When a couple has a child, mom and dad spend all their time on him, because without proper care the baby simply will not be able to develop normally, and perhaps even survive. What if the baby was born ahead of schedule? Care for premature babies must be special, because such babies sometimes cannot even breathe and eat without outside help.
Until recently, doctors did not undertake to resuscitate and save the life of a baby whose birth weight was less than a kilogram. Now everything has changed, and experts can give a chance to the baby, who was born the size of a palm and weighs half a kilogram. We will talk about caring for premature babies in intensive care, after discharge and in other conditions in this article.
Premature babies: features
Full-term babies are those born between the 37th and 42nd weeks of pregnancy. If a child is born earlier than expected, he is considered premature. The main problem of such babies is the underdevelopment of internal organs, and the earlier the birth occurs, the more thorough care the child will need. Nursing care for premature babies begins from the first minutes of his life; the mother will be able to independently begin to care for her child only after permission from the pediatrician, but more on that later. For now, we are interested in the physiological features of a baby born prematurely. How quickly can a mother snuggle her baby? It all depends on the degree of prematurity. There are three degrees in total:
- Extreme prematurity - weight less than a kilogram.
- Deep prematurity - weight from a kilogram to one and a half.
- Prematurity - weight from one and a half kilograms to two and a half.
The main features of a premature baby are:
- little weight;
- small height (up to 46 cm);
- disproportionately built body (large head, short legs, neck, navel shifted to the groin side);
- the shape of the skull is rounded, with a clearly visible fontanelle and sutures;
- the ears are pressed tightly to the head, very soft;
- the skin is very thin and wrinkled, all the veins can show through;
- the surface of the body is covered with small fluff;
- the fat layer is completely absent;
- the nails on the arms and legs may be underdeveloped or completely absent;
- undescended testicles in boys and unclosed genital slit in girls.
It is worth noting that all the above-described signs must be present in combination. Only in this case can we talk about the features of caring for premature babies. If one thing appears, this indicates pathology, and not prematurity.
Behavior of a premature baby
Newborns born at the wrong time also differ in behavior. They are inactive, and there is decreased muscle tone. Babies are sleepy (this is noticeable even against the backdrop of the fact that full-term babies sleep almost constantly), they startle for no reason and begin to move chaotically. The absence of a sucking reflex makes caring for premature babies especially difficult. The little one is hungry, but doesn’t know how to eat.
Briefly about caring for premature babies
We suggest looking at the intricacies of caring for your baby, and then we’ll go through each point in more detail.
Nursing care for premature babies, as we have already written, begins from the first seconds of his life. First of all, he is taken into a warm diaper and, if necessary, ventilated. This is the most responsible procedure. The baby's breathing may be impaired or stop altogether, since the prematurely born baby does not produce enough surfactant, a substance responsible for proper breathing. Therefore, the lung tissue cannot fully expand.
The second problem is that premature babies are completely unprepared for physiological existence in this world; they have an insufficient layer of subcutaneous fat, so thermoregulation is imperfect. Babies quickly become hypothermic and overheated, since the ambient temperature differs greatly from that in the mother's womb.
In the old days, this problem was solved by wrapping the baby in cotton wool or placing him on a warm stove. Now the problem of regulating the body temperature of a newborn is solved differently: the premature baby is placed in an incubator, or, in simple words, an incubator. A sufficient amount of oxygen gets there, it is isolated from extraneous noise and light. The temperature and humidity in the incubator are regulated, creating conditions similar to those in the womb.
There are no problems with feeding either. Features of nursing care for premature babies include swaddling, monitoring their general condition and, of course, feeding. Medical staff takes the expressed milk from the mother and adds the necessary vitamins, proteins and minerals to it. If a woman does not have milk, then infant formulas designed specifically for babies born ahead of schedule are used. Feeding a baby, if he has a weakly developed sucking reflex, is carried out using a syringe.
A baby whose reflex is well developed is given a bottle. If the child’s weight is so small that he cannot even swallow, a nasogastric tube is used or nutrients are administered intravenously. The probe is inserted through the baby's nose, and milk enters his stomach in small doses. In any case, feeding a premature baby is fractional and in small portions, even if his weight is more than two kilograms. The organs are not yet developed enough to function fully. Nursing care for premature babies is mandatory. After all, the mother can overfeed.
