A must-read for new parents! Changsha Fourth Hospital gives you a guide to raising premature babies, save it now!

With the progress of perinatal neonatal medicine, there are more and more special little angels - premature babies. Faced with these fragile little lives, new parents often feel anxious and helpless: "The baby is so young, how should we feed him?" Don't worry, Changsha Fourth Hospital will give you a guide to raising premature babies, save it quickly!

1. What is a premature baby?

Premature babies, in simple terms, refer to newborns whose gestational age is less than 37 weeks. According to the gestational age at birth, premature babies are divided into the following categories:

Late preterm infants: newborns born at gestational age of 34-36+6 weeks;

Mid-preterm infants: newborns born at gestational age of 32-33+6 weeks;

Extremely premature infants: newborns born at gestational age of 28-31+6 weeks;

Extremely premature infants: Newborns born at a gestational age of less than 28 weeks, among which those born at a gestational age of less than 24 weeks are called extremely premature infants with survival limits.

2. Six major challenges that premature babies have to overcome

The functions of many organs of premature babies are not yet fully developed. In the subsequent process of catch-up growth, they need to overcome six major difficulties. The younger the gestational age, the greater the risk.

1. Breathing

Premature infants have immature lungs and insufficient alveolar surfactant, which makes them prone to respiratory distress syndrome, apnea, and other problems. They need to be supported by ventilator-assisted ventilation, continuous positive airway pressure, or surfactant replacement therapy.

2. Body temperature

Premature infants have an underdeveloped temperature regulation center, thin subcutaneous fat, and a large body surface area. They are prone to hypothermia (<36°C) due to rapid heat dissipation, and may even develop scleredema or shock. They need to use an incubator or radiation table to maintain a stable body temperature.

3. Infection

Premature infants have weak immune systems and poor skin barrier function, making them susceptible to sepsis, pneumonia, or omphalitis. Daily care must strictly adhere to aseptic techniques, avoid visiting, and use antibiotics when necessary.

4. Feeding

Premature infants have poor sucking-swallowing-breathing coordination, small stomach capacity and immature intestinal function, which makes them prone to feeding intolerance, such as abdominal distension and vomiting. It is necessary to gradually transition from micro-feeding, nasogastric feeding to breast milk fortifiers, and monitor gastric residual volume. Due to the high nutritional needs of premature infants, additional parenteral nutrition is required to meet their nutritional and energy needs. As the intestinal tract matures, parenteral nutrition is gradually reduced, and finally transition to full oral feeding.

5. Jaundice

Premature infants have immature liver enzyme systems and weak bilirubin metabolism, making them prone to hyperbilirubinemia (especially pathological jaundice). They need to dynamically monitor bilirubin levels and receive timely blue light exposure to prevent riboflavin.

6. Bleeding

Premature infants have poor coagulation function and fragile blood vessels, making them prone to intracranial hemorrhage, pulmonary hemorrhage or gastrointestinal bleeding. Their blood pressure needs to be monitored and unnecessary operational stimulation should be minimized.

3. Nursing Guidelines for Premature Infants after Discharge

In the hospital, doctors and nurses will do their best to help premature babies overcome every difficulty. And when the baby is discharged from the hospital and returns to the arms of his parents, he still needs special family care.

1. Create a comfortable environment

Avoid direct strong light and noisy sounds to stimulate the baby. Use blackout curtains and soft lights. Also, pay attention to keeping the indoor temperature stable, control the room temperature at 24-26℃, and maintain the humidity at 55%-65%. Choose cotton clothes of appropriate thickness for the baby, and use the warmth of the baby's hands and feet as the standard. Before touching the baby, be sure to warm your hands first. When changing the baby's clothes or diapers, be quick to prevent the baby from catching a cold.

2. Master the tips of proper feeding

Breastfeeding is the first choice. For babies with birth weight less than 1800g, breastfeeding needs to be supplemented with breast milk enhancers under the guidance of a doctor. If breastfeeding is not possible, special formula milk for premature babies should be used. If the baby has poor sucking ability, you must be patient when feeding. During the feeding process, you must follow the principle of small amounts and multiple times, and closely observe whether the baby has vomiting, abdominal distension, etc. The baby should be burped in time after feeding to prevent choking.

3. Scientific nutritional supplementation

Vitamin A : Premature and low birth weight babies should start taking 2,000 units of vitamin A preparations daily within one week after birth, and change to 1,500 units per day after three months. It is recommended to continue supplementing until adolescence.

Vitamin D: For premature babies and those with low birth weight, take 800 units of vitamin D preparations orally every day starting from one week after birth, and change to 400 units every day after three months; if the baby is fed with premature infant formula, take 400 units of vitamin D preparations every day. It is recommended to continue supplementing until adolescence.

Iron supplements: Premature and low birth weight babies have low iron reserves and need to start supplementing with 2 mg/(kg.d) of iron 2 weeks after birth until the corrected age of 1 year. When using iron-fortified formula milk, breast milk fortifiers, and other iron-rich foods, the dosage of iron supplements can be reduced as appropriate. The specific dosage can be consulted by a doctor.

Growth and development intervention: According to the developmental level of premature infants, appropriate visual, auditory, tactile and other sensory stimulation can be given, and appropriate parent-child interaction can be carried out.

IV. The content of early development promotion for premature infants at different age groups is as follows:

In the hospital, medical staff use their expertise and love to help premature babies bravely pass through one level after another; after being discharged from the hospital, premature babies cannot do without the careful care of their parents. I hope all new parents can learn more about the knowledge of raising premature babies, so that every early angel can thrive.

Hunan Medical Chat Special Author: Kang Liyanshan from Changsha Fourth Hospital

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(Edited by Wx)