When a baby is born prematurely

Each year, about 11 percent of babies in the United States are born prematurely — that is, before they've completed 37 weeks of development. If your baby is among these ranks, you'll likely feel a range of emotions — including fear, disappointment and worry. This is natural and understandable.

The good news is that today's neonatal intensive care has dramatically improved the outlook for premature infants. In fact, more than two-thirds of babies born at 24 to 25 weeks can survive with the proper medical care. Because most premature babies can survive, much of the medical care given to mothers in preterm labor and to premature newborns focuses on minimizing possible complications of prematurity.

Footprint Baby Boy

Footprints of a full-term baby Footprints of a premature girl whose birth weight was baby boy whose birth weight

8 pounds, 4 ounces. was 1 pound, 8 ounces.

Footprints of a full-term baby Footprints of a premature girl whose birth weight was baby boy whose birth weight

8 pounds, 4 ounces. was 1 pound, 8 ounces.

What your premature baby may look like

Your first close-up look at your premature baby will likely be in the neonatal intensive care unit (NICU). You'll probably be amazed, overwhelmed — and perhaps a little shocked — by this first look.

You may first notice the array of tubes, catheters and electrical leads taped to your tiny baby. This equipment may be overwhelming and intimidating at first. It's important to remember that it helps keep your baby healthy and the medical staff continuously informed about your baby's condition.

You'll also notice right away your baby's tiny size. He or she will probably be considerably smaller than a full-term infant. Some very premature babies are so small that a man's wedding ring can serve as a loose-fitting bracelet.

Because premature babies have less body fat than full-term babies do, they need help to stay warm. They're often placed in an enclosed and warmed plastic box (isolette) to help them maintain a normal body temperature.

A premature baby's skin will have a number of notable characteristics not found on a full-term baby. Your baby's features will appear sharper and less rounded than a full-term baby's. The skin and cartilage that form your baby's outer ears will be especially soft and pliable. The skin may be covered with more fine body hair (lanugo) than is common in full-term babies. Your baby's skin may look thin, fragile and somewhat transparent — allowing you to see the blood vessels underneath it.

These characteristics will be easy to see because most premature babies won't be dressed or wrapped in blankets. This is so the nursery staff can closely observe their breathing and general appearance.

In the neonatal intensive care unit (NICU)

Immediately after birth, your premature baby is likely to undergo many of the same procedures as a full-term baby. But, of course, special precautions are necessary after a premature birth. For example, your baby's breathing, heart rate and blood pressure may be monitored.

Soon after birth, a baby born at less than 35 weeks may be transferred to an NICU or a special care nursery, sometimes called a level 3 or level 2 nursery. If your premature baby is born in a hospital without such a facility, he or she may be transferred to a nearby NICU.

In the NICU, your baby will receive specialized care — including a feeding plan tailored to your baby's specific needs. For the first few days or weeks after delivery, premature babies are usually fed intravenously because their gastrointestinal and respiratory systems may be too immature to safely start formula feedings. When your baby is ready, the intravenous feeding will end and a new form of feeding, called tube feeding, will likely be the next step. In tube feedings, your baby receives breast milk or formula through a tube that delivers the food directly to the stomach or upper intestine.

Getting involved

Become physically involved with your baby as early as possible. Loving care is important to your baby's physical and psychological growth and development.

When you were pregnant, you probably daydreamed about holding, bathing and feeding your new baby. As the parent of a premature baby, you probably won't be able to spend these first weeks with your baby in the way you had envisioned. Still, you can be involved with your baby in important ways.

The neonatal intensive care unit team

In the neonatal intensive care unit (NICU), your baby is cared for by many specialized and qualified people. The team attending to your baby may include:

• Neonatal nurses — registered nurses with special training in caring for premature and high-risk newborns

• Neonatal respiratory therapists — staff trained to assess respiratory problems in newborns and adjust ventilators and other respiratory equipment

• Neonatologists — pediatricians who specialize in the diagnosis and treatment of problems of the newborn

• Pediatric surgeons — surgeons trained in the diagnosis and treatment of newborn conditions that may require surgery

• Pediatricians — doctors who specialize in treating children

• Pediatric resident physicians — doctors receiving specialized training in treating children

Until your baby is ready to be held, you can reach through the openings in the isolette to hold your baby's hand or gently stroke him or her. Gentle contact with your premature baby can help him or her thrive. Help your newborn get to know you by humming a lullaby or talking softly to him or her.

As your baby's condition improves, you'll be able to hold and rock your baby. Skin-to-skin contact, sometimes called kangaroo care, can be a powerful way to bond with your baby. In kangaroo care, a nurse can help place your baby on your bare chest, then loosely cover him or her with a blanket. Some studies have shown that premature babies respond positively to this skin-to-skin contact with their parents and that kangaroo care can improve babies' recovery times.

Another important way the mother can be involved in her baby's health is by providing breast milk, which contains proteins that help fight infection and promote growth. In the NICU, your baby will likely be fed every one to three hours through a tube that goes from the nose or mouth to the stomach. Nurses can show the mother how to pump breast milk, which can be refrigerated and stored for use as the baby needs it.

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