November 17 is the International Day of the Premature Baby, which was established in 2009 at the initiative of the European Foundation for the Care of Newborn Patients.
Pregnancy is behind us - a time of joyful and, at the same time, anxious anticipation. Finally, the long-awaited baby was born, but, alas, earlier than expected. Of course, you are worried and ask a lot of questions.
After all, you will have to face many problems, since the baby will be in a hurry to be born, and his body is not ready for independent life. Therefore, the baby requires increased attention and careful care.
Which babies are considered premature
Today, a baby born from 22 to 37 weeks of pregnancy is considered premature.
There is such a thing as a live birth criterion. Russia switched to the criteria approved by the World Health Organization in 2012. According to these parameters, a premature newborn baby is an infant from 500 grams and 25 centimeters, born from the 22nd week of gestation. If a baby with such indicators survives, he is registered and nursed. Every year, 5-10% of such children are born in the world out of the total number of newborns. Prematurity of a child in the modern world is not a death sentence, since today there are all conditions for caring for “early” children.
How to catch up with peers?
This question worries any mother very much, but there is no need to worry too much: in the first year of life, the baby’s body is able to recover in record time. Of course, the child cannot do without your help, and one of the best methods is massage. It can be started when the baby’s weight reaches 2500 g: first simple stroking, then more intense movements. Be sure to consult with your pediatrician - he will show you special massage techniques.
Skills Comparison Chart
Sometimes experts also recommend infant swimming, water gymnastics and physiotherapy, but these procedures can only be carried out after consultation with a doctor. Of course, every mother wants her baby to develop “according to the books,” but, first of all, he needs time and your care. You'll see: by the age of two, your child will certainly catch up with his peers, and there will be no trace left of the difficult start.
Degrees of prematurity
There are four degrees:
- First degree - birth occurs at 36-37 weeks of pregnancy. The child weighs 2001-2500 grams at birth, his height is 41-45 centimeters;
- Second degree - birth at 32-35 weeks of gestation, the child’s body weight at birth is 1501-2000 grams, height is 36-40 centimeters;
- Third degree - birth at 28-31 weeks, the weight of the newborn is 1001-1500 grams, height - 30-35 centimeters;
- Fourth degree - birth occurs before 28 weeks of gestation. At birth, the baby weighs less than a kilogram and its body length is less than 30 centimeters. These newborns are called “extremely low birth weight preterm.”
Consequences of prematurity and developmental prognosis
The prognosis for life in premature babies depends on many factors. Primarily on gestational age and birth weight. If a baby is born at 22-23 weeks, the prognosis depends on the intensity and quality of therapy. The risk of death increases in the following cases:
- antepartum hemorrhage;
- breech birth;
- multiple pregnancy;
- asphyxia during childbirth;
- low temperature of the child;
- respiratory distress syndrome.
Long-term consequences of prematurity (the likelihood of these complications again depends on many factors; under other favorable conditions, these complications are quite rare):
- retardation in mental and physical development;
- cerebral palsy;
- convulsive and hydrocephalic syndromes;
- myopia, astigmatism, glaucoma, retinal detachment;
- tendency to frequent infections;
- hearing impairment;
- menstrual irregularities, genital infantilism and problems with conception in girls.
Premature babies: consequences
However, it is not at all necessary that all the difficulties listed above will affect the child. In addition, competent medical supervision and parental care work wonders. Many cope with all difficulties and continue to live fully.
Prematurity is not always a story of illness and weakness. Thus, it is known that such celebrities as the artist Leonardo da Vinci, the emperor and commander Napoleon Bonaparte, the scientist Albert Einstein and one of the founders of classical physics Isaac Newton were born prematurely.
Why is this happening?
Your baby was in a hurry to be born and was born ahead of schedule - what to do? First of all, don't panic. According to WHO statistics, in civilized countries, 9 out of 10 premature babies survive and subsequently develop successfully. And don't think it's just you: about 15 million babies are born prematurely every year, or about 1 in 10.
Of course, every woman who becomes an “early bird” mother is primarily concerned with why this happened.
