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Information on Premature Babies

Premature baby hand holding man's finger

Information for parents on premature babies

Everyone hopes their pregnancy will be uncomplicated and free from emergency. Few people consider the possibility that their baby could be born many weeks before the due date and need to be given special care for the first few day, weeks or months after birth.

However, the reality is that around 82,000 babies are born sick or premature each year in the UK.

Babies can be born prematurely for many different reasons:

  • Pregnancies with twins, triplets or more babies are very likely to end early.
  • Pre-eclampsia occurs in about 10-15 per cent of first time pregnancies and is responsible for at least 15 percent of all premature births.
  • About a third of premature births occur for no apparent reason. Often they happen with little or no warning.
  • Stressful events can start labour early. However there is no evidence that normal day-to-day stresses of living can bring on premature birth.
  • In some cases the mother's waters break early, starting the delivery process. If labour starts while a baby is less than 35 weeks, the doctors may give drugs to delay the labour for a day or two or to help the baby's lungs to mature quickly.

What to expect
If you are shocked when you walk into the neonatal unit, you are not alone. It is very likely to be different from almost any other place you have been, and you may have just experienced one of the most traumatic episodes of your life. The room is full of monitors, high-tech equipment and the frequent sound of alarms. But all of the staff know that you are under stress and are there to help you as well as your baby.

Many of the babies in the neonatal unit are extremely tiny and immature. The equipment that surrounds them is designed to keep them warm, to monitor many of their body's functions and to support their breathing.

Depending on how early your baby is born or how unwell he or she is, you may be shocked when you see him or her for the first time. Premature babies may appear thin with little body fat and look different from most term newborn babies that you may have seen before. This is simply because they are at an earlier stage of development as they were born early. If your baby is very premature, he or she may only be the length of your hand and may well sleep for almost 20 hours each day.

Your baby
Remember that in the middle of all the stress and heartache, you have given birth to a baby. This situation might not be what you had in mind for the first few days of your baby's life, but it is still alright to be congratulated and celebrate the fact that you have a new member in your family.

Coming to terms with what has happened
In many ways you have just suffered a loss. Although your baby is alive and being looked after, you may feel you missed out on a normal pregnancy, or worry that you can't go straight home with your baby. Many people find this to be an emotional time, and find that the support of family and friends helps them in some way.

The next weeks and months are likely to have days of stress and worry, so it is good to find people who can help you people that you find it easy to talk to. Some people find it easier to talk about their feelings and worries to someone who doesn't know them.

Medical problems
A premature baby has the basic problem of no longer being protected inside the mother's womb and some of the treatments can bring about their own stress for the baby. In addition, the baby may have some weaknesses or problems that were part of the reason why he or she was born early. Some of these can have significant long term effects.

Apnoea of prematurity - Babies born preterm often have a pattern of breathing in which there are short pauses. Occasionally, these pauses can be prolonged and the baby needs to be reminded to breathe with gentle stimulation. In most cases this problems get better once the baby reaches a corrected age of 34 weeks.

Chronic Lung Disease - Babies who are ventilated for long periods of time may get Chronic Lung Disease depending on the level of ventilation or oxygen they need or if they develop a chest infection. The baby may need additional oxygen support for a while when they go home.

Brain haemorrhage - The tiny vessels found in some areas of a developing baby's brain can sometimes break, causing some bleeding. These small haemorrhages appear to cause no long-term problems. Larger bleeds can occasionally occur and doctors will monitor this by carrying out regular ultrasound scans. These larger bleeds limit blood flow to certain areas of the brain, therefore those areas will not receive enough oxygen. The cells in this area will die, forming a cyst. Exactly how this may affect the baby will depend on where the cyst is.

Infections - It is hard for low birthweight babies to fight infection and so it is a common problem. Infections are caused by germs collecting on the tubes and lines used on your baby.

Heart defects - Babies with unusual heart problems may need to be urgently transferred to a cardiac centre or may be looked after in your local neonatal unit, either until they are big enough for surgery (not all babies will have to have surgery) or are followed up in the routine cardiac clinic.

Patent ductus - A common problem for very premature babies is that a connection between the vessels supplying blood to the body remains open. This connection is open when the baby is in the womb but should close at birth. Your baby may be given drugs to close the connection. On rare occasion an operation may be needed.

Making decisions
As the baby's parents, you have a major role to play when critical decisions have to be made about treatment. The doctors and nurses will advise what is best for your baby, but you will be expected to be involved in making important decisions wherever possible. This may be difficult in the case of emergency decisions that need urgent action. In general you should expect to be informed when any important decisions are being considered.

Help and support

You can call the Bliss Family Support Helpline on 0500 618 140 and talk to a member of our team. Helpline staff will listen to you and try to answer any questions you may have. Bliss also runs Parents 4 Parents - a network of parent volunteers whose babies have been in neonatal units and are bale to offer telephone support to other parents in a similar situation.

Discussing your feelings with other parents can also help. Many neonatal units run a group where parents meet to share their experiences or simply have a coffee and a chat.

Your GP may be able to refer you to a counsellor. You could also ask a member of staff at the neonatal unit if there is a counsellor or psychologist available to talk to parents and offer support.

Various voluntary organisations such as wpf Counselling and Psychotherapy, MENCAP, the British Association for Counselling and Psychotherapy and Threshold Women's Counselling Service are worth getting in touch with.

Having a premature baby in a neonatal unit is a very stressful experience. Looking after yourself will help you and help you look after your baby. Make sure you eat, rest and take time away from the unit.

For more information visit www.bliss.org.uk or call Bliss' Family Support Helpline on 0500 618 140.