Deeply premature baby: degrees and signs, features of care and development, photos and tips

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

A normal pregnancy, without any abnormalities, should last 38-42 weeks. But, unfortunately, this is not always possible. More and more often there are situations when labor activity occurs much earlier than the due date. What consequences await a very premature baby and is it possible to prevent their occurrence? More about everything in this article.

What is it?

A baby is term if it meets two related criteria: birth weight was over 2,500 grams; he was born later than 37 weeks of pregnancy. In other cases, the baby is premature, which means that it requires special care and close monitoring by medical specialists.

All premature newborns, depending on when they were born and the weight of the premature baby at birth, can be divided into several main degrees:

• 1 degree - the period from 34 to 36 weeks, weight from 2,000 to 2,500 grams;
• 2 degree - the period from 31 to 34 weeks, weight from 1,500 to 2,000 grams;
• 3 degree - the period from 28 to 30 weeks, weight 1,000 to 1,500 grams;
• 4 degree - period up to 28 weeks, weight up to 1,000 g.

1 and 2 grades are moderately preterm, severely premature babies are grades 3 and 4.

Characteristics

A baby born before the 7th obstetric month of pregnancy is noticeably different from those born at term. In total, several characteristic features can be distinguished for him:

• dark red skin color;
• the location of the navel in the lower abdomen;
• disproportionate body: big head, short arms and legs;
• very soft fingernails and toenails;
• open genital gap in girls;
• location of the testicles in the abdominal cavity in boys;
• lack of subcutaneous fat, at first glance the baby looks very thin;
• presence of wrinkles on the skin;
• expressed swelling of the whole body;
• the whole body is covered with vellus hair.

You can often see photos of very premature babies on women's forums and in medical institutions of the corresponding direction. On them you can see that the baby's skin is so thin that you can see the veins through it.

A distinctive feature is the behavior of the baby. He almost always sleeps, can't eat on his own.

Mom is the reason

It is worth talking separately about why a deeply premature baby was born prematurely. Doctors decide to perform surgery or induce labor if the following abnormalities are detected in a pregnant woman:

• Formation of an inflammatory or infectious process incompatible with pregnancy. In this case, if the fetus continues to be in the womb, then it is in serious danger.
• Any disease of the uterus that opposes the possibility of further pregnancy.
• Pathology of the cervix.
• Chronic endocrine diseases, which include: diabetes mellitus or any thyroid disorder.
• Leading an unhe althy lifestyle: excessive drinking or smoking.
• Hard physical labor can also provoke the development of preterm labor.
• High pressure.

When such pathologies are detected, doctors assess the patient's condition and decide on the delivery. But, with the appearance of certain diseases, the uterus stops stretching, so it begins to press on the fetus and labor begins.

Symptoms of preterm labor

A pregnant woman should be alert when pulling pains appear in the abdomen, especially in its lower part; too frequent urination or leakage of water; the appearance of blood secretions; contractions of the uterus (contractions).

If these symptoms appear, then you need to immediately callambulance and go to the hospital for treatment. The obstetrician-gynecologist, if necessary, will take all possible measures in order to stop labor and allow the baby to be in the womb until the due date.

Consequences for the mother

Natural childbirth is no different from those that take place between 38 and 42 weeks. But, due to the small weight of the fetus, they pass faster, without severe pain, and the likelihood of ruptures is also reduced.

Gynecologists after childbirth study the condition of the patient's genitals, check her hormonal levels and the presence of infectious agents in the body, after passing the caesarean section, the condition of the sutures is also assessed. In most cases, patients quickly recover physically, but recover psychologically for a long time, often, you have to seek help from a psychologist.

The reason is in the baby

In rare cases, the cause of preterm labor is due to the condition of the baby. For example, doctors come to such a decision if the child does not gain weight for a long time, receives insufficient oxygen, or has any gross pathologies. In this case, doctors come to a similar situation - they evaluate the possibility of maintaining the pregnancy, if there is none, then they perform an emergency caesarean section or induce labor.

Consequences for the child

The consequences for a very premature baby are not the most pleasant. Unfortunately, children born before28 weeks, have little chance of survival. Their body is not yet sufficiently formed to exist outside the uterine cavity. In children born between 28 and 30 weeks, the chances of survival increase markedly. But there is a high risk of developing a number of diseases:

• Weakened immunity. If a very premature baby was born, then the mother should be prepared for the fact that he will often get sick and catch a cold.
• Due to the open oval window, the load on the heart increases several times, respectively, there is a high risk of developing disorders in the functioning of the lungs and the cardiovascular system.
• In most cases, the negative consequences of very premature babies are associated with the immaturity of the nervous system. There is a high risk of developing cerebral palsy, epilepsy and other neurological diseases.
• Babies born prematurely have vision problems.
• Fragile blood vessels can cause bleeding in the brain.

