Premature Babies Can Live Normal, Healthy Life

The premature baby’s world was completely unknown to me until I joined a neonatal unit in a UK hospital in 2018. Babies are normally born at 40 weeks of post menstrual age, however, due to various complications during pregnancy including various maternal and medical conditions, around 15 million babies are born prematurely around the globe. The World Prematurity Day is celebrated around the world to raise awareness about premature births and its huge impact on families.

Most people are unaware that babies born at even 22 weeks can survive if they receive advanced neonatal care in a tertiary level neonatal unit. As per BAPM Framework 2019, only three babies survive out of 10 born at 22 weeks, four babies survive out of 10 if they are born at 23 weeks. The chance of survival and associated medical conditions are better if babies are born after 26 weeks of gestation. The disability rate is also high in the extremely premature babies (22-26 weeks of gestational age). Prior to birth, antenatal steroids are offered to mothers to reduce the risk of breathing problems, and prevent bleeding into the brain, all of this can reduce the risk of developmental delays.

Crucial care

The nursing and medical care at the early age of life is very crucial to determine the survival rate, as well as to promote positive growth and development of the newborn. The chance of survival and long-term outcomes will depend on the gestational age as discussed previously but also on other risk factors such as growth restriction, foetal abnormalities, antenatal steroids, management at birth and risk factor for infection. The most common health condition which specifically affects these vulnerable preterm infants is chronic lungs disease, patent ductus arteriosus, respiratory distress syndrome, retinopathy of prematurity, bronchopulmonary dysplasia, intraventricular haemorrhage, necrotising enterocolitis, sepsis, prolonged jaundice, anaemia of prematurity and gastro-oesophageal reflux. 

Giving birth to a premature baby is extremely stressful and devastating to the parents  because they are worried about the long-term health outcomes and frightened with the wires and breathing tubes along with intravenous lines on their tiny baby. All parents wish for a perfect and healthy baby at birth. When they see their little babies in the incubator for the first time, they feel very shocked and can be emotional. 

Initially parents can feel very scared to touch and provide cares to their babies, since they are worried their baby is small and delicate. They can find it difficult to care for their babies needs and feel confident handling. To overcome this, parent need continuous support, and updates about their babies on regular basis and encouragement to participate in the treatment plan made by medical and nursing team. Family centred care is prioritised to achieve optimal outcomes. Parents are seen as partners in care, and the expert on their baby’s needs.    

The positive news is that most of the preterm babies are truly fighter as many of them will normalise at 37-42 weeks of corrected gestational age and will be ready to go home. Most of the parents will spend a few days and nights with their babies at the neonatal unit immediately prior to the discharge, to build up their confidence to look after their babies. 

Parental role

Discharge advice is provided to parents to prevent any incident, and basic life support in case of an at home emergency. All vitamins and medications are prepared and given to parents before discharge. Parents can demonstrate a mix of emotion during the discharge. On the one side they are immensely happy to take their baby home, and on the other, they are worried about the baby’s cares and safety at home. Babies are seen by consultant in the community to monitor their growth and development. Most of the babies live normal healthy life like other full-term babies.  

(The author is a nurse at the UK-based West Hertfordshire Hospital.)