Premature babies are important rules for caring for babies who are in a hurry to be born. Premature newborn baby: features of care and nursing How many premature babies

The first year of a child's life is characterized by the most intensive growth and rapid development. But during this period the body is extremely vulnerable, the defenses are weak and imperfect. This is especially true for children who were born prematurely and are considered premature.

Risk factors for preterm birth can be both socio-demographic (unsettled family life, low social level, too young age) and medical (earlier abortions, multiple pregnancies, fetal hemolytic disease that develops as a result of Rhesus conflict, as well as acute and maternal chronic illness). The causes of prematurity also include harmful working conditions, bad habits, physical and mental trauma during pregnancy. A baby born between 22 and 37 weeks of gestation1 and weighing more than 500 g is considered premature. This provision was introduced by the World Health Organization, which was joined by the pediatricians of our country.

There are different degrees of prematurity. The main criterion for their determination is body weight. So, if a child is born with a body weight of less than 1 kg, then this premature with extreme weight; up to 1.5 kg - premature with low body weight, and more than 1.5 kg - just premature.

What does a premature baby look like?

Outwardly, a premature baby is significantly different from a baby born at term. Subcutaneous fat is expressed very weakly or completely absent (depending on the period of prematurity). The skin is very thin, dark red, wrinkled, abundantly covered with dense down on the face, back and limbs. located in the lower abdomen, while in full-term babies it is located in the center. The head is large relative to the size of the body, the sutures between the bones of the skull and the small one are open (there are areas between the bones of the skull and in the region of the small fontanel that are not covered by bone tissue), the large fontanel is small due to the displacement of the bones of the skull. The ears are very soft. The nails are thin, do not reach the edges of the nail phalanges. In girls, the large labia do not cover the small ones, so you can see a wide-open crimson-red genital slit; and in boys, the testicles have not yet descended into the scrotum, the scrotum itself is bright red. The umbilical cord in such children falls off later than in full-term ones, and the umbilical wound heals by the seventh to tenth day of life.

The functioning of all organs and systems is also associated with the absence of a certain period of intrauterine development and the peculiarities of the maturation and development of the organism in a new environment. Given the immaturity of all organs and systems (central nervous, cardiovascular, respiratory, digestive), adverse effects are tolerated by premature babies especially acutely. Consequently, diseases that do not pose a danger to other babies may be more severe in premature babies.

One of the most ancient, laid in the early stages of embryonic development, is sucking reflex. It may be absent only if the child is very premature, but in most cases it is present or weakened. Premature babies with a lack of a sucking reflex are given measures aimed at developing it. There is a special acupressure, which begins immediately after birth, if the reflex is absent. There are also special bottles for premature babies.

In addition, premature infants have imperfect mechanisms thermoregulation: they easily give off heat, but hardly produce it. In preterm babies, the sweat glands do not function, there is no sweating, as a result of which they easily overheat. Therefore, such children should be in the most comfortable temperature conditions in order to avoid both hypothermia and overheating. Maintaining an optimal ambient temperature is one of the most important aspects of effective care for a premature baby. This is achieved in special incubators for premature babies, where a constant temperature is maintained (about 36 degrees). The temperature regime must be maintained even after discharge from the clinic, avoiding hypothermia and overheating of the baby. The sense organs of premature babies are able to function from the first days of life.

Premature babies are more likely than full-term babies to have convulsive syndrome, but it proceeds in a slightly different way. The causes of convulsive conditions can be organic brain damage, epilepsy, high temperature, and various metabolic disorders. Compared to term babies, premature babies do not have seizures; for example, if in full-term children convulsions are clonic-tonic in nature (that is, periods of muscle twitching alternate with periods of "fading"), then in premature babies, convulsions are more often clonic in nature - the nature of "fading". The convulsive syndrome in any case requires emergency treatment and follow-up, since the causes that led to this condition can cause cerebrovascular accidents, which, in turn, can lead to brain damage.

Premature babies (especially those with extremely low body weight) often develop cerebral palsy. The final diagnosis can be made after a year, but the signs of the disease are visible from birth, and are more pronounced after three months. If a child has persistent changes in muscle tone, if he cannot move his arms or legs, if there is no positive dynamics after massage sessions and drug therapy during the first three to four months, then such a baby is at risk for developing cerebral palsy. Children with these disorders are actively treated; if age-appropriate reflexes are not formed, if motility (motor activity) lags behind, then a diagnosis is made - emerging cerebral palsy.

Given the above features of the nervous system, premature newborns are carefully monitored by pediatric neuropathologists, and in the clinic these children are prescribed several courses of preventive or therapeutic massage. But the mother herself can do gymnastics and massage with a premature baby using simple techniques that the pediatrician will teach her; this will help the baby not only develop physically correctly, but also establish psychological contact with the mother, which will have a positive effect on the formation of the nervous system.

Respiratory system of a premature baby

In premature babies, the respiratory rate usually exceeds the norm and depends on the degree of prematurity: the smaller the body weight of the child, the faster his breath.

Due to the immaturity of the nervous system, as well as the lipid metabolism system, the derivative of which is a surfactant, which ensures the opening of the lungs during the first breath and their normal functioning in the future, preterm infants often develop respiratory distress syndrome which is manifested by the development of atelectasis. Atelectasis - areas of collapsed or incompletely expanded lung tissue that are not involved in breathing and can cause respiratory failure. Such a child is transferred to artificial ventilation of the lungs until the respiratory system begins to function by itself. Against the background of respiratory distress syndrome, various infectious diseases (pneumonia) often occur, which, of course, worsens the child's condition. To avoid such complications, in case of predicting preterm birth (hemolytic disease of the fetus, severe forms of gestosis, etc.), special glucocorticoid drugs are administered to a woman during pregnancy, which accelerate the maturation of the fetal respiratory system.

After the baby is discharged from the maternity hospital or children's hospital, in order to reduce the likelihood of inflammatory diseases of the respiratory system, one should try to protect him from a large number of contacts with potentially infected relatives and friends, limiting the circle of contacts only to family members. To maintain a normal microclimate, it is necessary to ventilate the room where the baby is located, while, however, not forgetting the temperature regime.

Cardiovascular system of a premature baby

Like all other systems in the body of a premature baby, the cardiovascular system is imperfect. So, studies have shown that any irritation causes an increase in heart rate, increased sonority of heart sounds and an increase in blood pressure. Before birth, the fetus has its own specific circulatory system, but by the time of birth in full-term babies, all cardiac communications (transitions and connections between the vessels and the heart, holes inside the heart) are correctly formed. Premature babies, due to the fact that they were born prematurely, may have different heart anomalies, which cause changes in cardiac parameters and worsen the general condition of the child. Echocardiography (ultrasound of the heart) is now widely used to diagnose heart abnormalities.

Since the cardiovascular system of premature babies is sensitive to external stimuli, you should try to protect the baby from them (for example, from loud sounds).

