Care of premature babies in the hospital and after discharge

When a couple has a child, mom and dad spend all their time on him, because without the proper care the kid simply will not be able to develop normally, or maybe survive. And what if the baby was born before the due date? Care for premature babies should be special, because such crumbs sometimes even breathe and can not eat without help.

Until recently, doctors did not undertake to reanimate and save the life of a baby whose weight at birth is less than a kilogram. Now everything has changed, and experts can give a chance to the baby, who was born about the size of a palm and weighs half a kilogram. About care for premature babies in the intensive care unit, maternity hospital, at home after discharge and in other conditions, we will discuss in this article.

Premature babies: features

Pre-infants are those who were born from the 37th to the 42nd week of pregnancy. If the child was born before the prescribed, it is considered premature. The main problem of such babies is the underdevelopment of internal organs, and the earlier birth occurred, the more thorough the care the child will need. Nursing care for premature babies begins with the first minutes of his life, the mother will be able to start taking care of her child alone after the permission of the child's doctor, but more on this later. While we are interested in the features of the physiology of the infant, born before the time. How fast can mom take care of her baby? Everything depends on the degree of its prematurity. There are three degrees in common:

1. Extreme prematurity - weight less than a kilogram.
2. Deep prematurity - weight from a kilogram to one and a half.
3. Prematurity - weight from one and a half kilograms to two and a half.

The main features of a premature baby are:

• little weight;
• Small height (up to 46 cm);
• Disproportionately folded body (large head, short legs, neck, shifted navel navel);
• The shape of the skull is rounded, with markedly noticeable fontanelles and sutures;
• Ears tightly pressed against the head, very soft;
• Skin is very thin and wrinkled, all wreaths can shine through;
• The surface of the body is covered with a small fluff;
• Completely missing fat layer;
• On the arms and legs may be underdeveloped marigolds, or altogether absent;
• Uncoloured testicles in boys and an open sexual gap in girls.

It is worth noting that all the above characteristics should be in the aggregate. Only in this case it is possible to speak about the features of care for premature babies. If there is one thing that shows up, it indicates a pathology, and not a prematurity.

Behavior of the premature baby

Newborns born in the wrong time, differ in their behavior. They are inactive, there is a decreased muscle tone. Toddlers are drowsy (this is noticeable even against the background of the fact that full-term babies sleep almost constantly), they flinch for no reason and start chaotically moving. Especially complicating the care of premature babies is the lack of a sucking reflex. The baby is hungry, but does not know how to eat.

Briefly about the care of premature babies

We suggest to consider the subtleties of caring for the baby, and then we will walk through each point in more detail.

Nursing care for premature babies, as we have already said, begins with the first seconds of his life. First of all, it is taken in a warm diaper and, if necessary, makes ventilation of the lungs. This is the most important procedure. The breathing of the baby can be disturbed or even stopped altogether, since an early born baby does not produce enough surfactant - a substance responsible for the correct breathing. Therefore, lung tissue can not be fully disposed of.

The second problem is that premature babies are completely unprepared for a physiological existence in this world, they have an insufficient layer of subcutaneous fat, so thermoregulation is imperfect. Kids are quickly supercooled and overheated, as the temperature of the environment is very different from the one in the mother's womb.

In the olden days such a problem was solved by wrapping the baby in cotton wool or putting it on a warm stove. Now the problem of regulating the temperature of the newborn's body is decided differently: a premature baby is placed in a cuvette, or, in simple words, an incubator. There gets enough oxygen, it is isolated from extraneous noise and light. Temperature and humidity in the bowl are regulated, conditions similar to intrauterine conditions are created.

Problems with feeding are also absent. Features of nursing care for premature babies are wrapped, tracking the general condition and, of course, in feeding. Medical personnel take their mother's expressed milk, add to it the necessary vitamins, proteins and minerals. If a woman does not have milk, then children's formulas are used, designed specifically for babies born before the due date. Feeding the baby, if it has poorly developed sucking reflex, is carried out with a syringe.

