What features do babies born prematurely and low birth weight have?
20 out of 100 babies are born premature.
According to special terminology, all babies who “emerge” from the tummy at up to 38 weeks are considered to be born prematurely. It happens that a baby born prematurely, for example in the 8th month, is no different from a full-term baby, he has a good weight, and all reflexes are developed. However, this is rare; usually premature babies are still immature and they need special care. However, most of all, babies whose birth weight does not reach normal levels need attention, i.e. less than 2.5 kg (low body weight). If a baby is born weighing less than 1.5 kg, its body weight is considered extremely low. Such babies are usually sent to intensive care. Unfortunately, such babies are not always saved. However, in most cases, a miracle happens, thanks to good specialists and modern technology, even crumbs weighing 500g survive. In the United States, there was even a case where doctors managed to save a baby half her age.
Babies who do not receive the required amount of grams before birth are more likely to suffer from infections. Because of this, WHO strongly recommends breastfeeding these infants. However, in our country, such babies are still fed mainly with formula. Although gradually, more and more medical institutions agree that premature babies need to be fed breast milk. Parents also need to learn more about how they can help their child.
What difficulties do premature and low birth weight babies have?
During the first days of its life, a child born prematurely will “mature.” He will be immediately placed in a special apparatus - an incubator. Here it will be like it’s in mom’s tummy. Then, when his condition returns to normal and his life is not in danger, he will be handed over to his mother. As a rule, such babies are not discharged from maternity hospitals for a long time, and then they remain in a children’s hospital for some time. It’s good when mother and baby spend this long period of time in a joint ward, but not all clinics can offer such conditions.
If no complications have been identified in the baby, except for low weight, he only needs:
- prevention, treatment of hypoglycemia;
- ensuring thermoregulation;
- feeding.
There are problems with food intake, since low-weight children refuse their mother’s breasts, and, in addition, due to a difficult birth, problems with lactation may arise. That is why artificial feeding is practiced. But this is not a panacea; you need to fight for the opportunity to feed your baby breast milk! But first things first.
Hypoglycemia
Hypoglycemia should only concern doctors, but young mothers are frightened by the situation when no one tells them what is being done to their child and why. If a child has a low level of glucose in blood tests, there is a risk of seizures, breathing problems, and the worst outcome is lethargy.
This disease is common in premature babies. Glucose drips and regular blood tests will help get rid of hypoglycemia. Parents should know that all these unpleasant procedures really save the baby’s life. Prevention of this disease is early breastfeeding and feeding on demand, but sometimes the baby can only eat through a tube.
Thermoregulation
All babies do not retain heat well. However, babies born prematurely do not yet have a fat layer, thus their thermoregulation works even worse. They can experience hypothermia even in a relatively warm room.
In the delivery room, babies' temperatures are taken. If it is less than 32 degrees, the baby is placed in an incubator or on a special mattress. If the temperature is less than 36 degrees, then the baby is given to the mother so that she can hold him close to her, but sometimes this is impossible to do, for example, if the mother had a caesarean section. Then the kuvez comes to the rescue again. Until your temperature returns to normal, it will be measured regularly.
Today, medicine is actively introducing a method for carrying babies - kangaroo care. According to this theory, the baby should have constant contact with the skin of mom and dad, in turn. The results of this method are stunning; contact with the skin of the parents reduces the likelihood of complications.
But to implement this method, the baby must be in a stable condition, he must be born after 30 weeks, weigh at least a little more than 1 kg, and be able to suckle. If the baby meets all these requirements, the doctor will try to do everything possible to ensure that the child has contact with the parents as often as possible. The smallest baby will feel better when he is on his mother's breast. The beat of a mother's heart, the rhythm of her breathing, her smell - all this creates a familiar atmosphere for the child. Thanks to the mother's warm body, it is easier for the baby to maintain his normal temperature. Thus, the baby feels as if he is still in his mother’s tummy.
A naked toddler in one diaper lies on his mother’s stomach, under a blanket. It is possible, without interrupting this contact, to carry out all the necessary procedures for the baby (drips, oxygen therapy, insertion of a nasogastric tube). Then the mother constantly holds the baby in her arms, and the father periodically replaces her.