Inpatient care for premature babies may not be possible at first if there are health complications. In this case, the baby is transferred to the intensive care unit.
Critical Care
The medical staff of the maternity hospital takes care of the first stages. Most often, immediately after birth, the baby ends up in the pediatric intensive care unit, and it is good if the maternity hospital has one. But it happens that the hospital does not have such a department.
First of all, the baby is examined by a cardiologist, neurologist, orthopedist, ophthalmologist, neurosonography (ultrasound of the brain) is performed, and, if necessary, ultrasound of all internal organs. In addition, urine and blood tests are taken. After the procedures, the baby is placed in an incubator.
What happens if the maternity hospital does not have its own intensive care unit? Is there really no chance to “pull out” the child? Nothing like this. All are equipped with the necessary equipment for caring for premature babies, there is a ventilator, an incubator, special medications designed to support the life of the baby, and a neonatologist - a specialist trained to care for babies born at the wrong time.
But there is still a problem: neonatologists not only look after premature babies, but are also required to be present at every subsequent birth. This means that there will be less monitoring of premature babies and the neonatologist may miss the moment if the need suddenly arises to save the baby.
The intensive care unit is staffed by nurses and neonatologists, whose responsibilities include only caring for the children already in their department. In this case, the newborn will be constantly under vigilant medical supervision.
If the baby needs resuscitation, but there is none in the maternity hospital, then after stabilization of his condition, he will be transported to another hospital where the necessary department is available. Transportation is carried out in a specialized vehicle, which contains ventilators, an incubator and other necessary devices to support life.
When the baby is in intensive care, the mother can come to him at the appointed time, but “communicate” only through the glass of the incubator (incubator). There are departments where it is possible to visit the baby at any time of the day.
Feeding
Parents of babies born early need to know all the intricacies and features of caring for premature babies so as not to worry about their child. Many couples begin to worry excessively about the life of the baby and think that they won’t be able to cope. Of course, it is very difficult to survive such a difficult period of nursing, but progress does not stand still, and the medical staff is able to save even the smallest ones.
If the baby's weight reaches two kilograms and his sucking reflex is well developed, then breastfeeding is possible. Mothers will be able to often hold the baby in their arms, feed it, and help the medical staff care for it. Only a nurse feeds from a bottle or syringe to avoid problems with the esophagus. As was written earlier, if the sucking reflex is absent or poorly developed, then the digestive organs cannot fully cope with their task and feeding should be fractional.
Premature babies need plenty of fluids. Typically, to maintain the body, Ringer's solution diluted 1/1 with 5% glucose is used. In addition, vitamins are needed; in the first days, riboflavin, vitamin K and E, ascorbic acid, and thiamine are necessarily introduced. Based on the individual condition of the newborn, the doctor may prescribe other vitamins.
After some time, the baby’s diet will be no different from the diet of its peers. But in the first stages of nursing, special supplements are needed to accelerate the development and growth of the baby.
As parents can see, there is no need to worry about nutrition. Soon your baby will take over and turn from a thin, weak baby into a cheerful, rosy-cheeked and active toddler.
Nursing in the maternity hospital
Care for premature babies in a hospital necessarily begins with the neonatal pathology department. Here the baby will be constantly under the supervision of nurses and doctors, the necessary procedures and examinations will be prescribed.
The baby can be transferred to a regular department only when he has gained at least two kilograms of body weight, is actively sucking milk, can independently regulate body temperature, and is breathing well. The duration of stay in the incubator depends on the severity of the degree of prematurity, there are four of them:
- first degree - birth occurred at a period of 37 to 35 weeks;
- second degree - from 34 to 32 weeks;
- third degree - 31-29 weeks;
- fourth degree - 28 or less.
If by the time the mother is discharged from the maternity hospital the child has already reached the minimum parameters at which it is possible to care for a premature baby at home, then he is sent home with his mother. If there is no longer a need for resuscitation, but there remains any risk to health, the baby is transferred to the children's department. The mother herself decides how to proceed: go to the hospital with the baby or come to the hospital for feeding.
