In the United States, premature births account for 11 to 13 percent of pregnancies. A preterm baby is defined as one born prior to 37 weeks. Prematurity is more common in twins, triplets and other multiple births. Depending on how early a baby is born, they may require initial treatment in the NICU (neonatal intensive care unit).
Babies born early are a special subset of pediatrics and carry risks of unique health problems. Because these babies enter the world before they are fully physically developed, they are at a higher risk for disabilities. This is why premature babies often receive extra medical care and assistance right after birth. Depending on how early a baby is born and what co-existing conditions occur, many premature babies will follow with other doctors besides a pediatrician.
Common health conditions in preemies
- Jaundice: when a substance called bilirubin is elevated in the blood. This may cause your baby’s skin and whites of the eyes to appear yellow. Treatment involves phototherapy and frequent monitoring of bilirubin levels.
- Apnea and bradycardia: apnea is a brief period of not breathing, usually defined as 15 seconds or more, and is commonly seen in premature babies. Sometimes, the heart rate will slow at the same time. This is bradycardia. Babies born early are closely monitored for this and supported with oxygen when needed. Most preemies outgrow this by the time of hospital discharge, but some babies may need continued monitoring once home.
- RDS (respiratory distress syndrome): increased work of breathing due to the lungs not being fully developed. Babies born early lack surfactant, a compound in the lungs that allows them to stay expanded. Doctors can give exogenous surfactant to help ease the work of breathing. Often premature babies will require oxygen and help breathing when first born. As they grow, these things are slowly weaned away.
- BPD (bronchopulmonary dysplasia) or chronic lung disease: these babies typically require breathing support and a longer period of time on oxygen. These conditions can vary in severity and as premature babies’ lungs mature, they often outgrow these conditions.
- RPO (retinopathy of prematurity): the blood vessels in premature babies eyes are not fully developed. This typically requires frequent monitoring with an eye doctor but not necessarily treatment. This often resolves itself in most babies.
- Anemia of prematurity: low hemoglobin due to lower levels of red blood cells. Common in babies born early. Requires monitoring and often babies are discharged from the hospital on iron supplementation.
- Heart murmurs: much more common in babies born early and are caused by a number of factors. Depending on cause of murmur, your baby may follow with a pediatric cardiologist.
Premature babies are ready to come home once they can maintain body temperature, can breathe on their own, and can feed adequately to maintain weight.
Your baby’s pediatrician will be informed about the hospital course and your baby’s medical problems. They should be able to answer any questions you may have and will ultimately be the ones organizing specialty follow up care with other doctors or therapists.
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