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Caring For & Feeding Your Premature Infant
Premature infants, otherwise know as "preemies", come into the world sooner than full-term infants. The usual full-term infant is born some where between 38-42 weeks after they have been conceived. The age of a preemie is usually referred to in "post-conceptional" weeks, or the number of weeks since conception. If an infant is born before 37 weeks, that infant is considered premature. Since the very last weeks before birth are the time for a fetus to gain weight, usually these infants weigh a lot less than the full-term infant. It is not unusual for a preemie to be sent home from the hospital weighing less than 4 pounds. That's pretty little, but even someone this small can grow to a typical size and weight generally catching up to their full-term counterparts before the age of 2 years.
There are many reasons for an infant to be born prematurely. A variety of medical and non-medical reasons can be involved, such as hormone imbalance, a structural problem with the uterus, a chronic illness, an infection, or several other things can lead to a premature birth. Another factor is that women over the age of 35 years or under 19 years are more prone to have a premature infant. Mothers who are carrying multiple fetuses are at great risk for premature birth. Sometimes the cause remains unknown. It is best to talk to your doctor about why you have had a premature birth.
Because the premature infant has not had all the time it needs to develop as fully as the full-term infant, the preemie many times has special needs, so it is usual that these little ones spend some time in the hospital's neonatal intensive care nursery (NICU). The NICU is a place that is equipped to provide your preemie with an atmosphere that limits the amount of stress to its babies while meeting each child's basic needs for warmth, nutrition, and protection to assure proper growth and development. With advanced technologies developed over the years, even preemies weighing less that 2 pounds have a 90% chance of survival. The specific needs of each preemie depend on just how premature the preemie is. Many parents may ask if their preemie needs any special care once they are home. The needs of each infant vary, so your baby's doctor is the best person to ask this question. Below, we have tired to address some of the more common needs of the premature infant.
Feeding the Preemie
Breast milk is an excellent source of nutrition for your preemie. Breast milk can be given through the mother's breast, through a bottle, or through a nasogastric tube (NG) tube. Breast milk has an advantage over formula because it contains proteins that help fight infection and promote growth. If you decide not to breast feed your baby, your doctor can recommend special formulas for your preemie.
Nursing a preemie is not easy. Preemies have weaker sucking ability. They also get tired faster than babies who are not born premature. Breastfeeding is not only still possible, but it is very valuable for your preemie. Your baby will just need more time to get it right.
For most preemies you usually will be able to breastfeed your baby before taking your baby home. The first few weeks at home can be very difficult for preemie moms who are breastfeeding. If your baby was on a breastfeeding schedule in the hospital, you can try to follow the schedule at home, but don't get locked into set feeding times. Let your baby tell you when he is hungry. A preemie may want to breast feed every 2 hours, especially if he falls asleep while eating. Do not wait until your baby is really hungry before you breastfeed. If you do, he may be cranky and hard to breastfeed. Try to start and breastfeed for 5 minutes on each breast. If a feeding is going well, continue to breast feed for as long as your baby likes. If your baby becomes fussy or sleepy, stop breastfeeding and pump your breasts. Your baby will learn to regulate his feeding times and create his own schedule.
If your baby is not breastfeeding full time, your doctor may have you also give him a bottle with your breastmilk. Your baby may be too tired to suck on your breast and may fall asleep without getting enough milk. It doesn't take as much effort for your baby to suck on a bottle. If your baby is not breastfeeding full time, pump your breasts and store your milk for bottle feeding your baby. Pumping your breasts helps you make more milk while your baby is learning to breastfeed. Pumping your breast also keeps your breast soft. You will also be more comfortable.
The doctor may ask you to come to the office more frequently than usual until breastfeeding is well established and your baby is growing as he should. The doctor will weigh your baby to make sure he is getting enough nutrition.
Basic Needs
The last part of the pregnancy is the time when body fat is developed. Since the premature infant lacks the body fat necessary to maintain their body temperature, incubators or radiant warmers are used to keep them warm. The incubator is usually made of plastic that completely surrounds the infant to keep him warm. Radiant warmers are electrically warmed beds open to the air. These are usually used when the doctors and nurses need frequent access to the infant to provide care. By the time your infant comes home with you he won't be needing an incubator or radiant warmer, but keeping your infant warm is important. Generally speaking, if you are warm your baby is probably warm too. The same applies if you feel cold. If your baby is sleeping or not very active, he is probably colder than you are. After all, you're up and around working up a sweat, so be sure to cover your baby with a blanket and/or clothes appropriate for the season.
It is important that once your preemie is home you keep all your regularly scheduled doctor visits and that your baby receives all his routine immunizations. In addition, be sure to discuss protecting your infant from RSV (respiratory syncytial virus) with your doctor before the cold season begins. Getting one shot every month during the cold season can prevent your precious little one from this respiratory illness that can have long term effects on the future health of your child.
In addition to well baby check ups with your doctor, the preemie usually receives periodic hearing and eye examinations. Careful attention is paid to development of the nervous system so your baby's motor skills like sitting, smiling, and walking will be monitored closely. Muscle tone and positioning are also observed. Speech and behavioral development are other areas that are closely monitored. Some preemies may need the help of a physical therapist or speech therapist as they grow.
Remember, your baby's doctor should be a partner in the care of your infant. You should feel comfortable asking questions, even asking them more than once. In turn, your doctor should be able to explain things to you in a way you can easily understand. If you don't understand something, ask your doctor to explain it again.
Working together with your baby's doctor can assure your preemie will get the special care and attention he needs to grow up strong and healthy.
What are the feeding patterns of premature infants?
Premature babies may not cry to be fed as full-term babies do. Due to the immaturity of the nervous system, they may not sense when they are hungry. Because the stomach is small, their feedings need to be smaller and more frequent. They also take longer to feed. The premature baby needs a lot of energy for sucking. The baby's mouth is small, and in the beginning the muscles used for sucking are weak. A preemie nipple (special soft nipple designed for premature infants) makes sucking less tiring. The baby must be wide awake to feed well. Many times, stimulation is needed to wake the baby up. Unwrapping the baby and putting him or her in another position may help. Talking, touching, and exercising the baby's arms and legs also help. Once the baby is wide awake, help him or her concentrate on sucking. Feeding the baby in a quiet room without bright lights can help. Keep distractions, even talking, to a minimum. The baby may have a bowel movement after every feeding. For breastfed babies, the stools will be yellowish and soft - like butter. Try to make feeding a comfortable, relaxed time for the baby. Nutrition is important to the baby's growth and development, but so is making feeding a pleasant experience.
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