Your baby's healthcare needs will depend on how prematurely they were born. In this article, we would like to provide some information on what you can expect based on your babies gestational age (age they were born in terms of 40 weeks pregnancy/gestational period). This information is to support the conversation between you and your healthcare team. So it is not intended to as a substitute for medical advice. Your baby and their situation is unique so let your healthcare team guide you to get to know your baby
Your baby's healthcare will often depend on their gestational age (how prematurely they were born, full term is 40 weeks). To give you a guide we have detailed the different gestational ages at birth and effect on health. When you see your little one for the first time, it's only natural to feel daunted. You may feel disappointed about how you respond to your little one and doubt your instincts. A premature baby will look differently from your expectations; they will be smaller, seem frailer and are more vulnerable. The neonatal unit will provide specialised care to overcome this early start in life but as the babies family, you critical members of their care team. There is no better comfort to your baby than your presence. No other treatment or care can better build your baby's courage than you being there.
You may feel shocked and scared about what the future may hold. But try to stay calm and integrate with the healthcare team who will look after your baby and help you in the first steps of becoming a new parent. Your baby's health and the treatment they need will depend on many factors, including their condition immediately after birth. Know that your baby needs you and your involvement has been improven to improve their outcome.
You may feel shocked and scared about what the future may hold, so try to stay calm and have faith in the healthcare team who will look after your baby and help you in the first steps of becoming a new parent.
How unwell will my premature baby be?
Your baby's care will depend on how many weeks old they are at the time of delivery.
Near-term (34-36 weeks)
At this gestational age, your baby is more likely to manage the steep adaptation to breathe on their own but may still require some initial support. They may even be at risk of problems with blood sugar levels, blood pressure and infection, and may not be able to breast or bottle-feed quite yet. If that’s the case they are likely to have a small tube passed through the nose into their tummy so that the team can give them milk until they develop the stamina to manage to take all the fluid and nutrients they need by mouth. They will need help with feeding through a tube until they have developed the ability to suck and swallow themselves to keep their airway safe.
Moderate (32-33 weeks)
At this age, your baby will still need specialised care and may have low blood sugar and mild breathing problems, but their lungs will be much more mature. However, they will still be at risk of hypothermia, low blood pressure and infection.
Very preterm (28-32 weeks)
At this premature age, your baby will be susceptible to the same conditions as younger babies - but because they are more developed, the risk is lower. Their lungs still need further development and hence they are likely to need breathing support and are at risk of hypothermia (unable to regulate their body temperature and gets cold easily), low blood sugar and infection, but they are less likely to become severely ill. The large majority of babies born at this age in the UK survive to go home.
Extreme (less than 28 weeks)
At this age, your baby will be transferred to the neonatal intensive care unit after delivery if there isn't one in your hospital. They will be at high risk of having problems with breathing, as their lungs is not mature enough to breathe independently. They will need breathing support. They will need to be kept in a controlled temperature warm to avoid hypothermia, and will need to be given dextrose and IV nutrition to prevent low blood sugar and to help them grow (much like the nutrients you where supplying your infant via the umbilical cord in pregnancy). At the same, the unit will assist their adaptation to life outside of the womb by slowly transitioning on to milk feeds over a long slow period of time. They will be at high risk of low blood pressure and infection. There is a risk of brain injury among babies born at this time so the team will monitor this with ultrasound scans performed at the cotside.
What resources do I have?
Your neonatal team is there to assist. There are lovely resources available on the unit and as day to day. You'll experience a steep learning curve and a lot to update yourself with daily updates so not be distracted with excessive web browsing. Be present at the unit and ask for updates from the bedside nurse. Ask how you can assist in your babies care and what you can go learn at this time. There are also excellent parent support groups for parents of premature infants so do ask your unit for further information.
Good luck and best wishes on every step of your journey.
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