Of course, to implement the kangaroo method, certain conditions are required in a medical facility. This includes special training for staff and the presence of joint wards. If the mother needs to go somewhere, the child needs to be wrapped up well. In addition, mother and child should be constantly monitored by doctors and nurses. The mother should be provided with hearty meals and the opportunity to sleep for at least a few hours. But, unfortunately, not all hospitals are able to provide such conditions. And the traditional method is mainly used, when the baby stays in the incubator around the clock. His mother is only occasionally allowed to visit him and pass on expressed milk. Sometimes it is possible to breastfeed.
However, the kangaroo care method has many advantages, including reducing the likelihood of infection of the newborn and improving its overall development. The mother's lactation is established faster and better. The functioning of the heart and respiratory system is improved. The baby sleeps more soundly, is active while awake, cries less often, grows well, and requires less time for hospitalization. We hope this method will soon be accepted everywhere.
“Toropyzhki”, they are also “special people”: why a premature baby is not a death sentence
Every year, about 15 million babies around the world are born prematurely, more than one million of these children die soon after they are born, and many suffer from various types of physical, neurological disabilities or have learning difficulties.
Children who were born prematurely make up the largest group of sick children. According to statistics, premature birth is the cause of almost half of all newborn deaths in the world. Every tenth child in the world is born premature.
Milky Way. Anna Revyakina about the magic of breastfeeding a baby
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RIA Novosti, Alexander Paniotov |
Go to photobank International Day of Premature Babies was established in 2001 by the European Foundation for the Care of Newborn Babies. Modern technologies make it possible to care for even the smallest patients. Resuscitation measures are provided to a child weighing more than 500 grams. The world's smallest rescued child weighs 280 grams. The girl Emilia from the USA was born at 21 weeks of pregnancy, the baby’s height at birth was 24 centimeters.
Toropyzhki or individuals
The birth of a premature baby is a huge psychological burden on the entire family. Relatives don’t understand - is it necessary to congratulate? Dad still can't decide what role to take on. It’s too early to assemble a crib, too early to hold it in your arms, and it’s simply scary to plan anything.
It is difficult to describe in words how parents of premature babies feel. Many of them do not receive adequate information and support, are in the dark and do not understand what is happening. In anxiety and fear. Without knowing what will happen next, what chances does their child have for a normal life.
Caring for a premature baby is a huge job for a whole team of neonatologists. As medical care improves, the number of premature babies with a favorable life prognosis increases every day.
Babies are excellent and not so good. Anna Revyakina about the mysterious newborn assessment scale
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RIA Novosti, Sergey Venyavsky |
Go to photo bank The heroine of this material, Moscow hydro-rehabilitation specialist Alexandra Gladun , told me about how vulnerable parents of “in a hurry” can be, how important it is to protect parental feelings and what incredible successes premature babies can achieve thanks to the strength and perseverance of moms and dads.
Alexandra works with children from several weeks to one and a half years. “I work with premature babies, not even just premature, but deeply premature,” Alexandra shared with me, “such children are distinguished by the fact that their main body systems are underdeveloped from birth. The task of perinatal centers, roughly speaking, is to grow them, but, unfortunately, such “growing” outside the uterus does not pass without a trace. A lot of premature babies suffer from cerebral palsy. Premature babies are smaller than full-term babies, this is understandable; they look younger. Parents of such children can be hurt by simple questions about how old their baby is and what he can do.”
Alexandra told me that parents of premature babies, because they are not yet accustomed to their special status and have not yet gone through all the stages of accepting the situation to the end, may be offended when asked about the age of their child. Such a question evokes a huge number of thoughts in the head of the parent of a special baby: “Now, I’ll say that it’s five months, and they’ll tell me that he looks two, not five, and they’ll start asking questions...”
Diaper philosophy. Anna Revyakina about an indispensable pot for the “flowers of life”
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CC0, Pixabay
“You have to work very carefully with parents of premature babies,” says Alexandra, “they take a lot of things with hostility.