In the hospital
A baby born prematurely is transferred to a specialized children's department according to the instructions of the pediatrician and neonatologist. Such a move is possible even if the baby is still fed through a tube and requires artificial respiration. In this case, all care for premature babies is in the hands of medical staff.
The child will be placed in a heated crib or incubator. A more complete examination is carried out in the hospital; it is aimed at detecting pathologies and genetic diseases. The baby is examined by specialists and the necessary tests and procedures are prescribed.
Positive dynamics usually begin to increase from the day of the previously expected birth, that is, from the date when the child was supposed to be born on time. The length of stay in hospital depends on how quickly the baby gains weight, learns to suck and swallow, and on the presence of identified pathologies. Treatment in hospital can last from a week to several months.
At home
When the baby is finally ready to go home, the doctor issues detailed instructions. Caring for a premature baby after discharge is very difficult, especially for couples who have had their first child. The difficulties lie in the fact that only nursing staff cared for the baby and the parents may not even have a clue about how and what to do.
In any case, if the baby was born prematurely, patronage must be conscientious. If for some reason the pediatrician does not arrive on the scheduled day, call the clinic and request a visit. Now we will consider in detail all the subtleties of a premature baby, which all family members living in the same room must know.
- The first thing you should watch is the air temperature in the baby’s room, it should be about +22 degrees. Don't forget that premature babies may have problems with thermoregulation.
- You should bathe your baby at home for the first time after permission from your local doctor. The bathroom is heated to 24 degrees, and the water should be close to body temperature. After washing, the baby is thoroughly dried with a soft towel and dressed warmly, since children born at the wrong time can quickly become hypothermic.
- Walks are no different from those prescribed for full-term infants. In the warm summer, you can go out to get some air immediately after discharge, and in the cold season - after a month. The first walks last no more than half an hour, the time gradually increases.
- Breastfeeding a premature baby after discharge is most often impossible, since he will already be “spoiled” by the bottle and will be too lazy to suckle. Still, try to breastfeed or express milk as often as possible and feed it to your child, because mother's milk is the most important element of nutrition in the first year of life. If you don’t have enough milk or have lost it altogether after stress caused by worrying about your baby’s life, then buy formulas designed for premature babies.
- Caring for premature babies at home must include constant monitoring! If the baby becomes lethargic, weak, refuses to feed and spits up profusely, call a doctor immediately, these are very bad signs.
Care for a premature baby in an outpatient setting
A plan for examining children born early is drawn up individually. Often premature babies suffer from kidney and eye diseases, and neurological pathologies are observed. If there is any violation, the baby will be registered with the required doctor and will need to be visited regularly, without missing appointments.
If your little one is completely healthy, then you will only need a monthly examination at the clinic and visits to specialized specialists, which are carried out on “Days of Healthy Children”. The local nurse will visit you within a month to make sure your child is well.
Development of premature babies
If a little person was born early, then in the first two months of his life he will sleep almost constantly and get tired quickly even with low activity. After two months of age, the child will begin to develop faster and move more actively, which can lead to tension in the muscles of the limbs. It can be easily removed with special exercises.
We must not forget that the nervous system of premature babies is weak, so the baby may flinch for no reason and be frightened by sudden movements and sounds. Periods of restful sleep can change dramatically with bouts of agitation, again for no reason. Such children need peace and quiet; they do not tolerate meeting strangers and changing surroundings.
If the baby does not have pathologies, then he will develop and grow quite quickly. By the age of three months, he will catch up and perhaps even surpass his peers in height, weight and development!
Children born prematurely need special attention and care. Care for a premature baby in the maternity hospital is carried out by specially trained staff, and after discharge the baby is handed over to the parents. How do we care for children born earlier than nature’s due date?
Physiology of premature babies
According to WHO definition, premature babies are those born before the 37th week of pregnancy. Such babies are usually born weighing less than 2500 g. All organs and systems of premature babies are immature, and that is why such newborns require special care. All the achievements of modern neonatology are aimed at helping these children adapt to existence in a new world for them.
Physiological characteristics of premature babies
- Appearance: poorly developed fatty tissue, thin skin, thin fluff all over the body, open fontanelles, soft ears, underdevelopment of the genitals.
