Stages of nursing premature babies by months: features of care and feeding

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

Every woman is preparing for a little miracle, but sometimes it happens that the baby is born prematurely. And then a lot of questions arise. When is a child considered premature, causes, degrees, stages of nursing and feeding features? This is detailed in the article.

Degrees of prematurity

Back in the mid-70s of the 20th century, the World He alth Organization determined the minimum indicators for the weight, height and term of a child, which is considered premature. This is the baby born at 22 weeks with a height of 25 cm and a weight of 0.5 kg. In practice, these figures are often somewhat higher. A baby is considered premature if born at 28-37 weeks, with a height of 35-45 cm and a weight of 1 kg to 2.5 kg.

Degrees of premature baby:

• 1 degree - the baby weighs more than 2 kg, his height is 45 cm, was born at 37 weeks of pregnancy;
• 2 degree - indicators of weight, height and weekpregnancy - up to 2 kg, 35 and 40 cm respectively;
• 3 degree - the weight of the child is up to 1.5 kg, height is less than 35 cm, was born at 35 weeks of pregnancy;
• 4 degree - the weight of the baby is less than 1 kg, the height is up to 30 cm, the birth occurred before the 28th week.

Even a term baby can be considered premature if it is underweight. That is why the most important sign of prematurity is the baby's body weight.

Signs and causes

Before we talk about the stages of nursing premature babies, let's look at how such a baby differs from children born on time, and what can cause early birth.

Signs of a premature baby:

• the body is disproportionately developed - the upper and lower limbs are usually short, and the head takes up a third of the total length;
• hair down covered back, chest and face;
• fat layer is very thin or absent, the skin is wrinkled;
• eyes closed, silent crying;
• body thermoregulation is weak;
• ears are not fully formed, and nails have not grown to fingertips;
• abdomen sunken or not quite rounded, navel is pubescent and located in the groin area;
• h alt breathing with signs of apnea;
• lowered pressure, weak pulse;
• hyper- or hypotonicity due to poor muscle development;
• underdeveloped genitals.

These manifestations depend primarily on the degree of prematurity of the baby and may be present like everyone elseboth simultaneously and partially. The reasons for the birth of a child prematurely are often the illness of the mother, a hereditary factor or lifestyle.

Common causes of a premature baby:

• mom's lifestyle - emotional background, nutrition, bad habits and factors (working or environmental conditions), mother's age;
• mother's he alth status - diabetes, heart disease, rheumatism;
• diseases - early abortions or miscarriages, lack of observation during pregnancy, viruses or infections during the period of bearing a baby.

The first stage of nursing premature babies

It starts from the moment the baby is transferred to intensive care. Or a specialized clinic that takes care of premature babies. The baby is placed in an incubator or a special box, where oxygen is supplied and a certain temperature is maintained (+23 - +26 degrees, humidity 40% -60%). The chamber is made of transparent glass with windows through which you can carry out various manipulations, as well as connect the child to a ventilator.

At this stage, the baby is connected to various sensors through which the specialist is able to monitor the condition. It is important to maintain a certain temperature and humidity. If the thermal regime is not observed (hypothermia), a significant deterioration in the baby's condition and irreversible changes in organs and tissues are possible.

Depending on the degree of prematurity, the baby can breathe on its own,through an oxygen mask or using an endotracheal tube inserted into the trachea. A baby born weighing less than 1 kg is often on a ventilator for up to 2 weeks, until the condition stabilizes and spontaneous breathing returns.

At this stage of nursing premature babies, the thin and not yet mature skin of the baby needs to be taken care of. Therefore, bathing in the first two weeks of life is not carried out. It is also important that during this period the baby receives all the necessary nutrients and medications. They are administered intravenously through a catheter in the navel, which is installed in the first hours of a child's life. If the baby has jaundice, he is given phototherapy.

In premature babies, the immune system is still very weak, which is fraught with the development of infection, pneumonia, sepsis or the formation of a purulent focus in the bone. Therefore, antibiotics are often prescribed for such children.

When the child begins to breathe on his own and gains weight, he is transferred to the next stage of rehabilitation. This period (the most critical in a baby's life) can last from a few days to a couple of weeks. All the time the baby is under the supervision of specialists.

