Like many other pregnancy complexities, premature delivery is largely a mystery. Naturally, it is a matter of the highest concern for the parents and the doctor. Sometimes, the baby is literally transparent to an extent as the veins are visible under the skin! Preterm babies can weigh as less as 600 to 700 gm and be so small that the mom can hold the baby in one palm! The challenges of helping the fragile, tiny being to survive are very tough because often the baby’s internal organs are undeveloped.
However, modern medical facilities make the impossible possible. Madeleine Mann, born at a Chennai hospital in 1989 held the record for the smallest premature baby for some time. At birth, her height was 25 cm, and she weighed only 280 gm. When she survived, a leading newspaper reported, “A Miracle called Madeleine.” Indeed! Miracles happen.
Caring for an extremely premature baby (gestational age < 28 weeks)
No, you cannot take the baby home right now! The facility will supervise the baby’s progress in an incubator in the Neonatal Intensive Care Unit (NICU). The incubator keeps the air temperature at a precise comfort level and thus offers germ-protection. The best facilities also recognize that skin-to-skin care from mother to baby can actually do good along with the incubator (Kangaroo Care).
A specialist nurse will gently attach wires from monitoring machines to the baby’s body to keep a constant track of heart rate, breathing, and blood oxygen level. In so very premature babies, nutrition is administered first via a vein. If the baby has a breathing issue, a ventilator apparatus is arranged.
The doctor monitors the baby and will not give the green signal to take her home as long as she is sure that the baby can survive outside the incubator. Try and relax even when the baby is not showing much movement. They do not have much muscle tone. Think of it as if the baby is still in a womb (incubator)
Caring for the baby in the gestational age range 28 to 32 weeks
Your baby will still be kept in the incubator, but the arrangements will be slightly less intensive. However, it depends on the unique condition of your baby. If the little one still has severe breathing problems, then the usual intensive arrangements have to be made. If the conditions allow, then instead of the ventilator, the hospital will arrange the CPAP (Continuous Positive Airway Pressure), which is nothing but small tubes attached lightly to the baby’s nose
Sometimes, only an oxygen hood is used which does not touch the baby but maintain the required gas level within the incubator. Since the baby is not very premature, food may be provided through a special soft feeding tube to the stomach via the mouth or nose. In rare cases, the baby has been kept at the hospital for as long as up to one year from birth
Caring for the ‘normal’ premature babies (Gestational age 32 to 37 weeks)
Even neonatal jaundice is treatable, and your baby will be able to win her first fight with life by all the help you are arranging. In pre-term, breastfeeding is the best nutrition but your baby may not be able to suckle yet. You will have to use breast pumps to extract the milk and feed it from a bottle. The facility will collect the elixir from you and feed it via a NG (nasogastric tube) called gavage.
When the baby is home
You will need to take extra special care in nurturing the preterm baby after bringing him home
It is important to understand that premature babies are more prone to catching infections than others are. Since they did not get the full time required to develop completely, their immune systems remain week. Their bodies still lack the extra nutrition to be perfect.
However, there is an amazing solution and it is literally close to your heart! Yes, breast milk is like a magical elixir for the baby. Indeed, it is magical because every mother’s own milk has been found to be specially suitable for her baby. So, a pre-term mom’s milk has more protein concentrates and immune boosters than other mothers
Colostrum – the magic milk
The first milk or the colostrum is especially beneficial, being super rich in all kinds of beneficial ingredients for the baby. Always convince the doctor at the facility to be allowed to breastfeed. Even if the baby’s condition does not allow it, the best clinics can still facilitate the supply of breast milk obtained from a mother. Verify that this is possible where you are.
When the clinic allows taking the baby home, take all possible arrangements to help the tiny soul win this first fight of survival. You may also need to train how to do resuscitation to a pre-term baby, especially if he had respiratory problems at birth,. Hold him close often, give him comfort. It actually works wonders. Medical science may not be able to explain exactly why, but it actually works!