Premature child: care

What is it about ?

A normal pregnancy lasts an average of 40 weeks. The qualifier “premature” refers to an infant born too early, ie. before the 37^e

week of pregnancy. Most premature babies also have a low birth weight (less than 2,500 grams). No matter how long the pregnancy is, a baby with such a low weight will also be considered premature.

Smoking, stress and maternal weight can influence the premature birth.

How does the doctor judge it to be a premature birth?

Estimation of duration of pregnancy, supervision of the first echo and the date of the last period allow the correct age of the premature baby to be determined as accurately as possible. Indeed, in this case, a week more or less can be important. This estimate makes it possible to mark the birth weight at the right point on the growth curve, and to precisely follow the evolution and the growth.

With a birth weight over 1500 grams, normal weight gain is expected, as envisioned in the weight chart. At a weight below 1500 grams, weight gain will usually be delayed, followed by catch-up growth. Lack of catch-up growth indicates problems with feeding or an underlying disease.

When a baby arrives prematurely and / or with a very low birth weight (less than 1500 grams), the doctor monitors the infant in particular to detect possible disorders and a delay in psychomotor development. Prolonged supply of oxygen can slow down the maturation of the lungs. The baby has breathing problems and is more susceptible to infections. The doctor will give the child extra oxygen and medicine to open the airways.

Hearing loss and eye abnormalities are also more common. In assessing psychomotor development, the doctor will pay particular attention to abnormalities of the nervous system, such as decreased strength and symptoms of paralysis, as well as problems with the child’s concentration and cognitive skills.

What can you do ?

During pregnancy, avoid factors that increase the risk of a premature birth, such as smoking and excessive stress.

What can the doctor do?

Premature newborns are cared for in hospital until doctors decide, based on the progress, that they can be discharged from the hospital. Correct nutrition is important. These babies grow faster and need more food that is rich in protein, vitamins (especially vitamin D, to a lesser extent, vitamins A, B12, E and folic acid) and minerals (especially iron). This is why breast milk alone is sometimes not enough and they need to be given supplements.

Premature babies receive the same vaccines as other children. It is recommended that the flu shot be given to all premature babies over 6 months of age.

Children born prematurely or with a low birth weight receive an additional dose of the pneumococcal vaccine at 12 weeks.

The vaccines that are normally given at 15 months of age (4^e dose of hexavalent vaccine and meningococcal type C vaccine) are given earlier, at 13 months, to premature infants because they are more susceptible to infections.

Want to know more?

• The Premature Baby – Born and Growing

• Stop smoking. It’s possible – Tabacstop

Are you looking for more specialized help?

• ONE – Office of Birth and Childhood
• Smoking Assistance Center (CAF®) – FARES – Respiratory Affections Fund
• Tobacco specialists – FARES – Respiratory Affections Fund

Source

Foreign clinical practice guide ‘The premature child in an outpatient unit’ (2000), updated on 24.01.2017 and adapted to the Belgian context on 16.06.2018 – ebpracticenet