Baby Monitors: On Premature Babies

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Baby Monitors On Premature Babies

When a baby is born too early — before she has spent the full 37 to 40 weeks in the womb — she is called a premature baby, or a premie for short. Usually, there is no obvious reason for a premature birth. Some conditions, like maternal pre-eclampsia or womb abnormalities, may warrant the need for a premature birth. Multiple gestation, for example, having twins or triplets, may also lead to premature birth.

Not all babies who are born before their due date are considered premature. Sometimes, irregular periods or bleeding during pregnancy can make baby’s actual due date difficult to calculate. Similarly, a smaller-than-average baby is not necessarily premature. It is possible that she hasn’t grown properly while in the womb and has low birth weight although she is born at full-term.

About one in 10 babies are born prematurely. Although a premie soon catches up with other babies her age in terms of development, she still requires special care and attention both in the hospital and at home, to bolster her still fragile immune system.

Health challenges of premature birth

Some medical issues premies are born with include:

  • Breathing problems that require supplemental oxygen or a ventilator.
  • Apnea (irregular breathing).
  • Jaundice, because baby’s immature liver is unable to dispose of excess bilirubin, the yellow pigment produced by the breakdown of red blood cells.
  • Temperature regulation. Small infants lose body heat more rapidly.
  • Feeding problems.

As such, a premie may have to spend weeks, or even months, in a neonatal intensive care unit before she can be taken home.

Understanding baby’s hospital environment

In the unit, a premie will usually have to spend her time inside an incubator with various tubes and wires attached to her body. The sight of such a tiny, helpless infant being hooked up to so many wires can be very upsetting for a mother. However, the incubator is essential to provide an even, warm environment for the baby. Sometimes, baby may be made to wear a bonnet to stop heat loss through the head.

The tubes and wires serve various purposes. A premie’s lungs and digestive system are too immature to function well on their own. Therefore, baby will need the help of a ventilator to breathe and may be fed through a tube. Other tubes and wires help to measure baby’s heart and breathing rates, as well as the composition of her blood. Ultraviolet light may also be used to help baby recover from jaundice. To cause as little stress to baby as possible, the lights in the intensive care unit may be kept dim and the room as quiet as possible.

This situation, however, should not stop you from establishing physical contact with your baby. Although the incubator may stop you from cuddling your child as you would a healthy, full-term infant, you will still be able to gently stroke baby inside the incubator and perhaps speak or sing softly to her. Studies have shown that even tiny babies are soothed by this type of gentle touching.

If baby is not able to go home with you when you are discharged, speak to the unit’s nurses about visiting baby. The staff of a neonatal intensive care unit are usually extremely sensitive to and supportive of parents’ feelings, and will encourage you to visit baby as often and for as long as possible.

With sufficient medical care and parental support, a premie will eventually recover enough to function independently and go home. Some premies may require a step-down admission from an intensive to an intermediate unit (less specialised care than an intensive unit but more than a normal nursery unit) in preparation for discharge.

Bringing a premie home

When discharge is approved, it means that your premie no longer needs specialised care from a hospital.

The following are some of the basic criteria considered before discharging a preemie:

  • Can baby maintain healthy body temperature when placed in an open crib?
  • Can baby take breast or bottle feedings without supplemental tube feedings?
  • Can baby gain weight steadily?

Some hospitals may also require that baby attains a minimum weight for discharge.

The average premie (born without the need for surgery or weeks of ventilator support) will be able to meet all these criteria about two to four weeks before her original due date.

There are also several things you may be required to do before baby is discharged. This is important to ensure that you will be able to take care of baby on your own at home. These include:

  • Choosing a good pediatrician who will be experienced enough to provide follow-up care for your preemie.
  • Making an appointment for a week or two after discharge so that your pediatrician can give baby a thorough follow-up check-up.
  • Making an appointment for other routine tests for blood, hearing and vision health if the follow-up check-up does not include them.
  • Receiving specialized training or infant CPR training if your baby is to be sent home with special equipment, such as an apnea monitor or oxygen tank.

In addition to the above, do note that your baby will also require immunisations, usually on the same schedule as that for full-term babies.

Caring for your preemie

Parents of premies usually experience both intense joy and high anxiety during the discharge process. Although you may have waited weeks or months to finally bring baby home, it can be frightening to walk away from the 24-hour security of a hospital.

If you are overcome by anxiety, try to take it easy. After all, your hospital wouldn’t have sent baby home if they didn’t think she was safe to be discharged. But it’s good to remember the following to prevent any possible complications of caring for your infant at home:

Keep baby at home for the first few weeks: Her immune system is sill underdeveloped, and something as harmless as a walk in a mall can expose her to people with infections (especially viral infections) that can cause a serious illness. As far as possible, any outings should be limited to visits to the paediatrician’s office.

Ask for loved ones’ understanding: For the same reason as above, a sick relative or friend should be advised not to visit your child until they get well again. Similarly, no one should smoke in your home, and all visitors will need to follow strict hygiene standards if they are to touch or handle your child.

Feeding and sleep requirements: Your baby will need about eight to 10 feedings of breast or bottle milk a day, at no more than four-hour intervals to prevent dehydration. Ensure that she wets at least six to eight diapers per day. She will also probably sleep more than a full-term baby, but for shorter intervals. Put her to sleep on her back to reduce risk of Sudden Infant Death Syndrome (SIDS).

Have as much skin-to-skin contact as possible: Studies have shown that this is essential for improving a premie’s health. Also known as kangaroo care, skin-to-skin contact can be enhanced by dressing baby only in her diaper and placing her between the mother’s breasts, or in the centre of the father’s chest, with her ear against your heart.

Keep all developmental follow-up appointments: Most premies grow to become normal and healthy kids, but some premies may have special needs that can only be detected during follow-up check-ups. Babies born earlier than 29 weeks of gestation, or those who were very ill as newborns, may need close monitoring for the first two years and even later because these children could be at risk of conditions like developmental delays, problems with muscular coordination, learning disabilities and so on.

You need a break too!

Caring for a premie can be physically and emotionally draining for parents. Women who have just given birth need at least six weeks to recuperate. However, giving birth to and caring for a premie can significantly reduce your rest time. You can recuperate faster if you are willing to accept offers of help from family and friends. So be good to yourself! Do not hesitate to accept professional help if you feel you cannot cope or are extremely anxious about caring for your child.

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