When a couple has a baby, mom and dad spend all their time on it, because without proper care the baby simply will not be able to develop normally, or maybe survive. But what if the baby was born ahead of schedule? Care for premature babies should be special, because such crumbs sometimes can not even breathe and eat without help.
More recently, doctors did not undertake to resuscitate and save the life of a baby whose birth weight is less than a kilogram. Now everything has changed, and specialists can give a chance to a baby who was born the size of a palm and weighs half a kilogram. About caring for premature babies in the intensive care unit, maternity hospital, home after discharge and in other conditions, we will tell in this article.
Premature babies: features
Full-term babies are considered those born from the 37th to the 42nd week of pregnancy. If the baby was born earlier than it should be, then it is considered premature. The main problem of such babies is the underdevelopment of internal organs, and the sooner the birth takes place, the more thorough care the child will need. Nursing care for premature babies begins from the first minutes of his life, the mother will be able to independently take care of her child only after the permission of the pediatrician, but more on that later. While we are interested in the physiological features of the baby who was born prematurely. How fast can a mom sip her baby? It all depends on the degree of his prematurity. In total, three degrees are shared:
- Extreme prematurity - weight less than a kilogram.
- Deep prematurity - weight from a kilogram to a half.
- Prematurity - weight from one and a half kilograms to two and a half.
The main features of a premature baby are:
- little weight;
- small stature (up to 46 cm);
- disproportionately folded body (large head, shortened legs, neck, navel shifted to the inguinal side);
- the shape of the skull is round, with clearly visible fontanel and sutures;
- auricles tightly pressed to the head, very soft;
- the skin is very thin and wrinkled, all wreaths can shine through;
- the surface of the body is covered with a small fluff;
- the fat layer is completely absent;
- on the handles and legs may be underdeveloped marigolds, or may be absent;
- undescended testicles in boys and an uncovered genital gap in girls.
It is worth noting that all the above signs should be in the aggregate. Only in this case can we talk about the features of caring for premature babies. If one thing is manifested, this indicates a pathology, and not prematurity.
Behavior of a premature baby
Newborns who were not born at the right time are also distinguished by their behavior. They are inactive, there is a decreased muscle tone. Kids are sleepy (this is noticeable even against the background of the fact that full-term babies sleep almost constantly), they startle for no reason and begin to move erratically. Especially complicates the care of premature babies is the absence of a sucking reflex. Baby is hungry but doesn’t know how to eat.
Briefly about caring for premature babies
We offer to consider the intricacies of caring for a baby, and then go through each item in more detail.
Nursing care for premature babies, as we already wrote, begins from the first seconds of his life. First of all, they take it into a warm diaper and, if necessary, make ventilation of the lungs. This is the most responsible procedure. The baby’s breathing may be impaired or even stop, as an early born baby does not produce enough surfactant - the substance responsible for proper breathing. Therefore, lung tissue can not fully crack.
The second problem is that premature babies are completely unprepared for a physiological existence in this world, they have an insufficient layer of subcutaneous fat, so thermoregulation is imperfect. Babies quickly cool and overheat, as the ambient temperature is very different from that in the mother’s womb.
In the old days, this problem was solved by wrapping the baby in cotton wool or putting it on a warm stove. Now the problem of regulating the temperature of the body of a newborn is being solved differently: a premature baby is placed in an incubator, or, in simple words, an incubator. A sufficient amount of oxygen gets there, it is isolated from extraneous noise and light. The temperature and humidity in the incubator are regulated, conditions similar to those in utero are created.
There are no feeding problems either. Features of nursing care for premature babies are swaddling, monitoring the general condition and, of course, in feeding. The medical staff takes the expressed milk from the mother, adds the necessary vitamins, proteins and minerals to it. If a woman does not have milk, then infant formulas are used that are designed specifically for babies born before the due date. Feeding a baby, if he has a poorly developed sucking reflex, is carried out using a syringe.
