some of the most dramatic improvements in the latest three decades.

Survival is now possible in babies as small as 500 grams and of 23 weeks gestational age in the western countries, and there are instances of survival of babies born as early as 26 weeks and as tiny as 690 grams. “While professional care is essential, the bond developed between the baby and the parents from this stage itself is critical in ensuring the baby’s growth and development. Doctors encourage the parents to be very close to the baby, and take part in most of the daily activities involving their baby in the NICU. This can be a very trying, anxiety-ridden period, especially for the mother. It is important for her to relax, banish any guilt she may have about having ‘caused’ the premature delivery in any way and to think positively. It helps to talk and clarify any doubts; it is best to consult the doctors and staff of the NICU, since nobody understands the situation better than them. It is also essential to get friends and the families to help out with other necessary chores, as trips to the NICU are draining.

AT HOME

Having spent a few days or weeks at the NICU, the baby is ready to go home once it has reached a weight of about 1.8 kilograms and is 36 weeks old (and able to sustain on its own). Usually, the doctors and the NICU staff provide the mother with all the guidelines about caring for the baby at home.

However, it helps to take special advice on issues that may need attention, to take down all the phone numbers (especially of the NICU) and make sure of an alternative contact number in case the baby’s regular pediatrician cannot be contacted.

Once the baby has reached the full-term barrier, she may be shared joyfully with the family and friends. However, all parents should remember that the baby’s age is not to be counted from the date she was born, but from the date she was supposed to have been born. This becomes particularly important because the baby will probably reach some development milestone later than other babies. Mothers should remember to look at the development chart from the actual due date; then they will realize that the baby does not lag.

It takes two years for a premature baby to catch up with the other children of her age. And once she does, there will be no stopping her!

CAUSES FOR PREMATURE BABIES

Most women go into pre-term labour each year. While the exact causes are not clearly understood, risk factors in the expectant mother include:

Pre-eclampsia, a condition associated with the second trimester and characterized by high blood pressure, fluid retention and protein in urine.
Diabetes, kidney problems or heart ailments.
Multiple pregnancies, earlier abortions and a history of pre-term deliveries
Problems of the uterus or cervix
Persistent / untreated infection, especially of the urinary tract
Being under 18 or older than 35 years
Lack of adequate prenatal care