The digestive system and nutrition of a premature baby

The digestive system of immature children also has a number of features. First of all, this is expressed in the immaturity of the enzyme system. The glands of the gastrointestinal tract do not produce the required amount of enzymes and gastric juice. When colonizing the gastrointestinal tract with microorganisms, even a small amount of pathogenic bacteria, which would normally be neutralized with the help of the protective properties of gastric juice and pancreatic juice, causes dysbiosis in premature babies (an incorrect ratio of certain microorganisms in the gastrointestinal tract). Also, due to the immaturity of the nervous system and the transmission of nerve impulses, the motor (motor) function of the gastrointestinal tract suffers, the movement of food through the gastrointestinal tract slows down. As a result, there are problems with the flow of food into different parts of the stomach and intestines and its excretion. Despite the imperfection of the digestive system, even in very premature babies, the gastric juice contains rennet, which curdles milk. That's why The best and most necessary nutrition for a premature baby is mother's milk..

In addition to nutritional value, milk provides an invaluable service to protect the baby's body from environmental aggression factors. Therefore, even in the case when the child is immediately after birth in the intensive care unit and receives parenteral nutrition (through a dropper) or is so weak that he cannot suckle, it is necessary to take all possible measures to preserve breast milk, feed the baby from a spoon. This is one of the necessary factors in nursing premature babies. If the baby was born very premature and he does not have a sucking reflex, then feeding is carried out by drip: through special devices - lineomats with the help of a nasogastric (naso-gastric) tube, expressed breast milk or milk mixture is gradually introduced into the baby's stomach. Due to the fact that the need for premature babies in proteins, vitamins and trace elements is very high, they are prescribed additional supplements that are introduced into breast milk.

The skeletal system of a premature baby

Even in very premature babies, the skeletal system is formed by birth, but the mineralization of the bones is not yet complete, and therefore they are additionally prescribed calcium. With a lack of vitamin D, phosphorus and calcium in the body, the child develops rickets. Premature babies are at risk for developing this disease. In them, it flows especially sharply and progresses rapidly. Therefore, premature babies are certainly prescribed vitamin D to prevent rickets.

It happens that premature babies are born with unformed hip joints. Dysplasia (underdevelopment) of the joints threatens in the future with subluxations, dislocations and deprivation of the ability to move independently. Therefore, it is necessary to diagnose this pathology in time and prescribe treatment. For detection, an ultrasound examination of the joints is performed, which allows you to correctly diagnose. For treatment, depending on the degree of maturity of the joints, either wide swaddling, or wearing spacers, or, in severe cases, immobilization with plaster casts are prescribed.

What awaits a child who "hurried" to be born? The prognosis depends on the degree of prematurity. If the child was born after the 33rd week and did not suffer in childbirth, then after seven to ten days he can be discharged home. If the gestation period is shorter, and the body weight is low, then such children are transferred to the second stage of nursing in special children's hospitals. There they undergo a full examination, and in case of any pathology, treatment. After stabilization of the baby's condition, they are discharged under the supervision of a local pediatrician. A premature baby in the district clinic usually pays special attention.

Due to various circumstances, not every baby is born on time. Some babies are born premature. They require special attention, careful care, constant care. Even with a record low body weight, a child can quickly catch up with their peers in development. However, premature birth still does not go unnoticed.

Premature babies: signs

There are four degrees of prematurity:

First. The baby appeared at the 37th week of pregnancy, has a height of 45 centimeters and weighs more than two kilograms.
Second. The child was born at 35 weeks, has a height of 40 centimeters and weighs less than two kilograms.
Third. The baby appeared at 31 weeks with a height of up to 35 centimeters and a weight of up to one and a half kilograms.
Fourth. The baby was born at 28 weeks, his height does not exceed 30 centimeters, and his weight is less than one kilogram.

Sometimes a child appears on time, but his body weight does not reach the norm. Such a child is also considered premature. It will be distinguished from ordinary children by the following features:

slowing down the reaction;
hypertonicity and hypotonicity;
lack of pigmentation in the nipples;
underdevelopment of the genital organs;
hypotension;
frequent breaths and fading of breath;
perpendicular arrangement of ribs;
roundness of the abdomen;
finding the navel in the inguinal region;
underdevelopment of the nail plates;
disproportionate head size;
softness of the bones of the skull;
insufficient thermoregulation;
underdevelopment of the auricles;
a thin layer of subcutaneous fat;
skin wrinkling;
quiet voice;
pink or red skin tone;
the presence of a hair follicle.

The presence and severity of these signs depends on the specific week of birth of the crumbs.

Premature babies: causes

The appearance of a baby not in due time is caused by many reasons. Firstly, the reason for this is the mother's diseases: rheumatism, diabetes, heart disease and some others.

Secondly, premature babies are born to women who were not registered in the antenatal clinic; became pregnant earlier than two years have passed since the previous pregnancy; have had abortions in the past; have diseases of the genitourinary system.

Thirdly, premature birth occurs due to too early or late age of the mother, malnutrition, stressful situations, unwillingness to have a child.

There are other suggestions as well:

severe pregnancy;
heredity;
non-compliance with the recommendations of the gynecologist;
bad habits;
acute mental shocks;
carrying twins or triplets;
the presence of harmful factors in the workplace;
negligence of a pregnant woman;
fertilization by a weak or immature spermatozoon.

Every woman is able to minimize the risk of a premature baby. To do this, you should give up bad habits long before the desired pregnancy, lead a healthy lifestyle, get rid of existing ailments, protect yourself from stressful situations, get more positive emotions, follow the instructions of doctors.

Premature babies: consequences

If the baby's weight is insufficient at birth, he will be able to return to normal by one or two years. As for mental development, it will be equal to the level of peers at two or three years, and sometimes at five or six years. It all depends on the degree of prematurity, the individual characteristics of the child, the care of parents and the implementation of special procedures.

However, early birth causes a number of consequences for a person in the future:

instability of menstruation in a woman, severe pregnancy, premature birth;
dislocations and subluxations, dysplasia, diseases of the joints;
convulsions, cerebral palsy and other disorders in the functioning of the nervous system;
reduced immunity, poor health, susceptibility to frequent colds;
hearing problems;
poor eyesight;
diseases of the gastrointestinal tract;
difficulties with speech;
high risk of cardiovascular disease.

Due to the high likelihood of severe consequences, premature babies should be under regular medical supervision, undergo the necessary examinations not only during childhood, but also in adulthood.

Thus, children who appeared prematurely do not necessarily grow up weak and sickly, lagging behind in psycho-physical development from normal babies. However, they have a much higher risk of developing various ailments than others. Therefore, parents should pay more attention to their premature babies, take care of them, perform the exercises recommended by doctors and follow their advice. It is also important to be constantly under medical supervision in order to be able to identify serious diseases in time and start fighting them.

Proper care of premature babies - features and subtleties

Babies who rushed to be born ahead of time need special care. This applies not only to medical care in the first weeks of life, but also to further stay at home. However, parents should not panic, imagining incredibly complex and specific manipulations. In fact, all parents will be able to provide their beloved child with the right care for premature babies, the features and subtleties of which are described below.

All attention to the temperature regime!

