Premature births are more common in multiple deliveries and certain health conditions such as diabetes and preeclampsia also increase the risk of preterm delivery. A preterm delivery is defined as a baby who is born before 37 weeks of pregnancy; despite the medical advancements and care that can be provided in a Neonatal Intensive Care Unit (NICU), a delivery should not be induced before full-term as many developments are still ongoing during “late preterm” from 34 to 36 weeks.

What are the characteristics of a Preterm Baby

A preterm baby may look differently from a full term baby, for instance:

– Weighs less (from over 1kg to 2.2kg), therefore looks smaller
– Disproportional larger head compared to the body
– Inadequate fat to keep warm, thus requires to be placed in an incubator/ warmer
– Appears thin without enough fats
– More apparent veins due to the lack of fats underneath the skin
– No vernix at birth as vernix is produced only at late pregnancy
– Fine hair (lanugo) on her back and shoulders

A preterm baby may also behave differently, for instance:

– Her immature respiratory system may cause her to cry softly, and in certain cases, requires assistance with breathing; she may also need to be monitored with a cardio-respiratory monitor
– A preterm baby may require a ventilator or CPAP (continued positive airway pressure) to temporarily support her breathing
– Milk feeding can be a challenge and in some cases, expressed breast milk is fed through a tube
– A preterm baby may sleep more, but at shorter duration each time

Development Stages of a Preterm Baby

The development milestones of a preterm baby are similar to that of a full term baby, but you have to subtract the weeks borne prematurely from the age of full term baby milestones. A preterm baby is cared for at the NICU, and can be discharged when assessed to be able to (i) maintain her own body temperature; (ii) consume milk feedings and (iii) has gained weight since birth.

Thereafter, the development milestones are similar to full term baby:

What are the challenges faced by a Preterm Baby?

The risk of complications, and survival rate, is affected by how early the preterm delivery is; for instance, babies born after 30 weeks have a survival rate of about 90%, whereas, preterm babies born at 25 weeks have about 50% survival rate. This is due to the underdevelopment of various critical body systems, leading to complications such as disabilities or stunted growth.

Feeding Challenges – It may not be possible for your preterm baby to latch on; try expressing your breastmilk and if you have problems with sufficient breast milk supply, check with the hospital on donor milk to offer your baby the nutritional benefits of breastmilk. Feeding may have to be done via a tube instead.

Complications – Complications such as jaundice, anemia or low blood sugar are possible due to the underdevelopment of various body functions. Other complications include brain development, infection, apnea, impaired hearing and sight. Check with your doctor on how to deal with the complications, and how to reduce the likelihood of complications.

Here are some things to note while caring for a preterm baby!

Monitoring weight gain – Weight gain is an indicator of the growth of the preterm baby; monitor your baby’s weight gain and check with the doctor when the growth is behind the expected progress. Weight gain comes from adequate quality nutrition and the best source is your breast milk. Even if your baby is unable to latch on, start expressing milk to get your supply going.

Limiting infection – It is likely that you will have to limit visitors and ensure that family members have been vaccinated and not ill. Also check with your doctor on the vaccinations for your preterm baby. When bringing your baby for doctor’s consultation, ask for the first appointment to reduce waiting time at the clinic with other children who may have viral infection.

Proper sleep – Your baby should be put to sleep on her back, and also try to practice more skin-to-skin contact (you can check with the nurse on how to carry your preterm baby, for instance, “kangaroo care”).

How to Cope with Stress of Caring for a Preterm Baby?

It can be very stressful as your preterm baby’s survival is uncertain; there can be stress involved both when you have limited access to your baby when she is at the NICU and also when you care for your baby at home. Since much of the stress comes from worrying over the well-being of your preterm baby, be sure to have your questions answered before you bring your baby home. Work with a pediatrician who you feel comfortable with. Be sure that you obtain a care plan from the doctor and have your appointments scheduled, and number to call should there be an emergency.

Get plenty of rest at home, and reduce stressful activities; if you find that it is stressful to answer questions from well-meaning friends, politely reject face-to-face meetings or phone calls. Get as much help as possible on chores and activities not directly related to caring for your baby, such as preparing dinner and doing housework. Get enough rest, eat well and engage in moderate exercise; you can also seek support from your medical team or support groups.

Written by Mei