Each woman prepares for the appearance of a small miracle, but sometimes it happens that the baby is born prematurely. And then a lot of questions arise. When is a baby considered premature, causes, degrees, stages of nursing and feeding habits? About this in detail in the article.
Prematurity
Back in the mid-70s of the 20th century, the World Health Organization determined the minimum indicators of the mass, height and term of the child, which is considered premature. Such is the baby born at 22 weeks with a height of 25 cm and a weight of 0.5 kg. In practice, these indicators are often somewhat larger. Prematurely considered a baby who was born at the age of 28-37 weeks, with an increase of 35-45 cm and a weight of 1 kg to 2.5 kg.
The degree of premature baby:
- 1 degree - the child weighs more than 2 kg, his height is 45 cm, was born at 37 weeks of gestation;
- 2 degree - indicators of weight, height and week of pregnancy - up to 2 kg, 35 and 40 cm, respectively;
- Grade 3 - the weight of the child up to 1.5 kg, height less than 35 cm, was born at 35 weeks of gestation;
- Grade 4 - the baby's weight is less than 1 kg, height up to 30 cm, childbirth occurred earlier than 28 weeks.
Even a baby born on time can be considered premature if it has insufficient body weight. That is why the most important sign of prematurity is precisely the body weight of the baby.
Signs and Causes
Before talking about the stages of nursing of premature babies, we will analyze how such a baby differs from children born on time, and what can cause early birth.
Signs of a baby born early ahead of time:
- the body is disproportionately developed - the upper and lower limbs are usually short, and the head occupies a third of the total length;
- a hair fluff covers the back, chest and face;
- the fatty layer is very thin or completely absent, the skin is wrinkled;
- eyes closed, silent crying;
- body thermoregulation is weak;
- the ears are not fully formed, and the nails have not grown to the tips of the fingers;
- the belly is sunken or not quite round, the navel is pubescent and located in the groin area;
- intermittent breathing with signs of apnea;
- blood pressure is low, pulse is weak;
- hyper- or hypotension due to poor muscle development;
- underdeveloped genitals.
These manifestations depend primarily on the degree of prematurity of the baby and may be present both all at the same time or partially. The reasons for the birth of a child ahead of time are often mother’s disease, hereditary factor or lifestyle.
Common reasons for giving birth to a premature baby:
- Mom’s lifestyle - emotional background, nutrition, bad habits and factors (working or environmental conditions), mother’s age;
- maternal health - diabetes, heart disease, rheumatism;
- Diseases - previous abortions or miscarriages, lack of monitoring during pregnancy, viruses or infections during the period of gestation.
The first stage of nursing premature babies
It begins with the moment the baby is transferred to intensive care. Or a specialized clinic that cares for premature babies. The kid is placed in a couveuse or a special box where oxygen is supplied and a certain temperature is maintained (+23 - +26 degrees, humidity 40% -60%). The camera is made of transparent glass with windows through which various manipulations can be carried out, as well as connecting the child to an artificial lung ventilation device.
At this stage, the baby is connected to various sensors through which the specialist has the ability 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 condition of the baby 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 who was born with a weight of up to 1 kg is often on the ventilator for up to 2 weeks until the condition stabilizes and spontaneous breathing is restored.
At this stage of nursing premature babies, the thin and still not mature skin of the baby requires care. Therefore, swimming in the first two weeks of life is not carried out. It is also important that the crumbs receive all the necessary nutrients and medications during this period. They are administered intravenously through a navel catheter, which is installed in the first hours of a child’s life. If the baby has jaundice, he is given phototherapy.
In premature babies, immunity 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 the 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, they recommend the practice of “kangaroo” when the baby is constantly with his mother and thus better passes his adaptation. It is important to massage and carry out water procedures that will help stimulate the muscles.
Often parents ask a question about 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, since emotional contact with the mother remains.
If the child still does not retain heat well, periodically he is placed on the heated table. Feeding at this time occurs twice a day for up to 40 minutes so that the baby develops congenital sucking, swallowing and search reflexes. Drug therapy is applicable here, depending on the condition of the baby. These can be drugs aimed at improving the functioning of the brain or metabolism, the fight against seizures, vasodilators or drugs to nourish the heart muscle.
However, at the 2nd stage of nursing of premature babies, the emphasis is on rehabilitation therapy.
Rehabilitation
The goal of the 3rd stage of nursing premature babies is to monitor the development of the child (psychological and physical) in dynamics. In this period, a kind of diary of performance indicators of a small organism is kept: they measure blood pressure, monitor the work of the heart, fine motor skills, hearing, eyesight, the work of the digestive tract and the nervous system.
It is important at this stage to undergo examinations by a number of specialists, namely the surgeon, immunologist, orthopedist, surgeon. An ultrasound of the organs and a general blood test are also prescribed.
With what weight are premature babies prescribed?
After the baby’s vital signs are stabilized, he begins to suck on his own and assimilate food well, and when 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 which indicators the baby was born with, as well as on its development in dynamics.
It is believed that at least 2 weeks premature baby will be in the clinic. The average rate of stay of children who were born prematurely varies from one to two months. This is provided that he has not revealed other developmental pathologies. Then the rehabilitation period outside the home can last even longer.
After discharge, the stage of nursing of 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 the prematurely born baby is discharged home, he is visited by a nurse or local pediatrician several times a week. Mom may also be recommended to visit the clinic twice a month in order to monitor the dynamics of the baby.
At this home stage of nursing premature babies, it is important to follow all the instructions of a specialist. Namely:
- refrain from receiving guests for at least the first six months, with the exception of medical personnel;
- maintain a certain air temperature - not less than + 24 and not more than + 26;
- the nursery should be ventilated and wet cleaned several times a day;
- adhere to the rules of nutrition, child care and hygiene;
- minimize loud sounds near the baby, as this can adversely affect his condition.
Feeding Features
If full-term babies are applied to their mother’s breasts immediately after birth, then a baby with a body weight of up to 2 kg has some problems with the work 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 still cannot absorb all the necessary amount of nutrition, so often nutrients are administered intravenously.
Best of all, when the baby, depending on the degree of prematurity, gets her mother’s milk, even if she 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 a mixture.
The amount of feeding depends on the weight of the baby:
- the first feeding of 2-3 ml after 12-24 hours after birth - if the baby's weight is less than 1 kg, gradually the volume of breast milk or mixture increases;
- 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 or more - feeding a baby weighing 2 kg or more, in this case it is applied to the breast if a sucking reflex is developed, with a small amount of mother’s milk, it can be fed from a spoon, bottle or syringe.
The indicator of weight gain by a baby depends on the quality of food. But here it is worth knowing that premature babies gain very little, on average 5-15 gr. per day, may not be recruited at all for several days. It is important to ensure that the dynamics are positive.
Output
Premature babies are quite fragile and most defenseless. It is important to go through all three designated stages of nursing, as well as 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 prescriptions of the doctor, the child will not lag behind in development from his full-term peers.