- Nervous system: underdevelopment of reflexes, weak muscle tone.
- Respiratory system: lack of surfactant and various respiratory disorders.
- Cardiovascular system: high incidence of cardiac abnormalities.
- Digestive system: immaturity of enzymes, poor absorption of food.
- Musculoskeletal system: high risk of developing hip dysplasia.
- Thermoregulation: the inability to maintain heat on one's own.
Hospital care
Nursing of premature babies is possible starting from 22 weeks of gestation. Children born after this period weigh more than 500 g and are considered viable. If the baby is born between 22 and 32 weeks, he is transferred to a specialized unit for the care of very premature babies. In a regular maternity hospital there are no conditions for long-term nursing of such babies.
In a specialized department, the newborn is kept in an incubator where optimal temperature and humidity are maintained. Medical staff constantly monitors the baby's condition. The newborn is fed through a tube. The baby's health status is assessed by a neonatologist, ophthalmologist, neurologist and other specialists. This comprehensive approach allows you to achieve optimal results and prevent the development of complications after premature birth.
Babies born between 32 and 37 weeks and able to breathe on their own are in the NICU. Here the baby is also in an incubator, but quite often his mother may be next to the baby. If the newborn takes the breast, breastfeeding is allowed.
In recent years, many hospitals have successfully used the kangaroo method. The baby, undressed, is laid out on his mother’s stomach and wrapped in warm diapers. This approach improves lung function, evens out the baby’s breathing and heartbeat and populates the baby’s skin with maternal microflora. The “kangaroo method” is recognized in many countries as the optimal way to care for premature newborns.
At what weight is a small patient discharged home? Typically, discharge occurs when the weight reaches 2000-2500 g. At the same time, the baby is steadily gaining weight, is able to maintain body temperature and has no breathing problems. Such a baby can be at home under the supervision of a local pediatrician.
Care at home
And caring for it is a complex topic that can be discussed almost endlessly. After the baby is discharged from the hospital, he ends up in the hands of caring parents. What needs to be done to help the baby adapt to new living conditions?
Microclimate
The room where the baby is located should be sufficiently light and spacious. The optimal air temperature is 25 °C. The room should be regularly well ventilated. In summer, you can leave the windows open all day long, provided there are no drafts.
Some children require additional warming. For this purpose, you can wrap it in cloth. The water temperature in the heating pads should not exceed 60 °C. The heating pads are placed in the legs and also on the sides and are changed every 2 hours.
Do not remove all heating pads from your baby's bed at the same time, otherwise the baby may freeze.
The optimal humidity for the room is 50-70%. To create favorable conditions, you should regularly wet clean the room. It would be a good idea to purchase a special humidifier. Alternatively, you can place containers of water around the room or hang wet diapers.
Feeding
Nursing premature babies is impossible without proper nutrition. The best food for a premature baby is mother's milk. This product contains all the important nutrients, enzymes and antibodies necessary for the normal development of the baby. Even if the baby is bottle-fed, you should not completely deprive him of breast milk. You can feed your baby with a spoon. With properly organized feeding, the baby should gain weight according to the standards.
Bathing
It is not recommended to bathe children weighing less than 2000 g in the first month of life. Baby's skin is cared for using wet wipes. You can gently wipe the skin with a cotton swab dipped in warm water. After all procedures, you should use a hypoallergenic moisturizer.
Children who have reached a weight of 2 kg can be bathed in a baby bath. The optimal water temperature is 37-38 °C. Many experts recommend boiling water before swimming. If desired, you can add a decoction of chamomile or calendula to the water.
Walks
You can go for walks with your baby after 3-4 weeks of his stay at home. In summer, you should not be outside during peak solar activity (from 11 a.m. to 3 p.m.). In autumn and winter you can walk at temperatures not lower than minus 10 °C. Winter walks begin when the child reaches a weight of 3 kg and is allowed at an air temperature of at least 15° below zero.
Use quiet places for walks. Avoid crowded places in the first months of a baby's life.
The duration of walks should increase gradually. For the first time, 15 minutes of being in the fresh air is enough. If you feel well, you can gradually increase the duration of walks to 2-3 hours every day.
