HAVING A PRETERM BABY?

Here’s everything you need to know…

There are certain measures that a pregnant woman can take before giving birth to reduce the risk of having a preterm birth. However, no matter what you do, the risk of preterm birth can never be completely reduced. There are some factors that cannot be controlled. Talk to your doctor regarding the possible due date so that you can prepare accordingly. You can also talk to other parents who have had a preterm baby work to help you create a contingency plan. Take care of yourself. Eat a healthy diet, exercise and take proper rest.

There are certain challenges that accompany a premature birth. They are more vulnerable and need specialized care to have a normal, healthy growth. The staff at the hospital will provide you with all the information and support you need.

You and Your Baby

There are several factors that can contribute to premature birth. It is not very common and might not always be an emergency. Having your baby in the Neonatal Intensive Care can be stressful for the family. However, with experienced doctors and state-of-the-art infrastructure, you can rest assured that your baby is in the safest hands.

a. Factors that Cause Premature Births

Some of the most common factors leading to premature births include infection in the uterus or vagina, weakness in the womb’s neck, multiple births, pre-eclampsia, premature membrane rupture, or any other vaginal medical condition. The cause of premature delivery determines the gravity of the situation.

b. Need for Specialist Care

Premature babies need heightened medical attention when compared to normal babies. The level of care is determined by the cause of preterm delivery and how early the baby was delivered. In some cases, preterm babies have certain birth-related issues that will require specialized medical care. Typically, they have breathing issues, low immunity levels and are susceptible to infections, viral diseases and jaundice. In rare cases, they might have serious health conditions like sepsis, brain haemorrhage, etc. that will require special care.

c. Premature Birth & You

Complications and certain medical conditions can lead to a premature birth. Along with it comes the stress that your body and mind aren’t prepared for. Premature births have a considerable impact on a mother’s health and you might need specialized care as well. The heightened level of anxiety and stress could cloud your thinking and affect how you care for your baby.

Neonatal Care

Neonatology unit provides specialized medical care for premature babies and babies born with some medical conditions. Preterm babies often have birth-related conditions like infections, haemorrhage, infections, etc. The neonatology department has experienced and trained medical professionals that provide your baby with specialized care. Trained nurses monitor the different parameters and administer medications to the babies. They also place breathing support and other life-saving equipment on the baby. No matter what the required medical attention and emergency, they are trained to take the best care of your baby.

a. Clinical Expertise

Babies in our Neonatal Intensive Care Unit are kept under the care of a Consultant Neonatologist and qualified trained Resident Pediatric doctors manage the babies round the clock. Qualified trained nurses and other professional staff care for the babies at all times. We encourage mothers to continue the process of bonding with the babies even if in NICU and continue to breast feed babies if possible. The caregiving process continues even after the mother and baby are discharged from the hospital, as the team is willing and available to address the questions and concerns of the new parents. An isolation NICU is also in place to handle potentially infected cases and transfer cases.

b. Infrastructure
The hospital is well-equipped to cater to the medical emergency of preterm babies. With state-of-the-art facilities that can attend to extremely low birth babies. At Apollo Cradle and Children’s Hospital, we provide the following specialized infrastructure:

  • Advanced warmers and incubators
  • LED phototherapy units
  • Multi parameter monitors
  • Invasive ventilation
  • High frequency ventilators
  • Dedicated advanced neonatal ventilators
  • 24 hours portable ultrasound and X Ray

c. Allied Specialties
The Neonatology department coordinates with other subspecialties to provide well-rounded and comprehensive emergency medical care to premature babies. Through the support and expertise from other subspecialties like pediatric neurology, pediatric surgery, etc. we ensure that your baby is taken care of. Given the complexities of premature birth, the need for this multi-disciplinary approach increases.

Visiting Your Baby

Visiting your baby for the first time in Neonatal Care can be stressful. The Neonatal department is here to help you understand all issues concerning your baby’s health and all the precautions you need to take while visiting your baby.

The department tries to give you sufficient time to bond with your baby. From time to time, certain restrictions will be imposed to ensure that your baby has the best chance at recovery. Premature babies have low immunity, so if you are carrying an infectious disease like allergies, common cold, etc., it is best to stay away and avoid passing on any external infections that can affect the baby’s recovery.

Doctors provide you with all the information concerning your baby’s health, the possible date of recovery and the course of treatment. You can check with the support staff for timely counseling and regular updates. This will help the family cope with strain and stress.

Medical Conditions and Procedures

Almost all premature babies have issues with low birth weight and immunity. There are several calculations requiring accurate diagnosis, delicate handling and expert medical care. A premature baby can also be susceptible to some common medical conditions that will be discussed later.

Multiple births

Multiple births are a factor for increased risk of complications during delivery and even premature births. Apollo Cradle and Children’s Hospital is equipped with everything required to deal with multiple births. In several cases, one of the babies will be normal and healthy while the other will be critical and unwell. In such cases, specialized care and support is offered to the parents who are dealing with the emergency.