As soon as the baby and mother get home from the hospital, the first thing to take care of is maintaining the optimal temperature regime. Due to their low weight and insufficient fat layer, premature babies especially need warmth.

The temperature in the room in which the child will be located is from 22 to 25 degrees.
Near the baby and under his blanket, parents should constantly maintain the temperature in the aisles from 28 to 32 degrees. Rubber heating pads filled with water with a temperature of 60-65 degrees can help in this difficult matter. It is strictly forbidden to use electric heating pads, blankets and other similar products.
Warmers are placed on top of the blanket on the sides, at a distance of a palm from the baby, and also at his feet. In this case, such a heat source is pre-wrapped with a diaper. It is forbidden to put heating pads on top of the crumbs and under it, as this leads to burns and breathing problems.
Monitor the temperature with a thermometer. The regularity of changing water in heating pads is 1.5-2 hours.
Airing the room in which the child stays is carried out every 3 hours and lasts at least 20 minutes.

Important! A premature baby should not remain without heat even for a couple of minutes, as this immediately threatens with hypothermia of the body. Parents will need to adhere to such a strict temperature regime for the first month of the baby's life, after which he will already be able to cope with external changes on his own.

How to organize feeding?

The biggest problem that parents of a premature baby will have to face is the insufficient or complete absence of his sucking reflex. Also, such children are characterized by poor appetite, constant regurgitation, constipation, or, conversely, diarrhea. All this is due to the immaturity of the gastrointestinal tract.

Ensure your baby is breastfed. A young mother should think about maintaining lactation while still in the hospital. Good nutrition, lack of stress and a good sleep of a woman will provide the baby born prematurely with the most necessary things.
So that the baby does not burp after the next meal, it should be done often and in small amounts reclining. After that, the child should be in an upright position for 15-20 minutes.
In case of unstable stools or other problems with the digestive system, it is strongly not recommended to use tummy tuck massage, gas venting devices (tubes) and enemas.

Important! If problems with the gastrointestinal tract occur too often, accompanied by alarming symptoms, then you should immediately contact a specialist.

The first water procedures - what should they be?

If the baby was born weighing no more than 1800 g, then bathing for 2-3 weeks will have to be abandoned. Children with a larger mass enjoy water procedures already in the first week after their arrival from the hospital.

When bathing babies born prematurely, be sure to adhere to the following recommendations:

Babies before reaching 3 months should bathe in pre-boiled water, the temperature of which is 38 degrees.
The room where the procedures will be carried out should be heated to 25 degrees.
After bathing, you should not immediately transfer the baby to a room with a lower air temperature. Over time, the door to the bathroom can be left open so that the child can gradually adapt to new conditions.

It is with such hygienic procedures that the correct care for premature babies consists, the features and subtleties of which all parents can learn.

Massage - is it possible or not?

Of course, for premature babies, experts have developed special massages and procedures that will help the baby get stronger and master the necessary skills as quickly as possible.

In relation to such babies, there are some peculiarities:

If the child has muscle hypotension, then light strokes are suitable for him, which delicately relax the muscles.
After two months of age, such simple manipulations can be diversified with light gymnastic exercises. They will help to quickly develop and consolidate motor skills.
If the baby is already 3-4 months old, then parents can already teach him to turn sideways. The main thing is to do everything carefully and slowly.

Important! The main purpose of massage for premature babies is psycho-emotional contact with parents, during which they receive positive emotions and new skills.

Let's go for a walk - how to make it safe and useful?

As mentioned earlier, temperature changes for premature babies are contraindicated. If you want to go with an expensive child to fresh air as soon as possible, then you will need to follow the following rules:

The first walk for babies weighing more than 1500 g will take place no earlier than two weeks of age. And this is only on condition that it is summer outside and the air temperature is from 26 degrees.
Take trips to the street should be with 15 minutes of being outdoors. Then, gradually adding 20 minutes, the total time reaches 1.5 hours.
As soon as the child reaches a mass of 2500 g or 1.5 months, he is taken for a walk without fear in the spring and autumn, when the temperature outside is at least 10 degrees.
If the mark on the thermometer drops below 8, then walks are refused. The exception is crumbs weighing 2800 g and older than 2 months.

Under close medical supervision - which specialists should examine the child?

Before the onset of school age, premature babies are under dispensary observation. For such babies, regular visits to the following highly specialized specialists are mandatory:

Neurologist. As a rule, up to a year, such children almost completely catch up with their peers in development. But, if there are any problems, only a specialist will be able to diagnose them at an early stage and prescribe effective therapy.
Cardiologist. In addition to consulting a specialist, you will need to regularly undergo ECHO-KG procedures, as well as ECG, which allow you to assess the state of the child's cardiovascular system.
As soon as the baby is 2 weeks old, vitamin D and a special massage will be prescribed to prevent the development of rickets.

If at first glance everything seems complicated, then after a week of such a specific regime, parents will not even notice their fatigue. After all, every loving mother understands that proper care for premature babies, the features and subtleties of which are described above, will help the precious child grow up healthy and happy!

Determining prematurity by weight and height alone is not entirely correct, especially when the length of the pregnancy is difficult to ascertain. This classification method is used to standardize treatment and observation, for the needs of statistics. There are children born with a large weight and height, but with obvious signs of immaturity, which is typical for premature babies. In practice, in addition, it is necessary to take into account a wider range of positions for assessing the actual age of the child.

Signs of prematurity: weak cry of the child, shallow, weakened irregular breathing, insufficient development of the subcutaneous fat layer, in connection with which the skin is red, dry, wrinkled, abundantly covered with fluff; the small and lateral fontanels are open, the auricles are soft and fit snugly to the head, > the nails do not reach the edge of the phalanges of the fingers, the umbilical cord is located below the middle of the body length, the genitals are underdeveloped - in boys, the testicles are not lowered into the scrotum, in girls, the labia minora are not covered large; movements are scanty, hypotonia (reduced tone) of the muscles, physiological reflexes are reduced, even sucking and swallowing reflexes may be absent.

Maturation of the sense organs in preterm infants.

Touch: The system of somatic sensitivity (senses of touch, temperature and pain) develops between 8 and 15 weeks of pregnancy. At 32 weeks of gestation, the fetus always reacts to changes in ambient temperature, touch and pain.

Taste: Taste buds are morphologically mature by the 13th week of pregnancy. At 24 weeks of pregnancy, the fetus already reacts to taste stimuli.

Hearing in the fetus appears at 20 weeks of gestation. At 25 weeks pregnant, the fetus responds to intense vibrational and sound stimuli. Sensitivity and the ability to distinguish sounds in height reach an adult level by the 30th week of pregnancy. In a full-term newborn, they are no different from those in an adult.

Vision. By 24 weeks of gestation, all structures of vision are formed. The reaction of the pupils of the fetus to light appears at a gestational age of 29 weeks. At 32 weeks, it becomes stable. At 36 weeks of gestation, the vision of the fetus is no different from that of a full-term baby. It must be remembered that the vision of even full-term children is 20 times worse than that of adults; it is still fuzzy, vague. The child sees only the outlines of objects (moving and stationary) located at a distance of only 25-30 cm from his eyes. A full-term baby distinguishes between shiny and red objects.

