Priyanka S Reddy, a 30-year-old from Bangalore was in the 32nd week of her first pregnancy when her blood pressure shot up. Her gynecologist suggested immediate delivery as her scans showed that the blood flow to the placenta was affected. Reddy delivered a baby girl via C-section in December 2021, but the newborn weighed a mere 1 kg, as opposed to the ideal birth weight of 2.5 kg or more. Priyanka recalls that doctors explained various possible complications her little one could face and empowered her to deal with them.
Prematurity and low birth weight are major concerns in newborns and can lead to severe health complications in both the baby and the mother, say experts. Caring for a premature baby can be challenging as some tiny tots may require admission to the neo-natal ICU for survival. While parents do worry when a premature baby is born, according to a 2020 study by Netherland-based researchers published in Early Human Development journal, most premature babies grow into healthy adults.
Preemies vs full-term babies
Any baby born before 37 weeks of pregnancy is a preterm baby. Dr Karthik Nagesh, Chairman and HOD of neonatology and NICUs, Manipal Hospitals, Bangalore, who looked after Priyanka’s daughter, Dhrishika, says, “The earlier they are born, the more severe their health risks can be. While the full gestation period is about 40 weeks, some mothers may have complications, leading to early birth.”
“Preterm babies often face challenges with temperature regulation and feeding, with a higher risk of health complications and developmental delays,” says Dr Madhuri Prabu, consultant – pediatrician and neonatologist, Motherhood Hospitals, Chennai. “This distinguishes them from full-term babies who have completed their gestation and are generally more robust,” she explains. Dhrishika, too, had breathing issues and was on a CPAP (continuous positive airway pressure) machine, which offers non-invasive breathing support, for 15 days. Dr Nagesh says that preemies may develop chronic respiratory issues and have higher chances of infections and asthma as they grow up. “In preemies, neonatal jaundice is more common than in full-term babies,” he adds.
Premature babies: What kind of care do they need?
According to a recent study by the UN, about 13.4 million babies, or one in 10 of all births, were born preterm in 2020. Premature babies require special care due to their underdeveloped organs, low birth weight, and immature immune systems, necessitating medical attention and precautions against infections, says Dr Prabu.
Dr Nagesh explains the different categories of preterm babies, “Late preterm babies are born between 34-37 weeks, moderate preterm ones between 30 – 34 weeks and extreme preterm ones are born before 30 weeks. When preterm babies are born, most of the organs are underdeveloped and not fully functional. The most common problem seen in them is due to underdeveloped lungs resulting in respiratory issues.”
He further says, “While the baby is inside the womb, it gets its nutrition and oxygen from the placenta through the umbilical cord. Immediately after birth, their lungs need to function, such that they can breathe independently. With underdeveloped lungs, breathing becomes difficult — most of them need respiratory support and need to be on a nasal CPAP and sometimes, even a ventilator.” Dr Nagesh added that some preterm babies might have complications in their heart, kidneys, retina and brain.
Recalling the time when Dhrishika was in the NICU, Priyanka shares that the doctors stressed kangaroo care to improve bonding and help in growth and weight gain. “She had not developed the ability to breastfeed directly and was fed through Paladai (cup-shaped bowl with beak-shaped tip) for two months,” she remembers. She also added that she had low breast milk supply and had to depend on human milk donors to feed her baby.
What should parents know about preemies?
Parents of a preterm baby should be informed about their child’s medical condition and NICU routines at the time of discharge, says Dr Prabu. She added that parents must prioritize breast milk for the baby’s nutrition, follow infection control measures and seek emotional support. “They must practice developmental care while monitoring feeding and growth,” she said.
Dr Nagesh stresses that women with high-risk pregnancies should choose hospitals with NICU care for delivery as all premature babies require it. “Parents also need to know that premature babies can fall sick anytime and need to be looked after with special care post-discharge from the hospital. They must follow hand hygiene, hospital guidelines, and the vaccination schedule,” he said. Priyanka recalls being advised on feeding hygiene, proper bathing techniques, monitoring stool colors and nail-cutting methods.
Tips for parents to care for preemies at home
- Adhere to the discharge instructions provided by the NICU or your healthcare provider.
- Establish a consistent feeding schedule and monitor your baby’s intake and weight gain.
- Maintain a clean environment, wash hands before handling the baby and limit their contact with sick individuals.
- Keep your home warm and dress your baby in layers for temperature regulation. Also practice skin-to-skin contact for bonding and temperature regulation.
- Attend all appointments to monitor growth and development.
- Continue infection control measures, such as handwashing and avoiding gatherings including people who may be sick.
- Engage with your baby through talking, singing, and gentle touch.
- Watch for signs of respiratory distress and contact your healthcare provider immediately.
- Prioritize your rest and self-care to ensure you have the strength to care for your preterm baby.
- Babies born before 37 weeks of gestation are considered premature babies. They require special care.
- Most premature babies have low birth weight and have underdeveloped and immature organs, making them vulnerable to health conditions.
- Parents need to adhere to the instructions provided at the time of discharge and monitor the baby’s health and development consistently.