Degrees of prematurity and what they mean
Prematurity is assessed primarily by the gestational age at the time of delivery, and not just by weight. Babies born between 34 and 36 weeks often require only short-term support and supervision. At birth at 32–33 weeks, assistance with feeding and maintaining temperature is usually required. Babies born at 28–31 weeks, and especially those born before 28 weeks, require long-term nursing, breathing support and special nutrition. Birth weight completes the picture, but two babies of the same weight and at different ages can be very different in maturity.
- Late preterm - 34–36 weeks
- Moderate prematurity - 32–33 weeks
- Severe prematurity - 28–31 weeks
- Deep prematurity - up to 28 weeks
- Birth weight complements, but does not replace, term
What happens in the first weeks
The main tasks of nursing are warmth, breathing, nutrition and infection prevention. The child is placed in an incubator where the required temperature and humidity are maintained. If the lungs are immature, breathing support is used and, if necessary, drugs are administered to help the lungs expand. Feeding begins carefully: first through a tube in small portions, gradually increasing the volume, and then proceeds to sucking on the breast or bottle. Breast milk plays a huge role, reducing the risk of severe intestinal complications. Kangaroo care—skin-to-skin contact with the parent—helps the baby retain warmth, gain weight better, and start nursing earlier.
- Couvez and temperature control
- Breathing support on demand
- Feeding through a tube with a gradual transition to sucking
- Priority of mother's milk
- Kangaroo care and parental involvement
- Strict infection control
- Weight, glucose and bilirubin control
Adjusted age
This is a key concept for parents. To understand what to expect from a child, the number of weeks missing to 40 is subtracted from his actual age. For example, a baby is three months old, but he was born eight weeks premature: his corrected age is about one month, and his smile, head holding and other skills need to be assessed based on this. This amendment is used for approximately two years, sometimes longer. Understanding this relieves unnecessary anxiety and helps not to compare the child with peers born on time.
- Adjusted age = actual minus weeks of prematurity
- Used in skills and development assessments
- Can be used up to approximately 2 years
- Vaccinations are given according to actual age, unless the doctor decides otherwise.
- Comparison with peers without correction is incorrect
Post-discharge follow-up
A premature baby needs more frequent examinations than a full-term baby. The pediatrician monitors weight gain, height and head circumference, and evaluates feeding. The neurologist observes the development and muscle tone and, if necessary, prescribes repeated neurosonography. Particular attention is paid to the eyes: children born much prematurely are required to have their fundus examined at certain times in order to promptly detect retinopathy of prematurity, which can only be treated at an early stage. They check your hearing and, if necessary, consult with a cardiologist and orthopedist. Vaccinations are usually carried out according to actual age, the schedule is specified by the doctor.
- Regular examinations by a pediatrician with control of gains
- Observation by a neurologist and neurosonography
- Ophthalmic screening for retinopathy at scheduled times
- Hearing test
- Consultations with a cardiologist and orthopedist according to indications
- Vaccination according to an individual schedule
- Control of hemoglobin and iron metabolism
At home: feeding, care, infection prevention
It is important to maintain a comfortable temperature at home, avoid overheating and drafts, feed according to the regimen recommended by the doctor, and monitor weight gain. Breast milk remains the best nutrition; in case of deficiency, special formulas for premature infants are used as prescribed by a doctor. Infections are more dangerous for such children, so in the first months it is worth limiting visits from guests, not visiting crowded places, washing hands for all family members and not smoking in the house. A calm daily routine, limiting bright light and noise, and skin-to-skin contact are helpful. If you have any doubts about the child’s well-being, it is better to show him to the pediatrician than to wait.
- Comfortable temperature, no overheating
- Feeding according to the recommended scheme, weight control
- Breast milk or special formula as prescribed by your doctor
- Limiting contact during cold season
- Hand washing, no smoking in the house
- Calm mode, skin to skin contact
- Early consultation with a doctor if there are warning signs