Cloth
Children who have reached a weight of 2.5 kg can be dressed in the same way as their full-term peers. Avoid wrapping your baby too tightly as this can lead to heatstroke due to immature thermoregulatory systems.
Children weighing less than 2.5 kg should be dressed slightly warmer. 1-2 additional layers of clothing are allowed compared to full-term babies. The baby's head and feet should always be warm. Clothing should be made from natural fabrics and not cause any disturbance to the baby.
Medical observation
Caring for a premature baby requires constant supervision by a local pediatrician. If you have any abnormalities in your health, you should definitely consult a doctor. Children born prematurely get sick more often than their full-term peers, so they require special monitoring from all specialists.
Up to 2 years of age, premature babies are registered with a cardiologist, ophthalmologist and neurologist. According to indications, the help of other doctors may be required. Regular ECG and echocardiography are recommended to monitor heart condition.
Preventive vaccinations for premature babies are given according to an individual schedule. Vaccination against tuberculosis is carried out only when the child reaches a weight of 2.5 kg. The issue of other vaccinations is resolved with the local pediatrician. Vaccination is allowed only if the baby is in good health and has no serious illnesses.
With properly organized care, premature babies over time catch up with their peers in development. Following all the doctor’s recommendations will help your baby adapt to existence in an unfamiliar world and will help avoid serious health problems.
Premature babies are not only short in height and weight. Their organs and systems are immature, so such babies require special attention and careful care.The baby is discharged home when his weight reaches 2,000 g, he actively sucks and gains weight. When caring for a premature baby at home, a number of factors should be taken into account: air temperature and humidity, frequency of meals, walks, clothing, etc.
Babies born before 37 completed weeks of pregnancy are considered premature.
They typically weigh less than 2,500 g and are less than 45 cm long.
Climate in the children's room
Air temperature
For the health of newborns born prematurely, the temperature and humidity in the children's room are of great importance. The optimal air temperature for a premature baby is 23-25 degrees Celsius. A room thermometer will help you control the numbers. It is necessary to regularly ventilate the room. During the hot season, you can keep the window slightly open at all times, avoiding drafts.
Near the child (under the blanket) the temperature should be slightly higher - about 32 degrees. Additional warming of the baby may be required as prescribed by the doctor. In such cases, heating pads wrapped in soft cloth help. The water temperature in them should not exceed 65 degrees. According to the doctor's recommendation, heating pads are placed at the child's feet under the blanket, and on the sides - on top of the blanket. The heating pads are changed one by one every 1-1.5 hours. An infant should not be left without a source of heat, so it is not recommended to change all heating pads at the same time.
How to control your baby's body temperature
By the end of 1 month of life, the baby's thermoregulation is gradually improving. After the doctor's permission, you can gradually abandon additional heat sources.
It is necessary to monitor the body temperature of a premature newborn. This allows you to detect hypothermia or overheating of a child in time. Take your temperature in the morning and evening, and every time you change your baby's body. The ideal device for this purpose is a non-contact thermometer. It measures the temperature by holding it over a child's forehead in 5 seconds. When measuring temperature, the baby must be dressed, otherwise hypothermia will occur.
Air humidity
The optimal humidity level in a nursery is 50-70%. A device called a hygrometer helps control these parameters. It is necessary to humidify the dry air in the room during the period when the central heating radiators are operating. To do this, you can purchase a special device - an air humidifier. An alternative is to place vessels of water around the room or hang clean, wet diapers.
How to dress a premature newborn
Children weighing more than 2 kg are dressed in the same way as full-term peers. You cannot wrap your child up; this can lead to overheating due to an immature thermoregulation system.
Children weighing less than 2 kg are dressed warmer - 1-2 layers more. You should insulate your feet with socks and put a knitted cap on your head. The criterion for hypothermia is cold feet and the back of the head of the child.
Clothing for premature babies should be made of natural fabric and fit properly. It is recommended to avoid swaddling; it promotes hypothermia due to the tight fixation of the limbs.
Bathing premature babies
Babies born weighing less than 1.5 kg are not recommended to be bathed at home during the first 2-3 weeks of life. Baby hygiene is carried out with wet wipes and special baby cleansing milk. Babies with a birth weight of more than 1.5 kg should not be bathed until 1 week at home.
