When a baby is born before the 37th week of gestation, they are referred to as “premature”, which means that they are born before they have fully developed and will need medical care in hospital. This is necessary due to the fact that certain organs and bodily functions have not yet matured enough to function independently. The earlier a premature baby is born, the higher the risk of complications. That’s why a stay in the neonatal intensive care unit (NICU) is critical to their growth where doctors and nurses keep a close eye on their tiny patients providing them with round the clock care.   

The different types of premature babies

Premature babies are classified based on how early they are born:

• Late preterm: babies born between 34 and 37 weeks of pregnancy
• Moderately preterm: babies born between 32 and 34 weeks of pregnancy
• Very preterm, born at less than 32 weeks of pregnancy
• Extremely preterm, born at or before 25 weeks of pregnancy

However, the majority of preterm babies are born in the late preterm stage.

How are premature babies cared for in the NICU?

Premature babies will have a longer stay in hospital following their birth to assist them medically. Sometimes babies will stay in an intermediate care facility if their needs aren’t too serious, but very premature infants will move to the NICU. The length of their stay in these specialised units solely depends on the seriousness of their condition.

Tests

The first stage of premature infant care in hospitals is to do several tests on babies to determine how much care they will need. The most common tests include:

• Breathing and heart rate, conducted regularly.
• Blood pressure readings are also done frequently.
• Fluid levels by checking how much fluid the baby takes in through feedings and an IV versus how much fluid is expelled through urination or bowel movements.
• Blood tests to analyse calcium, glucose and bilirubin levels in the baby’s blood, as well as to measure the red blood cell count and check iron levels or for any infections.
• Echocardiogram to check for problems with the baby’s heart function. 
• Ultrasound scans may be done to check the brain and to examine organs for problems, such as in the gastrointestinal tract, liver or kidneys.
• An ophthalmologist (eye specialist) may examine a baby’s eyes and vision to check for problems with the retina which may be a result of a premature birth.

Incubation

Premature babies are typically placed in an incubator. Incubators are temperature-controlled to ensure the baby’s core temperature remains constant.

Vital signs

Sensors are often placed on the baby’s body – such as fingers and toes – to monitor blood pressure, heart rate, and respiration. In some cases, a ventilator may be used to help with respiration.

Feeding Tubes

A baby may receive vital fluids and nutrients through an IV tube. Later on, a tube may be passed through their nose and into the stomach. When strong enough, breast-feeding or bottle-feeding will be allowed.

Fluids

Premature babies need a particular amount of fluids each day. Fluids will be monitored closely, checking for sodium and potassium levels. If the baby requires additional fluids to stabilise the levels, they’ll be passed through an IV line.

Medication

If a premature baby requires medication to help assist with any condition or illness, they will be administered through an IV. Medication can also be given to help the baby mature and develop so that they can go home.

Medical procedures or surgery

Sometimes surgery is needed to treat any complications associated with a premature birth. 

Bottom line

Babies born before their due date, before the 37th week of gestation, are considered “premature”. Due to organs, such as the lungs, not being fully developed, these babies require special care from birth. Their stay and care in neonatal intensive care units are crucial to their health and development.

The lenmed Group is a world-class chain of Private Hospitals that brings quality healthcare to communities across Southern Africa.

For more information please contact: 

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.