Now is the time, we all spend a lot of time on the Internet, stewing in an information cauldron. What can I say, even if parents of healthy and full-term children sometimes read a lot and start asking questions. And when there is a real problem?! Parents of premature babies miss all the diagnoses themselves. I try to choose my words very carefully. You need to talk to your mother very tactfully, control every word, every intonation. My task is for the parent to adequately perceive the information that I tell him. When a child is very small, parents react painfully to everything. They have already suffered a lot, and they still have a lot of work to do.”
Nowadays you can often hear the following phrase: “A child owes nothing to anyone.” Both doctors and young mothers pronounce it. The norm has become different, or rather, not the norm, but a corridor of the norm.
If earlier (this was the case in my childhood) a child had to sit at 6 months, otherwise grandparents would begin to groan and independently diagnose delayed motor development, then today’s normal range suggests that a child may not be sitting at seven months or even eight, and this is also the norm. The child masters the skill of sitting independently from 6 to 10 months, the corridor for four months. All this applies to full-term babies.
As for premature babies, the work here follows a different principle. Yes, on the one hand, a premature baby also “doesn’t owe anyone anything,” but on the other, doctors and parents become a team whose task is to help the child eventually catch up with his peers.
Circles of parental hell
When I first met Alexandra, she told me that she was now working with a child whose mother spent three long months in the perinatal center next to the incubator (incubator for newborns) in which her tiny baby lay. Every day she came, sat next to me and talked, read fairy tales, sang songs.
The baby was warm under the artificial sun; the child received nutrition through a tube. Mom sat and looked at her baby every day from morning until late evening. And she thanked the doctors for letting me in.
To a new world with a new person. Expectant mother Anna Revyakina about what it’s like to give birth during a pandemic
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Anna Revyakina
“Of course, such a child is a huge challenge,” Alexandra shared with me, “both for the parents and for the entire large family.
Every mother has her own story about why her child was born so early. I look at special children and every time I think where their parents get their strength from. Some of these kids will never get up, never walk, and never sit down, but they have incredibly strong and united parents. It seems to me that such trials are given only to those who have the strength to endure them. It also happens, however, that a man cannot withstand such tests, and the mother is left alone with her grief. I always tell parents of those in a hurry that if there is work, there will be results. This is true. We work as a team, I work with the child in the water, the parents work at home and practice their skills. I always give homework.
Lucky are those children and those parents who end up in big cities and have the opportunity to get to centers where they rehabilitate children. Moscow, Kazan, St. Petersburg, Sochi, etc. In the outback they forget about such children, it’s as if they don’t exist.”
Third Maternity Hospital of Donetsk
In the article about the situation with covid in Donetsk, my heroine was Anna Pavlova (name and surname have been changed). Anna is an employee of the Third Maternity Hospital in Donetsk, which was converted into a covidarium in early October. Until October 2021, the Third Maternity Hospital specialized in premature births. I really hope that when the pandemic ends, everything in the third maternity hospital will return to normal, as in all other maternity hospitals of the Republic converted for Covid-19.
“Premature babies were always brought to us,” Anna told me, “both women who were afraid that they would start giving birth earlier and gynecologists in the region knew this. We all want professionals to deliver babies. And not just professionals, but those who know how to act if the birth is premature.
Healthy children are the key to family happiness and peace. The midwife in the discharge room tells all parents the same thing: “The most precious thing is our children.” Of course, you can feel more relaxed when there is a resuscitation specialist behind the obstetricians and gynecologists. Unfortunately, during the war we lost nine resuscitators. They just left. Kyiv, Sochi, Rostov-on-Don, etc. They immediately began working in maternity hospitals. Neonatologists and resuscitators are now worth their weight in gold.”
Against all odds. First story: The old midwife
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Go to photo bank According to Anna, children born weighing up to one kilogram have a high percentage of cerebral palsy.
“But sometimes it’s not,” Anna shared with me, “it happens that we give birth to 900 grams, and 800 grams, and even 600 grams.
The compensatory capabilities of a child are sometimes limitless. Our maternity hospital has specialized in caring for premature babies for many years. In the “troika” there was always a high chance of survival for a child. We have an order from 22 weeks - this is childbirth. 23-25 weeks are very difficult for children; even if they survive, they most often become disabled. It is better when the baby is born at 28-30 weeks. These are promising children."