Walking with premature babies
Walking for premature babies is a very serious issue. Sudden temperature changes are unacceptable. In the warm season, you can go for short walks with premature babies starting from the 3rd week of staying at home. In winter, it is necessary to let the baby get stronger.
In spring and autumn, walks for children 1-1.5 months old weighing more than 2.5 kg are allowed at temperatures of 10 degrees and above. At temperatures below 8 degrees, you can walk with 3-month-old children weighing 3 kg or more.
Limiting guest visits
Premature babies have weak immunity; therefore, it is recommended to limit the number of visitors and guests in the first months of the baby’s life. Doctors observing the child, if possible, should be invited home.
Feeding a premature newborn
Premature babies require frequent feeding, at least 10 times a day. This allows them not to lose strength for prolonged sucking and gain weight. Make sure your baby does not spit up milk or formula. If regurgitation occurs regularly, consult a doctor for help. This situation can prevent you from gaining weight.
The lower the child's initial weight, the slower it increases. During the first 2 weeks, the baby usually even loses weight, but, as a rule, begins to gain weight from 3-4 weeks, 100-200 g per week. At 3-4 months he will double his weight.
Doctors' supervision
Premature babies require not only high-quality home care, but also constant medical supervision. Dispensary observation is established at the place of residence for up to 7 years. Premature babies require constant monitoring by a pediatrician and regular consultations with a neurologist.
During the first 2 years of life, a premature baby is under the supervision of a cardiologist. An electrocardiogram should be performed regularly (at 2, 4, 6 and 12 months of life). An ECG allows you to assess the condition and functioning of the heart muscle. An ultrasound examination of the heart (echocardiography) is also performed. This study allows you to identify congenital heart defects, developmental anomalies and anatomical defects. Echocardiography is performed 4 times during the first 2 years of life (at 2, 6, 12 and 24 months).
Should not be used to warm premature newborns.
electric heating pads and blankets. It is strictly forbidden to place
heating pads under the baby or place them on top of him.
Preventive vaccinations
Premature babies are vaccinated according to an individual vaccination schedule, which is drawn up by a pediatrician. The guidelines are the child’s health status and psychomotor development.
Children born weighing less than 2 kg are not given the BCG vaccination (vaccine against tuberculosis) that is usual for all healthy newborns in the maternity hospital. It is performed later, when the child gains weight up to 2.5 kg, in a clinic at the place of residence.
Infants born weighing less than 1.5 kg receive a medical exemption from all preventive vaccinations until the end of 1 year of life.
Expert: Galina Filippova, general practitioner, candidate of medical sciences
Olesya Butuzova, pediatrician
A baby is considered premature if born before its due date - before 37 weeks. He was born small, with tiny weight and height, such a baby requires special care from his parents.
In most cases, the first months of caring for a premature baby for parents are a lot of difficulties that arise due to fears, lack of experience and ignorance of the developmental features of such babies. We will help you and tell you how to properly care for premature babies at home.
Nutrition of a premature baby
When a premature baby wants to eat, he may not cry, unlike full-term babies, because his nervous system is still immature, and the baby may not even know that he is hungry. And since his stomach is still too small, it is worth feeding the baby a little, but every 1.5–2 hours.
The muscles used for sucking and swallowing are too weak in a premature baby, and the sucking reflex is poorly developed, so problems can occur.
Your baby will eat better if he is fully awake, so help him focus on eating. Until the baby learns to suck properly, feed him in a room with dim lighting, in silence; if the baby begins to doze off during feeding, “wake him up.”
Breast-feeding
Breastfeeding has a number of benefits. Most importantly, breast milk helps strengthen your baby's immune system and is an ideal source of all essential nutrients. After discharge from the hospital, the baby may become tired during feeding and may not suck the breast completely. In order to ensure good milk production at first, express the remainder after feeding; if necessary, they can be used for supplementary feeding. The baby will need additional support for the head and shoulders during feeding.
