All babies born before 37 weeks of pregnancy are deemed premature, although a baby born at 24 weeks is obviously going to need a lot more help than one born at 36 weeks because he is still very immature. In the United Kingdom, approximately 7 per cent of babies are born prematurely and in the United States about 11.5 per cent of babies are premature.
reasons for early birth
Sometimes labour just starts unexpectedly early. At other times, labour may need to be induced before 37 weeks because there are serious concerns about the wellbeing of the mother and baby, for example, if the mother has severe pre-eclampsia or if the placenta is not functioning properly. Women with a multiple pregnancy, for example, twins - or especially triplets -are more likely to go into early spontaneous labour.
Early labours tend to be quicker as the cervix does not have to dilate to the full 10 cm to allow a small baby to pass through. However, an early labour can come as a great shock because you are seldom totally prepared.
care of premature babies
Many premature babies need help with their breathing because it is not until the final weeks of pregnancy that their lungs are fully mature. A mechanical ventilator may be used to push air in and out of your baby's lungs.
Also, small babies do not have much fat laid down and can lose heat very easily. If they get cold, they will not feed and their blood-sugar level will fall (hypoglycaemia). Many premature babies are therefore cared for in an incubator, where they can be kept warm.
Small babies are unable to suck at the breast at first, so it is important for you to express milk so that your baby can be given it through a tube. Expressing your milk ensures that you will have a good milk supply when he gets bigger and stronger and can be put to the breast.
Premature babies are also more prone to infection and, unfortunately, being premature is the single biggest cause of death in babies. Although the survival rate of premature babies has increased over the last few years - and many premature babies soon catch up with their full-term peers, the number of babies bom prematurely has not reduced significantly. Also, there is an increased risk of disability amongst premature babies, particularly in those born extremely early.
coping with a premature baby
When you are not practically or emotionally prepared, the early arrival of your baby can be quite overwhelming. You may find that his condition varies from day to day, depending on how early he was born, and that there are times when it is a matter of two steps forward and one step back.
If you have other children, you may have difficulty dividing your time between everyone. It is also difficult to make any plans because it is usually impossible for anyone to predict exactly when you will be able to take your baby home.
Parents have a vital role to play, even when a premature baby is on the special-care baby unit. If you are unable to put your baby to the breast you will still be encouraged to express your breast milk so that it can be given to your baby via a tube. There should be facilities on the unit for doing this. Your baby will recognize your voice so talk or sing to him, even if you cannot hold him.
Most babies on a special-care unit will be in an incubator. This is a plastic cot with a lid, which has a thermostat to control the heat so that the baby does not get cold. There is a port hole through which you can touch and stroke your baby. Parents are encouraged to provide as much of the care as possible in this unit, and you will be expected and encouraged to help with feeding, washing your baby and changing his nappy.
Risk factors for premature birth
It is difficult to identify which women are most at risk, but certain factors are known to increase the risk of having a premature baby.
Premature birth is also associated with infections so it is important to have your urine checked regularly at the antenatal clinic. Also tell your doctor or midwife if you have any unusual vaginal discharge. They can confirm any infection and advise appropriate treatment.