The condition of the fontanelles in very premature babies is also slightly different, they close much longer, which can cause unpleasant consequences, for example, hydrocephalic syndrome. For such patients, a planned ultrasound of the brain is prescribed monthly.

If doctors are ready to quickly let the mother of a very premature baby go home, then the little patient is in the hospital for a long time under the supervision of a number of doctors.

Apnea

One of the most dangerous diseases is deep sleep apnea in premature babies, which occurs in almost 50% of patients. In many cases, this pathology leads to the death of a newborn baby. The main reason for its development is the immaturity of the respiratory system. The baby was born too early and not all of his organs had time to form.

Apnea is a violation of the respiratory system and its periodic stops. This means that the baby can breathe calmly, but suddenly his breathing will become more frequent or, conversely, respiratory activity will completely disappear.

Treatment of such a pathology is long and complicated. The baby must be on a ventilator and receive artificial oxygen until his breathing stabilizes. In the future, when he is transferred to the ward, pediatricians will continue to monitor his state of he alth. A special sensor will be connected to the crib, which evaluates the pulse and respiratory activity of the baby. If breathing is lost or mommy gets the baby out of the crib, the equipment will give an appropriate signal. Doctors believe that it will be possible to get rid of sleep apnea only if the attacks can be stopped for more than 7 days.

Unfortunately, due to the immaturity of the nervous and respiratory systems, the risks are quite high. Breathing in very premature babies can stop at any time, which will lead to death. Even if the seizures were completely stopped, the child will continue to receive maintenance therapy for a long time after discharge.

Nursing in intensive care

Until the 31st week of pregnancy, the baby's internal organs continue to form, respectively, he is not yet adapted forlife outside the uterine cavity. After a premature birth, he cannot take his first breath on his own, so he needs to go through a long process of nursing very preterm babies in intensive care.

First of all, resuscitators create conditions for such patients similar to those in which he existed when he was in his mother's stomach. It is placed in a special device, which is a chamber and a cap - a pitcher. You can see that there are a lot of wires around the little crumbs. They are required to create the following functions:

• power supply;
• supply of humidified oxygen;
• implementation of mechanical ventilation;
• maintaining the necessary parameters of temperature, humidity level.

It is worth noting that in the process of nursing very premature babies, food enters the body through a special device - a probe. For this purpose, medical specialists use a special sparing mixture, but it is still recommended that the mother transfer expressed breast milk to the intensive care unit. Firstly, this way the baby will receive more useful substances, and secondly, the woman will be able to maintain lactation.

As mentioned earlier, premature babies do not have adipose tissue, so their metabolic thermal processes are disturbed. Heaters filled with warm water are used to create artificial heat.

The condition of a small patient is always monitored by a resuscitator and nurses. The equipment is equipped with sensors that can determine the statushe alth of the baby and establish an optimal environment in the incubator. If the child's he alth worsens, a signal is given, the doctors immediately provide the child with the necessary assistance.

Nursing in the ward

If the condition of the newborn normalizes, he decently gained weight and learned to breathe on his own, then the most long-awaited moment for each parent comes - the transfer of the baby to the ward, where he will stay with his mother for a long time. Doctors give the patient drug therapy, depending on the degree of prematurity and the state of he alth. In addition to the treatment of premature babies, for their full development, it is recommended to create favorable conditions in the ward:

• It is recommended to dress the baby warmly or wrap it in a warm, but not heavy blanket. The child's body will still continue to poorly retain heat on its own.
• Mom should master the Kangaroo method, it consists in creating skin-to-skin contact. As a result of numerous studies, it has been proven that if you conduct such a session, at least 20-30 minutes a day, then the child's well-being will quickly improve, and he will gain weight better.
• Many children are prescribed additional massage to improve skin condition.
• To improve muscle tone, it is additionally recommended to do light exercises, but only as prescribed by a doctor.

In the process of nursing the baby in the ward, he is being watched by many specialists of various narrow speci alties, mainly a therapist, ophthalmologist, ENT and neurologist. To assess the state of he alth, heyou will need to regularly take tests and conduct ultrasound examination of important parts of the body.

Mother and baby can stay in the ward from 2 weeks to 3 months. He can be discharged from the department of premature babies only if he has gained weight up to 2,500 grams, feels satisfactorily, sucks his breast on his own, his body maintains an optimal body temperature. They also evaluate the ability of a mother to take care of a special baby on her own.

