Premature birth and care of your pēpi Mō te whakawhānau pēpi wawe

Most pēpi are born between 37 and 42 weeks of pregnancy. Premature pēpi are those born before 37 weeks of pregnancy.

Premature birth is quite common. About 10% of pēpi are born before 37 weeks. About 1% of pēpi are born before 30 weeks, which is classified as very premature.

Pēpi can survive outside the womb from 23 to 24 weeks. But the earlier they are born, the more help they will need to survive, and the more likely they are to have lifelong problems.

The nearer to term a pēpi is born, the fewer problems they are likely to have. This is because they have had more time to grow and develop in the womb.

Several things can increase your risk of going into premature labour. These include if you:

• have already had a premature pēpi
• are pregnant with twins or triplets
• smoke
• are underweight or very overweight
• have a medical condition such as diabetes or high blood pressure
• have a problem with your cervix or uterus.

When your pēpi is born, they may be extra care in a neonatal (newborn) unit. How long they need to stay in the unit depends on how premature they are and what problems they have.

Feeding

Premature pēpi usually take a while to feed well on their own. This depends on how early they were born.

They may need to be fed through a tube that goes from mouth or nose (a nasogastric tube) to their stomach.  They may be given:

• your breast milk
• pasteurised donor breast milk
• a special formula.

Breast milk is the best food for pēpi, especially premature ones. But sometimes it can take a while for your milk supply to start if your pēpi is premature. Your pēpi may be able to receive donated breast milk during this time.

Donated breast milkexternal link

Breathing

Because a premature baby's lungs are not developed, they may have problems breathing. They may need to be placed on a ventilator to help them until they can breathe normally on their own.

Keeping warm

Because premature pēpi have very little fat on them, they can:

• get cold very quickly
• struggle to stay a constant temperature.

This is why they need to be in an incubator or in skin-to-skin contact with mum or dad. This means they can use their energy for growing rather than keeping warm. Skin-to-skin contact has many benefits including helping you and your pēpi to bond. 

Low blood sugar

Premature pēpi struggle to control their blood sugar levels. If their blood sugar gets low, it can cause seizures. They need frequent testing (usually done with a heel prick) to check their blood sugar level.

Infections

A premature baby's immune system is still developing so they may be more likely to get infections than a full-term pēpi. Feeding a premature pēpi breast milk is the best way of boosting their immunity and protecting them from infections.

Medical complications

Your pēpi may have problems because their digestive system is not fully developed. A condition called necrotising enterocolitis can badly damage the lining of their intestines. The best way to protect premature pēpi from this is to feed them breast milk.

Premature pēpi have very thin-walled blood vessels, which can cause bleeding in their brain. This is called an intraventricular brain haemorrhage. Sometimes this is minor and does not cause any long-term damage. But sometimes it can cause serious brain damage.

Premature pēpi are also more likely than full-term babies to get jaundice.

Jaundice in babies — KidsHealth

The more premature a pēpi is, the more likely they are to have long-term problems. Some who are born close to term have no long-term problems at all, while others can have several problems.

Every pēpi is different, but the long-term problems that can affect premature pēpi include:

• cerebral palsy
• long-term lung problems
• sight and hearing problems
• neurodevelopmental disorders such as ADHD (attention deficit hyperactivity disorder)
• learning difficulties.

Not all very premature pēpi will have long-term problems. Modern advances in newborn care are helping many of these pēpi grow into healthy children and adults.

Having a premature pēpi can be an emotional time. Your new pēpi may be in the neonatal unit in an incubator and attached to machinery. You may find it harder to bond because your pēpi is not in your arms.

The neonatal unit staff are there to help you through this time. They will keep you informed about how your pēpi is being cared for and provide emotional support for you and your whānau.

Your midwife or doctor will also provide postnatal care and support for 4 to 6 weeks after your pēpi is born.

You can get support from the Little Miracles Trust, a charity that operates throughout Aotearoa New Zealand. It offers a range of support including while your pēpi is still in the neonatal unit and when you get home.

Little Miracles Trustexternal link