In addition to mother's milk, some premature babies need a special supplement fortified with essential nutrients, but if this is really required, your doctor will tell you about it. Also discuss with him how to feed the child correctly, and make a feeding plan together. To understand whether the baby is eating well enough, have a check weighing first, then your doctor will be able to determine whether the baby has enough food.
Bottle feeding
If for some reason you cannot breastfeed your baby, your doctor will prescribe you a special formula for premature babies. They contain much higher concentrations of nutrients than regular infant formulas.
For the jar from which you will feed the baby, you will need a special soft nipple, designed specifically for premature babies; it will make sucking less tiring for the baby.
While you are in the hospital, you will have time to find out how much formula your baby needs during the day.
Because premature babies are at risk of developing iron deficiency, make sure you get enough iron in your diet or give your baby the medicine your doctor prescribes. This is due to the fact that by the age of two months a child’s iron reserves may be depleted, and this can lead to anemia.
Premature baby's room
Air temperature
The most comfortable temperature in a children's room is 22–24˚С. Do not forget to ventilate the room, but at this time it is better to leave it with your child so that he does not get sick. In summer, you can keep the window slightly open, the most important thing is that there are no drafts.
Body temperature
Also monitor the baby’s body temperature; 36.6–37.4˚C is considered normal for a premature baby. If you notice that your child has cool, pale or bluish hands and feet, warm him up. Since the child’s thermoregulation does not work well, doctors advise making warm, dry heating pads, wrapping them in cloth and placing them at the baby’s feet under the blanket and on the sides on the blanket. But be careful, the temperature under the blanket should not exceed 32˚C, and the temperature of the heating pad itself should not exceed 65˚C. Measure your baby's body temperature in the morning, evening and, if possible, during swaddling. If your baby's skin is warm and excessively red, he may be dressed too warmly.
Avoid exposing your baby to direct sunlight, as the skin of premature babies is very sensitive. Also, try to avoid cold drafts and excessively dry air.
The closeness of a premature baby to its mother is very important. To keep your baby's body temperature normal and help him grow faster, place your naked baby on your stomach and cover him with a warm blanket as often as possible.
Humidity
Monitor the humidity in the baby's room; its level should be from 50 to 70% so that the premature baby feels comfortable. It is best to buy a humidifier with a humidity control sensor; it will turn on automatically when the air becomes too dry. This is especially true in the cold season, when the central heating is turned on. An alternative humidifier is to use vessels with water in the room or hanging wet fabrics. Be sure to buy a hygrometer to monitor humidity levels.
Crib
The distance between the bars of the crib was no more than 6.5 cm, this will protect the baby as much as possible. Make sure the mattress fits snugly against the bed frame so that your child's arm or leg doesn't get caught in the gap. By the way, the mattress should be firm enough.
There should only be a thin, tightly stretched sheet between the mattress and the baby. And do not place soft bulky objects in the baby’s crib; they can interfere with the baby’s breathing.
Premature baby clothes
You should not swaddle the baby, as due to the tight fixation of the limbs the child may become hypothermic, and you should not wrap the baby either, otherwise he may overheat. It is better to buy him special small-sized clothes for premature babies, they are sold in specialized stores. Don’t overdo it, the child will grow out of these clothes in just a month and will switch to the dowry that you have prepared for him.
If the child weighs less than 2 kg, then he needs to be dressed in 1-2 layers more than children born on time. Buy diapers specifically for premature babies.
Bathing
Bathing a premature baby should be as short as possible, since the baby quickly cools down, and only after a week of staying at home. For the first three months, bathe your baby in boiled water.
Before putting your child in the bath, check the water temperature, it should be 38˚C. There should be no drafts in the bathroom itself, and the optimal air temperature is 25–28˚C.
The child needs to be bathed very carefully with soft and caressing movements. After bathing, wrap him in a soft towel.
But if your child was born less than 1.5 kg, then do not bathe him at home for the first 2-3 weeks, it is better to wipe him with wet wipes and special baby cleansing milk.
Walks
Be careful when walking, as sudden temperature changes are dangerous for a premature baby. If your child weighed more than 1.5 kg at the time of birth, then you can start walking with him 2 weeks after his birth, but only on the condition that the weather outside is warm and not lower than +22⁰C. The first time the walk can last 10-15 minutes, then adding 5 minutes every day, increase it to 1-1.5 hours.