Famous people born before
I really hope that mothers of premature babies will be encouraged by this part of my post dedicated to premature babies. When prematurity did not become a death sentence in order to become famous throughout the world.
It seems that there is no person on this planet who does not know Isaac Newton . The great scientist was born on January 4, 1643 in a small village in the family of a small farmer. The newborn was so small that there is a legend: the baby was placed in a sheepskin mitten lying on a bench. And despite poor health in infancy, the world-famous scientist lived for 84 years.
Against all odds. Second story: I brought you love
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Anna Revyakina
The great Leonardo da Vinci , a man ahead of his time in every sense, was born so tiny that he was placed in a vat of rags.
At first, the author of the most famous painting in the world was bathed in a beer mug, he was so small. Red Army commander Vasily Chapaev was born premature and so tiny that he could fit into a mitten. This baby was also bathed in a mug that was specially carved from wood for him.
The great Russian commander Alexander Suvorov was born in Moscow. At first, midwives kept the baby in a sponge because of his extreme prematurity.
The legendary French commander Napoleon Bonaparte was born at seven months, as were Charles Darwin , Albert Einstein , Antonio Vivaldi and Victor Hugo .
British Prime Minister Winston Churchill was also born prematurely. It happened at a ball, in the ladies' room, on a pile of coats and boas.
As you can see, prematurity is not a death sentence! Especially taking into account the capabilities of modern medicine and modern methods of caring for babies.
How to feed a baby born prematurely
Feeding a small baby is very difficult. The fact is that such babies do not have the necessary reflexes fully working, and it is difficult for them to suck. But in order to receive milk through the breast or pacifier, you need to be able to do this. In addition, low birth weight babies are often supplemented because they need more calcium, protein... Therefore, very rarely, such children eat mother’s milk. Although the inability to breastfeed the baby does not cancel natural feeding, milk can be expressed and given to the baby, alternating with formula if necessary.
So, in the event that your premature or low birth weight baby is unable to latch on, give him expressed colostrum and then milk. If colostrum is not released, sterile “nurse” milk is sometimes used. Today, many maternity hospitals still practice collecting excess milk from young mothers, it goes through special processing and then it is given to the baby as supplementary feeding. It is believed that this is healthier than an artificial mixture. But in any case, it’s up to mom to decide.
Babies born prematurely are fed differently. For example, babies born before 32 weeks eat through a tube or IV. Those born after 32 weeks may be able to latch on to their mother's breast, at least a little, and then they are spoon-fed. Babies born after 36 weeks latch on easily.
You should know that it is not necessary to bottle feed your premature baby if you plan to resume breastfeeding. Many people believe that drinking from a bottle is easier for a baby, but this is not always the case. Therefore, pay attention to other supplementary feeding methods.
Expressed milk
The baby cannot suckle at his mother’s breast, but the expressed milk of mothers whose babies were born prematurely contains many nutrients, including a double dose of protein. All this is designed to help the child “mature.” Therefore, without fail, mothers in maternity hospitals are recommended to express their milk. At first it will seem that there is very little of it, but its quantity will increase. You can improve lactation through regular pumping.
Clinical breast pumps are ideal for this procedure; you can borrow them from the medical staff. But they may not exist, then pay attention to manual breast pumps, and if your budget allows, then to electric ones. As a last resort, you can do everything yourself. This procedure is not so complicated, the main thing is to get used to it.
Even three drops of mother's milk will benefit the newborn. However, if the amount of milk exceeds the baby's needs, you can divide the excess into portions and freeze it. Hind milk is mainly used for feeding; it is released towards the end of feeding and contains a lot of nutrients.
To find out how much milk is needed for supplementary feeding you need:
- If your baby weighs more than 2.5 kg, follow the following formula - 150 ml of milk per 1 kg of weight per day. We divide what we get by 8 and give it to the baby every 3 hours;
- If your baby's weight is less than 2.5 kg, follow the following formula - 60 ml on the first day. Next +20 ml per 1 kg of weight, daily, until the norm is 200 ml per 1 kg daily. Let's say a child weighs approximately 2,000 g, during the first day of his life he should drink 60 ml, then 100 ml, 140 ml... and so on up to 400 ml. We divide this number by 10 and give it to the baby regularly.