A baby who has a well developed reflex is given a bottle. If the child’s weight is so small that he cannot even swallow, a nasal gastric tube is used or nutrients are administered intravenously. The probe is injected through the nose of the crumbs, and milk in small doses enters his stomach. In any case, feeding a premature baby is fractional and in small portions, even if its weight is more than two kilograms. The organs are not yet developed enough to work fully. Nursing care for premature babies is required. After all, the mother can overfeed.
Care for premature babies in the hospital at first may not be possible if there are health complications. In this case, the baby is transferred to the intensive care unit.
Resuscitation care
The care of the newborn premature baby in the first stages is taken care of by the medical staff of the hospital. Most often, immediately after birth, the baby falls into the children's intensive care unit, and it is good if it is in the maternity hospital. But it happens that the hospital does not have such a department.
The first thing the baby is examined is a cardiologist, neurologist, orthopedist, ophthalmologist, neurosonography (ultrasound of the brain) is performed, if necessary, an ultrasound of all internal organs. In addition, urine and blood tests are taken. After the procedures, the baby is placed in the incubator.
What happens if the hospital does not have its own resuscitation? Is there really no chance to "pull" the child? Nothing like this. All maternity hospitals are equipped with the necessary equipment for caring for premature babies, there is also an apparatus for ventilation of the lungs, and a kyuvez, and special preparations designed to support the life of the crumbs, and a neonatologist - a specialist trained to care for children born out of order.
But still there is a problem: neonatologists not only look after preterm infants, but are also required to attend every subsequent birth. This means that there will be fewer observations of premature babies and a neonatologist can miss the point if it suddenly becomes necessary to save the baby.
In resuscitation, nurses and neonatologists work, whose duties include only caring for children already in their ward. In this case, the newborn will be constantly under vigilant medical supervision.
If the baby needs resuscitation, but it is not in the hospital, then after stabilization it will be transferred to another hospital, where there is a necessary department. Transportation is carried out in a specialized machine, where there are apparatuses for ventilation, an incubator and other necessary devices to support life.
When the baby is in intensive care, the mother can come to him at the appointed time, but only “communicate” through the glass of the incubator (incubator). There are departments where it is possible to visit the baby at any time of the day.
Feeding
Parents of babies born early need to know all the subtleties and features of caring for premature babies so as not to worry about the child. Many couples begin to worry too much about the life of the crumbs, they think that they will not cope. Of course, it is very difficult to survive a period of such difficult nursing, but progress does not stand still, and medical staff can save even the smallest ones.
If the baby's weight reaches two kilograms and the sucking reflex is well developed, then there is the possibility of breastfeeding. Moms will often be able to hold the baby in their arms, feed and help the nursing staff with the care of it. Only a nurse feeds from a bottle or syringe so that there are no problems with the esophagus. As already mentioned earlier, if the sucking reflex is absent or poorly developed, then the digestive organs can not fully cope with their task and feeding should be fractional.
Premature babies need a large amount of fluid. Usually, Ringer's diluted 1/1 with 5% glucose solution is used to maintain the body. In addition, vitamins are needed, in the first days, riboflavin, vitamin K and E, ascorbic acid, and thiamine are necessarily introduced. Focusing on the individual condition of the newborn, the doctor may prescribe other vitamins.
After some time, the baby's nutrition will not be any different from the nutrition of peers. But at the first stages of nursing, special additives are needed so that the development and growth of the crumbs are accelerated.
As parents can be sure, do not worry about food. Soon, your baby will take its toll and turn from a thin, weak baby into a cheerful, rosy-cheeked and active little one.
Nursing in the hospital
Care for premature babies in a hospital necessarily begins with the department of pathologies of newborns. Here, the baby will be constantly monitored by nurses and doctors, the necessary procedures, examination will be prescribed.
A baby can be transferred to a regular ward only when he gains a body weight of at least two kilograms, actively sucks milk, independently cope with the regulation of body temperature, and breathes well. The duration of stay in the incubator depends on the severity of the degree of prematurity, there are four in total:
- first degree - childbirth occurred in the period from 37 to 35 weeks;
- second degree - from 34 to 32 weeks;
- third degree - 31-29 weeks;
- fourth degree - 28 or less.