Smell: By 28-32 weeks of gestation, premature babies begin to react to strong odors.

Features of the course of the neonatal period in premature babies.

The course of the neonatal period in premature babies has some features and depends on the degree of physiological maturity.

In premature newborns, lethargy, drowsiness, weak cry, physiological erythema is pronounced.

Physiological jaundice is usually detected somewhat later due to the bright color of the skin and is often delayed up to 3-4 weeks of life.

The umbilical cord in premature babies is thick, juicy, disappears later (by the 8-14th day of life), the healing of the umbilical wound is slow.

Many premature babies have edema at the 1-2nd week of life, which are located mostly on the lower extremities and abdomen.

Thermoregulation is not stable enough, a naked child quickly cools, the body temperature can drop below 36 °, and at an elevated ambient temperature, overheating (“couvez fever”) quickly sets in.

The respiratory rate in premature infants is unstable, when moving it reaches 60-80 per 1 min., at rest and during sleep it decreases significantly, prolonged apnea (breathing stops) can be observed, especially during feeding. In preterm infants, pulmonary atelectasis is often observed in the first days of life.

Heart sounds may be muffled, and the heart rate varies depending on the conditions and condition of the child (120-140). With anxiety and an increase in ambient temperature, the heart rate can reach up to 200 beats per 1 minute.

Physiological weight loss is restored by the 2-3rd week of life. Weight gain in the first month is insignificant (100-300 g).

At the 2-3rd month of life, when an intensive weight gain begins, premature babies often develop anemia. With proper nutrition with a sufficient introduction of protein and vitamins, it gradually passes. Decrease in hemoglobin below 50 units. requires special treatment.

A premature baby requires close attention, since a number of problems often arise in the process of nursing it. First of all, this applies to children born with a body weight of 1500 g or less (“deeply premature”) and, especially, less than 1000 g (“extremely premature”).

In developed countries, premature babies are usually cared for in intensive care units. Pediatricians who specialize in nursing children up to the 28th day of life are called neonatologists.

Particularly worth mentioning is the feeding of premature babies. Children born before 33-34 weeks of gestation, as a rule, are fed through a tube inserted into the stomach, because their sucking and swallowing reflexes are either reduced or completely absent. In addition, coordination of these reflexes is necessary, which develops only by 33-34 weeks of gestational age. The food used is expressed breast milk and / and infant formula specially adapted for such babies. That part of the food that children do not absorb in the digestive tract due to the reduced activity of digestive enzymes and other functional and morphological features of premature babies is administered in the form of separate solutions of proteins, fats and carbohydrates intravenously (parenteral nutrition).

Modern neonatal intensive care includes the most sophisticated methods of temperature control, respiration, heart activity, blood oxygenation and brain function.

Conditions for nursing premature babies.

The group of small children is especially dependent on the influence of external factors. They require ideal nursing conditions in order to achieve not only their survival, but also favorable further development.

One of the most important conditions for nursing premature babies is the optimal temperature regime. Most often, children weighing up to 1500 g are placed in incubators. If a child does not retain its own heat well, then even if it is more than 1500 grams, it can be placed in an incubator.

Immediately after the birth of the child, they are placed in an incubator with an air temperature of 34 to 35.5 degrees (the smaller the weight of the child, the higher the temperature), by the end of the month the temperature is gradually reduced to 32 degrees. The temperature regime in the couveuse is selected individually. To control the child's body temperature, special temperature sensors can be used, connected to the monitor on one side, and attached to the child's body with a patch on the other.

Also, the thermal regime can be maintained using special changing tables with a source of radiant heat.

Another important condition for nursing is air humidity and in the first days it should be 70-80%. For this purpose, there are special humidifiers in incubators.

The goal of creating conditions favorable for the development of a child receiving intensive care is associated with minimizing adverse effects, as a result of which the prognosis of psychomotor development improves.

Creating favorable conditions for the development of newborns in intensive care units (optimal light regimen, noise elimination, minimizing painful manipulations, tactile stimulation) has a positive effect on the subsequent development of children with serious illnesses.

Newborns are very vulnerable. Their reaction to damaging factors is common, that is, it involves the response of several body systems at once. The elimination of pain and anxiety reduces the need for oxygen in the blood (and, consequently, in the correction of the artificial lung ventilation), reduces its energy costs, improves food tolerance, and reduces the duration of hospitalization.

The inclusion of parents in the treatment process reduces pain and stress reactions in newborns and has a positive effect on subsequent development.

Newborns in intensive care units continue to develop sensory organs. Negative and positive environmental factors affect the conduction of excitation along the nerve pathways.

Critical changes occur in the brain of a premature baby during the period when he is in the intensive care unit (22-40 weeks of gestation):

Environmental influences influence the formation of the important processes listed above during this critical period. If these effects are inadequate, they can irreparably disrupt the process of formation of the nervous system.

A neonate receiving intensive care is exposed to light and sound. The very medical procedures necessary to save his life are a great burden for a premature and seriously ill child. These medical procedures include airway debridement, chest vibration massage, gastric tube insertion and feeding, vein catheterization, chest x-ray, ultrasound, ophthalmoscopy, daily physical examination, vital signs, hygiene procedures, weighing.

According to rough estimates, a seriously ill newborn is shifted and subjected to various manipulations for care, treatment and condition control more than 150 times a day. Thus, periods of continuous rest do not exceed 10 minutes.

What can reduce this kind of stress?

Creation of comfortable conditions, elimination of noise and bright light, convenient placement in an incubator (incubator) or in a bed.
Cooperation with parents, strengthening their attachment to the child.
Use of natural soothing and self-regulating factors: pacifiers, kangaroo care, twins in the same bed (incubator).
Laying in the midline in a flexor position, swaddling, simulating a limited space in the uterus.
Conducting several care manipulations in the same period of time to provide the child with longer periods of rest.

Eliminate noise and glare. Prematurity itself is a risk factor for sensorineural hearing loss and deafness. It is detected in 10% of those born prematurely and only in 5% of those born full-term. Noise disrupts the formation of auditory pathways in the central nervous system necessary for the development of speech.

Light levels of less than 6 foot-candles (60 lux) and noise levels of less than 50 decibels (calm, low speech) recommended in intensive care units reduce the risk of hearing loss and improve the subsequent development of seriously ill children. In the intensive care unit, therefore, only calm speech without raising the voice is allowed. It must be remembered that the doors of the incubator must be closed carefully quietly, do not knock on the incubator and other nearby surfaces.

Eyelids do not protect the eyes of newborns. At least 38% of white light passes through the eyelids and irritates the child.

Elimination of pain and congestion:

Premature babies are very sensitive to rough touch. They react to such touches with tachycardia, agitation, increased blood pressure, apnea and a drop in hemoglobin oxygen saturation, disorders in the regulation of physiological processes, and insomnia.

However, premature infants are not able to respond to pain with changes in physiological parameters and behavior over a long period of time. Their reactions are quickly depleted, so it is difficult to notice them. The scales for assessing the intensity of pain, developed for full-term newborns, are not applicable to preterm infants.

