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The Preemie Purple Heart Story One day a child was born, too early, too small but loved as much as any child could be. As the parents of this child entered this journey they found themselves feeling alone. They had the joys of being new parents but the fear of losing their child, the thrill of giving birth the grief of a lost dream. This was supposed to be a joyous time, not a time filled with grief, anger and pain. Little did these parents know they were not alone.
The Preemie Purple Heart is born of an idea borrowed from the US army, a medal given for being wounded in battle. What bigger battle is there than the battle for life and the wounds of premature birth live on with the infant and family forever. The color was once reserved for royalty, making it special and it is gender neutral. The heart is not a solid color and the strips in each heart are a little different, just as every child and every journey is a little different, but the basic design is the same just like the basic experience is the same. The heart is made of glass it is strong but not so strong it could withstand a crushing blow. The premature child is strong but not invincible. It is a heart because the heart is our center, it's every beat renews life and hope, it symbolizes love. At the bottom of the Preemie Purple Heart is a teardrop, it is symbolic of the tears shed during the journey of a premature family, good and bad, joy and sorrow.
The Preemie Purple Heart is an outward sign of unity among a special group of people. A group that knows no country, language, economic, ethnic or religious bounds. A group with one common goal: hope for the future of premature children. This group includes not only parents and child but siblings, grandparents, aunts, uncles, cousins, nurses, doctors, clergy and friends. This group shares a bond beyond words, a bond only the heart knows.
The Heart can be with you when you feel alone, remind you there are hundreds of others who keep you in their hearts. It can give you a chance to share your story, when someone asks about the heart you wear you can tell them about the heart that beats inside you.
Please see below to connect to site to order your Preemie Purple Heart.
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About Preterm Birth from March Of Dimes Foundation
Most pregnancies last around 40 weeks. Babies born between 37 and 42 weeks of pregnancy are called full term. Babies born before 37 completed weeks of pregnancy are called premature or preterm. Almost 12 percent of babies in this country are born preterm. Of those babies born preterm, the majority (about 83 percent) are born between 32 and 36 weeks of gestation. About 10 percent are born between 28 and 31 weeks of gestation, and about 6 percent are born at less than 28 weeks of gestation. All babies born preterm are at risk for serious health problems, but those born earliest are at greater risk of long-term disabilities and death. Fortunately, advances in obstetrics and neonatology, the branch of pediatrics that deals with newborns, have improved the chances for survival for even these smallest babies.
Babies born preterm face a greater risk of serious health problems for several reasons. The earlier a child is born, the less she will weigh, the less developed her organs will be, and the more complications she is likely to face. These babies usually require care in a neonatal intensive care unit (NICU), which has specialized medical staff and equipment that can deal with the multiple problems faced by premature infants. Very premature babies also have the highest risk of death and lasting disabilities, such as mental retardation, cerebral palsy, lung and gastrointestinal problems, and vision and hearing loss.
Not only are premature babies often small and sick, but they look and behave very differently than full-term babies. For example, their skin may be thin and wrinkled, and their heads may look too large for their bodies. But these babies look the way they should at their stage of development, and will begin to appear and act more like full-term babies as they continue to develop and grow. Throughout their first year of life, these babies should be evaluated according to their adjusted age (which takes their prematurity into account).
What causes preterm birth?
A baby may be delivered preterm after a doctor induces labor due to pregnancy complications or health problems in the mother. However, most preterm births are a result of preterm labor (which may follow premature rupture of the membranes or PROM). The causes of preterm labor and PROM are not fully understood, but the latest research suggests that many cases are triggered by the bodys natural response to certain infections, including infections involving the amniotic fluid and fetal membranes. However, in most cases, a doctor cannot determine why a woman delivered preterm. And, at this time, there often is little the doctor or the pregnant woman can do to prevent preterm labor.
Studies do suggest that certain factors increase a womans risk of delivering preterm:
Previous preterm birth
Expecting twins or other multiples
Uterine or cervical abnormalities
Obstetric complications (such as placental problems)
Smoking, drinking alcohol, or using illicit drugs
Age under 18 or over 35
Maternal or fetal stress
What medical complications are common in premature babies?
There are a number of complications that are more likely in premature than full-term babies. While babies born near term may have few or none of these problems, babies born before 32 to 34 weeks gestation may have a number of complications. In some cases, these complications may be fairly mild while, in other cases, they are severe and may lead to death of the premature infant.
Respiratory distress syndrome (RDS). About 40,000 babies a year are most of whom were born before the 34th week of pregnancy suffer from this breathing problem. Babies with RDS lack a protein called surfactant that keeps small air sacs in the lungs from collapsing. Treatment with surfactant helps affected babies breathe more easily. Since treatment with surfactant was introduced in 1990, deaths from RDS have been reduced by more than 60 percent.