If the temperature outside is up to +10⁰С, then you can only walk with a 1-1.5 month old baby who weighs at least 2.5 kg.
Control by doctors
Since a premature baby has a very weak immune system, in the first months of life, make sure that there are as few guests in the house as possible, and so that the doctor examines the child, invite him home if possible.
The baby needs constant monitoring by a pediatrician and regular consultations with a neurologist. Also, for the first two years of his life, a premature baby should be observed by a cardiologist, who will do an electrocardiogram at 2, 4, 6 and 12 months of life. It is necessary to perform ultrasound of the heart 4 times during the first 2 years of life - at 2, 6, 12 and 24 months. And when the child is two weeks old, it is worth starting to prevent rickets - vitamin D, massage, hardening, ultraviolet irradiation.
With vaccinations for premature babies, everything is also special. The pediatrician will draw up an individual vaccination schedule.
It is also very important to give the baby a massage and perform simple gymnastics with him, but before that, consult a doctor on how to do them correctly so as not to harm the baby, since a premature baby is too fragile.
Carry your baby in your arms more often, talk to him and sing. This has a positive effect on the baby's health.
After discharge, many parents are at a loss, what to do with a small lump, how to properly care for it? There is no need to be scared; it is important to understand the main thing: your child requires special attention. Additional conditions are added to the usual rules for caring for a newborn, which we will discuss in detail.
Bathing a premature baby
If swimming is allowed, the water should be at least +38°C, and the ambient temperature should be +25°C. The process of water procedures itself is no different from bathing full-term babies.
For convenience, you can use special devices: circles, support collars. Cosmetics for bathing in the first six months of a baby’s life are not needed; herbal preparations are enough: chamomile, lavender, oak bark, celandine, etc. The duration of water procedures is on average 5-7 minutes, gradually increasing the bathing time.
After bathing, be sure to treat the umbilical wound and skin with special children's cosmetics: oil, powder. Remember that all folds of the baby need to be treated!
How to dress a premature baby?
Due to the immaturity of the nervous system, the baby’s thermoregulation is unstable, so you need to dress the baby according to his comfortable state.
Mandatory are: socks, mittens, hat. Accessories (clasps, hooks, buttons, etc.), rough seams on the inside of clothes are not welcome, as they can damage the baby’s skin. Since in the first months the baby spends more time lying on his back, the fasteners can be on the side or in front.
Baby clothes should be made only from natural fabrics!
Sample kit for home:
- seamless vest or bodysuit made of cotton fabric;
- blouse made of flannel or knitwear;
- diaper;
- sliders;
- socks;
- mittens;
- seamless cap.
If you are dressing your baby for a walk in cold weather, in addition to the above list, the child should wear warm overalls and a warm hat. When the weather outside is warm, just throw on a light blanket.
Walking with premature babies
The question of the possibility of walking with a prematurely born child is decided individually. If the child is healthy and there are no contraindications to walking, walking can be beneficial, but the mother must make sure that there is no hypothermia.
Walks are always necessary, even if there is bad weather outside, it strengthens the baby. The exception is if the baby is sick - in this case, festivities are not recommended. If there is snow or rain outside, the stroller can be covered with special devices. In hot weather, you should take your baby out for a walk in the morning or afternoon.
At first, the duration of walks is 10 minutes in winter and 15-20 minutes in summer. Gradually, the walking time is increased in accordance with the baby’s condition and weather conditions.
When walking, monitor the temperature of your baby's hands and nose. If the child’s limbs are cold, he should be wrapped up or taken indoors!
Many mothers use the balcony as an alternative to walking outside. This option does exist, but it is not comparable to walking in the park or in the yard. In the latter case, the baby receives a dose of fresh air, and the mother regains her shape.
Vaccinations for premature babies
The baby must be vaccinated in the maternity hospital:
- Hepatitis B.
Children born prematurely are under constant medical supervision. This is necessary in order not to miss pathological changes that may occur at any time.
After discharge from the hospital, a premature baby, as a rule, requires further rehabilitation, so you should strictly follow the doctor’s recommendations after hospital treatment.