Premature baby means a premature baby. The generally accepted definition; Babies born before 37 weeks of gestation are considered premature (premature birth). According to the data of the World Health Organization, there are approximately 15 million preterm births in the world every year and this number is increasing every year.
What is a Premature Baby?
Deaths due to complications related to preterm birth are the leading cause of death in children under 5 years old. Many survivors have learning difficulties, vision and hearing problems.
Prematurity is divided into three according to the week of gestation:
- Extreme prematurity (those born before 28 weeks; usually less than 1 kg)
- Premature prematurity (those born between 28-32 weeks; usually 1-1 ,5 kilos)
- Late prematurity (those born between 32-37 weeks; usually 1.5-2.5 kilos)
What Happens in Premature Birth Baby
The earlier the baby is born and the lower its weight, the more severe the complications of preterm birth. The main problems seen in premature babies are as follows:
- Premature babies cannot regulate their body temperature properly. Premature babies are born with insufficient adipose tissue. In addition, the heat regulation center in the brain is not fully developed. Therefore, their body temperature drops quickly.
- In order to maintain body temperature, the clothes taken should be of appropriate size and should cover every part of their body. If this cannot be achieved, the premature will use more energy to warm itself, which will slow down its growth rate and cause different problems. If; If suitable size cotton clothes cannot be found, a solution can be produced by wrapping cotton and gauze on the hands and feet, two overalls on top of each other, and wearing two pairs of gloves and socks.
- The room temperature should be kept constant. (24 °C – 25 °C) It should not be forgotten that very cold and very hot temperature changes will endanger the health of the baby. If possible, a thermometer should be kept in the room. A digital ear thermometer will be beneficial for the control of the baby's temperature measurement.
- Nutrition problems are common in premature babies. These babies grow quickly to catch up with term babies in growth and development. walks. However, since the reflex with sucking, swallowing and breathing coordination develops after the 33rd week of gestation, babies should be fed with gavage in the previous weeks. (Gavage: It is a method of feeding with breast milk or formula by inserting a tube through the mouth or nose into the stomach.)
- Gavage is a method of feeding the baby with breast milk or formula in the first period when the care of the baby is largely dependent on the medical personnel. It provides great benefits in terms of emotional needs.
- As long as babies stay in our hospital, parents are informed about breastfeeding methods, breastfeeding methods, feeding with bottle, gavage and the importance of breast milk.
- You can find detailed information about breast milk at the address Importance of Breast Milk and Benefits of Breastfeeding.
- Low blood sugar (hypoglycemia): Premature babies are born without liver glycogen storage to balance blood sugar. Therefore, hypoglycemia is very common in premature babies. It is treated with sugary serums and regular blood sugar monitoring.
- Neonatal jaundice (hyperbilirubinemia): In premature babies, jaundice usually develops within the first 24 hours. It presents with jaundice in the skin and eyes. The younger the gestational week, the more severe the jaundice. It is treated with phototherapy. If jaundice reaches very high levels, it can cause brain damage. Some babies may require exchange transfusion to treat jaundice.
- Heart problems: PDA (Patent Ductus Arteriosis): As most of them can close spontaneously, it can cause respiratory distress and heart failure in the baby.
- Nervous system related problems: There may be respiratory arrest called apnea due to the nervous system not being fully developed. Cerebral hemorrhage is common, especially in very early preterm infants. Babies born prematurely may have learning difficulties and developmental delays in the future.
- Sepsis: Sepsis is a severe and serious disease caused by the spread of bacteria or virus to the body. It occurs as a result of the infant's vulnerability to infections.
- Necrotizing enterocolitis: It can develop with or without sepsis. The earlier the baby is born, the greater the risk. Symptoms include feeding difficulties, bloating, bloody or bile vomit, and blood in the stools. is thick.
- They can develop retinopathy of prematurity (ROP). Especially in very premature babies, abnormal vascularization occurs in the retina layer of the eye. Due to premature birth, the retina cannot receive full oxygen due to the vessels that have not completed their development. This problem, which is seen in premature babies, may improve or go towards complete blindness. All babies born under 1500 grams and 30 weeks should have an eye scan. Premature babies are referred to an ophthalmologist within 4 weeks of birth. In addition, myopia and strabismus are more common in premature babies.