A doctor may suspect a baby has RDS if she is struggling to breathe; a lung X-ray and blood tests often confirm the diagnosis. Babies with RDS may need additional oxygen and mechanical breathing assistance to keep their lungs expanded. They may receive a treatment called continuous positive airway pressure (CPAP), which delivers pressurized air to the babys lungs. The air may be delivered through small tubes in the babys nose, or through a tube that has been inserted into his windpipe. CPAP helps a baby breathe, but does not breathe for him. The sickest babies may temporarily need the help of a respirator to breathe for them while their lungs mature. They also may be treated with a gas called nitric oxide, which can improve breathing by helping blood vessels in the lungs relax.
Apnea. Premature babies sometimes stop breathing for 20 seconds or more. This interruption in breathing is called apnea, and it may be accompanied by a slow heart rate. Premature babies are constantly monitored for apnea. If the baby stops breathing, a nurse will stimulate the baby to start breathing by patting him or touching the soles of his feet.
Intraventricular hemorrhage (IVH). Bleeding in the brain occurs in about 10 to 50 percent of babies born before 34 weeks gestation, with the most premature babies at highest risk. The bleeds usually occur in the first four days of life and generally are diagnosed with an ultrasound examination. Most brain bleeds are mild and resolve themselves with no or few lasting problems. More severe bleeds can cause the fluid-filled spaces (ventricles) in the brain to expand rapidly, causing pressure on the brain that can lead to brain damage (resulting in learning and behavioral problems). In such cases, surgeons may insert a tube into the brain to drain the fluid and reduce the risk of brain damage. In milder cases, drugs sometimes can reduce fluid buildup.
Patent ductus arteriosis (PDA). PDA is a heart problem that is commonly seen in premature babies. Before birth, a large artery called the ductus arteriosus lets the blood bypass the lungs because the fetus gets its oxygen through the placenta. The ductus normally closes soon after birth so that blood can travel to the lungs and pick up oxygen. In premature babies, the ductus may not close properly, which can lead to heart failure and lack of oxygen to the organs. PDA can be diagnosed with a specialized form of ultrasound (echocardiography) or other imaging tests. Babies with PDA are treated with a drug that helps close the ductus, although surgery may be necessary if the drug does not work.
Necrotizing enterocolitis (NEC). Some premature babies develop this potentially dangerous intestinal problem (usually 2 to 3 weeks after birth), which leads to feeding difficulties, abdominal swelling and other complications. It is believed that the bowel may become damaged when its blood supply is decreased, and bacteria that are normally present in the bowel invade the damaged area, causing more damage. When tests (including X-rays and blood tests) show that a baby has NEC, he will be given antibiotics and fed intravenously while his bowel heals. In some cases, surgery is necessary to remove damaged sections of the intestine.
Retinopathy of prematurity (ROP). ROP, an abnormal growth of blood vessels in the eye, occurs mainly in babies born before 32 weeks of pregnancy. It can lead to bleeding and formation of scars that can damage the retina of the eye, sometimes resulting in vision loss and blindness. Babies with mild ROP which is diagnosed during an examination by an ophthalmologist eye doctor) usually require no treatment because, in most cases, the eyes heal by themselves with little or no vision loss. In more severe cases, the ophthalmologist may treat the abnormal vessels with a laser or with cryotherapy (freezing) to protect the retina and preserve vision.
Jaundice. Premature babies are more likely than full-term babies to develop jaundice because their livers are too immature to remove a waste product called bilirubin from the blood. Babies with jaundice have a yellowish color to their skin and eyes. Jaundice often is mild and usually is not harmful; however, if bilirubin levels get too high, it can cause brain damage. This generally can be prevented because blood tests will show when bilirubin levels are too high, so the baby can be treated with special blue lights (phototherapy) that help the body break down and eliminate bilirubin. Occasionally, a baby may need a blood transfusion.
Anemia. Premature infants often are anemic, which means they do not have enough red blood cells. Normally, the fetus stores iron during the later months of pregnancy and uses it late in pregnancy and after birth to make red blood cells. Infants born too soon may not have had enough time to store iron. Babies with anemia tend to develop feeding problems and grow more slowly; anemia also can worsen any heart or breathing problems. Anemic infants may be treated with dietary iron supplements, new drugs that increase red blood cell production or, in severe cases, blood transfusion.
Bronchopulmonary dysplasia (BPD). BPD is a chronic lung disorder that most commonly affects premature infants who have required treatment with mechanical ventilation and oxygen for more than 28 days. These babies develop fluid in the lungs, scarring and lung damage, which can be seen on an X-ray. Affected babies are treated with medications that make breathing easier, and are slowly weaned from the ventilator. Their lungs usually heal over the first two years of life. Sometimes, however, severely affected babies develop a chronic lung disease resembling asthma.
Infections. Premature babies have immature immune systems that are inefficient at fighting off bacteria, viruses and other organisms that can cause infection. Serious infections that are commonly seen in premature babies include pneumonia (lung infection), sepsis (blood infection), and meningitis (infection of the membranes surrounding the brain and spinal cord). Babies can contract these infections at birth from their mothers, or they may become infected after birth from contact with infected family members, hospital staff or equipment; they also may develop infections from usually harmless bacteria found in their own bodies. Infections are treated with antibiotics or antiviral drugs.