The causes of prematurity are not fully understood, but several factors increase the chance of preterm birth:
- History of abortion or premature birth;
- Multiple pregnancy;
- Infection while expecting a baby;
- Preeclampsia;
- Placental abruption;
- Diabetes mellitus in mother;
- Hypertension and heart disease;
- Smoking and drinking alcohol during pregnancy;
- Poor maternal nutrition;
- Pregnancy at too young or late age.
Premature babies: development
The development of such a newborn certainly has its own characteristics. But, in most cases, after a while these children “catch up” with their full-term peers in development and in the future are no different from them.
Natalya Zotkina, founder and director of the Right to Miracle charity foundation for premature babies:
— About 80% of “early” children catch up with their peers in development by the age of 2-3 years. However, 20% of babies are at risk for various diseases. My daughter was born at 27 weeks weighing 1 kilogram and she has cerebral palsy. She studies in a regular school along with everyone else, although she uses a wheelchair. At the same time, I know children with the same weight and born at the same stage, who are in excellent health and have no pathologies. Everything is very individual. Our foundation always emphasizes: every story is unique. You cannot compare one premature baby to another.
Development of premature babies by month
Only children born prematurely , as a rule, need special conditions and constant supervision by doctors. Often these babies are fed through a feeding tube and their breathing is supported through artificial oxygen.
A premature baby is one month old: at this time he may completely lack innate reflexes. During this period, the baby gains very little weight.
In the second month, such children already begin to gain weight, but they are still very weak: they get tired quickly and mostly sleep. In the third month, the baby already acquires reflexes, reactions to sound and even facial expressions.
By 6 months , the child, in a good situation, increases weight approximately three times. By this time, babies with the first degree may no longer be any different from their peers born at term.
Premature babies: development up to one year
By the age of one year, children, as a rule, have already completely “evened out” in development - both physical and psycho-emotional. The development of a premature baby largely depends on the care and responsible attitude of parents to the recommendations of doctors.
Born prematurely: what does a premature baby look like?
Of course, a premature baby is different in appearance from a full-term baby, but much depends on the gestational age.
The main external distinctive signs of premature babies
Moderate prematurity: I-II degree
* Muscle tone is somewhat reduced, but the baby is generally active. * The skin is pink and the subcutaneous fat layer is moderately thin. * Vellus hair (lanugo) is absent from the skin on the face from 32-33 weeks, and starting from 35-37 weeks - usually on the entire surface of the skin. * The nipples and peripapillary areas (the skin around the nipples) are clearly visible and pigmented (colored). * The first bends in the ears appear at 35-37 weeks. * Usually the physique is proportional: the size of the head and the length of the limbs (arms, legs) relative to the body are of normal size. * The navel is located closer to the center of the abdomen, but still slightly lower than in full-term babies. * Nails typically extend to the edges of the toes (nail bed). * The external genitalia are well developed. In girls, the genital slit is almost closed. In boys, the testicles are located at the entrance to the scrotum (in the upper third), but sometimes there is unilateral cryptorchidism (one testicle does not descend into the scrotum).
Deep prematurity: III-IV degree
* Due to decreased muscle tone, the child lies with his arms and legs extended. * The skin is dark red, thin and wrinkled (like an old man’s), often swollen, and abundantly covered with vellus hair. * The subcutaneous fat layer is thinned. * The baby has a somewhat disproportionate physique: the size of the head is large in relation to the length of the body, and the limbs are short compared to the body. * The navel is located in the lower third of the abdomen. * The nipples and parapapillary areas are poorly pigmented and difficult to see. * The ears are soft, have no convolutions and are shapeless, pressed to the head and located low. * Baby's nails are underdeveloped and usually do not reach the fingertips. * The cranial sutures are open, the small, large and lateral fontanelles are large, and the bones of the skull are soft. * External genitalia are underdeveloped. In girls, the labia majora do not cover the labia minora, so the genital slit is gaping (open). In boys, the testicles usually have not yet descended into the scrotum.
However, it should be remembered that the same baby does not always show all the signs of prematurity equally clearly and clearly in accordance with the gestational age. It often happens that some of them are more pronounced and others less.