Nursing at home

If the child was at home, then the doctors noted that he had a stable state of he alth. In this case, parents should monitor the well-being and development of a deeply premature baby. First of all, they need to create special conditions at home for a premature baby to live in it:

• The room should not have loud sounds and flickering elements. The insufficiently strengthened nervous system of the baby is not yet capable of perceiving such phenomena. If possible, it is recommended to place the baby's crib in a bedroom where there is no TV or other sources of noise.
• In the first month of life at home, you should dress your baby warmly and fix his body position with special pillows so that the baby does not use up his own energy in the process of turning over on his side.
• The room should always be fresh and maintained at the optimum level of humidity. Therefore, it is recommended to install a humidifier. It is recommended to ventilate the room daily, but the baby should be moved to another room during this time.
• A very important condition is to completely limit contact with infected people. Any viral disease can provoke the development of pathologies in the fragile body of the baby.

Every day it is necessary to carry out the procedures necessary for every newborn baby: bathing, feeding, changing bed linen, clothes and diapers, treating the skin from diaper rash, walking in the fresh air.

Regardless of the consequences that have arisen in very premature babies, they are required to come to the doctor every month for a check-up. Usually, premature babies are registered in a specialized clinic.

Feeding Features

Many mothers have a question about how to feed a very premature baby? In fact, this process is quite a bit different from the process of feeding full-term babies. In the first days of life, a special substance is introduced into the baby's body - a 5% glucose solution. Usually, crumbs are given to them through a probe or syringe. If it is assimilated well, then in this case, you can start feeding the baby.

Doctors recommend sticking to breastfeeding, as there are a lot of useful substances in mother's milk that a fragile body needs. Every day, the mother should bring fresh expressed milk to the intensive care unit, and the doctors will feed it to the baby through a syringe or tube. When transferring the baby to the ward, you can already begin to apply it to the breast, forcing him to feed on his own.

If it is not possible to stick to breastfeeding, then as the main foodmix should be used. But it is required that artificial nutrition be selected by a pediatrician. The volume of a single feeding is calculated based on the weight of the crumbs:

• up to 1,000 grams - 2-3 ml;
• from 1,000 to 1,500 grams - 3-5 ml;
• from 1,500 to 2,000 grams - 4-5 ml;
• from 2,000 to 2,500 grams - 5 ml;
• over 2,500 grams - up to 10 ml.

Feed your baby every 2-3 hours. Once the baby's weight has reached 2,500 grams, he continues to be fed in the same way as a newborn full-term baby.

Modern doctors do not recommend introducing complementary foods before 6 months. Accordingly, if the child was born 2 months earlier, then the first complementary foods need to be introduced only at 8 months. It is required to start it with vegetables, gradually introducing fruits, porridge, meat, cottage cheese and yogurt. It is worth adding new products until the baby is one year old. How to feed a deeply premature baby after a year? By this age, his body is already fully formed, so the diet of such a baby does not differ from the diet of a full-term baby.

Child Development

Severely preterm babies may develop differently month by month than those born at due date. Approximately, the picture looks like this:

• 1 month for such a child is the most difficult. Most likely, he will spend most of the first month of his life in intensive care, where his body will fight for life. The baby almost always sleeps, respectively, leads an almost motionless lifestyle. Even baby foodcan be carried out in a dream.
• By 2 months of life, the baby noticeably gains weight. By this time, he gradually begins to look like a newborn full-term baby. The skin becomes thicker, the fluff on the body disappears, and now, the veins under the skin are almost invisible. At 2 months, a premature newborn should begin to breastfeed to develop sucking reflexes.
• By the age of 3 months, the baby begins to develop some reflexes. He already reacts to light and sound. His body weight is actively starting to increase. If you put the baby on his stomach, you can see how he begins to tear his head off the surface a little. He still sleeps most of the time, waking up only when he feels hungry.
• Developmentally premature babies should be similar by months to those babies who were born 2 months later than their full-term ones. That is, at 4 months, its development should correspond to 2 months. The baby, when lying down, can already tear his head off the surface and hold it in an upright position. He sleeps less, stays awake more than before. By this time, the child is already beginning to fix his gaze on objects.
• 5 is the most enjoyable month for many parents. By this time, the baby was already strong enough and gained strength. Now he is already able to give his parents the first smile. Hearing any sound, he begins to react and turn his head to the side. By 5 months, the baby begins to hold his head upright.
• Children bornpremature, at 6 months they begin to recognize their loved ones, as well as respond to the appearance of unfamiliar faces. During this period, he begins to master coups from the back to the tummy.
• At 7 months, the baby is already actively turning over on his stomach. He takes the toys in his hands and carefully examines them. He has a natural desire to reach for bright objects.
• 8 months is the right time to introduce complementary foods for very preterm babies. If the baby is gaining weight well, it is recommended to start with vegetables (cauliflower, broccoli or zucchini). During this period, the baby has a new ability - to roll over from his stomach to his back.
• According to many pediatricians, the 9th month of life is the most active and progressive period, when the crisis has passed, the baby has already become strong enough. He begins to get on all fours and learns to crawl. And by the end of the 9th and the beginning of the 10th month of life, many children are already actively moving around the apartment on all fours, sitting confidently.
• At 10 months, babies continue to learn to crawl, doing it faster and more clearly. They already know their names and react to their name.
• By 11 months of life, a premature baby begins to catch up with his peers in gestation. He already knows how to stand, holding on to a support, and move along it. In the same period, the baby begins to speak many of the same type of words and point his finger at an object familiar to him, pronouncing the corresponding sound.
• So the premature baby turned one year old. By this time, the children had already practically caught up with their physical and psychological development.peers. By the first year of life, such children are already beginning to confidently stand without support and take their first steps.

