What is a premature baby? Yeditepe University Kozyatağı Hospital Child Health and Diseases Specialist Prof. Dr. Filiz Bakar stated that termination of pregnancy before 37 weeks of gestation is defined as premature birth. While a normal, healthy pregnancy lasts 37-41 weeks, 6 days, and an average of 40 weeks, there is no clear explanation for the causes of 25 percent of premature births. How is premature baby care performed? How do premature babies eat? Here are the details...

Stating that premature babies will start life in a risky situation in many respects compared to babies born on time, Yeditepe University Kozyatağı Hospital Pediatrics Specialist Prof. Dr. Filiz Bakar gives some suggestions on the problems that await premature babies.

Especially urinary tract and genital infections in the mother, problems in the uterus, high blood pressure in the mother, diabetes, heart disease, multiple pregnancies, high amniotic fluid in the baby, placental problems, maternal age under 18 or over 40, premature birth of the mother, stress are among the risk factors that can lead to premature birth.

Premature babies start life in a risky situation in many respects compared to babies born on time. Therefore, it is important to prevent preterm birth with bed rest and medical treatments if possible, and if it cannot be controlled, to give steroid treatment to the prenatal mother so that the baby can be born more ready for early life.

Problems Waiting For Premature Babies

• Premature babies face inadequacies in many organ systems. The earlier the baby is born the greater the risks. In addition to the week of birth, birth weight, gender, being single or twin, and having prenatal steroids are important in determining the risks.
• Emphasizing that one of the most common and most important problems of premature babies is respiratory distress, Prof. Dr. Filiz Bakar states that respiratory distress, called respiratory distress syndrome, is common because the surfactant substance, which is the most important indicator of lung maturation, is low, and continues as follows: “Surfactant is treated by administering the substance to the baby's respiratory tract and supporting respiratory devices and respiratory tract. Premature apnea caused by the immaturity of the respiratory center is common in these babies. Oxygen therapy, respirators, and many other factors can cause chronic lung disease in these infants, who may require long-term oxygen and medication support.”
• Brain damage can develop as a result of intracerebral hemorrhages, hydrocephalus due to fluid accumulation in the brain cavities, and irregularities in blood flow and oxygen levels to the brain. While low-grade bleeding can often resolve spontaneously over time, shunt surgery may be required in the presence of hydrocephalus. As a result of these events experienced in early return, permanent problems such as movement problems, perception problems, learning difficulties, and transference can be seen.
• Problems with the heart can occur. The vessel that connects the aorta to the lung and should close after birth may not close in the premature baby and may lead to a heart problem called Patent Ductus Arteriosus. Operation may be required in cases that do not respond to drug treatment
• Since babies are born before their eye veins are developed, a disorder called Retinopathy of Prematurity may develop in their veins in the retinal layer. In order to detect this condition without progression, eye examinations are performed at regular intervals starting after 4 weeks during the hospitalization of the babies and treatment can be planned if necessary. In cases where treatment is delayed, this problem may result in blindness.
• Hearing problems are frequent. Hearing screening tests should be performed and repeated at the age of 1 year.
• Digestive problems can be seen in the immature intestinal system of the baby. Necrotizing can progress to severe problems called enterocolitis. Reflux, which occurs as a result of gastric contents escaping back into the esophagus, is more common in premature babies. Anemia and jaundice are also more common in premature babies.

Feeding Premature Babies

Especially babies born under 34 weeks of age may experience nutritional problems because their jaw muscles are not strong enough and they are born before their sucking and swallowing reflexes and breathing coordination have developed. According to the birth week of the baby, protein, sugar, and fat support are provided intravenously in the first days. In the meantime, very small amounts of breast milk are also started. Infants in the intensive care unit can be fed through a catheter that descends from the mouth or nose to the stomach until the sucking-swallowing reflexes develop. After the coordination of sucking-swallowing-breathing develops, it is started to be fed by sucking. Breast milk, in particular, is a very valuable food source for premature babies. Mothers should be supported in breastfeeding. If there is no breast milk, formula foods are used.

Post-Discharge Care

Stating that the stay of the mother and the baby in the same room for a few days before discharge will reduce the anxiety of the family and increase their competence in baby care, Prof. Dr. Filiz Bakar also underlines that premature babies should be fed every 3 hours on average during their hospitalization.

It is recommended that people who take care of the baby at home without the baby being discharged should have a whooping cough vaccine. If there is a discharge in the winter season, people at home need to be vaccinated against the flu. During the winter season, small premature babies should be given a respiratory syncytial virus vaccine once a month, while other vaccines should be given at the same time as babies born on time.

It is important to provide an appropriate hygiene and care environment at home. Since these babies are more sensitive to heat loss, it is necessary to keep the house temperature around 23-24 c, dress them appropriately when they go out, and to wear gloves and hats. Since they are prone to infections, they should not be taken to crowded environments outside the home, those who come to visit the house should be warned, and those who have the flu should not be contacted. Other issues that should be considered are that everyone who will touch the baby should wash their hands very well and not smoke.

Apart from routine doctor visits, when symptoms such as vomiting, cough, bruising, fever are observed, it is absolutely necessary to consult a doctor.

Premature babies should be evaluated considering their developmentally and physically corrected ages. Prof. Dr. Filiz Bakar lists her sleep recommendations for premature babies as follows…

• Create a safe sleeping environment
• No covers, toys, or pillows should be kept on the bed
• A sleeping bag should be used