Feeding

The best nutrition for a baby is mother’s milk. In case of premature babies admitted in the NICU, it might be stressful and cumbersome for the mothers to feed their little ones. The pre-birth learning might not be applicable to premature babies and you will have to adapt. The growth rate for a premature baby is different and a mother has to respond to the baby’s needs and provide proper feeding.

a. Total Prenatal Nutrition

In this method, all the nutrients like protein, fat solutions, and glucose are fed directly to the bloodstream of the baby. The nutrients are injected through a vein. In a premature baby, the digestive system is immature and needs time for development. This gives the digestive system time to take shape.

b. Tube Feeding

In this method, mother’s milk or formulated milk is fed to the baby through a tube. The tube will be inserted through either the oral or nasal cavity of the child. This is the most common method for feeding the premature babies as they can’t feed themselves. This method helps all the nutrition reach the baby without putting stress on their metabolic systems.

c. Breastfeeding

A premature baby can also be fed breast milk either directly or through a pump. It is a great option as this gives the baby the best nutrition. However, there can be some challenges of digesting the milk. Sometimes, mothers might not be able to produce sufficient milk.

d. Weaning

After a certain period of time, the baby will have to start taking solid food. This is a slow process that can take a longer time for the premature babies.

If you have had a premature baby, taking them home will be even more profound, having survived the storm of possible complications. Your child will be leaving a safe and sterile environment, so it is important to stay cautious. Since your baby will be exposed to several unforeseen conditions, you need to understand these factors before you take them home.

Our doctors will be in constant touch with you, and will let you know the best time to take your baby home. Your time at the hospital will be stressful but remember that it is okay to be nervous and anxious. The right date for taking your baby home will be determined by the doctor once they are sure that the baby’s health is stable.

a. Multiple Babies
If you have had multiple births, it is possible for one of them to make a quicker recovery. Depending on their health conditions, it is possible to either send one of them home or keep them both in the hospital.

b. Length of Hospital Stay
The length of the hospital duration will be determined by the progress your baby is making. Only after there is evidence of a regular health pattern, normal vital signs and no pertinent or immediate threat to baby’s health, will they be allowed to leave the hospital.

c. Growth of the Baby at Home
A child, irrespective of whether he/she is normal or premature born, will have a normal timescale of growth. Slight variances are normal and you don’t have to worry about that. With proper care, adequate nutrition and attention, your baby will grow as normal as any.

Preparing to Go Home

Before you leave the hospital, you will be given an advanced note on the discharge date to help you prepare. There are several factors that need to be taken care of including the following:

  • All the reports and documentation should be kept for future purpose.
  • The house should be cleaned and have all the required equipment.
  • Keep a list of emergency contacts.
  • Arrange for comfortable and adequate transportation.
  • Hospital bills should be settled in advance.

Before You Leave

Before you move out of the neonatal ward, you should make a checklist of things to do. This checklist will help in ensuring that you take adequate care of your baby once he/she is at home.

  • Bathing your baby
  • Making the baby feel reassured and comfortable
  • Administering medications
  • Using specialized equipment
  • Keeping the baby’s bottles sterile
  • Performing emergency CPR
  • Checking and monitoring temperature
  • Breastfeeding

Allow the staff help and support you till you are ready to take your baby home and provide the best care.

Going Home on Oxygen

Once the doctors are confident of the baby’s condition, they discharge the child and it’s over to you. In some cases, the baby is sent home on oxygen. Make sure that you understand all the modalities of oxygen administration. Also, you will have to work with an authorized vendor so that you have an ample supply and oxygen support. Don’t worry, it is normal to have a premature baby on oxygen support as they might not be getting enough. This will subside over a period of time.

Transporting Your Baby

It is your responsibility as a parent to take your baby home in safe and proper transportation. The baby is coming from a clean and safe environment. You need to ensure that the mode of transportation is clean and safe as well. Avoid high traffic areas and find the shortest route home. It is important that the baby is safe from bumps, jerks, and pollution.

When you take your baby home, it will be the first time you are caring for them alone. This will be challenging but there is also so much to learn and look forward to. You have to stay calm and positive. Don’t hesitate to ask for support and advice.

Settling at Home

When you bring your baby home, it is important to give them time and space to settle down in the environment. Only then will you be able to take care of their needs. You are both bound to experience some stress, anxiety and anticipation. However, with the right support, you will be able to create a comfortable rhythm with your baby. All you need to do is make sure that the environment is comfortable and safe for the baby. This will ensure their safety and encourage their growth.

a. Dealing With Visitors

When your baby comes home, you will have visitors. You cannot ignore the social niceties. However, it is important to know that during this, the most important factor for you is the safety of your child. You should give your baby to visitors only once you’re sure that they aren’t exposed to any external infection and they have had sufficient rest.

b. Feeding Your Child

After you have left the hospital, follow the prescribed schedule of the baby. Your doctor will provide all the information on the baby’s prescription and needs. Take your time and do not rush anything.

c. Follow-up Appointments

After you have settled in at home with your baby, make sure that you have a regular doctor interface through follow up visits. This will help monitor the proper growth of the child while keeping them away from any condition relapse.

d. Monitoring Your Child’s Development

Your doctor will help you understand the growth patterns of your child. With this, you will be able to identify them and report any changes. Your child needs their time and space to grow. Given sufficient time, they will attain the normal benchmarks.

