Yeditepe University Hospitals Pediatrics Specialist Dr. Filiz Bakar states that premature babies born without developing defense systems should be cared for very carefully in the first six months.

What does premature birth mean?

Normal pregnancy is defined within 38-42 weeks. Babies born at 37 weeks and under are premature babies and require special care. Especially babies born under 32 weeks of age are the main problematic group. Today, with the increase in assisted reproductive techniques, there is an increase in the number of multiple births and parallel premature babies.

What should be the first care of premature babies?

The baby lives in a constant temperature, sterile, less noisy, dark, safe environment in the womb than in the outside environment. With the birth event, the baby temperature comes to a very different, non-sterile, noisy, very bright, and unsafe environment. Babies born on time are dried, dressed and placed on their mother's chest to provide a safe and warm environment. The baby will soon adapt to this new environment. However, babies born prematurely are exposed to some interventions as soon as they are born, and they should be removed from the mother's safe environment. Since some systems related to preterm birth are not well developed, they have difficulty in adapting to the new environment. These babies are cared for in incubators, which are an environment similar to the mother's womb. The incubator is heated at the ideal temperature for the baby, and the desired level of humidity is provided to prevent heat loss. By keeping the baby separate from the outside environment, a more sterile environment is provided by giving air through special filters. Adjusted oxygen can be given to the baby in the incubator. An isolated environment where noise is minimized for the baby is provided. When necessary, a dark environment is provided by covering the incubator. Thus, until the baby is healed, all the care and treatments in this environment, which is similar to the mother's womb, are provided in a way that will least harm the baby. During their stay in the intensive care unit, these infants may have respiratory distress due to the inability to develop well, respiratory arrest, problems in heat preservation, infections, nutritional problems, low blood sugar, jaundice, cerebral hemorrhage, anemia, intestinal gangrene, eye problems that may narrow blindness called retinopathy of prematurity. Treatments are made for these problems. Babies who have been in the intensive care unit for a long time, who have successfully overcome these problems, who can be fed by sucking, and who do not need respiratory support are discharged. Discharging premature babies and sending them home does not mean that all their problems are over. It is also necessary to pay attention after going home. Special care is necessary both because the baby is in intensive care and because the factors related to resistance are missing. Resistance factors are passed from mother to baby during the last months of pregnancy. However, since these babies are born prematurely, their resistance factors are missing, and they are more vulnerable to infections. Therefore, hand cleaning is of primary importance when touching these babies. These babies should not be placed in crowded environments. In the meantime, you should not overdo it while protecting the baby. We also don't recommend keeping the baby indoors at all times. Especially in temperate air, it is very important that they are taken to fresh air and sunbathing.

How long is the period to be considered for premature babies?

Premature babies are usually discharged at 34-35 weeks of age. In premature infants, there may be respiratory stops called apnea because the respiratory center has not yet completed its development by 40-45 weeks. For this reason, apnea beds are recommended for at-risk babies at home. Babies usually start to form their own defense factors by 6-7 months of age. In terms of infections, they require special attention for the first 6-7 months or even the first year.

How should premature babies be fed?

Early and correct nutritional support of premature infants after discharge is decisive in their long-term normal growth and development. The ideal food is breast milk. If the breast milk is sufficient, we prefer these babies to be fed with breast milk. However, since the nutritional needs of premature babies are higher, we support breast milk with breast milk boosters when necessary, according to the baby's weighing monitoring. If breast milk is not enough, we use special formula foods for premature babies.