Babies born 2 months premature
Premature baby | Pregnancy Birth and Baby
Premature baby | Pregnancy Birth and Baby beginning of content10-minute read
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What is a premature baby?
Most pregnancies last 40 weeks. A baby born before the 37th week is known as a premature or pre-term baby. Medical advances have meant that more than 9 out of 10 premature babies survive, and most go on to develop normally.
In Australia, almost 1 in every 10 babies is born prematurely. Most Australian premature babies are born between 32 and 36 weeks and don't have any serious long-term problems.
Very premature babies are at a higher risk of developmental problems. It is possible for babies born at 23 to 24 weeks to survive, but it is risky.
Most babies born before 32 weeks, and those weighing 2. 5 kg or less, may need help breathing and may be cared for in a neonatal intensive care unit (NICU) until they have developed enough to survive on their own. Babies born between 32 and 37 weeks may need care in a special care nursery (SCN)
Why are babies born prematurely?
The cause of premature birth is unknown in about half of all cases. However, some of the reasons babies are born prematurely include:
- problems with the cervix, when it is too weak to hold the weight of the baby and uterus so it starts to open prematurely (called cervical incompetence)
- multiple pregnancy (twins or more)
- the mother gets an infection
- the mother has a medical condition that means the baby must be delivered early, such as pre-eclampsia
- problems with the placenta such as placental insufficiency, placenta praevia, placenta accreta or placental abruption
- preterm premature rupture of membranes, when the amniotic sac spontaneously ruptures
- the mother has a health condition like diabetes
- a history of premature birth
If you are less than 37 weeks pregnant and you experience any of the signs of premature labour, such as contractions, your waters breaking, bleeding, a 'show' of mucus from your vagina or a sudden decrease in your baby's movements, contact your doctor or nearest delivery suite immediately. It may be possible to slow down or stop the labour. But each day the baby stays inside your womb, the greater their chance of survival.
In most cases labour starts by itself, and the signs will usually be the same as labour that starts at full term.
The signs of premature labour include:
- pressure in the pelvis, as if the baby is pushing down
- cramping in the lower part of the belly
- diarrhoea, nausea or vomiting
- constant lower back pain
- a change in your vaginal discharge, or more discharge than normal
- mucous, blood or fluid leaking from your vagina
- waters breaking
- regular contractions, or contractions that come more than 4 times an hour
- baby’s movements slowing down or stopping
Find out more about the signs of labour and what happens.
What should I do if I experience the signs of premature labour?
If you have any of the signs listed above, contact your midwife or doctor straight away. If you are going to have your baby early, it’s important to get help as soon as possible.
You should also contact your midwife or doctor if you experience swelling in your face, hands or feet, or double vision, blurred vision or other eye disturbances. These are signs of pre-eclampsia, which is a common cause of pre-term deliveries.
If you go into labour prematurely, you will need to be treated in a hospital that has facilities for the newborn, such as a neonatal intensive care unit (NICU) or special care nursery (SCN).
You can find your nearest suitable hospital on the Miracle Babies Foundation website.
How is a premature labour managed?
At the hospital, you will probably have a pelvic examination or an ultrasound. The medical team will check whether your cervix has started to open for labour and monitor the baby.
It is best for very premature babies to be born at a hospital that has an NICU. If the hospital where the baby is born does not have an NICU, you and your baby may be transferred to another hospital.
When you are in labour, you may be given medicines to stop the contractions for a while. This allows you to be transferred to another hospital if necessary. You may also receive injections of corticosteroids 12 to 24 hours before the birth. Steroids will reduce the risk of the baby suffering from the complications of being born very early (particularly breathing difficulties and bleeding).
Premature babies can be born very quickly. They will usually be born through the vagina. However, in some cases the doctor may decide it is safest to deliver the baby via caesarean. Your doctor will discuss this decision with you.
A medical team from the neonatal (newborn) unit will be there for the birth. As soon as your baby is born, they will care for the baby in your room, possibly using a neonatal (baby) resuscitation bed. The team will keep your baby warm and help them to breathe with an oxygen mask or breathing tube, and possibly medicine. Some babies need help to keep their heart beating with cardio-pulmonary resuscitation (CPR) or an injection of adrenalin.
Once your baby is stable, they may be transferred to the NICU or SCN.
Will I be able to hold my baby?
