What is a premature baby?

If your baby was born prematurely, you will have many questions about how to give him the extra care he needs. It all depends on how many weeks before your baby is due. The earlier the birth, the greater the likelihood of complications in the child.

Doctors call a baby "premature" if he was born more than 3 weeks before his due date. Because premature babies don't have much time to develop in the womb, some may have health problems and need to stay in the hospital longer than full-term babies.

Most premature babies are called late premature babies, which means they are born between the 34th and 36th week of pregnancy. Your child may also be:

Moderately preterm, born from 32 to 34 weeks
Very preterm, are born at less than 32 weeks
Extremely preterm, born at or before 25 weeks

Symptoms of a premature baby

At first, your baby may be different from other newborns you've seen:

Premature babies are smaller than those born closer to their due date, with less fat.
Your baby's head might look a little large for their body.
Their skin might seem thin, and it could be covered in a fine hair called lanugo.
Their features may look less rounded than those of full-term babies.

You may notice some other differences, too:

Your preemie may cry softly or not at all, at first, since their breathing system isn't fully developed. They may also have breathing problems.
They may have trouble feeding because they don't have reflexes for sucking and swallowing.
Your baby's temperature might be low, since they don't have much body fat to keep them warm.
As the baby grows, they'll start to look and act more like other infants.

Causes of premature birth and risk factors

Doctors don't always know why a baby is born prematurely. But you may be more likely to have a premature baby if you:

Are expecting twins or other multiples
Had a preemie before
Have problems with your uterus, cervix, or placenta
Are under 17 or over 35
Were underweight or overweight before pregnancy
Smoke or use illegal drugs
Conceived with in vitro fertilization
Have had multiple miscarriages or abortions
Got pregnant less than 6 months after an earlier pregnancy
Have a health condition like diabetes or high blood pressure
Had an infection or injury during pregnancy
Went through a stressful situation, like the death of a loved one

Prevention of premature birth

There is no reliable way to prevent preterm labor. But if you're planning a pregnancy, follow these steps to stay healthy:

Wait at least 18 months between pregnancies.
Maintain a healthy weight.
Don’t smoke, drink, or use drugs.
Start seeing a doctor for prenatal care as soon as you think you're pregnant.
Get treatment for any health conditions you have.
Get any vaccines you need, and take care to avoid infections.
Try to reduce your stress levels.
If you have depression, get treatment for it.

If you are pregnant and at high risk of preterm labor, your doctor may prescribe:

Progesterone supplements. This hormone may help if you have problems with your cervix or a history of preterm labor.

An operation called cervical cerclage. If you have a "short" cervix, your doctor may put in stitches to support your uterus. They will remove the stitches when you are ready to give birth.

Premature babies receive extra care from birth. Your child may need to see a neonatologist, a pediatrician who treats premature babies.

Your doctor may suggest that your baby receive special care in the neonatal intensive care unit. Your child may be connected to various machines. Each piece of equipment plays an important role in keeping them healthy and ready to return home.

For example, nurses may put your baby in an incubator, a plastic cradle that keeps him warm. They can put sensors on their bodies to monitor their heart rate, blood pressure and temperature.

Your premature baby may also need a machine called a ventilator to help him breathe. They could receive fluids and nutrients intravenously. Nurses may place a feeding tube in the baby's nose to give him breast milk or formula.

Even if your baby is in the neonatal intensive care unit, you will still have a chance to bond. After your doctor cleans it, you can touch, hold, and breastfeed or bottle feed your baby. You may be asked to express breastmilk until your baby is breastfeeding to help him grow and fight infection.

In many neonatal intensive care units, mothers and fathers provide physical care for premature babies. You can hear them talking about caring for kangaroos. You lay your baby on your bare chest, which helps him stay warm, breathe better, and sleep better. Some babies sleep on the skin of their parents. Others simply enjoy close contact.

Not all premature babies have complications. And for those who do, modern advanced medical care means babies born very early are more likely to survive than ever before.

Complications in premature babies

Premature babies are at risk of complications because their organs haven't had time to develop in the womb. When babies are born very prematurely, they are at higher risk for certain health problems.

Some short term issues that may arise are:

Loss of body heat. Lack of body fat makes premature babies susceptible to rapid heat loss. If their temperature gets too low, they may have breathing problems and hypoglycemia.
Breathing problems. Some premature babies suffer from apnea, long pauses in breathing. Another condition called respiratory distress syndrome. occurs when your baby's lungs don't produce enough of a fluid called surfactant. If this happens, doctors will treat the child with an artificial version of the fluid that helps the lungs expand. They may have to put the child on a ventilator.With bronchopulmonary dysplasia, your child will need oxygen for several weeks or months. Premature babies often outgrow it as their lungs mature.
Problems with heart. A persistent ductus arteriosus is when your child has a hole between two large blood vessels leading away from the heart. Often closes on its own. Premature babies can also have low blood pressure. This may mean that they need intravenous fluids, medications, or possibly a blood transfusion.
Problems with the brain. A very early birth makes the baby more likely to bleed into the brain, called an intraventricular hemorrhage. They often pass without causing much harm.
Problems with digestion. After feeding is started, some premature babies may develop a condition called necrotizing enterocolitis. This happens when the tissues in their intestines become inflamed. The risk is lower in infants who are exclusively breastfed.
Problems with blood. Anemia, in which your child's body does not produce enough red blood cells, can prevent your child from gaining weight and being active. Doctors treat it with iron supplements, medications, or blood transfusions.

When your baby has jaundice, his skin turns yellowish. This is because a chemical called bilirubin builds up in their blood. Your child may need treatment with special lamps.

Possible long-term complications include:

Vision problems. Retinopathy of prematurity occurs when a baby's retina is not fully developed. This can lead to scarring of the retina. In rare cases, the retina can detach.
Hearing problems. Premature babies are at increased risk of hearing loss. They are usually tested in the neonatal unit. Your pediatrician can follow closely.
Dental problems. Premature babies may have late eruptions, discolored or misaligned teeth.
Cerebral palsy. This is a disability that affects movement and muscle tone. Although most patients are not born prematurely, preterm birth is a risk factor. Occupational therapy and physical therapy can help infants and children with cerebral palsy.
Problems with learning and behavior. Premature babies are often slower to reach milestones than full-term babies. Later, they may have learning difficulties and behavior problems. Talk to your doctor if you are concerned.
Other health problems. Premature babies are more likely to develop long-term illnesses such as infections, asthma, and feeding problems.

At home

The time until your child returns home varies. This may be a few days or weeks after birth.

Your child's doctor will allow her to return home as soon as your child:

Breathes on their own
Can breastfeed or bottle-feed
Weighs at least 1.8 kilograms
Gains weight steadily
Stays warm without help

Your baby may need special equipment, even if he has settled at home. Some babies use monitors, for example, to monitor sleep apnea, or continue to receive oxygen. Whatever your child's needs, your nurses and doctors will teach you how to use the equipment before you leave. They should also train you in infant cardiopulmonary resuscitation.

Caring for a premature baby will likely take up a lot of your time and attention, but don't forget to take care of yourself too. Relax, eat healthy, and get help from friends and family.

It's normal to feel like you're on an emotional roller coaster. Consider joining a support group where you can talk to other parents who are going through the same thing as you. You can also meet with a counselor to discuss the issues you are facing.