Seeing your tiny premature newborn for the first time, you are probably filled with worries, questions and hopes. Over the coming weeks, you’ll get used to how he looks, what he needs and how to look after him. In the meantime, here are some essentials that every mom of a premature baby needs to know.
1. You are not alone
15% of babies are born prematurely. The percentage is much higher when it comes to multiple births. Thousands of moms have been where you are now and are a ready-made support system for each other. It also means that maternity hospital and doctors have lots of experiences looking after tiny babies.
2. There’s a good chance your baby will be fine and healthy
Thanks to ongoing advances in medical science, more than 90% of babies born weighing 800 grams or more will survive. As a general rule, the smaller the baby and the younger the gestational age, the greater the chance of complications.
3. They look a little different
The first sight of your prem baby can be a shock. He will be very small and his head may appear too big for his body. Without subcutaneous body dat, the skin looks lose and translucent. Your baby may be covered in fine hair, called lanugo. Depending on the gestational age, he may also be underdeveloped in various areas-for instance, some have no nails yet, or the genitals appear immature.
4. Size matters
Your baby’s prognosis will depend on a number of factors. Most important is gestational age. A baby who is born at 34 weeks will have a very good chances of survival and is likely to have minimal immaturity or delay. A baby of 25 or 26 weeks is much smaller and less developed and will probably need a prolonged period of medical care. Other factors that play a role are size, the maturity of the organs (lungs in particular) and whether there is an infection or other medical problem present.
However, in some instances a 28 weeker who does not have immature lungs mat fare better than a 36 weeker who does.
5. Your baby needs you
Your baby needs your love and your touch. Try to be involved in your baby’s care, to the extent that you can. Depending on your baby’s medical condition, you may be able to help feed or hold him, even though he is attached to monitors. Touch has been shown to be comforting, and even to help physical growth. Scrub your hands well (infection is always a danger in the ICU and prems are particularly at risk) and gently stroke your baby’s arms or legs, if the medical staff recommend it.
In recent years, researchers and doctors have discovered the extraordinary effects of skin-to-skin contact. Many advocate Kangaroo Mother Care, whereby the baby and the mother are in close, physical contact, skin-to-skin. You act as a natural incubator, keeping your baby warm and at a constant temperature. Your heartbeat comforts him and his own heartbeat stabilises. Discuss with your doctor whether you can implement this with your baby.
6. The hospital is part of your life
Your premature baby will be admitted to the neo-natal intensive care unit which is equipped to give preemies the care they need, under the watchful eye of expert doctors and nurses. It is a strange environment at first, with its medical equipment and low lighting, but this is the best place for your baby at this time. It’s hard to see your tiny person attached to tubes and wires, but it’s comforting to know that these enable him to be fed and for his vital signs, breathing and temperature to be monitored on-goingly.
It’s uncommon for preemies to spend an extended period in hospital. Most stay until around their intended due date, by which time they weight around 2kg are able to feed from the breast or bottle, maintain their body temperature and breathe unassisted.
7. Preemies have special needs
Because they have so little fat on their bodies and they are not fully developed, premature babies have difficulty maintaining their body heat. Incubators and other machines are used to keep them warm and at a constant temperature. The other important need is for nutrition. They grow at a fast rate, so their nutritional requirements are relatively high, but at the same time their digestive systems are underdeveloped and they are unable to suck directly from the breast or bottle. Milk is fed to the baby’s stomach via a tube. Consider breastfeeding your preemie. At first, you will have to express breastmilk to be fed via tube. If you persist, you may be able to switch your baby to the breast when he is strong enough and mature enough to suckle. If you can’t or don’t want to breastfeed, your baby will be fed with formula specially designed for preemies.
8. There may be medical problems.
Premature babies are particularly prone to certain health problems, including jaundice, anemia, low blood pressure, respiratory problems and apnea. The staff at the neo-natal ICU monitor these tiny patients for all of these common problems, and others, and are experienced in dealing with them. Advise for moms: “You have the right to ask questions of doctors and nurses; you are entitled to proper information about your child.”
9.Adjust your expectations to his corrected age
When considering your baby’s development, don’t think of his actual age, but of the age he would have been if he’d been born on his due date. Try not to compare your baby to your friends’ babies of the same age. It may take a few years before he overcomes the effect of prematurity. When it comes to growth and height, preemies may be playing catch-up until adolescence.
A percentage of preemies do have long-term health and development problems as a result of their prematurity. These include developmental delays, learning problems, growth problems, sensory impairment (vision and hearing problems) and even dental problems. The earlier developmental problems are identified and tackle, the better the prognosis. Therapy often begins in hospital or soon after your baby is discharged: “A speech therapist will help with the development of the jaw and mouth and the sucking reflex. Your baby will also need a physio or occupational therapist. In the womb, baby kicks against mom. In the incubator, there’s no resistance, so muscles don’t develop properly.”
10. Look after yourself
Just like any new mom, you need to take care of your own needs in order to take care of your baby’s needs. Sleep as much as you can, eat well, and accept offers of help and support.