Every year in the United States, more than 450,000 babies are born before 37 weeks' gestation. Infants who are mildly to moderately premature (30 to 35 weeks) generally face fewer health challenges than babies who are extremely premature (26 to 29 weeks) and "micropreemies," or infants born before 26 weeks. Almost all premature babies will spend some time in the hospital, and are likely to face medical issues related to breathing and digestion. The good news is, most preemies overcome these issues by the time they are 1 year old.
Respiratory Problems
Unlike other organs, the lungs don't fully develop until late in gestation. Almost all babies born early have some breathing trouble, which often resolves when they get older. The most common breathing issue is known as respiratory distress syndrome (RDS). This syndrome is caused by a lack of surfactant, the substance that keeps the lungs from getting too wet and collapsing. Your doctor may give your baby artificial surfactant if this is an issue.
Premature infants are also at much higher risk of contracting respiratory syncytial virus (RSV) during cold and flu season. RSV is the leading cause of hospitalization of all babies under 1 year old. Talk to your doctor about how you can protect your baby from contracting this virus.
Reflux
Gastroesophageal reflux disease (GERD)--otherwise known as reflux--is a digestive problem experienced by most premature babies. Because their digestive systems were not fully formed when the babies were born, stomach acid and milk can leak into the esophagus, causing pain similar to heartburn. The discomfort of reflux can be reduced by keeping the baby upright, or by slightly elevating the head of a sleeping infant with a blanket or pillow. Severe GERD can be treated with heartburn medications.
Feeding Challenges
Premature infants are not born with a fully developed sucking reflex. This makes nourishment a challenge. Even if the baby remains in the hospital, most experts recommend that mothers pump their breast milk. The nurses can feed breast milk to the baby through a feeding tube. If you have delivered a premature baby, your milk contains the special nutrients that the baby needs. Premature babies who are not breastfed often need special higher-calorie formulas to help them grow.
Jaundice
Jaundice causes newborns to be yellow or red in color, and most premature babies have it. Fortunately, jaundice is easily treated by putting the baby under special lights to help decrease bilirubin levels. Bilirubin is a by-product of the excess red blood cells present in all newborns. Premature babies often have difficulty getting rid of bilirubin because their livers are not fully developed.
Retinopathy of Prematurity
Retinopathy of prematurity (ROP) is a condition caused when the growth of blood vessels in the retina is interrupted. When a baby is born prematurely, the vessels stop growing. When they start growing again, they may grow too quickly, causing damage to the retina. ROP is most common among younger preemies: of babies who weighed less than 2 lb. at birth, about 90 percent will have some ROP. Most preemies see an eye doctor at least once during their first year to make sure their eyes are healthy.
Apnea
Apnea is the medical term for short pauses in breathing. Because premature babies have immature nervous systems, they sometimes forget to breathe. Most babies outgrow apnea by the time they reach 37 weeks, but occasionally a baby will need to go home with an apnea monitor.
Anemia
When the number of red blood cells falls below normal, a baby is considered to be anemic. Producing new red blood cells can be stressful on the small bodies of preemies, and premature infants often need iron supplements to increase red blood cell production. Infants born before 28 weeks may require blood transfusions to replenish their blood volume while they are in the hospital.
References
- "The Premature Baby Book"; William Sears et al; 2004
- RSV Protection
- PAGER: About GERD
