WHAT HAPPENS TO PREMATURE BABIES?
Doctors today talk more of pre-term babies (ones born before 38 weeks) than premature babies.
Prematurity is defined by weight; a baby under 2-5 kilogrammes (5 1/2 pounds) is treated as premature whatever the length of the pregnancy which produced him. However the point must be made that length of pregnancy is most important – a baby who is small but was in the uterus for the full term is less of a worry to the doctors than a bigger one born before term.
The causes of pre-term births are many, and not always understood. Twins (and triplets or more) are usually pre-term. Preeclampsia can lead to a pre-term baby as can problems of the placenta during development. If the placenta lies between the baby and the opening of the birth canal, this means delivery is very difficult – the condition is called placenta praevia – and in a few cases the placenta may separate from the wall of the uterus. In this case early caesarian section may be needed and so the baby may be pre-term. Other causes may include illness in the mother,such as anaemia, or fibroids in the uterus.
If it is possible to delay a pre-term birth, the doctors will do so – with bed-rest and sedation and in a few cases with hormone treatment, and sometimes with alcohol, given in an intravenous drip. In other cases it is not possible to do this, and in some, of course, the pre-term delivery is deliberate, for example in severe pre-eclampsia.
The baby’s needs vary with his size. Some need little more than care in an environment in which heat and humidity are carefully controlled – an incubator – being able to feed normally, even at the breast. Others, however, need to be tube-fed, and also need special high nutrient feeds to enable them to gain as much weight as possible.
The major problems with pre-term babies are breathing difficulties, which need great care by the pediatrician, feeding problems, infections and anaemia. All these need constant watchfulness by the nursing staff and some of the most superb nursing anywhere is that provided in special care baby units in this country. Even babies weighing just under one kilogramme (two pounds) at birth have survived and grown up to be normal and well. And no mother need fear that the treatment her preterm baby has will damage his eyes. In the early days of incubator care it was not realized that the giving of excess oxygen could lead to eye damage and tragically some babies were so hurt. Nowadays this does not happen.
A pre-term baby usually leaves hospital once he reaches the weight of 2-5 kilogrammes (5 1/2 pounds), and after his mother has been taught by the nursing staff how to handle him. There are no set rules about this; the most important thing is that the baby has settled into the routine of feeding and that his metabolism can take care of itself. Usually these babies rapidly catch up with their bigger colleagues by the second birthday.
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