If by the time the mother is discharged from the hospital, the child has already reached the minimum parameters at which it is possible to care for the premature baby at home, then he will be allowed to go home with his mother. If the need for resuscitation is already absent, but there remains any risk to health, the baby is transferred to the children's department. Mother herself decides how to proceed: to go to the hospital with the baby or come to the hospital for feeding.
In the hospital
A baby born prematurely is transferred to a specialized children's department as ordered by a pediatrician and a neonatologist. Such a move is possible even if the baby is still fed through a probe and needs artificial respiration. All care for premature babies in this case is in the hands of the medical staff.
The child will be placed in a heated bed or a couveuse. A more complete examination is carried out in the hospital, it is aimed at detecting pathologies and genetic diseases. Specialists examine the infant, necessary tests and procedures are prescribed.
Positive dynamics usually begin to increase from the day of the earlier anticipated birth, that is, from the date the baby was due to be born on time. The time spent in stationary conditions depends on how quickly the baby gains weight, learns to suck and swallow, on the presence of identified pathologies. Hospital treatment can last from a week to several months.
Houses
When the baby is finally ready to go home, the doctor issues detailed recommendations to the parents. Caring for a premature baby after discharge is very difficult, especially for couples with a first-born. The difficulty lies in the fact that only nursing staff nursed the baby, and parents may not even have a clue about how or what to do.
In any case, if the baby was born prematurely, patronage must be conscientious. If for some reason the pediatrician did not arrive on the appointed day, call the clinic and request a visit. Now we will consider in detail all the intricacies of home care for a premature baby, which all family members living in the same room should definitely know.
- The first thing you should watch is the temperature of the air in the baby’s room, it should be about +22 degrees. Do not forget that premature babies may have problems with thermoregulation.
- For the first time, a baby should bathe at home after the permission of the local doctor. The bathroom warms up to 24 degrees, and the water should be close to body temperature. After washing, the baby is thoroughly wiped with a soft towel and dressed warmly, as children born out of time can quickly become cold.
- Walks are no different from those assigned to full-term babies. In the warm summer, you can go out to breathe air immediately after discharge, and in the cold season - after a month. The first walks last no more than half an hour, time gradually increases.
- Breastfeeding of premature babies after discharge is most often impossible, since he will already be "spoiled" by the bottle and he will be too lazy to suckle. Nevertheless, try to breast-feed or express milk as often as possible and feed them your child, because mother's milk is the most important element of nutrition in the first year of life. If you don’t have enough milk or if it completely disappeared after the stress received due to worries about the life of your baby, then buy mixtures designed for premature babies.
- The care of premature babies at home necessarily includes constant monitoring! If the baby becomes lethargic, weak, refuses to feed and spits up abundantly, immediately call a doctor, these are very bad signs.
Care for a premature baby in an outpatient setting
A plan for examining young children born early is made individually. Often premature babies suffer from diseases of the kidneys, eyes, neurological pathologies are observed. If there is any violation, then the baby is registered with the necessary doctor and it will be necessary to visit him regularly, without missing the prescribed methods.
If your little one is completely healthy, then only a monthly examination in the clinic and a round of narrow specialists who are performed in the "Days of Healthy Children" will be required. Within a month, the local nurse will visit you to make sure that the child is feeling well.
Development of premature babies
If the little man was born early, then in the first two months of his life he will sleep almost constantly, get tired quickly even with low activity. After two months of age, the child will begin to develop faster, move more actively, which can lead to muscle tension in the limbs. It is easy to remove with special exercises.
We must not forget that the nervous system of premature babies is weak, so the baby can startle for no reason, be afraid of sudden movements and sounds. Periods of restful sleep can change dramatically with bouts of agitation, again for no reason. Such children need peace and quiet, they poorly tolerate meetings with strangers and a change of scenery.
If the baby does not have pathologies, then he will develop and grow quite quickly. By the age of three months he will catch up and even, possibly, overtake his peers in growth, weight and development!