Safe Sleeping

Once your baby is home from the hospital, they will need some time adjusting to their surroundings. So, in the initial days, they might have some trouble sleeping. To help them sleep adequately and better, you need to provide a cozy place where they get plenty of peace, love, and no disturbance. You can try cuddling them, massaging them or gently lulling them to sleep.

Soon, babies will have a regular sleep-wake cycle. To provide your baby with full attention while they are awake, you might have to change your lifestyle accordingly. You can try making your baby sleep next to you. This will help in building a maternal bond and a sense of togetherness.

It is also important for the baby to sleep in the right sleeping position. The baby should lay on their back at the start of their sleep. If during the night, they roll onto their side or tummy, roll them back.

Multiple Babies

Dealing with one baby is hard enough. Dealing with multiple babies is even more challenging. Both parents need to provide a hand. All the babies will have their specific emotional, nutritional, and growth requirements. They might also have different sleep cycles and parents will have to deal accordingly.

In case of premature multiple births, it is possible that one child is well while the other is facing serious health conditions. This might put an emotional paradigm in front of the parents. You just have to remember that each child is unique and the best way of dealing with multiple births is to not think of them as a set.

If Your Baby Is Unwell

There are certain health conditions that you might have to deal with after your baby has left the hospital. These could be fever, cold, small infections or even something serious. You need to prepare to deal with these conditions so that you can respond in a timely manner.

The first step is understanding the symptoms and signs of their health. Only after that will you be able to develop a response mechanism. Here are some of the most common symptoms:

  • Changes in temperature
  • Vomiting
  • Excessive crying
  • Rapid breathing
  • Lack of appetite
  • Skin changes
  • Rapid breathing
  • Change in stools

The response mechanisms to these symptoms include emergency care, first aid and consulting with the pediatrician.

Weaning

It doesn’t matter if your baby was born prematurely. His/her age will be calculated according to their birth date. After a certain amount of time, they will have to stop mother’s milk and switch to solid food. This is a slow process and can take a longer amount of time in case of premature babies.

You can switch your baby to solid foods when:

  • They can hold their head in a stable position
  • They start sitting all by themselves
  • They show interest in your food
  • They put their hands into their mouths
  • They are able to handle new food

Here are the foods that you can give your baby at first:

Foods that can be easily mashed inside the mouth

  • Cooked soft rice
  • Cooked soft vegetables
  • Soft fruits like peaches or bananas

Here are some important points to note:

  • You should never feed the baby forcibly
  • Solid foods shouldn’t be added to the bottle
  • Don’t add sugar to baby’s food
  • Don’t feed them junk food
  • Don’t add salt or chilli
  • Keep your baby away from whole nuts

Developmental Milestones

Infants grow every day. However, for every kid, growth is different. You don’t have to worry about delayed or inadequate growth. You need to be patient and give them time and space. Just give them proper nutrition and support to help them grow better.

If you have had a premature baby, the developmental milestones will be different for them. They will be a little behind than the rest. However, this is no cause for worry because they will catch up eventually. In some cases, babies will require physiotherapy and additional support for growing adequately.  In other cases, you just have to be patient and wait for them to catch up.

In case of a premature baby, it is beneficial to assess the progress of the child regularly. You also have to take advice from their paediatrician. To aid the growth of the child, it is important to undergo regular monitoring along with support and nutrition.

Starting Primary School

For every child, starting primary school is a major milestone. Usually, they start at the age of four years in kindergarten. Some kids start even earlier in a play school. However, if you have had a premature baby, you shouldn’t put too much pressure on him/her. They should be allowed to have their own time and space. Your child is impressionable and sensitive. Any extra pressure applied to them to start school can be counterproductive.

Alternatively, you can start teaching them at home. Begin with basic things and slowly they will start coming up the curve. It is normal for premature babies to take time to do things that the kids normally do at that age. You have to support your child, instead of pushing them harder.

Advice For Families With Disabled Child

Compared to other children, premature children might have certain disabilities. In such cases, it is the responsibility of a parent to provide complete support to their child. For better guidance, you can try contacting a counselor on the best ways to help a disabled child. It is very important for the children’s growth that they are provided with all the love and affection. You need to make your child feel that they are no different from any other kid.

Disabilities can be overcome and your child shouldn’t be made to feel any different from the others.

The Next Pregnancy

Just because you have had a preterm pregnancy before, it doesn’t mean that your next pregnancy will also be preterm. There are some challenges with preterm pregnancy. Couples often get pessimistic and avoid subsequent pregnancies. These fears are completely unfounded. There are several factors that can lead to preterm pregnancy. So, instead of avoiding pregnancy, they should try to understand these factors and if possible, take preventive measures.