The baby, who has developed this reflex, is given a bottle. If the weight of the child is so small that it can not even swallow, a nasogastric tube is used, or nutrients are injected intravenously. The probe is injected through the spout of the crumb, and the milk enters the stomach in small doses. In any case, the feeding of a premature baby is fractional and in small portions, even if its weight is more than two kilograms. The organs are not yet developed enough to work fully. Nursing for premature babies is compulsory. After all, the mother can overfeed.

Care of premature babies in the hospital at first can be impossible, if there are complications with health. In this case, the baby is transferred to the intensive care unit.

Resuscitative care

Care for the newborn preterm baby in the first stages is borne by the medical staff of the maternity home. Most often immediately after birth, the baby enters the children's intensive care unit, and it's good if it is available in the maternity hospital. But it happens that in the hospital there is no such separation.

First of all, a cardiologist, a neurologist, an orthopedist, an ophthalmologist are examined by a neurosonography (ultrasound of the brain), if necessary, ultrasound of all internal organs. In addition, urine and blood tests are taken. After the procedure, the baby is placed in the cuvetes.

What happens if the hospital does not have its own resuscitation? Really there is no chance to "pull out" the child? Nothing like this. All maternity hospitals are equipped with the necessary equipment for the care of premature babies, there is also a device for ventilation, and a cuvette, and special preparations designed to support the life of crumbs, and a neonatologist is a specialist trained to take care of children born in the wrong time.

But nevertheless there is a problem: neonatologists not only look after premature babies, but also must attend every subsequent birth. And this means that observations of preterm infants will be less and the neonatologist may miss the moment, if suddenly there is a need to save a crumb.

In resuscitation, nurses and neonatology doctors are working, whose duties include only nursing of children already in their ward. In this case, the newborn will be constantly under the watchful medical control.

If the baby needs resuscitation, but does not have it in the hospital, then after stabilizing his condition, he will be transferred to another hospital where there is a necessary separation. Transportation is carried out in a specialized machine, where there are devices for ventilation, cuvies and other necessary appliances for life support.

When the baby is in intensive care, the mother can come to him at the due time, but "communicate" only through the glass of the incubator (kuveza). There are offices where there is an opportunity to visit the baby at any time of the day.

Feeding

Parents of babies born early, you need to know all the subtleties and features of care for premature babies, so as not to worry about the child. Many couples begin to worry too much about the life of a crumb, they think they can not cope. Of course, it is very difficult to survive the period of such difficult grooming, but progress does not stand still, and medical personnel can save even the smallest.

If the weight of the child reaches two kilograms and the sucking reflex is well developed, then there is the possibility of breastfeeding. Mom can often keep a crumb on their hands, feed and help with the care of the medical staff. Only a nurse feeds from a bottle or syringe, so that there are no problems with the esophagus. As it was already written earlier, if the sucking reflex is absent or poorly developed, the digestive organs can not fully cope with their task and feeding should be fractional.

Premature babies need a large amount of fluid. Usually, the diluted 1/1 with 5% glucose Ringer's solution is used to maintain the body. In addition, vitamins are needed, riboflavin, vitamin K and E, ascorbic acid, thiamine are necessarily introduced in the early days. Focusing on the individual condition of the newborn, the doctor may prescribe other vitamins.

After a while, baby food will not be anything different from that of peers. But in the first stages of nursing special supplements are necessary, so that the development and growth of crumbs are accelerated.

As parents can be sure, you should not worry about food. Soon your baby will take his own and turn from a thin, weak baby into a cheerful, rosy-cheeked and active youngster.

Nursing in the hospital

Care of premature babies in the hospital necessarily begins with the separation of pathologies of newborns. Here, the baby will be constantly monitored by nurses and doctors, the necessary procedures will be prescribed, a survey will be conducted.

The transfer of an infant to an ordinary department can be made only when he gains at least two kilograms of body weight, will actively suck the milk, cope with the regulation of body temperature, breathe well. The length of stay in the cuvette depends on the severity of the degree of prematurity, there are only four:

• The first degree - birth occurred on the period from 37 to 35 weeks;
• Second degree - from 34 to 32 weeks;
• The third degree is 31-29 weeks;
• The fourth degree is 28 or less.