According to one study, three out of four episodes of hypoxia and a drop in hemoglobin oxygen saturation are associated with care and treatment procedures. In addition, in response to them, stress hormones are released. A premature baby who covers his face with his hands gives us a signal that he is experiencing discomfort.

It is very important to try to reduce stress and pain effects.

Non-drug methods for minimizing pain and overload in newborns include using a pacifier and a nipple with a bottle of water, swaddling to simulate an enclosed womb, reducing exposure to light and noise, and performing several manipulations at the same time in order to increase the gaps between them and allow the baby to rest.

Correct placement of premature babies:

When a baby is in the neonatal intensive care unit, it is important to create an environment that mimics the closed space of the uterus (“nest” made of soft materials).

Neural connections are strengthened by repeated stimulation and weakened by its absence. After birth, a premature baby, having left the closed space of the uterus, ceases to receive constant tactile stimulation from its walls, which supports muscle development. The weak muscles of a premature baby cannot resist gravity. He takes a sprawled pose with limbs extended, abducted and turned outward. Gradually, this posture leads to the formation of abnormal muscle tone and postural (associated with a forced position of the body) deformities.

Thus, the increasing flattening of the skull from the sides leads to a narrowing and lengthening of the head (the so-called scaphocephaly and dolichocephaly). It is due to the thinness and softness of the bones of the skull, which is why it is easily deformed. This deformity of the head apparently does not affect the development of the brain, but makes the child outwardly unattractive and interferes with his socialization. However, with good care, the deformation can be significantly reduced.

Prolonged stay in the same position leads to muscle and skeleton deformities that disrupt subsequent motor development and the ability to learn about the world around, play, master social and other skills.

Giving the newborn the correct posture prevents deformations of the skull, trunk and pelvis, which disrupt and slow down subsequent development. Newborns themselves cannot turn, so attention should be paid to the correct posture. The child should be laid in a collapsed position in the "nest" and regularly turned from one side to the other. It is allowed to lay out premature babies on the stomach, but only under the control of monitoring supervision and personnel.

Every mother is always eager to look at the miracle that has been hiding in her stomach for nine months. However, sometimes she can see her own much earlier. Premature births, that is, those that occur before 37, happen for various reasons, sometimes even unidentified. If the child survives at the same time, then he is considered premature either. In the people, such people are affectionately called "hurry-ups". The features of premature babies and the possible consequences for them and their development in the future will be discussed in our article.

Premature babies: features

A premature baby is considered to be a child who came into this world before the 37th week, with a body weight of 1 kg to 2.5 kg, underdeveloped systems and organs. Babies weighing less than 1 kg are considered extremely premature.

Usually, such children cannot breathe on their own - due to the immaturity of the lungs, eat - due to unformed sucking and swallowing reflexes, they are weak, they have practically no subcutaneous fat layer.

The success of survival and the absence of further health problems depends on the period at which the baby was born, on the quality of medical care provided in the first hours after, and on the availability. Nursing of such babies takes place in special conditions.

Did you know? The baby with the smallest weight in the world who survived was born in 2006 in the United States. The girl, who appeared at 22 weeks and six days, was named Taylor. Her birth weight was 284 g, height - 24 cm. After three months spent in the hospital after birth, she was able to go home with a weight of more than 2 kg.

Classification

The degree of underdevelopment in each child may be different. Depending on the degree of underdevelopment, body weight and gestational age, four degrees of prematurity are classified. The main criterion in this case is the weight of the baby..

First degree

The diagnosis of "prematurity of the first degree" is made if the baby was born in the period from the 35th to the 37th week with a weight of 2.1 to 2.5 kg.

Second degree

Babies of the second degree of prematurity are born at 32 weeks of gestation with a weight of 1.51-2 kg.

third degree

Deeply premature babies are born from the 29th to the 31st week. In the medical card, they enter the diagnosis "degree of prematurity - the third."

fourth degree

Children who appear for a period of less than 28 weeks with a critically low weight, less than one kilo, are credited with the fourth degree. In the medical records of babies, the gestational age is most often prescribed, and not the degree of prematurity.

Did you know? Today, the survival rate of children born with low body weight in countries with developed medicine is 96%, with critically low birth weight (less than 1 kg) - 90%.

What does the baby look like: anatomical and physiological signs

Anatomical and physiological features of a premature baby will vary depending on the degree of underdevelopment. "Hurry" look very small and fragile. Some of them can easily fit in an adult's palm. They cry weakly, move slowly, often cannot breathe, eat, or defecate on their own. During sleep, they can grimace and shudder strongly.

Usually, a baby born weighing less than 1.5 kg has thin and wrinkled dark red skin. The whole body can be covered with fluff and grease. The size of the head is equal to one third of the entire length of the body. At the same time, the arms and legs look short.

The sutures of the skull are not overgrown, as well as the large and small fontanelles. The navel is low. In boys, the testicles are absent in the scrotum; in girls, the labia is not fully formed. Nipples are practically not expressed. Nails, eyebrows and eyelashes may be missing.

Babies that appeared at the 33rd and later weeks already have pink skin without fluff, a head ¼ of the body length, and a normally located navel. The testicles in boys are located in front of the entrance to the scrotum. The genital slit in girls is almost closed.

Premature babies are born with abnormalities that affect the respiratory, cardiovascular, endocrine, digestive, central nervous systems, brain, kidneys, muscles, eyes. A number of similar deviations can be identified:

Respiratory system. Most children have an incompletely formed respiratory system - newborns are diagnosed with narrow passages in the upper respiratory tract, a high position of the diaphragm, and compliance of the sternum. Because of this, their breathing is weak, rapid and shallow. It is not uncommon for such babies to have the following respiratory problems:
- sudden short-term cessation of breathing;
- pneumonia;
- respiratory distress syndrome.

The cardiovascular system. On the part of the heart and blood vessels, deviations such as pulse instability, tachycardia, quiet heart tones, low blood pressure, heart murmurs, congenital heart defects (open foramen ovale and Botalla duct), hemorrhages in the brain, other internal organs, anemia can be observed.

gastrointestinal tract.Practically all sections of the gastrointestinal tract in a prematurely born child are not fully formed. They may experience frequent regurgitation, flatulence, dysbacteriosis.

Endocrine system. Newborn babies suffer from impaired excretion, hypothyroidism.

Liver, kidneys. From these bodies problems such as:
- bilirubin encephalopathy;
- disturbances in the electrolyte balance;
- swelling;
- dehydration.

organs of vision. Many newborns have strabismus (persistent or short-term), retinal detachment, retinopathy.

Causes of prematurity

Premature birth can be triggered by several factors:

socio-biological (very young or elderly couple; unhealthy lifestyle of parents; ignoring preventive medical examinations and registration in the antenatal clinic; work related to contact with harmful emissions, heavy physical exertion);
in history;
the difference between children is less than two years;
health problems in the expectant mother;
complications ;
improper development of the organs responsible for bearing the baby;
by using .