How soon you are able to hold your baby will depend on their medical condition. You may be able to hold them on the day they are born, but you might need to wait a few days or weeks until they are stable enough.
Holding you baby, known as kangaroo care, is important part of your baby’s health and wellbeing, and the maternity staff will support you as soon as you are able.
Will I be able to feed my baby?
After your baby is born, you’ll be asked to start expressing breastmilk. Maternity staff, lactation consultants and Australian Breastfeeding Association counsellors will help you. Breastmilk is full of antibodies and nutrients that will be very important for your baby’s health and growth.
What will my premature baby look like?
Babies born at 36 to 37 weeks usually look like small full-term babies. Very premature babies will be small (perhaps fitting in your hand) and look very fragile.
- Skin: it might not be fully developed, and may appear shiny, translucent, dry or flaky. The baby may not have any fat under the skin to keep them warm.
- Eyes: the eyelids of very premature babies may be fused shut at first. By 30 weeks they should be able to respond to different sights.
- Immature development: your baby might not be able to regulate its body temperature, breathing or heart rate. They may twitch, become stiff or limp or be unable to stay alert.
- Hair: your baby may have little hair on its head, but lots of soft body hair (called 'lanugo').
- Genitals: the baby's genitals may be small and underdeveloped.
Will my premature baby's development be delayed?
Some common issues for premature babies include:
- breathing problems
- heart problems
- problems in their digestive tract
- jaundice
- anaemia
- infections
Most premature babies will develop normally, but they are at higher risk of developmental problems so will need regular health and development checks at the hospital or with a paediatrician. If you are worried about your child's development, talk to your doctor.
Problems that may occur later in children who were born prematurely include:
- language delays
- growth and movement problems
- problems with teeth
- problems with vision or hearing
- thinking and learning difficulties
- social and emotional problems
How do I calculate my baby's correct age?
When you're judging whether your premature baby is developing normally, it is important to understand their 'corrected age'.
The corrected age is your baby's chronological age minus the number of weeks or months they were born early. For example, a 6-month-old baby who was born 2 months early would have a corrected age of 4 months. That means they may only be doing the things that other 4-month-olds do. Most paediatricians recommend correcting age when assessing growth and development until your child is 2 years old.
When will my baby be able to come home?
The hospital will not send your baby home until they are confident both the baby and you are ready. Staff will make sure you understand how to care for your baby at home. They will also show you how to use any equipment you may need.
You will need appointments to see a neonatologist (newborn baby doctor) or paediatrician. Your local child health nurse will also see you regularly.
It is normal to feel a little worried when you are looking after your baby yourself after so long in hospital. Take it slowly in a calm and quiet environment until you both get used to being at home.
Who can I talk to for advice and support?
If you need support, contact the Miracle Babies Foundation's 24-hour support line on 1300 622 243.
The Australian Breastfeeding Association can provide advice and support on feeding your baby on 1800 686 268.
Speak to a maternal child health nurse
Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.
Sources:
Australian Institute of Health and Welfare (AIHW) (Mothers and babies), Raising Children Network (Premature labour, birth and babies), Raising Children Network (Your premature baby's appearance), Raising Children Network (Premature baby development concerns), Raising Children Network (Going home with your premature baby), Women’s and Children’s Health Network (Premature babies), NSW Pregnancy and Newborn Services Network (Birth before 32 weeks), Miracle Babies (What is prematurity?), Miracle Babies (Treatment of preterm labour), Queensland Government (Queensland Clinical Guidelines; Preterm labour and birth)Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: March 2020
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Related pages
- Neonatal intensive care unit (NICU)
- Special care nursery (SCN)
- What is kangaroo care?
Need more information?
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Why babies are born prematurely
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Scientists cannot say with certainty what triggers the process of childbirth. But the causes of premature birth are well known.
If delivery occurs before 37 weeks of gestation, the World Health Organization (WHO) defines the baby as preterm and preterm. The term "prematurity" also means that the child was born before the due date of intrauterine development and is not sufficiently developed . The weight of premature babies usually ranges from one and a half to two and a half kilograms. The modern level of medicine allows such children not only to survive, but also fully developed . However, some time must pass before such babies begin to feed on their own and can leave the maternity hospital.
Prematurity and consequences
There are several degrees of prematurity in newborns. A mild one, as a rule, does not pose a danger to the baby's health, while a severe one requires serious medical care. Find out the dangers of having a baby prematurely.
Are all premature babies born prematurely?