If by the time of the mother's discharge from the hospital, the child has already reached the minimum parameters at which the premature baby can be taken care of at home, then he is released home with his mother. If the need for resuscitation is no longer available, but there is still a risk for health, the baby is transferred to the children's department. The mother herself decides how to proceed further: go to the hospital with a crumb or go to the hospital for feeding.

In the hospital

In a specialized children's department, a baby born before the term is transferred at the instruction of a pediatrician and a neonatologist. Such a move is possible even if the crumb still feeds through the probe and needs artificial respiration. All care for premature babies in this case is in the hands of medical personnel.

The child will be placed in a heated bed or a cuvette. In a hospital, a more complete examination is conducted, it is aimed at finding pathologies and genetic diseases. The baby is examined by narrow specialists, the necessary tests and procedures are prescribed.

Positive dynamics begins to increase usually from the date of the earlier expected birth, that is, from the date when the child was to be born on time. The time spent in hospital depends on how quickly the baby gains weight, learns to suck and swallow, from the presence of identified pathologies. Treatment in the hospital can last from a week to several months.

At home

When the crumb is finally ready to go home, the doctor gives detailed recommendations to the parents. Care for a premature baby after discharge is very difficult, especially for couples who have a born firstborn. The difficulty lies in the fact that nursing nursing only nursing staff and parents can even have no idea about how and what to do.

In any case, if the baby was born before the term, the patronage should be conscientious. If for some reason the pediatrician did not come on the day, call the clinic and ask for a visit. Now consider in detail all the subtleties of home care for a premature baby, which must necessarily be known to all family members living in the same room.

1. The first thing you should watch is the temperature of the air in the crumbs room, it should be about +22 degrees. Do not forget that preterm infants may have problems with thermoregulation.
2. For the first time to bathe at home the baby is after the permission of the district doctor. The bathroom warms up to 24 degrees, and the water should be close to body temperature. After washing the baby carefully wipe with a soft towel and warm clothes, since children born not on time, can quickly become supercooled.
3. Walking does not differ from those that are assigned to term infants. In the warm summer, you can get out of the air immediately after discharge, and in the cold season - in a month. The first walks last no more than half an hour, the time gradually increases.
4. Breastfeeding of premature babies after discharge is often impossible, since he will already be "spoiled" by a bottle and will be too lazy to suck his breast. Nevertheless, try to breastfeed or as often as possible, express milk and feed them your child, because mother's milk is the most important element of nutrition in the first year of life. If you do not have enough milk, or if it has completely disappeared after the stress caused by experiencing the life of your crumb, then buy the mixtures designed for premature infants.
5. In the care of premature babies at home, constant monitoring is mandatory! If the baby becomes sluggish, weak, refuses to feed and regurgitates abundantly, immediately call a doctor, these are very bad signs.

Care for a premature baby in an outpatient setting

A plan for examining babies born early is compiled individually. Often, premature babies suffer from kidney and eye diseases, neurological pathologies are observed. If there is any violation, the baby is registered with the necessary doctor and must be visited on a regular basis, without missing the prescribed methods.

If your karapuz is absolutely healthy, then only a monthly check-up in the clinic and bypassing the narrow specialists that are produced in the "Days of healthy children" will be required. During the month, the district nurse will visit you to make sure that the child is well.

Development of premature infants

If a little man was born early, in the first two months of his life he will almost always sleep, quickly get tired even with low activity. After two months of age, the child will develop faster, move more actively, which can lead to muscle strain of the limbs. It is easy to remove special exercises.

We must not forget that the nervous system in preterm babies is weak, so that the baby can shudder without reason, frightened by sudden movements and sounds. Periods of restful sleep can be dramatically changed by attacks of stimulation, again without cause. Such babies need peace and quiet, they do not tolerate meeting with strangers and changing the situation.

If the baby does not have pathologies, then it will develop rather quickly and grow. By the age of three months he will catch up and even, perhaps, drive his peers in growth, weight and development!