A normal pregnancy, without any deviations, should take 38-42 weeks. But, unfortunately, this is not always possible. More and more often there are situations when labor takes place much earlier than the due date. What consequences await a deeply premature baby and is it possible to prevent their occurrence? Everything in more detail in this article.
What?
A child is full-term if it corresponds to two interconnected indicators: his birth weight was more than 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 careful monitoring by medical professionals.
All premature infants, depending on when they were born and the weight of the premature baby at birth, can be divided into several main degrees:
- 1st 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;
- Grade 3 - the period from 28 to 30 weeks, weight 1,000 to 1,500 grams;
- Grade 4 - period up to 28 weeks, weight up to 1,000 g.
Grades 1 and 2 relate to moderate prematurity; a deeply premature baby corresponds to grades 3 and 4.
Specific traits
The baby, who was born before the onset of the 7th obstetric month of pregnancy, is noticeably different from those who were born on time. In total, several characteristic features can be distinguished:
- dark red skin color;
- the location of the navel in the lower abdomen;
- disproportionate body: the head is large, the arms and legs are short;
- very soft nails on the hands and feet;
- open sex gap in girls;
- the location of the testicles in the abdominal cavity in boys;
- the absence of a subcutaneous fat layer, at first glance the baby looks very thin;
- the presence of wrinkles on the skin;
- severe swelling of the whole body;
- the whole body is covered with fluffy hair.
Often you can see photos of deeply premature babies in women's forums and in medical institutions of the corresponding direction. On them you can see that the skin of the baby is so thin that through it you can see the veins.
A distinctive feature is the behavior of the baby. He almost always sleeps, does not know how to eat on his own.
Reason in mom
We should also talk about why a deeply premature baby was born prematurely. Doctors decide to undergo surgery or stimulate labor if the following abnormalities are found in a pregnant woman:
- The 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 disorders.
- Unhealthy lifestyles: excessive drinking or smoking.
- Hard physical labor can also become a provocateur of the development of premature birth.
- High pressure.
If such pathologies are detected, doctors evaluate the patient's condition and decide on the delivery. But, with the appearance of some diseases, the uterus stops stretching, so it begins to put pressure on the fetus and labor begins.
Symptoms of Preterm Birth
A pregnant woman should be wary of the appearance of pulling pains in the abdomen, especially in its lower part; urinating too much or leaking water; the appearance of blood discharge; contractions of the uterus (contractions).
If such symptoms appear, then you need to immediately call an ambulance team 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 before the due date.
Consequences for mother
Natural births do not differ from those that occur between 38 and 42 weeks. But, due to the small weight of the fetus, they pass faster, without severe pain, and the likelihood of breaks is also reduced.
Gynecologists, after passing the birth, study the condition of the patient's genitals, check her hormonal background and the presence of infectious pathogens in the body, after undergoing a cesarean section, the state of the sutures is also evaluated. In most cases, patients quickly recover physically, but recover psychologically for a long time, often they have to turn to a psychologist for help.
Reason in baby
In rare cases, the cause of premature birth 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 revealed any gross pathologies. In this case, doctors come to a similar situation - they evaluate the possibility of preserving the pregnancy, if there is none, then they perform an emergency cesarean section or stimulate the birth.
Consequences for the child
The consequences for a deeply premature baby are not the most pleasant. Unfortunately, children born before 28 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 deeply 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; accordingly, there is a high risk of developing disorders in the functioning of the lungs and the cardiovascular system.
- In most cases, the negative effects of deeply premature babies are associated with the immaturity of the nervous system. There is a high risk of cerebral palsy, epilepsy and other neurological diseases.
- Children born prematurely have vision problems.
- Fragile blood vessels can cause cerebral hemorrhage.
The condition of the fontanelles in deeply premature babies is also slightly different, they close much longer, which can cause unpleasant consequences, for example, hydrocephalic syndrome. For such patients, a scheduled brain ultrasound is prescribed monthly.
If the doctors are ready to quickly let go the mother of a deeply premature baby, then the small patient is in a hospital for a long time under the supervision of a number of doctors.
Apnea
One of the most dangerous diseases is deep 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 soon and not all of his organs had time to form.
Apnea means 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.
The treatment of such a pathology is long and complex. The baby must be on mechanical ventilation and receive oxygen artificially until his breathing is stabilized. In the future, when transferred to the ward, pediatricians will continue to monitor his state of health. A special sensor will be connected to the crib, which measures the pulse and respiratory activity of the baby. If breathing is lost or Mom 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 apnea only if seizures 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 deeply premature babies can stop at any time, leading to death. Even if the attacks were completely stopped, then for a long time, the child after discharge will adhere to maintenance therapy.
Resuscitation nursing
Up to 31 weeks of pregnancy, the baby continues to form internal organs, respectively, he is not yet adapted for life outside the uterine cavity. After a preterm birth, he cannot take his first breath on his own, so he needs to go through a long process of nursing deeply premature babies in intensive care.
