health Short-term complications during stay in Neonatal Unit The more premature your baby is at delivery, the more assistance he/she will be needing. That could mean that the first time you meet your baby it might have some medical devices attached to him/ her which could look very intimidating. This is however to make sure that your baby’s vital signs get monitored accurately and that your baby gets the necessary supportive treatment. These attachments could include intravenous lines, nasogastric feeding tubes, saturation monitors, ECG leads, temperature monitors, breathing devices, etc. In the first weeks, the complications of premature birth may include: Immediate breathing problems – when a preterm delivery is anticipated, you will in most cases receive antenatal steroid injections to help mature your baby’s lungs. Despite this, premature babies often have difficulty in breathing due to an immature respiratory system. Your baby may need breathing support- nasal cannula oxygen, HiFlow oxygen, CPAP or ventilation. Apnea – is also common in preterm babies. Your baby will stop breathing for a few seconds and then start again. Bronchopulmonary dysplasia – very premature babies can develop a lung disorder known as bronchopulmonary dysplasia, where they remain oxygen dependent for more than a month. In exceptional cases they might even get discharged home on oxygen support. Heart problems – the most common heart problem premature babies experience is a patent ductus arteriosus (PDA). PDA is a persistent opening between the aorta and pulmonary artery. While this heart defect often closes on its
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own, left untreated it can lead to a heart murmur, heart failure as well as other complications. Brain problems – the more preterm your baby is born, the greater the risk of bleeding in the brain. This is known as an intraventricular haemorrhage. Most haemorrhages are mild and resolve with little short-term implications. Some babies may have larger brain bleeding that causes permanent brain injury. The size of the bleed does not necessarily predict the neurological outcome.
Premature babies are at risk of blood problems such as anaemia and neonatal jaundice. Temperature control problems – premature babies’ skin is still underdeveloped and relative to their weight they have a significantly bigger body surface area. They can lose body heat rapidly. They don't have the stored body fat of a full-term infant, and they can't generate enough heat to counteract what is lost. Hypothermia in a premature baby can lead to breathing problems and low blood sugar levels. In addition, a premature infant may use up all of the energy gained from feedings just to stay warm. That is why smaller premature infants require additional heat from a warmer or an incubator until they're larger and able to maintain body temperature without assistance. Gastrointestinal problems – premature infants are more likely to have immature
gastrointestinal systems, resulting in complications such as necrotizing enterocolitis (NEC). This potentially serious condition, in which the cell lining of the bowel wall is injured, can occur in premature babies after they start feeding. Premature babies who receive only breast milk have a much lower risk of developing NEC. Blood problems – premature babies are at risk of blood problems such as anaemia and neonatal jaundice. Anaemia is a common condition in which the body doesn't have enough red blood cells. While all newborns experience a slow drop in red blood cell count during the first months of life, the decrease may be greater in premature babies. For this reason, they might need a blood transfusion (mostly the very premature infants) or be started on iron supplementation. Newborn jaundice is a yellow discoloration of your baby's skin and eyes that occurs because the baby's blood contains excess bilirubin, a yellow-coloured substance, from the liver or red blood cells. While there are many causes of jaundice, it is more common in preterm babies, and they might need phototherapy for a few days Metabolic problems – premature babies often have problems with their metabolism. Some premature babies may develop an abnormally low level of blood sugar (hypoglycaemia). This can happen because premature infants typically have less brown fat than full-term babies. Premature babies also have more difficulty converting their stored glucose into more-usable, active forms of glucose. Immune system problems – an underdeveloped immune system can lead to a higher risk of infection. Infection in a premature baby can quickly spread to the bloodstream, causing sepsis and needing intravenous antibiotics. www.babysandbeyond.co.za