Is it possible to diagnose a deviation in the womb

Often preterm birth occurs due to premature aging of the placenta, development (late). Therefore, it is important to go through planned for the timely detection of problems.

An increased activity of the fetus in the womb may indicate oxygen starvation. Therefore, if the mother feels that the child is too mobile, this is a reason to seek advice from a gynecologist.

The fact that the child is not gaining weight well, lagging behind the norm in this indicator, can also be told by the ultrasound doctor during a routine examination. A gynecologist may suspect a fetal growth retardation with a monthly weighing of a pregnant woman and measuring the circumference of her abdomen. A woman will feel bad or not gain it at all, and her belly will stop growing.

Features of caring for premature babies

Immature babies require special care and conditions for maturation. If the baby can breathe on his own, then he and his mother are placed in the neonatal pathology department, where the child is carefully examined, and in the absence of problems, they keep him in a medical facility under supervision until he gains 2.5 kg.

weight gain of at least 2.5 kg;
persistent sucking reflex;
absence of serious diseases requiring inpatient treatment.

At home

After the infant is discharged from the OPN, he, like his other peers, will be observed by the local pediatrician. He will also undergo regular examinations by a neurologist, ophthalmologist, cardiologist, urologist, gynecologist, surgeon, orthopedist. Until the fontanel is completely overgrown, you will need to undergo an ultrasound of the brain.

Usually, minor deviations in the form of mild, non-critical heart disease, retinopathy, with appropriate therapy, go away in a child by the age of three. If there are problems with the child's eyes, they will be registered with an ophthalmologist, whom he will have to visit regularly until his visual acuity is determined. Physiotherapy for myopia, glaucoma, astigmatism, optic nerve atrophy. As a rule, premature babies with extremely low body weight have many more health problems than those who were born with a weight close to a normal baby.

If you look at the statistics, the frequency of cerebral palsy, which is placed in two-year-old children, in premature babies is 14-16%, while in all newborns this figure is 0.5%.

Premature babies are a high risk group for development of abnormalities in mental development. Approximately 60% have problems of a neurological and neurosensory nature. These children are more susceptible to viral diseases,. Girls who appeared prematurely may have problems with the menstrual cycle, conception and bearing offspring in the future.

Modern medicine has successfully learned how to save and nurse almost all premature babies. With proper medical care and further care provided in the first hours of life, the prognosis for the baby is generally positive. In terms of body weight and length, some “hurry-ups” catch up with their mature peers by the age of one, but most often this happens by two or three years.

Alignment in terms of psychomotor and speech occurs depending on what stage of prematurity the child was given and what deviations were diagnosed in him. Most often this happens about two years, but it can take up to five or six.

In the future, premature babies are no different from peers. Nevertheless, it should be noted that there is a rather large percentage of “hurry-ups” who remain disabled for life. According to statistics, about a third of cases end up like this.

A normal pregnancy, without any abnormalities, should last 38-42 weeks. But, unfortunately, this is not always possible. More and more often there are situations when labor activity occurs much earlier than the due date. What consequences await a very premature baby and is it possible to prevent their occurrence? More about everything in this article.

What's happened?

A baby is full-term if it meets two related criteria: its birth weight was more than 2,500 grams; he was born later than 37 weeks of pregnancy. In other cases, the baby is premature, which means that it requires special care and careful monitoring by medical specialists.

All premature newborns, depending on when they were born and the weight of the premature baby at birth, can be divided into several main degrees:

1 degree - the period from 34 to 36 weeks, weight from 2,000 to 2,500 grams;
2 degree - the period from 31 to 34 weeks, weight from 1,500 to 2,000 grams;
3 degree - the period from 28 to 30 weeks, weight 1,000 to 1,500 grams;
Grade 4 - period up to 28 weeks, weight up to 1,000 g.

Grades 1 and 2 refer to moderate prematurity, a deeply premature baby corresponds to grades 3 and 4.

Character traits

A baby born before the 7th obstetric month of pregnancy is noticeably different from those who were born on time. In total, there are several characteristic features for him:

dark red skin color;
the location of the navel in the lower abdomen;
disproportionate body: head is large, arms and legs are short;
very soft fingernails and toenails;
open genital gap in girls;
the location of the testicles in the abdominal cavity in boys;
the absence of a subcutaneous fat layer, at first glance, the baby looks very thin;
the presence of wrinkles on the skin;
severe swelling of the whole body;
the whole body is covered with fluffy hair.

You can often see photos of very premature babies on women's forums and in medical institutions of the corresponding direction. On them you can see that the baby's skin is so thin that veins can be seen through it.

A distinctive feature is the behavior of the baby. He almost always sleeps, does not know how to eat on his own.

The reason is mom

Separately, it is worth talking about why a deeply premature baby was born prematurely. Doctors decide to perform surgery or induce labor if the following abnormalities are detected in a pregnant woman:

The formation of an inflammatory or infectious process that is incompatible with pregnancy. In this case, if the fetus continues to be in the womb, then it is in serious danger.
Any disease of the uterus, opposing the possibility of further pregnancy.
Pathology of the cervix.
Chronic endocrine diseases, which include: diabetes mellitus or any disorders of the thyroid gland.
Leading an unhealthy lifestyle: excessive drinking or smoking.
Heavy physical labor can also become a provocateur of the development of premature birth.
High pressure.

When such pathologies are detected, doctors assess the patient's condition and decide on the delivery. But, with the appearance of certain diseases, the uterus stops stretching, so it begins to press on the fetus and labor begins.

Symptoms of preterm labor

A pregnant woman should be alert when pulling pains appear in the abdomen, especially in its lower part; too frequent urination or leakage of water; the appearance of blood secretions; cramping contractions of the uterus (contractions).

If these symptoms appear, then you need to immediately call an ambulance team and go to the hospital for treatment. The obstetrician-gynecologist, if necessary, will take all possible measures in order to stop labor and allow the baby to be in the womb until the due date.

Consequences for the mother

Natural childbirth is no different from those that take place between 38 and 42 weeks. But, due to the small weight of the fetus, they pass faster, without severe pain, and the likelihood of ruptures also decreases.

Gynecologists after childbirth study the condition of the patient's genitals, check her hormonal background and the presence of infectious pathogens in the body, after passing a cesarean section, the condition of the sutures is also assessed. In most cases, patients quickly recover physically, but recover psychologically for a long time, often, they have to seek help from a psychologist.

Cause baby

In rare cases, the reason for the development of preterm labor is due to the condition of the child. For example, doctors come to such a decision if the child does not gain weight for a long time, receives insufficient oxygen, or has any gross pathologies. In this case, doctors come to a similar situation - they evaluate the possibility of maintaining the pregnancy, if there is none, then they perform an emergency caesarean section or induce labor.

