Premature babies 413

with age (by 50 postconceptional weeks, apnea is rare). All premature babies are monitored for apnea; if it occurs, the baby is gently stimulated to restart breathing. If apnea occurs frequently, the infant may require medication (most commonly caffeine or theophylline) and a special nasal device that blows a steady stream of air into the airways to keep them open.

Anemia Many premature babies do not have enough red blood cells to carry sufficient oxygen throughout the body. This is easily diagnosed in the lab, which can determine the severity of anemia and the number of new red blood cells being produced. Some premature infants require red blood cell transfusions.

Low blood pressure This is a relatively common complication that may occur shortly after birth due to infection, blood loss, fluid loss, or medications given to the mother before delivery. Low blood pressure is treated by boosting fluid intake or giving medication.

Respiratory distress syndrome (RDS) Breathing problems are one of the most common and serious problems of prematurity. With respiratory distress syndrome (RDS), (formerly known as hyaline membrane disease), the infant's immature lungs do not produce enough surfactant, which normally allows the inner surface of the lungs to expand properly when the infant makes the change from the womb to breathing air after birth. RDS is treatable and many infants do quite well.

If premature delivery cannot be stopped, most pregnant women are given medication just before delivery to help prevent RDS. Immediately after birth and several times later, artificial surfactant can be given to the infant. Although most premature babies without enough surfactant will need a ventilator, the use of artificial surfactant has greatly decreased the amount of time one is necessary.

Bronchopulmonary dysplasia (BPD) A lung reaction to oxygen or a ventilator used to treat a lung infection, severe RDS, or extreme prematurity. Preemies are often treated with medication and oxygen for this condition.

Infection This is a threat to premature infants, who are less able than full-term infants to fight germs that can cause serious illness. Infections can be passed on from the mother or be acquired after birth.

Patent ductus arteriosus The ductus arteriosus is a short blood vessel that connects the aorta (main blood vessel leaving the heart) to the main blood vessel supplying the lungs. In an unborn baby, it allows blood to bypass the lungs, since oxygen comes from the mother and not from breathing air. In full-term babies, the ductus arteriosus closes shortly after birth, but it often stays open in premature babies. When this happens, too much blood flows into the lungs and can cause breathing problems and sometimes heart failure. This condition is often treated with a medication called indomethacin, which can successfully close the blood vessel in more than 80 percent of cases. If indomethacin fails, surgery may be required to close the vessel. Maintaining an open ductus is a requirement for the successful treatment of some congenital heart diseases.

Retinopathy of prematurity Abnormal growth of the blood vessels in an infant's eye. About 7 percent of very small premature babies develop retinopathy of prematurity (ROP), and the resulting damage may range from needing glasses to blindness. Experts do not know what causes ROP, but oxygen levels (either too low or too high) are only a contributing factor. Premature babies receive eye exams in the NICU to check for this condition.


Premature babies need a great deal of special care to survive. Because they lack the body fat necessary to maintain their body temperature, even when swaddled with blankets, incubators or radiant warmers are used to keep these babies warm. Premature babies also have special nutritional needs because they grow at a faster rate than full-term babies and their digestive systems are immature.

Although breast milk is an excellent source of nutrition, preemies are too immature to feed directly from the breast or bottle until they are 32 to 34 postconceptional weeks old. Most premature infants have to be fed slowly because of the risk of developing an intestinal infection. Breast milk can be pumped by the mother and fed to the premature baby through a gastric tube directly into the stomach. The baby's blood chemicals and minerals are monitored regularly, and the baby's diet is adjusted to keep these substances within a normal range.

Getting Back Into Shape After The Pregnancy

Getting Back Into Shape After The Pregnancy

Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.

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