First of all, resuscitation doctors 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 camera and a cap - a couveuse. You may notice that there are many wires around the little crumbs. They are necessary to create the following functions:
- power supply;
- humidified oxygen supply;
- the implementation of mechanical ventilation;
- maintaining the necessary parameters of temperature, humidity level.
It is worth noting that in the process of nursing deeply premature babies, food enters the body through a special device - a probe. For this purpose, medical specialists use a special gentle mixture, but it is still recommended that mom transfer expressed breast milk to the intensive care unit. Firstly, this way the baby will receive more nutrients, and secondly, a woman will be able to maintain lactation.
As mentioned earlier, premature babies do not have adipose tissue, so they have impaired metabolic heat processes. To create artificial heat use heating pads filled with warm water.
The condition of a small patient is always monitored by a resuscitator and nurses. Sensors are installed on the equipment, by which it is possible to determine the state of health of the baby and establish the optimal environment in the couveuse. If the child's well-being 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 is normal, he decently gained weight and learned to breathe on his own, then the most long-awaited moment for each parent comes - transferring the baby to the ward, where he will be with his mother for a long time. Doctors conduct drug therapy for the patient, depending on the degree of his prematurity and state of health. In addition to treating premature babies, it is recommended to create favorable conditions in the ward for their full development:
- It is recommended to warmly dress the baby or wrap a warm, but not heavy blanket. The baby’s body will still continue to retain heat poorly on its own.
- Mom should learn the “Kangaroo” method; it consists in creating a “skin to skin” contact. As a result of numerous studies, it was proved that if you conduct such a session, at least for 20-30 minutes a day, then the child’s well-being will quickly improve, and he will gain weight better.
- Many children are additionally prescribed massage to improve skin condition.
- To improve muscle tone, it is additionally recommended to do light exercises, but only as directed by a doctor.
In the process of nursing a baby in the ward, a lot of specialists of various narrow specialties observe him, mainly therapist, optometrist, ENT and neurologist. To assess the state of health, he will need to regularly take tests and conduct an ultrasound examination of important parts of the body.
In the ward, mother and baby can be from 2 weeks to 3 months. They can be discharged from the department of premature babies only if he has gained weight up to 2,500 grams, feels satisfactory, independently breastfeeds, his body maintains optimal body temperature. They also evaluate the mother’s ability to take care of a special baby on her own.
Nursing home
If the child is at home, then the doctors noted his stable state of health. In this case, parents should already 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 in it:
- The room should not have loud sounds and flickering elements. The baby’s insufficiently strengthened nervous system is not yet capable of perceiving such phenomena. If possible, it is recommended that you place the baby's crib in the bedroom, where there is no TV and other sources of noise.
- In the first month of life at home, you should warmly dress the baby and fix his body position with special pillows so that during the coup on the side the baby does not spend its own energy.
- The room should always be fresh and maintained at an optimal level of humidity. Therefore, it is recommended to install a humidifier. It is recommended to ventilate the room daily, but the baby at this time should be moved to another room.
- A very important condition - it is necessary 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 each newborn baby: bathing, feeding, changing bedding, clothes and a diaper, treating skin for diaper rash, walking in the fresh air.
Regardless of what the consequences are for deeply premature babies, they are required to visit a doctor every month. Usually, premature babies are registered in a specialized clinic.
Feeding Features
Many mothers have a question about how to feed a deeply premature baby? In fact, this process is very slightly 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 - 5% glucose solution. Usually, crumbs are given to them through a probe or syringe. If it is learned well, then in this case, you can start feeding the baby.
Doctors recommend adhering to breastfeeding, as breast milk has a lot of beneficial substances needed by a fragile body. Every day, the mother should bring fresh expressed milk to the intensive care unit, and doctors will feed him the baby through a syringe or probe. When transferring a baby to the ward, it is already possible to start applying it to the chest, forcing it to feed on its own.
If it is not possible to adhere to breastfeeding, then the mixture should be used as the main food. But it is required that the artificial nutrition be selected by the pediatrician. The amount of one-time 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.
The baby should be fed every 2-3 hours. As soon as the weight of the crumbs has reached 2,500 grams, they continue to feed him the same way as the newborn full-term baby.
Modern doctors do not recommend introducing complementary foods before 6 months. Accordingly, if the baby was born 2 months earlier, then the first lure is required 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 crumbs are 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
Monthly development of deeply premature babies may differ from those born on time. Approximately, the picture is as follows:
- 1 month for such a child is the most difficult. Most likely, he will spend most of the time in 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 immobile lifestyle. Even baby food can be carried out in a dream.
- By the age of 2 months, the child is noticeably gaining 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 baby should begin to be applied to the chest so that it develops sucking reflexes.