Consequences for the child

The consequences for a deeply premature baby are not the most pleasant. Unfortunately, babies born before 28 weeks have little chance of survival. Their body is not yet sufficiently formed to exist outside the uterine cavity. In children born between 28 and 30 weeks, the chances of survival increase markedly. But there is a high risk of developing a number of diseases:

Weakened immunity. If a deeply premature baby was born, then the mother should be prepared for the fact that he will often get sick and catch a cold.
Due to the open oval window, the load on the heart increases several times, respectively, there is a high risk of developing disorders in the functioning of the lungs and the cardiovascular system.
In most cases, the negative consequences of severely preterm infants are associated with the immaturity of the nervous system. There is a high risk of developing cerebral palsy, epilepsy and other neurological diseases.
Babies born prematurely have vision problems.
Fragile blood vessels can cause bleeding in the brain.

The condition of the fontanels in deeply premature babies is also slightly different, they close much longer, which can cause unpleasant consequences, for example, hydrocephalic syndrome. For such patients, a planned ultrasound of the brain is prescribed monthly.

If doctors are ready to quickly let the mother of a very premature baby go home, then a small patient is in the hospital for a long time under the supervision of a number of doctors.

Apnea

One of the most dangerous diseases is deep sleep apnea in premature babies, which occurs in almost 50% of patients. In many cases, this pathology leads to the death of a newborn baby. The main reason for its development is the immaturity of the respiratory system. The baby was born too early and not all of his organs had time to form.

Apnea refers to a violation of the respiratory system and its periodic stops. This means that the baby can breathe calmly, but suddenly his breathing will become more frequent or, conversely, respiratory activity will completely disappear.

Treatment of such a pathology is long and complicated. The baby must necessarily be on a ventilator and receive artificial oxygen until his breathing stabilizes. In the future, when he is transferred to the ward, pediatricians will continue to monitor his state of health. A special sensor will be connected to the crib, which evaluates the pulse and respiratory activity of the baby. If breathing is lost or mommy gets the baby out of the crib, the equipment will give an appropriate signal. Doctors believe that it will be possible to get rid of apnea only if the attacks can be stopped for more than 7 days.

Unfortunately, due to the immaturity of the nervous and respiratory systems, the risks are quite high. Breathing in very premature babies can stop at any time, which will lead to death. Even if the seizures were completely stopped, the child will continue to follow maintenance therapy for a long time after discharge.

Nursing in intensive care

Until the 31st week of pregnancy, the internal organs continue to form in the baby, respectively, he is not yet adapted for life outside the uterine cavity. After the implementation of premature birth, he cannot take the first breath on his own, so he needs to go through a long process of nursing very premature babies in intensive care.

First of all, resuscitators create conditions for such patients similar to those in which he existed when he was in his mother's stomach. It is placed in a special device, which is a chamber and a cap - a pitcher. You can see that there are a lot of wires around the little crumbs. They are required to create the following functions:

power supply;
humidified oxygen supply;
implementation of artificial ventilation of the lungs;
maintaining the necessary parameters of temperature, humidity level.

It is worth noting that in the process of nursing deeply premature babies, food enters the body through a special device - a probe. For this purpose, medical specialists use a special sparing mixture, but it is still recommended that the mother transfer expressed breast milk to the intensive care unit. Firstly, this way the baby will receive more useful substances, and secondly, the woman will be able to maintain lactation.

As mentioned earlier, premature babies do not have adipose tissue, so they have impaired metabolic thermal processes. To create artificial heat, heating pads filled with warm water are used.

The condition of a small patient is always monitored by a resuscitator and nurses. Sensors are installed on the equipment, by which it is possible to determine the state of health of the baby and set the optimal environment in the incubator. If the child's health worsens, a signal is given, the doctors immediately provide the child with the necessary assistance.

Nursing in the ward

If the condition of the newborn normalizes, he decently gained weight and learned to breathe on his own, then the most long-awaited moment for each parent comes - the transfer of the baby to the ward, where he will stay with his mother for a long time. Doctors give the patient drug therapy, depending on the degree of prematurity and the state of health. In addition to the treatment of premature babies, for their full development, it is recommended to create favorable conditions in the ward:

It is recommended to dress the baby warmly or wrap it in a warm, but not heavy blanket. The child's body will still continue to poorly retain heat on its own.
Mom should master the Kangaroo method, it consists in creating skin-to-skin contact. As a result of numerous studies, it has been proven that if you conduct such a session, at least 20-30 minutes a day, then the child's well-being will quickly improve, and he will begin to gain weight better.
Many children are additionally prescribed massage to improve skin condition.
To improve muscle tone, it is additionally recommended to do light exercises, but only as prescribed by a doctor.

In the process of nursing the baby in the ward, he is observed by many specialists of various narrow specialties, mainly, these include a therapist, ophthalmologist, ENT and neurologist. To assess the state of health, he will need to regularly take tests and conduct an ultrasound examination of important parts of the body.

Mom and baby can stay in the ward from 2 weeks to 3 months. He can be discharged from the department of premature babies only if he has gained weight up to 2,500 grams, feels satisfactorily, sucks his breast on his own, his body maintains an optimal body temperature. They also evaluate the mother's ability to independently care for a special baby.

Nursing at home

If the child was at home, then the doctors noted that he had a stable state of health. In this case, parents should monitor the well-being and development of a deeply premature baby. First of all, they need to create special conditions at home for a premature baby to live in it:

The room should not have loud sounds and flickering elements. The insufficiently strengthened nervous system of the baby is not yet capable of perceiving such phenomena. If possible, it is recommended to place the baby's crib in a bedroom where there is no TV and other sources of noise.
In the first month of life at home, you should dress the baby warmly and fix his body position with special pillows so that in the process of turning over on his side, the baby does not expend his own energy.
The room should always be fresh and maintain an optimal level of humidity. Therefore, it is recommended to install a humidifier. It is recommended to ventilate the room daily, but the baby should be moved to another room for this time.
A very important condition is to completely limit contact with infected people. Any viral disease can provoke the development of pathologies in the fragile body of the baby.

Every day it is necessary to carry out the procedures necessary for each newborn baby: bathing, feeding, changing bed linen, clothes and a diaper, treating the skin from diaper rash, walking in the fresh air.

Regardless of the consequences that have arisen in very premature babies, they are required to come to the doctor every month for a check-up. Usually, premature babies are registered in a specialized clinic.

Features of feeding

Many mothers have a question about how to feed a very premature baby? In fact, this process is quite a bit different from the process of feeding full-term babies. In the first days of life, a special substance is introduced into the baby's body - a 5% glucose solution. Usually, crumbs are given to them through a probe or syringe. If it is well absorbed, then in this case, you can start feeding the baby.

Doctors recommend adhering to breastfeeding, as there are many useful substances in mother's milk that a fragile body needs. Every day, the mother should bring fresh expressed milk to the intensive care unit, and the doctors will feed it to the baby through a syringe or tube. When transferring the baby to the ward, you can already begin to apply it to the chest, forcing you to eat on your own.

If it is not possible to adhere to breastfeeding, then a mixture should be used as the main food. But it is required that artificial nutrition be selected by a pediatrician. The volume of a single feeding is calculated based on the weight of the crumbs:

up to 1,000 grams - 2-3 ml;
from 1,000 to 1,500 grams - 3-5 ml;
from 1,500 to 2,000 grams - 4-5 ml;
from 2,000 to 2,500 grams - 5 ml;
over 2,500 grams - up to 10 ml.

