Preterm Babies

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Introduction 

An estimated 15 million babies are born too early every year. That is more than 1 in 10 babies. Approximately 1 million children die each year due to complications of preterm birth. Many survivors face a lifetime of disability, including learning disabilities and visual and hearing problems.

In low-income settings, half of the babies born at or below 32 weeks (2 months early) die due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. In high-income countries, almost all of these babies survive. Suboptimal use of technology in middle-income settings is causing an increased burden of disability among preterm babies who survive the neonatal period.

Neonatal nutrition for preterm babies

Preterm babies need to receive good nutrition so they grow at a rate close to that of babies still inside the womb. They will often stay in the neonatal intensive care unit to be watched closely to make sure they are getting the right balance of fluids and nutrition.

Incubators or special warmers help babies maintain their body temperature. This reduces the energy the babies have to use to stay warm. Moist air is also used to help them maintain body temperature and avoid fluid loss.

Neonatal nutrition for Preterm babies

Babies born before 34 to 37 weeks often have problems feeding from a bottle or a breast. This is because they are not yet mature enough to coordinate sucking, breathing, and swallowing.

Breathing problems, Low oxygen levels, Circulation problems, Blood infection can also affect their feeding and most of the time they may need to get nutrition and fluids through a vein (IV).

As they get stronger, they can start to get milk or formula through a tube that goes into the stomach through the nose or mouth. This is called gavage feeding. The amount of milk or formula is increased very slowly to reduce the risk of an intestinal infection called necrotizing enterocolitis (NEC).

Nutritional needs for preterm babies 

Preterm babies have a harder time maintaining the proper water balance in their bodies. These babies can become dehydrated or over-hydrated.

They also need human milk from their mother’s breast, this is the best for babies born early and at a very low birth weight. Human milk can protect babies against infections and sudden infant death syndrome (SIDS) as well as NEC and in cases where the mothers cannot feed, Special preterm formulas can also be used.

A supplement called human milk fortifier mixed into their feedings. This gives them extra protein, calories, iron, calcium, and vitamins. Babies fed formula may need to take supplements of certain nutrients, including vitamins A, C, and D, and folic acid.

Methods Of Feeding a Preterm baby

Intravenous lines – These lines carry nutrition directly into the baby’s bloodstream. They are used for premature babies who have immature digestive systems and are unable to suck, swallow and breathe normally. This method is sometimes used when treatment for other health complications is being implemented. This approach utilizes an IV that may be placed in the scalp, arm or leg.

Umbilical catheter – This painless method involves a tube that is surgically placed into a vessel of the umbilical cord. However, there are risks associated with this method that include infection and blood clots. Therefore, the method is normally used only in the most critical cases and only when the baby might need this type of feeding for several weeks. For these babies, it is the safest and most effective way to receive nutrients.

Oral and nasal feeding – This method utilizes a narrow flexible tube that is threaded through their nose (nasogastric tube) or mouth (orogastric tube). It is a solution for babies who are ready to digest breast milk or formula but are not yet able to suck, swallow and breathe in a coordinated manner.

Central line (sometimes referred to as a PICC line) – This is an intravenous line that is inserted into a vein, often in the arm, that allows the use of a larger vein. This is a method of delivering nutrients and medicines that might otherwise irritate smaller veins.

Weight gain for Preterm babies

Weight gain is monitored closely for preterm babies because if their growth is too slow they might have more delays in their development. It is normal for babies to lose weight in the first few days of life but they should start gaining weight within a few days of birth.

Why Do Premature Newborns Need Special Care?

Premature babies are not fully equipped to deal with life in our world. Their little bodies still have underdeveloped parts that include the lungs, digestive system, immune system and skin. Thankfully, medical technology has made it possible for preemies to survive the first few days, weeks or months of life until they are strong enough to make it on their own.

References

  1. American Pregnancy. Premature care. Accessed on 9th October 2018.
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