The second stage of nursing premature babies - after resuscitation

During this period, the baby begins to adapt to environmental conditions. He begins to interact with his mother and learns to control his body. Often at this stage, the practice of "kangaroo" is recommended, when the baby is with his mother all the time and thus his adaptation is better. Here it is importantgive massages and conduct water treatments that will stimulate muscle stimulation.

Often, parents ask how many days the 2nd stage of nursing of premature babies lasts. It all depends on the body weight with which the child was born, as well as the dynamics of its development. On average, this period lasts from several weeks to 3 months. Such a baby is in the hospital of a specialized clinic with his mother. Thus, the mother learns to care for the baby, and he, in turn, feels more comfortable, as the emotional contact with the mother is maintained.

If the child still does not retain heat well, periodically it is placed on a heated table. Feeding at this time occurs twice a day for up to 40 minutes in order for the baby to develop innate sucking, swallowing and search reflexes. Applicable here is drug therapy, depending on the condition of the baby. These can be drugs aimed at improving the functioning of the brain or metabolism, fighting seizures, vasodilators or drugs to nourish the heart muscle.

However, at stage 2 of nursing premature babies, the emphasis is on restorative therapy.

Rehab

The purpose of the 3rd stage of nursing premature babies is to monitor the development of the child (psychological and physical) in dynamics. In this period, they keep a kind of diary of the indicators of the work of a small organism: they measure pressure, observe the work of the heart, fine motor skills, hearing,vision, the work of the digestive tract and the nervous system.

It is important at this stage to be examined by a number of specialists, namely a surgeon, immunologist, orthopedist, surgeon. An ultrasound of the organs and a complete blood count are also prescribed.

What weight are premature babies discharged with?

After the baby's vital signs stabilize, he begins to suck on his own and absorb food well, and if he gains more than 2 kg, he can be discharged home. This period can last from a few weeks to a couple of months. It all depends on what indicators the baby was born with, as well as on its development in dynamics.

It is believed that a premature baby will be in the clinic for at least 2 weeks. The average stay of children born prematurely ranges from one to two months. This is provided that he does not have other developmental pathologies. Then the period of rehabilitation outside the home may last even longer.

After discharge, the stage of nursing premature babies begins at home. It is important to follow all the recommendations of a specialist. This period is the longest. It can last up to six years.

What to do with a premature baby at home?

The first few months after a premature baby is discharged home, a nurse or a district pediatrician visits him several times a week. Mom may also be advised to visit the clinic twice a month in order tofollow the dynamics of the development of the baby.

At this home stage of nursing premature babies, it is important to follow all the instructions of the specialist. Namely:

• refrain from receiving guests for at least the first six months, except for medical personnel;
• maintain a certain air temperature - not less than +24С and not more than +26С;
• children's room should be ventilated and wet cleaned several times a day;
• follow the rules of nutrition, child care and hygiene;
• minimize loud noises around the baby, as this can negatively affect his condition.

Feeding Features

If full-term babies are applied to their mother's breast immediately after birth, then a baby weighing up to 2 kg has some problems with the functioning of the digestive tract. And in order to start fully feeding, his intestines and stomach are prepared by introducing a 5% glucose solution. Also, an immature baby cannot yet absorb all the necessary amount of nutrition, so nutrients are often administered intravenously.

Best of all, when the baby, depending on the degree of prematurity, receives mother's milk, even if he has not yet learned to suck. He receives mother's milk through a syringe. It has important components for the formation of the stomach and intestines. If this is not possible, the child is fed formula.

Feeding volume depends on baby's weight:

• first feeding 2-3 ml 12-24 hours afterbirth - if the baby weighs less than 1 kg, gradually increase the volume of breast milk or formula;
• 5 ml - the first feeding of a baby weighing from 1.5 kg to 2 kg, feeding occurs every two hours with a gradual increase in volume;
• 10 ml and more - feeding a baby weighing 2 kg, in this case, he is applied to the breast if a sucking reflex is developed, with a small amount of mother's milk, he can be fed from a spoon, bottle or syringe.

Baby weight gain depends on the quality of nutrition. But here it is worth knowing that premature babies gain quite a bit, on average 5-15 grams. per day, may not gain at all for several days. Here it is important to ensure that the dynamics are positive.

Conclusion

Premature babies are quite fragile and most defenseless. Here it is important to go through all three indicated stages of nursing, and also tune in to the fact that the recovery period will be long. On average, it lasts about six years. But if you follow all the doctor's prescriptions, the child will not lag behind in development from their full-term peers.