Stages of nursing premature babies
The first stage of nursing is care and supervision by medical staff in the maternity hospital. Large perinatal centers have a special intensive care unit for such newborns. At this stage, it is important that the baby does not become hypothermic, so doctors touch him only with warm hands, wrap him in heated diapers, and even the changing table is preheated.
The second stage is nursing the baby in the pathology department of the hospital. In modern departments, mothers can stay with their children. The child is weighed every day, height and head circumference are measured. As soon as the newborn reaches the desired two kilograms in weight, he is discharged home. If there are any deviations in health, the baby is left in the pathology department until complete recovery.
And finally, stage three : observation at home. The doctor and nurse at the children's clinic must examine the child on the first day after discharge. Then doctors will periodically visit the baby, monitor his condition and development and give recommendations for care to parents. Humidity is about 70%, a comfortable temperature of 20-22C, ventilation of the room, water for bathing heated to approximately 39C: premature babies require all this. The stages of nursing include, first of all, medical control and a special, attentive attitude of mom and dad to the child.
Here we are at home!
The baby will be discharged from the hospital as soon as he no longer needs constant medical supervision. Several more conditions must be met: stable weight gain, normal thermoregulation (the baby must maintain temperature without additional heating for 24 to 48 hours), the ability to feed independently (breast milk or formula). And most importantly, you must be able to care for your baby without outside help.
Here are some general tips to help during your first weeks at home.
- Remember the peculiarities of thermoregulation of premature babies. The room should not be too hot or too cold. The optimal temperature is 24 – 26 degrees. The room needs to be ventilated regularly; a humidifier won’t hurt either;
- Try to create soft lighting in your baby’s room and avoid harsh noise, because his nervous system has not yet matured;
- At first, you should not invite guests: for the baby this is additional stress and a potential source of infection;
- When bathing, you need to take into account the degree of prematurity: with moderate prematurity, you can wash the baby in the bath from the 7th to 10th day of life, with deep prematurity - from the 3rd to 4th week. To avoid drying out your baby’s thin skin, use special moisturizers and avoid soap;
- It is better to plan walks with a premature baby a week or two after discharge. If it’s not very cold outside, start with 10–15 minutes, gradually increasing the duration of “exercise” to an hour and a half a day.
Nursing premature babies
Caring for a premature baby in a maternity hospital usually begins with placing the baby in a special “incubator” with a given temperature and humidity. Here the baby grows up in conditions as close as possible to those in the womb. He is weighed daily. Parents can talk to the baby and hold his hand, and later, when he gets stronger, pick him up and hold him close. It has been proven that this has a positive effect on the neuropsychic development of the child.
After the premature baby has gained vital grams, doctors can finally discharge him and his mother home.
It is also important to maintain proper child care at home. Parents are recommended to carry out special gymnastics and massage for the baby. Massage at this stage, as a rule, is an important component of care: you can resort to the services of a professional, but it is better for the specialist to come to you himself, and all manipulations take place in the usual home conditions. The immunity of early children is very weak at first, so it’s worth being safe.
The newborn should be placed on his stomach: this will strengthen his muscles in the back of the head, limbs, abdomen and back. It is important to harden the baby: give him “air baths” and bathe him every day, but the water temperature should not be lower than 37 degrees.
The nutrition of a premature baby should not be based on the principle: the more the baby eats, the better, because he will gain weight faster. At the same time, overfeeding such children is a common mistake of parents. The digestive system of early babies is not well developed, as is the sucking reflex, which is important for the child. Therefore, it is better to feed more often, but in small portions, so as not to overload digestion. The best nutrition for a baby born prematurely is mother's milk. But, if for some reason natural feeding is not possible, the doctor will help the parents select a special artificial formula.
Psychological aspect
If your baby was born prematurely, you probably spend hours searching for information about how he will develop and how to help him. But try to stop for a second and think about your own mood and well-being. Most “hurried” mothers experience a huge feeling of guilt in front of their child, lack of self-confidence, and dissatisfaction with their body. Be sure to talk about your condition with your loved ones, because they are also scared and confused. Don’t be shy about asking your family for help, delegate as many household chores to them as possible, and get plenty of rest. If the baby is still in the hospital, gradually prepare a dowry for him and arrange a nursery: this will lift your spirits and give you confidence that you will soon be reunited with your little fighter.