- The baby does not necessarily eat the same amount of milk all the time. The feeding schedule may also change. Try to make your low-birth-weight baby cry less, such cries require a lot of energy. If your baby has eaten less than normal at one feeding, move the next feeding to an earlier time and you can offer more milk. If your baby constantly eats poorly, he may need the help of a nasogastric tube.
How to breastfeed
Babies weighing about 1.5 kg are already successfully suckling at the breast. There are babies who fully switch to breastfeeding with a weight of 1.6 kg. So, as soon as your baby's condition returns to normal, start breastfeeding. Don't be alarmed if your baby doesn't latch on to the breast right away. Usually such babies taste the nipple for a long time and adjust. It is not correct to assume that a baby who is not actively breastfeeding is not ready for natural feeding; it will just take some time for everything to get back on track. Mom can help the baby and express milk directly into his mouth. At the same time, you need to continue “supplementing feeding”.
After the baby learns to fully suckle at the breast, breaks are possible during feeding. Let's say the baby suckles for a few minutes, then there is a pause. Here you can advise your mother, just be patient. Just give your baby about an hour for feeding, let him decide how much to eat and how much to rest. If you doubt whether the baby is full or not, give him expressed milk from a spoon. If the baby is full, he will refuse supplementary feeding. Of course, it is not easy to devote so much time to feeding, but the mother needs to remember that natural feeding will have a positive effect on the health of her baby and on his future.
To improve the eating process, check out the special technique that is designed specifically for premature babies.
It is difficult for a low weight baby to hold the breast in his mouth. So feed him mainly “under the arm”; in this position, the mother supports the newborn’s neck, making it easier for him to latch on to the nipple. Or a traditional “cradle” will do; here the baby is also not left without support.
Usually, babies born prematurely swallow air while they eat, because of this their breathing is impaired, they cough, the problem is immature regulation of breathing, and muscle tone is low. It’s better for the mother to try, lean back while feeding the baby, let the mother sit in such a position that the pressure of the milk is lower and the baby can cope with it more easily. You can fix the pose with pillows.
It may be difficult for a baby to hold the breast in his mouth, since the ribs on the palate and fat pads on the cheeks are not fully formed. To help the baby, the mother needs to support the jaw and cheeks with a “dancer’s hand.” Those. During feeding, hold the cheek with your thumb, hold the other cheek with your index finger, and hold the chin with your middle finger. This way, the baby will not slip off the nipple.
Low birth weight children. Personal experience.
What to say. 1730 g at birth, even if the baby is full-term, is extremely small and requires a systematic approach to nursing)
Like this! And nothing else. Girls, mommies, everything, everything, everything. I was caught by my own ignorance and incompetence of local doctors in this matter. And only when everything began to worsen did the Internet and my sister’s experience with a premature, low-birth-weight nephew come to my aid.
On the fifth day after birth, Mishka was taken out of the incubator (where, by the way, he was fed my expressed milk), they said that he was already sucking from the bottle the 20 grams he was supposed to have according to his age, they say, give him the breast, all in a bunch!
1. DO NOT BELIEVE THAT A LOW WEIGHT BABY WILL EAT THE BREAST IMMEDIATELY, EVEN IF HE IS STRONG AND FULL-TERM!!!
The neonatologist also told me that such children are highly susceptible to any viruses and infections, due to the weakness of their immunity and the body as a whole. At the same time, we were transferred after the pediatric intensive care unit to the children's department on a general basis, where on one floor there are 18-year-old teenagers with bronchitis and pneumonia, and any other infection. + visits are allowed.
2. DO NOT INVITE ANYONE TO VISIT YOUR HOSPITAL, EVEN IF IT IS ALLOWED!!! VIRUSES EVERYWHERE!!!
Then the pediatrician from the children's department convinced me that I should only breastfeed and nothing else, otherwise babies wouldn't take the breast after a bottle. And I don’t care that a low birth weight baby simply doesn’t have enough strength to suck out the required volume.
