The term "premature" refers to a baby born between week 24 and 37 of pregnancy. Some premature infants have no problems after birth, while others spend months in neonatal intensive care units. The basic needs of premature infants, like the needs of full-term infants, remain constant. Treatments vary depending on the premature infant's ability to maintain basic physiological needs.
Oxygen Supplementation
Adequate oxygenation, a basic human need, poses several problems for premature infants as their lung tissue may not be well-developed. Babies with severely underdeveloped lung tissue require help from a ventilator to force enough oxygen into their lungs. This is also true for babies who are too weak to breathe in enough oxygen. Surfactant, a medication that helps lungs function, may be given to babies whose lungs haven't developed adequately, the Merck Manual explains.
Older preemies may require small doses of oxygen through a tube that fits into the nose. Because some preemies "forget" to breathe from time to time, stimulating medications may be given to prevent apnea, or periods in which the baby stops breathing.
Fluid
The ability to suck and swallow in a coordinated fashion without tiring or stressing the ability to breathe is complex and takes time to develop, the Merck Manual explains. Most extremely premature infants get fluids, an essential human need, through intravenous lines until they can coordinate sucking and swallowing.
Warmth
Premature infants often can't maintain their core, or inner body temperature, within a normal range before 34-weeks gestation, according to Dr. Venkataraman Balaraman, medical director of the special care unit at the University of Hawaii. Lack of body fat, an immature temperature regulation system and a large body surface area to body mass ration contribute to poor temperature control. Babies who are cold use more energy than normal trying to keep their temperature up, which leaves less energy available for eating, breathing and growing. Most premature babies are placed in incubators or in Isolette tables that are warmed to help them maintain adequate body temperature.
Nutrition
Premature infants need a high caloric intake that's in proportion to their size and needed growth. Initially, very small preemies get their nutrition through intravenous feedings, because their intestines aren't mature enough to break down and absorb milk. Once their gut matures, nasogastric tube feedings are started to conserve energy or until an adequate suck/swallow reflex develops. Special formulas designed to supply extra minerals and vitamins preemies lack may be used if breast milk is not available, Balaraman states.
Other Treatments
Because premature infants have immature immune systems, infections occur commonly. Antibiotic treatment is started as soon as an infection is suspected, because infection can spread rapidly and become life-threatening. Many very small preemies require occasional blood transfusions due to frequent blood draws to check oxygen levels and other parameters; transfusions replace the blood lost through blood draws. Many premature infants have jaundice in the first few days of life and need light therapy to break down bilirubin and allow its excretion. Difficulty regulating blood sugar leading to hypoglycemia may necessitate supplemental glucose infusions.
