Every parent naturally desires that his/her baby should be healthy, chubby and intelligent. To enjoy good fruits one has to plan and work hard. For planning, both the parents must have sound knowledge about the normal baby and infant care in general. The parents with sound knowledge only can manage the baby tactfully and with confidence. This article discusses various aspects of post mature and premature babies and how to take care of such babies, what problems they face, which will help parents with management of such babies.
1. Premature Babies
A. When are babies called as premature babies ?
Normally babies are born after the completion of 40 weeks in their mother’s womb. However, the delivery may take place anytime between 37 to 42 weeks i.e. between 259 and 293 days. These babies are called as mature or full term babies and weigh more than 2.5 kgs at the time of birth. Babies born before the end of 37th week i.e. before 259 days of pregnancy are known as pre-term or premature babies and usually weigh less than 2.5 kgs.
B. What are the problems of premature babies ?
A premature baby does not have enough time for the development and maturity of its various organs. Younger the baby, more immature are its organs.
The following problems are commonly seen in premature babies :
Babies born on the completion of 20 weeks of pregnancy may have a problem in sucking and swallowing.
Their digestive power is Hence regurgitation, vomiting, diarrhoea, distension of abdomen etc. are not uncommon in these babies.
Immaturity of the liver gives rise to more intense physiological jaundice.
Their body temperature is unstable and fluctuates widely.
Their muscles of respiration are Hence their cry and cough are weak.
Their respiratory centre in the brain which controls breathing is Hence respiration is fast, irregular, shallow and superficial.
Their blood does not clot easily. Hence they have a tendency to bleed.
They are prone to develop infections as the ability of their white blood cells to kill the germs is In addition, they have a limited ability to form antibodies against various germs.
They do not tolerate drugs well as their immature liver and kidneys have a limited capacity to detoxicate and excrete the drugs from their body.
C. What special care is necessary in premature babies ?
A premature baby is handicapped because of its immature organs. Hence it needs expert medical attention and management as follows :
Respiration : Some babies may not breathe properly and become blue intermittently. Such babies require constant attention as they require oxygen and help in maintaining the breathing.
Temperature : If the premature baby is not able to maintain its body temperature, it should be kept in an incubator with an inbuilt light and warming apparatus and a thermostat which enables to control the temperature and humidity of the baby’s surrounding.
Wrapping with blankets and heating the room by electric heaters, water bags or electric bulb of 100 watts may be sufficient to maintain body temperature in many premature babies. The baby should not be exposed to breeze directly.
Prevention of infection : Both the baby as well as the mother should be well No visitor should be allowed to come near the baby as he may pass the germs normally present on his skin and his breath to the baby. The baby should be washed scrupulously. The baby’s room should be free from dirt and dust which harbour germs. Furniture should be minimum as it harbours dust. The floor should be mopped with wet cloth twice a day.
Feeding : Feeding a premature baby depends on the baby’s ability to suck and swallow. If the baby is unable to suck and swallow, all its nourishment should be supplied by intravenous fluids in the first few days. Later the baby is fed either with a tube in the stomach or with a spoon, till it starts sucking and swallowing.
Drugs : Drugs like antibiotics should not be given unnecessarily to the premature baby. After 10 days, the baby should be given vitamin drops. Iron drops should be started after 6 weeks of These babies require vitamin and iron drops earlier compared with the babies born at full term.
Management of a premature baby is a challenge by nature. We should accept it and try to overcome the difficulties with confidence.
D. How does prematurity affect the growth and development of a baby ?
Premature babies are of course smaller in height and weight at birth compared to fully mature babies. However, if it has no other complications at birth like infection, brain injury, developmental defects etc. it will ultimately grow up into a normal adult attaining the average weight and height for its community, race and socio-economic status. Premature babies when compared with the normal babies are slightly late in achieving their milestones such as sitting, standing and speaking. However, they catch up with the normal babies by the age of 2 years.
E. What are the chances of survival of premature babies ?
Survival of a premature baby depends on how premature is the baby and what complications the baby has suffered from during and after birth. If it does not breathe soon after birth or develops severe infection, there would be less chances for survival. In the best of nursing homes babies weighing less than 1000 gms have 25% chance of survival. Babies born after 33 weeks of pregnancy and weighing more than 1500 gms have a 50 to 70% chance of survival.
F. When is the feeding in premature baby started ?
The premature baby is given its first feed within four hours of birth. Early feeds are important as such babies do not have sufficient store of calories and fats. The first feeds should consist of 1/2 to 1 teaspoonful of distilled water only. During feeds the sucking and swallowing ability of the baby is observed carefully. If there is no feeding difficulty, the second feed is given after two hours consisting of glucose water. Each subsequent feed is increased by a half to one spoon till the baby takes four to five teaspoonful per feed. Cow’s or buffalo’s milk is introduced when the baby can take two to three teaspoonful of feed at a time. Bigger premature babies can be put to the breast after the first two feeds of water or glucose water. The premature babies also become restless and cry when hungry though the cry is weak.
2. Post-mature Baby
Babies born after 42 weeks i.e. 294 days of pregnancy are termed as post-term or post-mature babies. After full term i.e. 40 weeks, the placenta usually undergoes degeneration. Hence, food and oxygen supply to the post-mature baby in the mother’s womb is decreased.
These babies appear as if they have lost weight recently. Their skin appears loose and wrinkled and has shiny and papery appearance. They appear pale and their hands and feet are blue. Their body temperature is low and their activity is sluggish. They appear anxious and alert.
These babies should be watched closely as they are likely to develop subnormal temperature, irregular respiration and convulsions. The death rate gradually increases with advancing pregnancy. Hence a pregnant woman should consult her obstetrician when pregnancy proceeds beyond 41 weeks.
Reference : Sanatan Sanstha’s Holy text ‘Your baby (Birth to 1 year)’.