When Your Baby's Born Premature

What Is Prematurity?

Babies born more than 3 weeks earlier than their expected due date are called "premature." Premature babies (preemies) didn't have enough time to grow and develop as much as they should have before birth.

Why Was My Baby Born Early?

Most of the time, doctors don't know why babies are born early. When they do know, it's often because a mother has a health problem during pregnancy, such as:

• diabetes (high blood sugar)
• hypertension (high blood pressure)
• heart or kidney problems
• an infection of the amniotic membranes or vaginal or urinary tracts

Babies also may be born early if:

• there's bleeding, often due to a low-lying placenta (placenta previa) or a placenta that separates from the womb (placental abruption)
• the mother's womb is not shaped typically
• they're part of a multiple birth (twins, triplets, or more)
• their mother was underweight before pregnancy or didn't gain enough weight during pregnancy
• their mother smoked, used drugs, or drank alcohol while pregnant

Does My Baby Need Special Care?

Yes, preemies may have many special needs. Younger and smaller babies tend to have more health problems than babies born closer to their due dates. So they often need care in a neonatal intensive care unit (NICU).

Why Must My Baby Stay Warm?

Preemies don't have enough body fat to hold their body temperature. Incubators or radiant warmers keep them warm in the NICU:

• Infant warmers: These small beds with heaters over them help babies stay warm while being monitored. Because they are open, the team has easy access to babies to provide care.
• Incubators: These small beds are enclosed by clear, hard plastic. Temperature in the incubator is controlled to keep a baby's body temperature where it should be. Doctors, nurses, and others can give care to the baby through holes in the sides of the incubator.

What Are My Baby's Nutritional Needs?

Breast milk is the best nutrition for all babies, especially preemies. It has proteins that help fight infection. Most preemies can't feed straight from the breast or bottle at first. Mothers pump their milk and it's given to babies through a tube that goes through the nose or mouth and into the stomach.

If that is not an option, doctors may suggest giving the baby donor milk from a milk bank, which is safe.

If you don't breast feed or pump milk, your baby will get formula. Preemies need more calories, proteins, and other nutrients than full-term babies do. So extra nutrients called fortifiers may be added to pumped milk or specially designed preterm formulas may be used to help your baby grow.

Preemies are fed slowly because they can get necrotizing enterocolitis (NEC), a serious intestinal problem that affects preemies.

Some babies who are very small or very sick get their nutrition through intravenous (IV) feedings called total parenteral nutrition (TPN). TPN has a special mix of nutrients like proteins, carbohydrates, fats, vitamins, and minerals that can fully support a baby’s growth until they can feed.

Doctors and dietitians watch the diets of preemies very carefully and make changes when needed to make sure the babies get the nutrients needed to grow.

What Health Problems Can Happen?

Because their organs aren't fully ready to work on their own, preemies are at risk for health problems. In general, the earlier a baby was born, the greater their chances of health problems.

These problems include:

• anemia, when babies don't have enough red blood cells
• apnea, when a baby stops breathing for a short time; the heart rate may lower; and the skin may turn pale or blue
• bronchopulmonary dysplasia and respiratory distress syndrome, problems with breathing
• hyperbilirubinemia, when babies have high levels of bilirubin, which is produced by the normal breakdown of red blood cells. This leads to jaundice, a yellowing of the skin and whites of the eyes.
• necrotizing enterocolitis, a serious disease of the intestines
• patent ductus arteriosus, a problem with the heart
• retinopathy of prematurity, a problem with the eye's retina
• sepsis infections that babies can get before, during, or after birth

What Else Should I Know?

Preemies often need special care after leaving the NICU, sometimes in a high-risk newborn clinic or early intervention program. Depending on their health, they may need care from specialists, such as doctors who treat problems with the brain and nervous system (neurologists), eyes (ophthalmologists), and lungs (pulmonologists).

Preemies must go to all doctor visits (including well-child checkups), get the vaccines that all babies need to stay healthy, and have routine hearing and eye exams. As your little one grows, doctors will check your baby's:

• growth
• development, including speech and language, learning, and motor skills
• muscle tone, strength, and reflexes

Looking Ahead

Caring for a preemie can be more demanding than caring for a full-term baby.

Take care of yourself by eating well, resting when you can, and getting exercise. Spend one-on-one time with your other children when you can, and get help from others. Look for support from friends, family, and support groups. You also can get support online from groups such as:

• March of Dimes
• Graham's Foundation
• Life's Little Treasures Foundation
• Hand to Hold