Normal Growth And Development Of Premature Infants

Premature infants, also called preterm infants, are babies born earlier than 37 weeks of gestation. Gestation is the number of weeks a baby spends in his mother's womb. Full-term infants spend 40 weeks in their mother's womb. Most premature babies are born before vital parts of the body have fully formed. This may cause different problems in their body systems, including problems with feeding, breathing, or staying warm. Your baby may need to stay in a special care unit in the hospital while he continues to grow and develop. Each premature infant may be affected differently depending on how early he was born. The earlier he is born, the higher the risk of having health problems.

How is a premature infant's age counted?

The age of a baby born prematurely may be counted by the following:

• Gestational age: This is the time measured from the first day of the mother's last menstruation (monthly period). Gestational age is used to know your premature baby's age when he was born. This also gives an idea on how far your baby's development has reached at the time of birth.
  
• Chronological age: This is measured from the day your baby was born, which is the usual way a person's age is counted.
  
• Corrected age: This age counts the time that your baby should have been in the womb. Corrected age is used to check your baby's normal growth and development for the first 2 to 3 years of his life. This is measured by getting your baby's chronological age minus the period of time he was born early. For example, if your 12 week old baby was born four weeks early, his corrected age is eight weeks.

How does a premature infant develop?

A premature infant's development may be slower than babies who were born full-term. Most of the time, development problems go away as your baby catches up or outgrows them.

• Growth: This may be affected by poor feeding and nutrition problems. Babies born too early may have problems with sucking and swallowing, and controlling their tongue. If these problems are not managed, your baby's body may have a hard time growing.
  
• Heart and lungs: Your baby may be born with less than normal development of his heart and lungs. This may cause problems in his blood supply or breathing.
  
• Motor system: This body system controls how your baby's muscles grow and how his muscles work. At birth, your baby's limbs are often kept extended, unlike full-term babies whose arms and legs are often bent. Skills such as sitting, walking, running, and talking may develop later. His movements may seem awkward and random.
  
• Neurodevelopment: This is also called brain development. This may be affected by diseases, infections, or poor nutrition. Injury to the brain may lead to other problems with hearing, eyesight, and learning.
  
• Social development and interaction: Your baby's ability to respond to things he sees and hears may be slower than other children. This may include seeing and knowing family members and smiling back at them.

What health problems may develop in a premature infant?

Health problems that occur in premature infants are usually due to their immature organs and weak immune system. The immune system is the part of the body that normally fights infection. Your baby may have or be at risk of having one or more problems in the following:

• Brain: Your baby may have breathing pauses, called apnea of prematurity, when part of the brain that controls breathing is not fully developed. Injury to the growing brain may cause cerebral palsy, lower intelligence quotient (IQ), and behavioral or social problems. Brain damage may also cause some amount of hearing loss. This may then cause problems with talking and understanding things that people say.
  
• Eyes: The blood vessels in the eyes may not grow normally and may lead to poor vision or blindness.
  
• Lungs: Lung problems include bronchopulmonary dysplasia or chronic lung disease.
  
• Other health problems: These may include heart or digestive problems, hernias, and infections.

What are the signs and symptoms that a premature infant needs treatment?

A premature infant may need to stay in the Neonatal Intensive Care Unit (NICU). Treatment may be needed if he has any of the following:

• Problems maintaining body heat in an open crib: Your baby may be placed in an enclosed bed, such as an incubator, to keep him warm.
  
• Problems feeding through the mouth: A feeding tube that is passed through the nose or mouth going to the stomach may be used to feed your baby. This may last until he can be fed with his mother's breast or through a bottle. Milk may also be given through cup feeding.
  
• Poorly developed lungs or problems breathing normally and regularly: An oxygen tube or a ventilator (breathing machine) may be used to help your baby breathe. Some babies may also need medicines to help open the lungs.

How can I take care of my premature baby?

The following are things you can do to help your baby get better and feel more comfortable:

• Change the things around your baby to decrease stress. Keep the room quiet and warm, and the lights dim. Swaddling your baby (wrapping him snugly in a blanket) may help him feel safe.
  
• During feeding, hold your baby so his head is higher than his stomach. Feed your baby in a place with enough light which will let you see any skin color changes. Stop from time to time to allow him to take enough breaths between sucks on the bottle or breast. Your baby may tire easily when feeding, always check for signs of fatigue (tiredness). Stop the feeding if he looks tired.
  
• Make and keep all appointments with your baby's caregivers. Regular medical checkups and vaccinations (shots) are necessary. Shots should be given based on your baby's chronological age. Your baby may get infections easily because of his weak immune system. It is important for him to get these shots to protect his health.
  
• Understand your baby's behavior and signs. Learn to know his signs, such as when is hungry. You can then give him the things he needs based on your baby's messages. Ask caregivers for information about infant massage and other ways to comfort your baby.
  
• Use approved car seats or beds correctly. Use a car seat without a shield harness since the shield can be too high for small infants. Put the car seat in the back seat of the car and face it backward. Make sure an adult stays with your baby in the back. Ask your caregiver for instructions on putting a premature infant in a car seat or bed.
  
• When your baby is sleeping, lay him down on his back. Avoid placing your baby to sleep on his stomach or his side.