Baby came sooner? Here’s how to care for a preemie

Pregnancy is a vulnerable stage as women nurture another life within them. A state of partial immune suppression makes pregnant women more vulnerable to viral infections. With seasonal influenza and COVID 19, it has become a worry for parents whose infants are born early from the desired cycle of birth and are premature babies.

The neonatal intensive care units (NICU) have become extremely cautious and careful dealing with preterm babies. Babies who are born prematurely are almost immediately transferred to the NICU within 24 hours of the birth and the length of the stay depends on the condition of the baby.

As per the World Health Organisation, India is among the top 10 countries contributing to 60 percent of the world’s premature deliveries. It is a well-known fact that preterm birth complications can be fatal and thus needs immediate attention (within the golden hour). In the last decade, neonatal care has grown phenomenally with enhanced technology, extensive training of NICU, and overall increased awareness of premature babies. The survival rate of preemie babies has improved drastically over the years which is good news.

Babies are considered to be pre-term if they are born before 37 weeks of pregnancy are completed. There are subcategories of preterm birth, based on gestational age:

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1. Extremely preterm (babies that are born in less than 28 weeks)
2. Very preterm (born between 28 to 32 weeks)
3. Moderate to late preterm (born between 32 to 37 weeks)

Things to do immediately after a premature baby is born

1.Skin to skin care

This practice is different from Kangaroo Care. The World Health Organization (WHO) recommends skin-to-skin care immediately after delivery for every new-born, irrespective of the birth weight to ensure warmth and early initiation of breastfeeding in the delivery room.

2. Kangaroo Mother Care

This is a cost-effective and impactful standardized care for low birth weight infants, which should be part of routine care. It can prevent up to half of all deaths in infants weighing less than 2000g. KMC can reduce complications like mortality at discharge and help with improved weight, length and head circumference. KMC can increase breastfeeding rates, better mother-infant bonding and maternal satisfaction with the method of care, as compared with conventional methods. It satisfies all five senses of the infant.

3. NICU care

Premature babies, especially the ones that are younger than 33 weeks, are not strong enough to gain nutrition by direct breastfeeding to gain weight. In the NICU, premature babies need extra care and nutrition so that their organs can develop and they can grow normally. Taking care of the nutritional needs of babies is equally important as other things. Breast milk and breastfeeding remain the preferred feeding choice for nearly all infants. Breast milk is of particular importance for premature infants due to its role in reducing the risk of necrotizing enterocolitis.

Things to know for parents to care for a premature baby post discharge:

It is important for parents to understand that post hospital discharge is also a critical phase. They must stay cautious while taking care of their bundle of joy.

1. Spend time

Mothers must spend time with the baby to enhance bonding and thus, comfort the baby.

2. Optimal temperature at home

It’s ideal to keep the baby warm at home. You can put several layers of clothes but one has to be careful not to overload the baby with too many blankets. A digital thermometer is ideal to keep a watch on the temperature.

3. Helping baby to sleep

You can create an incubation like set up at home by keeping the lights of the room dim while the baby is sleeping. This will enhance the right environment required for the baby. Preterm babies also feel hungry quite often therefore it is better to keep the feeds handy.

4. Bathing your baby

It is best to keep the bath simple and the water warm. Use of liquids is avoidable and sponge bath is recommended.

5. Tube feeding

Babies that are born before 32 weeks of pregnancy will have to be fed through a feeding tube. This tube goes through their nose or mouth to their stomach. The hospital staff will feed them this way initially, and if required they can teach the parents to feed the baby in this manner.

6. Sudden Infant Death Syndrome (SIDS)

This is a syndrome where even healthy babies can die in their sleep. However, premature babies are more at risk. One must be cautious and take care that the baby does not sleep on his stomach. Sleeping on the back is advisable. This will help give them access to fresh air and the risk can be avoided as well.

7. Be gentle with your baby

As soon as you get a go ahead from the doctor to touch and hold the baby, it is still advisable to be gentle with the baby.

8. Avoid crowded places

Since premature babies are prone to infections, it’s best to avoid crowded and public places. One must also keep visitors/ guests at home bare minimum.
NICU follow-up for preterm babies is crucial for babies

Since parents should keep an eye on the cognitive development of the baby, they must consult caregivers at regular intervals. NICU graduates are prone to re-hospitalisation and therefore, it is important to keep your paediatrician’s number handy or on speed dial. One has to be prepared for an emergency.