Not all low weight babies are born before 37 weeks. Some of them failed to gain enough weight during pregnancy. Experts believe that with the same degree of readiness of the baby's body for independent existence , normal birth weight is always an advantage .
- Placental insufficiency
One of the causes of low birth weight is placental insufficiency, in which the placenta ceases to function normally. Because of this, the fetus does not receive enough nutrients for normal growth. Placental insufficiency occurs with complications of pregnancy, for example, with gestational diabetes - a violation of glucose metabolism caused by malnutrition of a pregnant woman. - If mother smokes
An equally serious cause of growth retardation is maternal smoking. Depending on the number of cigarettes smoked during pregnancy , the growth of the baby slows down to varying degrees. In pregnant women who smoke daily, the risk of having a baby weighing less than 2500 g is doubled. - Other causes
Other causes of low birth weight are malformations and chromosomal abnormalities in the child. Most of them are detected during screening in the second trimester of pregnancy.
Also, various infectious diseases that affect both the mother's body and the child during intrauterine development lead to low birth weight.
Why are babies born prematurely?
Despite numerous studies, scientists still cannot say with certainty what triggers the birth process. In recent years, the most popular theory among specialists is that the child's body independently determines the optimal time for childbirth. The pituitary gland of the child is presumably responsible for this mechanism. The causes of preterm birth, on the other hand, are well known.
Active pregnancy
Many women, fearing for the health of the child, almost completely stop moving while waiting for the baby. While physical activity during pregnancy protects against complications.
- Stress
Often, early childbirth causes stress and hard physical work. Thus, the results of studies show that the death of close relatives, job loss or divorce can lead to premature birth. - Infections
Also, premature birth can be triggered by an infection of the urinary and genital tract of a woman. Experts believe that the bacteria secrete chemicals that cause uterine contractions. Often such diseases are asymptomatic, and a woman may not know that she is sick. The risk of preterm birth can be reduced by identifying and treating the infection before or early in pregnancy. Currently, there are a sufficient number of drugs that do not harm the baby. - Cervical weakness
In about 20 percent of preterm births, cervical weakness is the cause. This disorder is easy to detect during pregnancy if you visit a doctor regularly. The weakness of the cervix is eliminated by strengthening the tissues with a surgical thread. - Other causes
In addition, preterm labor often begins with multiple pregnancies, uterine bleeding of various origins, high blood pressure and pregnancy complications.
Also, according to some reports, the tendency to early childbirth can be inherited. Mothers who were born prematurely are more likely to have preterm births.
Essential
A premature baby can be born prematurely due to stress or illness of the mother. However, the birth of an underdeveloped child can also be provoked by the mother herself, if she smokes during pregnancy, eats improperly and neglects frequent visits to the doctor during the entire period.
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Premature baby: development by month
Nursing methods for premature babies are developing rapidly these days. It happens that babies are born with a weight of 500 grams. How do doctors assess their condition? What indicators of development should be guided by in order to understand whether everything is normal for the baby?
Official language
Russia switched to the medical birth criteria approved by the World Health Organization in 2012. They are determined by the presence of the following signs in a newborn: breathing, heartbeat, pulsation of the umbilical cord, or voluntary muscle movements.
According to these parameters, a premature newborn is an infant weighing over 500 grams, over 25 centimeters tall, born at 22 weeks of gestation. Every year, 5-10% of such children are born from the total number of newborns around the world.
Today there are all conditions for nursing "early" children.
Early help
A 500g baby is not just very small. In such babies, the organs and systems are immature, the immune system does not work at full strength, so the body of prematurely born children is very vulnerable and susceptible to the effects of various adverse factors. What does not harm the health of full-term babies may affect a child with extremely low body weight.
Children weighing 1000-1499 g and less than 1000 g are most at risk of developing various diseases. Moreover, the shorter the gestation period, the higher the risk that the baby may have several problems at once.
The sooner doctors can identify possible pathologies and disorders, the sooner it will be possible to start adequate treatment, facilitate the adaptation of the baby to the air environment and provide him with the most favorable opportunities for development.
Three ages of premature baby
Usually a person's age is calculated from the moment of his birth. But for each premature baby, doctors determine three ages at once.
Chronological
This is a familiar indicator for everyone. It is counted from the moment the child is born. If the baby was born on December 1, then on January 1 he will be 1 month old.