Don't worry if the baby is a little behind in physical development from the norms dictated by pediatricians. You should not rush him and give him the opportunity to develop as he is comfortable. But, if the baby is far behind the developmental norms of a deeply premature baby, then it is worth conducting a series of examinations for him:

• visit a neurologist;
• do an ultrasound examination and tomography of the brain in order to exclude the presence of cysts and other pathologies;
• visit an orthopedist.

Often the reason for the delay in the development of a premature baby is hypotonicity of the muscles. In this case, children are prescribed vitamin D, strengthening massage and daily exercise. With proper care, the baby will soon gain strength and will delight parents with new successes.

Long-term effects

It is generally accepted that the most difficult for a newborn baby and his parents is the first year of life. Due to the immaturity of the body, pathologies and various diseases can develop. But by the year their body becomes noticeably stronger, all their organs are already formed, and unpleasant diagnoses recede one after another. The consequences in the future for very premature babies are no longer so terrible. Usually, quite normal people grow up out of them, who do not differ at all from others, and only information from the medical record speaks about the degree of prematurity.

Interesting facts about premature babies

Scientific research around the world has revealed some interesting facts about premature babies:

• Deeply premature babies are small people with big character. From the very first day of their birth, they struggle with extraordinary strength to live. Therefore, quite often it is these qualities that are transmitted to already adult people. They are distinguished by strong character and good endurance.
• Unfortunately, the number of very premature people is constantly progressing.
• Many famous people were also born prematurely, such as: Voltaire, Rousseau, Newton, Darwin, Napoleon and Anna Pavlova.
• As a result of numerous studies, it has been repeatedly proven that the mental abilities of premature and full-term babies do not differ.
• Approximately 13-27% of premature babies develop chronic diseases: cerebral palsy, dementia, hearing loss, blindness or epilepsy.
• Approximately 30-50% experience anxiety attacks and night terrors.
• Because of prematurity, girls may experience impaired reproductive function, which causes problems with the regularity of the menstrual cycle.
• If mother and father were born prematurely, then there is a high probability that they will also have premature babies. The same applies to women who have previously had a preterm birth or spontaneous abortion.
• Men may also experience reproductive disorders, therefore, may decrease1-5% chance of becoming a father.

Preventive measures

Unfortunately, there is no such method that could definitely prevent the risk of preterm birth. But subject to certain preventive measures, there is a high probability that the expectant mother will be able to give birth to a he althy baby in a normal period - from 38 to 42 weeks.

• A girl should understand from an early age that she is a future mother and needs to take care of her he alth. This rule must be communicated to her by her mother. Therefore, it should be that the girl does not sit on cold objects, does not get cold of the kidneys and appendages, leads a he althy lifestyle and avoids prolonged stressful situations.
• Chances of a premature baby are markedly increased if a woman has had an abortion before.
• When planning a pregnancy 3 months from conception, it is recommended to give up bad habits and eating fatty foods. On the contrary, expectant parents should take vitamins such as folic acid.
• If a pregnant woman works in production, then you need to go to work while waiting for the baby in more favorable working conditions. The employer has no right to refuse such a request.
• It is necessary to follow all medical recommendations, take all medical measures in a timely manner in order to be able to identify the pathology at an early stage of its development and prevent it in a timely manner.
• It is worth avoiding contact with infected people.

But evenA completely he althy mother may suddenly begin labor activity, due to the individual characteristics of the body.

Conclusion

In conclusion, it is worth saying about the development of a premature baby that a baby born prematurely differs from a full-term baby only in that he needs more careful medical supervision, as well as doubled love and care from parents. If the baby was born prematurely, then you should believe in his strength, very soon he will grow up, and will not differ from his peers.