3. DON'T LISTEN TO ANYONE, THE MAIN THING IS TO FEED THE CHILD. AND IT'S EVEN BETTER TO SEE HOW MUCH HE EATED!!!
I ended up bottle feeding both of them. And at least one nurse told me that I needed a bottle with a soft nipple, to make it easier. No, I was fiddling with Avent bottles simulating breasts. The weight was practically constant, the gain was only due to the round-the-clock torment of the children with feeding, which, presumably, also made them very tired. Then a bad urine test happened. + apparently because of the infection, Mishka became completely weak and it became incredibly difficult to wake him up for feeding, he stopped sucking, even stopped swallowing if milk was poured into his mouth from a spoon. And I lost 50 grams... taking into account the fact that it didn’t even contain 2kg!!! The only thing left, probably, was to try feeding it like a kitten using a pipette!?!? After all, according to the local doctor, probing (this is when a tube is inserted into the mouth and fed through it) is an unnecessary intervention and will only be harmful. Feed them as you please. And honestly, it’s as if he’s not a real person. In the end, it's still a probe! No, to first fatten up the boy, and then everything else - bottles there, breasts... as it should be. On our collective farm, in our hospital, they did the opposite and simply extended the length of our stay here, spoiled quite a few nerves for me and gave me the opportunity to catch an infection from the corridor, how sweet)))
And what’s most interesting is that the days when we switched from a tube to a bottle and from a bottle to a breast were determined by me myself... with the help of intuition... at the same time, I know for sure that in specialized centers this process is strictly monitored by a doctor, a scheme has been developed, there is experience, which is working! And why weren’t we immediately sent to Moscow!?!? ... Oh, yes, we are full-term ..... and little do we know, apparently this is a big plus for us, but it does not eliminate “minor” problems at all ...
4. STUDY ALL ANALYSIS AND PURPOSE IN DETAILS, ASK FOR NUMBERS, FIND OUT AGE NORMALS, ETC. AND SO ON. MONITOR THE DOCTOR'S EVERY STEP.
Indeed, I personally trust the doctor’s phrase “Leukocytes are elevated, there is an infection, we will inject antibiotics.” OK. I understand everything, it would seem... Hmmm, how many leukocytes were there I was told only when the second antibiotic was already prescribed and positive dynamics began, i.e. decrease in leukocytes. And there are all sorts of other indicators. Rods... and another mutata, but if you encounter this, then it’s not all that difficult. At least somehow you can keep abreast of events... In general, what I mean is that, for example, I was so unaware of the seriousness of the situation that it became downright scary. God knows what I would do if I knew and controlled the process. But I certainly wouldn’t sit on my butt... and I wouldn’t ask to bring my daughter to visit!!!
5. GET OUT OF THE HOSPITAL ON TIME)))
This is the last thing I want to write. At this point I understand that it is time to go home. I'm already green without fresh air. The boys have low hemoglobin (and, as I understand it, due to the lack of walks). But we need to finish the course of antibiotics (at the moment when Mishka was cured, Max got sick, now we have him on injections). Aaaaaaaah, I hope that on that happy day a new infection will not come to us from the corridor and we will not spend another couple of years here (((
Now, in terms of food and weight, everything has improved. We eat breast milk, the weight is stable, ttt, we gain. All that's left is to check out. Ehh, the babies are already a month old on Thursday, and we’re all stuck here. If I knew everything written above right away... I would put all the doctors on their heels and explain how to fatten a low-weight baby, and I would wipe the hands in the room with alcohol every 5 minutes.
I WANT TO GO HOME!!!
P.S. I don’t even know who to thank to tell that the hospital has Wi-Fi)))
After discharge
Usually, having returned home with the baby, the mother is already quite oriented in caring for the premature baby. Some hospitals give good advice, others not so much. The same applies to the course of treatment. In the best case, the mother gets a healthy baby, active and eating well. But medical personnel do not always help establish feeding. But mom can always ask for it.
However, their own walls help, and mothers always want to be discharged. But for this, a low-weight baby must meet the following criteria:
- health must be good;
- weight should increase steadily;
- body temperature should be normal;
- the baby should actively suck the breast or pacifier;
- The mother can take care of the baby herself at home.
Know that you can always turn to breastfeeding experts to answer all your questions. If your baby is no longer in danger, then it’s time to establish natural feeding.
