Patient education: When a baby is born premature (The Basics)

What does it mean when a baby is born premature? — 

A baby born before 37 weeks of pregnancy (3 or more weeks before the due date) is called "premature" or "preterm." Pregnancy normally lasts about 40 weeks, counting from the first day of your last period. Premature babies are sometimes called "preemies" for short.

Doctors use several categories to describe babies who are born premature:

●"Extremely preterm" babies were born before 28 weeks of pregnancy.

●"Very preterm" babies were born between 28 and 32 weeks of pregnancy.

●"Moderately preterm" babies were born between 32 and 34 weeks of pregnancy.

●"Late preterm" babies were born between 34 and 37 weeks of pregnancy.

"Term" babies are born between 37 and 40 weeks of pregnancy. "Full-term" babies are born after 40 weeks.

Babies who are born closer to their due date can look like full-term babies. They might have fewer problems than babies who are born earlier. But all premature babies are at risk for certain problems.

What causes premature birth? — 

It's not always possible to know the cause. Some things might cause a person to go into labor early. These include:

●Bleeding or other problems in the uterus (figure 1)

●Being pregnant with twins, triplets, or more babies

●Infection in the uterus or other part of the body

●Problems during pregnancy, such as diabetes, high blood pressure, or heart or kidney problems

●Smoking, drinking alcohol, or using illegal drugs during pregnancy

●Stress

What kinds of problems can premature babies have after birth? — 

Premature babies can have many different problems after being born. Every baby is different. In general, babies are more likely to have health problems:

●The earlier they are born

●The less they weigh

While a baby is in the uterus, their body is growing. Premature babies can have problems because their organs did not get enough time to finish developing.

Premature babies commonly have these issues:

●Trouble keeping warm – Very small babies can have trouble staying warm. Special hats and blankets can help keep them warm. It can also help to hold your baby directly against your skin. This is called "skin-to-skin" contact (figure 2).

While your baby is in the hospital, they might be put in an incubator or "isolette." This is a bed that is surrounded by clear plastic. It can also have a heater. The bed helps keep your baby safe and warm.

●Feeding problems – Many babies who are born early cannot suck and swallow well enough to drink milk. Babies who are very sick need a feeding tube. This is a small tube that goes into their mouth or nose, down their throat, and into their stomach.

●Breathing problems – Premature babies sometimes have trouble breathing on their own after birth. This is usually because their lungs have not fully developed. Your baby's doctor or nurse will monitor (watch) their breathing.

●Heart problems – In some premature babies, a blood vessel that should close after birth stays open. In time, the blood vessel might close on its own, or it might need treatment. Low blood pressure is also common in premature babies.

●Infection – Babies who are born early are more likely to get infections. That's because they cannot fight off germs as well as full-term babies.

●Digestive system problems – Some premature babies have a problem with their intestines that can be serious. It can cause diarrhea, vomiting, and sometimes blood in bowel movements. This usually happens within a few weeks after birth.

●Low or high blood sugar – Premature babies are more likely to have blood sugar that is lower or higher than normal. Doctors will do tests to check the baby's blood sugar levels and give medicines or fluids to treat it.

●Bleeding in the brain – Babies born early sometimes have bleeding inside their brain. This happens within a few days of being born. The bleeding can be mild and stop on its own, or it can be more serious. In very premature babies, brain imaging tests are done to look for this problem.

●Jaundice – This is when the skin or white part of the eye turns yellow. There are ways to treat this.

What treatments might my baby need? — 

It depends on:

●How early your baby was born

●How much they weigh

●What health problems they have

Your baby might need to go to the neonatal intensive care unit ("NICU"). This is a part of the hospital for babies who need special care. Some babies only need to stay in the NICU for a few days. Others might need to stay there for weeks or even months. These are usually babies who are very sick or were born very early.

A premature baby might need 1 or more of the following:

●A machine to help them breathe

●Extra oxygen

●A feeding tube – This delivers milk into the baby's stomach.

●A thin tube that goes into a vein (called an "IV") – This can be used to give the baby fluids and medicines.

●Surgery

●Light therapy (to treat jaundice)

If your baby's condition is stable, the doctor or nurse might suggest you hold your baby directly against your body for "skin-to-skin" contact (figure 2).

Will my baby have long-term problems? — 

Maybe. Some premature babies have health problems later in life, while others do not. The earlier a baby is born, the higher the chances of long-term problems.

Some of the problems that can affect premature babies later in life are:

●Cerebral palsy – This is a disorder that causes problems with movement and balance.

●Vision problems – Sometimes, babies who were born very early (usually before 30 weeks of pregnancy) have problems with their eyes. If this isn't treated, it can cause trouble seeing. An eye doctor can check your baby's eyes and suggest treatments if needed.

●Problems affecting the brain – Some premature babies grow up to have problems with thinking, learning, or memory. They can also have attention deficit hyperactivity disorder ("ADHD"). There are programs that can help babies and children with these problems.

●Growth problems – Very premature babies are more likely to grow up to be shorter and weigh less than average.

●Ongoing health issues – Babies who were born premature might get sick more often as children or adults.

How can I get support? — 

Having a premature baby can be hard and stressful. Some ways to get support include:

●Social workers and hospital chaplains (spiritual counselors) – They can provide support during this difficult time.

●Support groups for parents and caregivers of premature babies – It can help to talk to other people who are going through the same things.

●Relatives and friends – It can help to have support once you bring your baby home.

More on this topic

Patient education: Premature baby – Discharge instructions (The Basics)
Patient education: What to expect in the NICU (The Basics)
Patient education: Preterm labor (The Basics)
Patient education: Jaundice in babies (The Basics)
Patient education: Newborn necrotizing enterocolitis (The Basics)
Patient education: Sepsis in newborn babies (The Basics)
Patient education: Cerebral palsy (The Basics)
Patient education: Having twins (The Basics)
Patient education: Newborn screening (The Basics)
Patient education: Caring for your newborn (The Basics)
Patient education: Benefits of breast milk for premature babies (The Basics)
Patient education: Car seat safety for premature babies (The Basics)
Patient education: Newborn hypoglycemia (The Basics)
Patient education: Apgar score (The Basics)
Patient education: Skin-to-skin care with your newborn (The Basics)

Patient education: Preterm labor (Beyond the Basics)
Patient education: Jaundice in newborn infants (Beyond the Basics)