Gestational
This is the age that is equal to the number of completed weeks of pregnancy at the time of delivery. It is counted in weeks and days. For example, a child was born on January 1 at 25 weeks and 5 days. In this case, his age is 25 weeks, rounding up does not occur.
Corrected
This is the child's age minus the "missing" weeks. It is considered relative to 40 weeks.
Corrected age = chronological age - (40 weeks - gestational age)
For example, the child's chronological age is 4 months (i.e. 16 weeks). The baby was born at the 28th week of gestation, that is, 12 weeks earlier (term delivery = 40 weeks). Corrected age of the child: 16-12 = 4 weeks (or 1 month).
This means that if a full-term baby usually starts crawling around the age of 9months, then for a child born 3 months premature, it is permissible to start crawling at the age of up to 12 months. This is by no means considered a pathology. In addition, if a premature baby was sick after birth and, for example, was connected to a ventilator, this period will affect its development. In this case, such a baby will learn everything a little later.
The most commonly used skill scale for preterm infants, adjusted for age.
Peculiarities of psychomotor development
Each child is individual, and one should not compare different children with each other. It is quite natural that a baby born at 34 weeks is more likely to catch up with his full-term peers than a baby born at 27 weeks. What indicators do doctors focus on? What should parents pay attention to?
Pediatrician Natalya Maykova tells about what scientists know today.
- The child develops gradually and progressively.
- In premature babies, skills are formed in approximately the same sequence as in full-term babies, but adjusted for corrected age.
- The individual characteristics of a child's development are related to his gestational age (the gestational age at which he was born) and his condition at the time of birth. That is, the more problems the baby experienced in the first months of his life, the longer it will take him to acquire new skills.
- For an adequate assessment of the pace and level of development of the baby, dynamic monthly monitoring of the child is necessary.
Development by month
There is a rough list of skills and abilities that can be expected from a premature baby in the first 18 months of his life. However, it is worth remembering that one should focus not on the chronological age, but on the corrected one.
Of course, conditional standards cannot be applied to absolutely all premature babies, but they can serve as a guideline for both doctors and parents.
Only prematurely born children, as a rule, need special conditions and constant medical supervision. Often these babies are fed through a food tube and supported by their breathing through artificial oxygen supply.
2 months of corrected age
The baby holds his head well, his first coos, smiles appear. The child begins to listen, recognize native people and rejoice when communicating with them.
4 months
The child lies confidently on his tummy, raises his head, looks around. He watches over objects and people. Some babies are already well rolled over on their stomach and back.
6 months
The child learns several skills at once: he learns to sit down, crawl, stand on all fours. Babble appears in the baby’s speech when he repeats the same simple syllables: “ma-ma-ma”, “yes-yes-yes”, etc. He enthusiastically plays with toys and various objects. He is interested in those that are out of his reach, and tries to crawl up to them or reach out to them.
9 months
Baby crawls everywhere, gets up, reaches for objects, plays with them. More and more new syllables appear in his "lexicon", he tries to imitate new sounds. At this time, the child begins to understand the word "no" well.
12 months
By the age of one, children, as a rule, are already completely catching up with their peers who were born on time, both physically and psycho-emotionally. They already know a lot: they take their first steps, walk holding on to walls and furniture, bend down and pick up objects from the floor. The speech of a one-year-old child is actively developing: the baby consciously pronounces new words, enters into communication, answering the questions posed. He likes to communicate with the help of gestures: he waves his hand, shakes his head, nods. During this period, the child begins to get upset at the moments of the absence of a close adult nearby.
15 months
The child's vocabulary grows quickly. He can, upon request, point his finger at objects, animals, body parts. The coordination of movements improves, the gait becomes confident, the child knows how to squat. The kid's games with simple educational toys (cubes, pyramid) become conscious. He learns to sort objects, to solve simple puzzles.
18 months
At this age, the child can confidently use a spoon and drink from a cup. He knows how to go up and down the stairs, tries to dress and undress on his own. The child communicates emotionally, uses more and more words in speech.
Specialists: a pediatrician and a neurologist can help parents assess the harmonious development of their baby. Doctors will notice “weak points” in the development of the child in time and help develop a plan for his further observation and, if necessary, treatment, which includes not only drugs, but also massage, physiotherapy exercises, kinesitherapy and other modern methods.
It is important to remember that the development of a premature baby largely depends on the care and responsible attitude of parents to the recommendations of doctors.