What is the outlook for babies born at less than 29 weeks?
Fewer than 2 percent of babies in this country are born this early, but these babies have the most complications. Most of these babies are born at very low birthweight (less than 3 pounds, 4 ounces). Those born at less than 26 weeks are likely to weigh only 1 to 2 pounds. Almost all will require treatment with oxygen, surfactant, and mechanical assistance to help them breathe. These babies are too immature to suck, swallow and breathe at the same time, so they must be fed through a vein (intravenously) until they develop these skills. They often cannot yet cry (or you cannot hear them due to the tube in their throat) and they sleep most of the day. These tiny babies have little muscle tone and most move very little.
Babies born at this time look very different than full-term babies. Their skin is wrinkled and reddish-purple in color, and is so thin that you can see the blood vessels underneath. Their face and body are covered in soft hair called lanugo. Because these babies have not had time to put on fat, they appear very thin. Most likely, their eyes are closed and they have no eyelashes.
These babies are at high risk for one or more of the complications discussed above. However, most babies born after about 26 weeks gestation do survive (about 75 percent at 26 weeks and about 85 percent at 29 weeks), although they may face an extended stay in the NICU. Unfortunately, about 30 percent of babies born at less than 26 weeks and about 20 percent of those born at 26 to 29 weeks develop serious, lasting disabilities.
What about babies born at 30 to 34 weeks gestation?
These babies look quite similar to babies born earlier, although they are larger (usually between 2 and 5 pounds) and even more likely to survive (about 90 to 95 percent). Some can breathe on their own, and many others just need supplemental oxygen to help them breathe (few need a respirator). Many of these babies can be fed breast milk or formula through a tube placed through their nose or mouth into the stomach; although some will need to be fed intravenously.
Some of these babies can cry. They can move more, although their movements may be jerky. A baby born at this time can grasp your finger. These babies can open their eyes and they begin to stay awake and alert for short periods.
Babies born at 30 to 34 weeks remain at risk for some of the complications discussed above; however, when complications occur, they may not be as severe. ROP rarely develops in babies born after 32 weeks gestation. Only about 15 percent of these babies develop serious disabilities.
Are babies born at 35 to 37 weeks gestation at risk of medical problems?
Most babies born at this time require little or no special care after birth, and they are nearly as likely as full-term babies to survive. They usually weigh between 4 and 7 pounds, and still appear thinner than most full-term babies. Some will experience mild problems, such as breathing difficulties or jaundice, but most will make a quick recovery. Many of these babies can be breast- or bottle-fed, although some (especially those with mild breathing problems) may need tube-feeding for a brief time. These babies are very unlikely to develop disabilities resulting from premature birth.
How can a woman reduce her risk of preterm delivery?
A woman may be able to reduce her risk of preterm delivery by visiting her health care provider before pregnancy and, once pregnant, seeking early and regular prenatal care. A pre-pregnancy visit is especially crucial for women with chronic disorders such as diabetes and high blood pressure, which sometimes can contribute to preterm birth. When a woman receives adequate prenatal care, problems usually can be identified early and treated, to reduce the risk of preterm birth. One study suggests that consuming the recommended amount of folic acid throughout pregnancy may reduce the risk of preterm birth. A woman should avoid alcohol, smoking and illicit drugs beginning before pregnancy and throughout pregnancy.
Can medical problems in premature newborns be prevented?
When a doctor suspects that a woman may deliver preterm, he may suggest bedrest and treatment with corticosteroid drugs. Corticosteroids cross the placenta and speed maturation of fetal lungs, reducing infant deaths by 30 percent and cutting the incidence of the two most serious complications of premature birth, RDS (by 50 percent) and bleeding in the brain (by 70 percent). These drugs are given by injection and are most effective when administered at least 24 hours before delivery. Her doctor also may suggest treatment with medications (called tocolytics) that may postpone labor (though often not for more than a couple of days). Even this short delay can give the doctor time to treat the pregnant woman with corticosteroid drugs and arrange for delivery in a hospital with a NICU that can give appropriate care to a premature infant, which could make a life-saving difference for her baby.
What research is being done?
The March of Dimes supports a number of grants aimed at improving understanding of the causes of preterm labor, with the goal of learning how to prevent it. For example, researchers are looking at how genes, maternal stress, racism, occupational and environmental factors and infections may contribute to preterm labor. Others are seeking to improve treatment for premature babies. Grantees are looking for ways to make surfactant treatment even more effective, as well as to improve treatment of NEC.
References:
Linden, D.W., Paroli, E.T., Doron, M.W. Preemies. New York: Pocket Books, 2000.
Manginello, F.P., DiGeronimo, T.F. Your Premature Baby. New York: John Wiley & Sons, 1998.
Ventura, S.J., et al. Births: Final Data for 1999. National Vital Statistics Reports, volume 49, number 1, April 17, 2001.
All materials provided by the March of Dimes are for information
purposes only and do not constitute medical advice.
