Premature Babies: What You Need to Know

Several factors or conditions related to the expectant mother may contribute to prematurity, including smoking, alcohol consumption, poor nutrition, intense stress, chronic illnesses, infections, anatomical abnormalities of the uterus or hormonal disorders.

Since premature babies are not fully prepared to handle conditions outside the womb, they may face certain problems that need regular monitoring and management. Of course, these depend significantly on the degree of prematurity (i.e., the week of birth) and the baby’s birth weight.

Premature newborns do not have sufficient body fat to maintain an adequate body temperature. For this reason, they are placed in special incubators at birth. Proper feeding is also crucial in the care of premature infants. A premature baby with low birth weight may have difficulty breastfeeding, which is why persistence is recommended. Their gastrointestinal system is not yet mature, which can make feeding more challenging and increase the likelihood of spitting up (a sign of gastroesophageal reflux). Jaundice (elevated bilirubin levels) is also common and tends to be more pronounced compared to full-term babies.

The lungs of a premature newborn are not mature enough to produce “surfactant,” which often results in breathing difficulties. Respiratory problems may arise at birth or afterwards (e.g., apnea, bronchopulmonary dysplasia).

Premature anemia is a condition caused by reduced production of red blood cells in the first days of life, combined with the fact that newborns’ red blood cells have a shorter lifespan compared to those of adults. Therefore, blood tests for anemia are conducted, and premature infants are given iron and folic acid orally for a duration determined by their degree of prematurity. These guidelines are always provided by the paediatrician.

Regular ophthalmic examinations are also essential due to the risk of retinopathy of prematurity. In addition, premature babies are advised to undergo brain ultrasounds (to check for possible cerebral hemorrhage), a cardiac evaluation, hearing tests and an assessment of their neurological status.

The follow-up schedule for a premature infant is determined upon discharge from the maternity clinic and takes place at specified intervals both by the pediatrician and at a designated follow-up clinic at the hospital of birth. All of the complications mentioned above are simply potential issues and do not necessarily occur. In fact, there are premature newborns who, as one might expect, only differ in their birth weight since they “hurried” out of their mother’s womb a bit early! These checks should be done even as a preventive measure. Even in cases where complications arise, there are now ways to manage them to a great extent.

Note: Regular paediatric check-ups are recommended. The information included in this article is general, and in any case, you should consult your paediatrician.

Written by paediatrician Katerina Katsibardi.