Orange Park Medical Center - November 01, 2019

Premature infants, known as preemies, come into the world earlier than full-term babies. Prematurity occurs when a pregnancy lasts less than 37 weeks (full-term infants are born between 37 to 42 weeks).

It's important to know that any pregnant woman may deliver prematurely - including many who have no known risk factors.

Although there are some things within a mother's control (such as poor nutrition, smoking or illicit drug use during pregnancy), the cause of preterm delivery is often unknown and not within a mother's control. The best way to control risk factors for premature deliveries is to talk to your doctor about making the choices that are best for you and baby.

A preemie's basic needs

Preemies have many special needs that make their care different from that of full-term infants, which is why they often begin their lives after delivery in a neonatal intensive care unit (NICU). The NICU is designed to provide an atmosphere that limits stress to the infant and meets their special needs of warmth, nutrition and protection to ensure proper growth and development.

Warmth

Premature babies lack the body fat necessary to maintain their body temperature, even when swaddled with blankets. So incubators or radiant warmers are used to keep them warm in the NICU.

Incubators are made of transparent plastic, and completely surround babies to keep them warm, decrease the chance of infection, and limit fluid loss. Radiant warmers are electrically warmed beds open to the air.

Nutrition and growth

Premature babies have special nutritional needs because they grow at a faster rate than full-term babies and their digestive systems are immature. Full-term babies usually weigh more than 2,500 grams (about five pounds, eight ounces), whereas premature babies weigh anywhere from about 500 grams (about one pound, one ounce) to 2,500 grams.

Breast milk is an excellent source of nutrition, but premature infants are too immature to feed directly from the breast or bottle until they're 32 to 34 weeks gestational age. Additionally, most premature infants have to be fed slowly because of the risk of developing necrotizing enterocolitis (NEC), an intestinal infection that primarily affects preemies.

Breast milk has an advantage over formula because it contains proteins that help fight infection and promote growth. However, pasteurized human breast milk from a milk bank or formula may be alternatives for your little one in the NICU as well. Also, special fortifiers (for calcium and phosphorous) may be added to breast milk or formula because premature infants have higher vitamin and mineral needs than full-term infants.

Some preemies who are very small or very sick cannot use their digestive systems to process food. These babies require intravenous (IV) feedings -- called TPN, or total parenteral nutrition -- made up of fats, proteins, sugars and nutrients.

Common health problems of preemies

Premature infants are prone to a number of problems, mostly because their internal organs aren't completely ready to function on their own. In general, the more premature the infant, the higher the risk of complications. Some common health complications of preemies to ask your doctor about include:

  • Hyperbilirubinemia
  • Necrotizing enterocolitis
  • Apnea
  • Anemia
  • Low blood pressure
  • Respiratory distress syndrome
  • Bronchopulmonary dysplasia
  • Infection
  • Patent ductus arteriosus
  • Retinopathy of prematurity

After the NICU

Preemies often require special care after leaving the NICU, sometimes in a high-risk newborn clinic or early intervention program. In addition to the regular well-child visits and immunizations that all infants receive, premature infants receive periodic hearing and eye examinations.

Speech and behavioral development also are important areas during follow-up. Some premature infants may need speech therapy or physical therapy as they grow up. Babies who had complications in the NICU may need additional care from medical specialists.

Family support is also important. Caring for a premature infant is even more demanding than caring for a full-term baby, so high-risk clinics pay special attention to the needs of the family as a whole.