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Frequently Asked Questions - Premature Infants
NICU nurses developed the following FAQ guide to address frequent questions and concerns parents have regarding premature infants.
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At what point is an infant considered developed and ready for birth?
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A term pregnancy is 38-40 weeks long. A preterm infant would be less than 37 weeks and a pregnancy would be considered post term if lasted 41-42 weeks or longer.
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What causes a baby to be born prematurely?
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Predisposing factors for a preterm delivery would be:
a. Medical obstetric history including:
- Preterm labor and birth
- Multifetal gestation ( twins, triplets, etc.)
- Uterine anomalies
- Incompetent cervix
- Uterine and genital tract infections
- Polyhydramnios
- Abruption placentas or placenta previa
b. Lifestyle factors:
- ETOH use or cigarettes drugs
- Stressful work or personal situations
c. Socioeconomic effects:
Low socioeconomic status and non white race, poor nutrition and inadequate prenatal care.
d. Premature delivery of unknown etiology
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Are there common medical conditions that affect premature babies?
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Yes, some of these include:
RDS - Respiratory Distress Syndrome
NEC - Necrotizing Enterocolitis
ROP - Retinopathy of Prematurity
PDA - Patent Ductus Arteriosis
IVH/PVL - Intraventricular Hemorrhage
Hyperbilirubinemia BPD - Bronchopulmonary Dysplasia
Anemia of prematurity
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Are most conditions treatable? Are there long-term physical and developmental effects? |
Each premature infant has its own individual course of treatment in the Neo Natal Intensive Care Unit. Some conditions are more treatable than others depending on the severity of the illness. There are many factors to take into consideration when treating the infant. Maternal factors, gestational age, weight of the infant, multiple gestation, sex of the infant and level of neonatal care that can be given to the infant immediately after birth are some things looked at during the care of the infant while in the NICU. As for physical and developmental issues, these cannot be looked at until the infants are expected to meet developmental milestones, which are monitored closely in the newborn follow up programs associated with neonatal intensive care units.
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How long does it take for a premature baby to catch up to a term baby?
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Most infants will be monitored at a corrected age until the age of 2 years old. This means that infants will be referred to by their actual age (age at birth) and their corrected age (age they would be if they were born at full term).
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How do you calculate a preemies age?
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On admission, a gestational age assessment is performed using the Ballard Exam containing physical and Neuromuscular Criteria. The maternal prenatal history is also reviewed consisting of the estimated date of confinement and gestational age and size via prenatal ultrasound.
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When does a preemie receive immunizations?
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Unless there is some medical reason not to do so, preemies will receive their first immunizations at the age of 2 months and will then follow the standard immunizations schedule that newborns follow.
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Are parents encouraged to spend time with their infants in the NICU?
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Parents are always welcome to spend time with their infants and they are also encouraged to participate in the care of their infant as long as the infant is medically stable.
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When can parents take their preemie home? Do they have to reach a certain weight before going home or are there other factors?
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Each NICU has their own set of criteria for discharge, so parents must check with their NICU first. Usually the infant must be at least 35 weeks corrected age, weigh between 4 and 4.5 pounds, able to maintain their body temperature in an open environment (crib), able to successfully take all of their feedings by breast or bottle and they must be free of any episodes of holding their breath (apnea) or dropping their heart rates (bradycardia).
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What kind of support are the parents given when they take their preemie home?
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The infant’s medical condition at discharge could range from normal infant care to more complicated medical issues. Parental support could include medication teaching, home cardio/respiratory monitor classes, oxygen therapy instruction, respiratory treatments, modified feedings. Follow up appointments may include general pediatric visits, pediatric specialist appointments (i.e.: cardiology etc.) newborn apnea clinic, newborn follow up developmental programs. Parents are discharged from the NICU with detailed contact information for their infants needs and are encouraged to call the NICU with any general questions regarding the care of their infant after discharge.
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Are parents who have had one premature infant at risk to have another?
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Not necessarily. Most likely, it would depend upon the reason (if ever determined) the first child was premature. If the issue involved an incompetent cervix, procedures and treatments can be instituted to help prevent this from happening with subsequent pregnancies. If the issue was PIH , this may cause another premature delivery as the next pregnancy could result in increased hypertension. The only cure for PIH is to deliver the infant. This could mean delivering the infant prematurely to save the life of the mother. In any situation, women who have previously delivered a premature infant are very closely monitored with their next pregnancies to reduce the chances of delivering another premature infant.
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What are the signs of preterm labor?
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Signs could range from subtle to severe. Preterm labor is defined as irregular uterine contractions and cervical dilatation before the 37th week of gestation”. Factors such as uterine anomalies, multiple gestation, polyhydramnios, and urinary tract infections put a woman at an increased risk of preterm labor. Physically a woman may experience uterine cramping, vaginal bleeding (frank red), persistent lower back discomfort, vaginal discharge (mucus plug). However, there are instances where no physical changes are apparent to the mother, she may just claim to not feel “right”. Women should always their OB with any concerns. return to top
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At What age do preemies open their eyes?
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Premature infants usually open their eyes between 23-24 weeks of gestation. There are always exceptions, however, this is the most common time frame. return to top
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What is the difference between a preemie and a micro-preemie?
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A micro preemie usually weighs between 500-1000gms categorizing the baby as infant with ELBW (extremely low birth weight) A VLBW (very low birth weight) infant weighs between 1000-1500grams. LBW (low birth weight can be an infant weighing 1500-2000grams
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Can an infant be discharged home
while still on oxygen?
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Yes, if medically indicated.
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Do most preemies come home on monitors?
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This depends on the infant's neonatal course and status at discharge. Other factors are considered such as family history of previous monitor use.
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Are preemies more receptive to RSV
when going home?
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Yes, Infants meeting the criteria are given Synagis prior to discharge and will receive it monthly between the months of October and April during prime RSV season.
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What respiratory effects do respirators have on preemies lungs?
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They can cause barotraumas to the lungs, which could lead to Chronic Lung Disease.
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Can an infant’s eyesight be affected by
being premature?
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Yes, premature infants have immature eyes. They will usually receive an initial eye exam at 6 weeks of age to check for r retinopathy of prematurity. They will be followed regularly by the pediatric ophthalmologist during their hospitalization and if necessary, after discharge.
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What is the purpose of the isolette covers?
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Isolette covers provide light shielding, enhance diurnal rhythm, help to muffle sound and act as an additional barrier for heat loss.
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Do preemies have an increased sensitivity to their faces after being released from the hospital due to all the tubes?
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Sometimes infants will have some oral aversions where they have difficulty bottle-feeding and have an increased sensitivity to different textures that may cause gagging. These infants may need some speech or occupational therapy in the future.
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for educational and informational purposes, and is not meant to
supplement or replace medical advice of professionals familiar with your
specific condition. The statements of the professionals on this website
are only their opinions based upon the information you have provided to
them. You should consult with your own physician or other medical
professional regarding the applicability of any of the opinions or
recommendations expressed herein with respect to your own symptoms or
medical conditions.
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