Feed the baby should be every 2-3 hours. As soon as the weight of the crumbs has reached 2,500 grams, they continue to feed him in the same way as a newborn full-term baby.

Modern doctors do not recommend the introduction of complementary foods before 6 months. Accordingly, if the child was born 2 months earlier, then the first complementary foods need to be introduced only at 8 months. It is required to start it with vegetables, gradually introducing fruits, porridge, meat, cottage cheese and yogurt. It is worth adding new products until the baby is one year old. How to feed a deeply premature baby after a year? By this age, his body is already fully formed, so the diet of such a baby does not differ from the diet of a full-term baby.

Child development

The development of very premature babies by months may differ from those who were born at the scheduled time. Roughly, the picture looks like this:

1 month for such a child is the most difficult. Most likely, he will spend most of the first month of his life in intensive care, where his body will fight for life. The baby almost always sleeps, respectively, leads an almost motionless lifestyle. Even the nutrition of the baby can be carried out in a dream.
By 2 months of life, the child noticeably gains weight. By this time, he gradually begins to look like a newborn full-term baby. The skin becomes thicker, the fluff on the body disappears, and now, the veins under the skin are almost invisible. At 2 months, a premature newborn baby should begin to be applied to the breast so that he develops sucking reflexes.
By the age of 3 months, the baby begins to develop some reflexes. He already reacts to light and sound. His body weight is actively starting to increase. If you put the baby on his stomach, you can see how he begins to tear his head off the surface a little. Still most of the time he continues to sleep, waking up only when he feels hungry.
In terms of development, deeply premature babies should be similar in months to those children who were born 2 months later than their full-term ones. That is, at 4 months, its development should correspond to 2 months. The baby, when lying down, can already tear his head off the surface and hold it in an upright position. He sleeps less, stays awake more than before. By this time, the child is already beginning to fix his gaze on objects.
5 months for many parents is the most enjoyable period. By this time, the baby was already strong enough and gained strength. Now he is already able to give his parents the first smile. Hearing any sound, he begins to react and turn his head to the side. By 5 months, the baby begins to hold his head upright.
Babies born prematurely at 6 months old begin to recognize their loved ones, as well as respond to the appearance of unfamiliar faces. During this period, he begins to master coups from the back to the tummy.
At 7 months, the baby is already actively turning over on his stomach. He takes the toys in his hands and carefully examines them. He has a natural desire to reach for bright objects.
8 months is the time when it is time to introduce complementary foods for very premature babies. If the baby is gaining weight well, it is recommended to start with vegetables (cauliflower, broccoli or zucchini). During this period, the crumbs have a new ability - to roll over from the stomach to the back.
According to many pediatricians, the 9th month of life is the most active and progressive period, when the crisis has passed, the baby has already become strong enough. He begins to get on all fours and learns to crawl. And many children by the end of the 9th and the beginning of the 10th month of life are already actively moving around the apartment on all fours, sitting confidently.
At 10 months, children continue to learn to crawl, doing it faster and more clearly. They already know their names and react to their name.
By the 11th month of life, a premature baby begins to catch up with his peers in gestation. He already knows how to stand, holding on to a support, and move along it. In the same period, the baby begins to speak many of the same type of words and point his finger at an object familiar to him, pronouncing the corresponding sound.
So the premature baby turned one year old. By this time, the children had almost caught up with their peers in terms of physical and psychological development. By the first year of life, such children are already beginning to confidently stand without support and take their first steps.

Do not worry if the baby is a little behind in physical development from the norms dictated by pediatricians. You should not rush him and give him the opportunity to develop as he is comfortable. But, if the baby is far behind the developmental norms of a very premature baby, then it is worth conducting a series of examinations for him:

visit a neurologist;
do an ultrasound examination and tomography of the brain in order to exclude the presence of cysts and other pathologies;
visit an orthopedist.

Often the cause of the delay in the development of a premature baby is muscle hypotonia. In this case, children are prescribed vitamin D, strengthening massage and daily exercise. With proper care, the baby will soon gain strength and will delight parents with new successes.

Long-term consequences

It is generally accepted that the first year of life is the most difficult for a newborn baby and his parents. Due to the immaturity of the body, pathologies and various diseases can develop. But by the year their body becomes noticeably stronger, all their organs are already formed, and unpleasant diagnoses recede one after another. The consequences in the future for very premature babies are no longer so terrible. Usually, quite normal people grow up out of them, who do not differ at all from others, and only information from the medical record speaks about the degree of prematurity.

As a result of scientific research conducted around the world, several interesting facts have been revealed about premature babies:

Deeply premature babies are small people with big character. From the very first day of their birth, they struggle with extraordinary strength to live. Therefore, quite often it is these qualities that are transmitted to already adult people. They have a strong character and good endurance.
Unfortunately, the number of deeply premature people is constantly progressing.
Many famous people were also born prematurely, such as: Voltaire, Rousseau, Newton, Darwin, Napoleon and Anna Pavlova.
As a result of numerous studies, it has been repeatedly proven that the mental abilities of premature and full-term children do not differ.
Approximately 13-27% of premature babies develop chronic diseases: cerebral palsy, dementia, hearing loss, blindness or epilepsy.
Approximately 30-50% experience anxiety attacks and night terrors.
In girls, due to prematurity, there may be a violation of reproductive functions, which causes problems with the regularity of the menstrual cycle.
If the mother and father were born prematurely, then there is a high probability that they will also have premature babies. The same applies to women who have previously had a premature birth or spontaneous abortion.
Men may also experience reproductive disorders, therefore, the probability of becoming a father may decrease by 1-5%.

Preventive measures

Unfortunately, there is no such method that could definitely prevent the risk of preterm birth. But subject to certain preventive measures, there is a high probability that the expectant mother will be able to give birth to a healthy baby in a normal period - from 38 to 42 weeks.

A girl should understand from an early age that she is a future mother and it is necessary to take care of her health. This rule must be communicated to her by her mother. Therefore, it should be that the girl does not sit on cold objects, does not get cold of the kidneys and appendages, leads a healthy lifestyle and avoids prolonged stressful situations.
The chances that a child will be born prematurely increase markedly if a woman has previously had an abortion.
When planning a pregnancy for 3 months from conception, it is recommended to abandon bad habits and eating fatty foods. On the contrary, expectant parents should take vitamins, such as folic acid.
If a pregnant woman works in production, then it is required to go to work while waiting for the baby in more favorable working conditions. The employer does not have the right to refuse such a request.
All medical recommendations should be followed, all medical measures should be taken in a timely manner in order to be able to identify the pathology at an early stage of its development and prevent it in a timely manner.
Avoid contact with infected people.

But even in a completely healthy mother, labor can suddenly begin, due to the individual characteristics of the body.

Conclusion

In conclusion, it is worth saying about the development of a premature baby that a baby born prematurely differs from a full-term baby only in that he needs more careful medical supervision, as well as doubled love and care from parents. If the baby was born prematurely, then you should believe in his strength, very soon he will grow up, and will not differ from his peers.