- By the 3rd month of life, some reflexes begin to develop in the baby.He is already reacting 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 slightly off the surface. Still, most of the time he continues to sleep, wakes up only when he feels a sense of hunger.
- By development, deeply premature babies by months should be similar to those babies born 2 months later than their full-term babies. That is, in 4 months its development should correspond to 2 months. The baby in a prone position can already tear his head off the surface and hold it upright. He sleeps less, awake more than before. By this time, the child is already beginning to fix his gaze on objects.
- 5 months for many parents is the most enjoyable period. By this time, the baby had already grown strong enough and gained strength. Now he is already able to give his parents a 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 in an upright position.
- At 6 months old, babies born prematurely begin to recognize their loved ones and also respond to the appearance of strangers. During this period, he begins to master the coups from the back to the tummy.
- At 7 months, the baby is already actively turning on his stomach. He picks up toys and carefully examines them. He has a natural desire to reach out for bright objects.
- 8 months is the time when it is time to introduce complementary foods for deeply premature babies. If the baby is gaining weight well, it is recommended to start with vegetables (cauliflower, broccoli or zucchini). During this period, the crumbs have a new ability - to roll over from the abdomen to the back.
- According to many pediatricians, 9 months of life is the most active and progressive period, when the crisis has passed, the baby has already become quite strong. He begins to get on all fours and learns to crawl. And many children by the end of 9 and the beginning of 10 months of life are already actively moving around the apartment on all fours, sitting confidently.
- At 10 months, children continue to learn to crawl, doing it faster and more clearly. They already know how they are called and respond to their name.
- By the age of 11 months, a premature baby begins to catch up with their peers by 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 is one year old. By this time, the children have almost caught up with their peers in the physical and psychological development. By the first year of life, such children are already beginning to confidently stand without support and take their first steps.
Do not worry if the baby is slightly 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 development standards of a deeply premature baby, then it is worthwhile to conduct a series of examinations for him:
- visit a neurologist;
- make an ultrasound examination and tomography of the brain in order to exclude the presence of a cyst and other pathologies;
- visit the orthopedist.
Often the cause of a lag in the development of a premature baby is muscle hypotension. In this case, children are prescribed vitamin D, a firming 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 believed that the first year of life is the most difficult for a newborn baby and its parents. 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 future consequences of deeply premature babies are not so terrible. Usually quite normal people grow out of them, who are completely different from others, and only information from a medical record speaks of the degree of prematurity.
Interesting facts about premature babies
As a result of scientific research conducted around the world about premature babies, several interesting facts were revealed:
- Deeply premature babies are small people with a large character. From the very first day of their birth, they are struggling with extraordinary strength to live. Therefore, quite often it is these qualities that are passed on to adults. They are distinguished by a strong character and good stamina.
- Unfortunately, the number of deeply premature people is constantly progressing.
- Many famous people were also born prematurely, such are: Voltaire, Russo, Newton, Darwin, Napoleon and Anna Pavlova.
- As a result of numerous studies, it was repeatedly proved that the mental abilities of premature and full-term babies do not differ.
- About 13-27% of premature infants develop chronic diseases: cerebral palsy, dementia, hearing loss, blindness or epilepsy.
- Approximately 30–50% have seizures of anxiety and nightly fears.
- In girls, due to prematurity, there may be a violation of reproductive functions, which causes problems with the regularity of the menstrual cycle.
- If the mother and father were born prematurely, then there is a high probability that they will have premature babies. The same applies to women who have previously had a preterm birth or spontaneous abortion.
- Men can also have impaired reproductive function, therefore, the probability of becoming a father may decrease by 1-5%.
Preventative measures
Unfortunately, there is no such method that would surely be able to prevent the risk of premature birth. But subject to certain preventive measures, there is a high probability that the expectant mother will be able to give birth to a healthy 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 that she needs to take care of her health. This rule should tell her her mother. Therefore, it follows that the girl does not sit on cold objects, does not get cold in her kidneys and appendages, lead a healthy lifestyle and avoid prolonged stressful situations.
- The chances of a baby being born prematurely increase noticeably if a woman has had an abortion before.
- When planning a pregnancy for 3 months from conception, it is recommended to abandon bad habits and eating fatty foods. On the contrary, future parents should take vitamins, for example, folic acid.
- If a pregnant woman works in production, then it is required to switch to work while waiting for the baby in more favorable working conditions. The employer has no right to refuse such a request.
- All medical recommendations should be followed, all medical measures should be taken in a timely manner in order to be able to identify pathology at an early stage of its development and to prevent it in a timely manner.
- Avoid contact with infected people.
But even in a completely healthy mother, labor can suddenly begin, 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 it requires more thorough medical supervision, as well as doubled love and care of the parents. If the baby was born prematurely, then it is worth believing in his strength, very soon he will grow up and will not be different from his peers.