- They experience lung problems more frequently. There is a substance called surfactant that prevents the alveoli from deflating in the lungs. This substance is not produced sufficiently until 34 - 36 weeks of gestation. Therefore, severe respiratory distress is observed in babies born before this period.
- Mild cases are treated in the neonatal ward, and severe cases are treated in the intensive care unit. Surfactant can be given to the lungs of these babies. Babies with insufficient self-respiration and low blood oxygen levels are connected to a device called a ventilator.
- Bronchopulmonary dysplasia develops in some babies leaving the intensive care unit. Bronchopulmonary dysplasia is a chronic lung disease. These babies may need oxygen support for a long time. Long-term ventilator therapy may be required. Bronch-opening drugs and cortisone are used in the treatment to relax the airways.
- Meningitis is an inflammation of the meninges. It is usually seen together with sepsis. It is a serious infection. It can cause blindness, deafness or epilepsy in the baby. During the illness, the baby may have convulsions.
- Anemia develops easily in premature babies.
- Apnea, which is common in premature babies, is caused by insufficient maturity of the brain and weakness of the rib cage muscles. Respiratory pauses shorter than five seconds and self-correcting are physiological. This problem, which is very common in the neonatal intensive care unit, may continue after the baby is discharged. Respiratory arrest that lasts longer than ten (10) seconds and causes bruising and weakness on the baby's lips is pathological and a doctor should be consulted immediately. Whether the baby will be connected to the apnea bed and monitor at home The decision is made before discharge. Its use and supply are explained to the family in the discharge plan.
How Should the General Care of Premature Babies Be Done?
· Feeding: Points to be considered while feeding the baby's head at an angle of 45 degrees are just a few of them. should try to remove it. Since the jaw muscles of premature babies are not fully developed, they can get tired very quickly during the sucking process and go into the sleep phase. For this reason, you can help your baby by providing support from the chin with your finger, especially while feeding with a bottle.
- Adjust the feeding time not to exceed 30 minutes.
- The longer the feeding, the less the number of meals. The more weight loss will be.
- Lay your baby on the right or left side after feeding. It is beneficial to raise the head up to 10% with the body. Attention must be paid.
- During feeding, you need to observe the color and movements of your baby correctly. The color of a healthy baby is pink.
- Consult your doctor if you observe the baby's color turning yellow or pale according to the hospital discharge. Infection How to Control?
Since the immune systems of premature babies are not fully developed, they are open to all kinds of infections. Therefore, visitors, especially school-age children, should be treated sensitively in restrictions. If toys will be kept in the room; Care should be taken to ensure that the toys are washable, dust-free and lint-free.
Hand cleaning is the first step in infection control. is mak. Before touching the baby, care should be taken to clean the hands after the bottom cleaning. they are very inclined. In particular, the longer the time allocated for feeding, the more the baby's tendency to sleep will increase due to fatigue. For this reason, attention should be paid to the time spent in nutrition, nutrition and sleep patterns should be adjusted well.
Growth hormone is secreted during the sleep phase. Therefore, care should be taken while the baby is sleeping. In addition, adjusting the room lamp will be useful for the baby to distinguish between day and night. Transitioning from a more active life during the day to sleep and silence at night is important for the baby's adaptation to the home environment.
A low-pitched music can be played in the room during the day. However, it should be known that a high sound level can cause permanent damage to the hearing organ, which is just beginning to mature. . Especially in premature babies, since the parts with cartilage tissues such as the ear do not mature, stickiness and necrosis may occur in the ears when the position is not changed for a long time when they are tilted to the right or left side. Again, positional flattening can be seen in the head region. For this reason, it will be beneficial to change positions frequently (with an interval of 3 hours) and to support sensitive areas with materials such as towels and pads. In this case, it would be beneficial to consult your doctor. You can do eye care with sterile water. Do not use the gauze used in one eye in the other, because if there is any infection, you can infect the other. If there is edema, redness and yellowish discharge in the eyes, this may indicate an infection.
You can still use sterile water for oral care. Pay attention to the presence of white particles on your baby's palate, on the tongue. In such a case, it will be recommended to wrap your little finger in gauze and clean the thrush area with sterile water in a scraping manner. not sure�
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