By Luna 
The early arrival of a baby can bring joy, but it also comes with unique challenges. Premature babies, born before 37 weeks of gestation, often face a host of health issues due to their physical and physiological immaturity. From breathing difficulties to feeding issues, these little ones face hurdles that can feel overwhelming for new parents. But with the right support and medical care, many of these conditions can be managed, helping preterm babies grow stronger each day. We spoke to our expert Dr C Sai Narasimha Reddy, Consultant – Paediatrician and Neonatologist, Gleneagles BGS, Hospital Kengeri, Bengaluru, who explained the common conditions that affect these babies and their treatment measures.
In India, the incidence of preterm births varies, with around 14.5% occurring in health facilities and 9.8% in community settings, said Dr Reddy. According to the World Health Organization (WHO), complications from preterm births were the leading cause of death among children under 5 in 2019, accounting for around nine lakh fatalities.
Premature babies can be categorised based on their gestational age:
- Extreme preterm: Born before 28 weeks
- Very preterm: Born before 32 weeks
- Moderate preterm: Born between 32 and 34 weeks of gestation
- Late preterm: Born between 34 and 37 weeks
Common Conditions In Preterm Babies and Their Management
1. Inability to Maintain Body Temperature
“Premature babies often struggle to regulate their body temperature due to their less mature skin and low body fat. This inability can lead to hypothermia, which is dangerous for their fragile systems,” said Dr Reddy.
Management
Preterm babies are often placed in incubators or radiant warmers to maintain body temperature. Proper clothing and environmental control also help provide the necessary warmth.
2. Respiratory Distress Syndrome (RDS)
RDS is a common condition in premature babies, particularly in those born before 34 weeks. The immature lungs of these babies do not produce enough surfactant, a substance critical for keeping the lungs expanded.
Management
Advances in neonatal care have improved outcomes for babies with RDS. Key treatments include:
- Antenatal corticosteroids (ANS): Administered to mothers before birth to accelerate lung maturity in the foetus.
- Surfactant therapy: Direct administration of surfactant into the lungs to improve respiratory function.
- Respiratory support: Techniques, such as Continuous Positive Airway Pressure (CPAP) or mechanical ventilation help maintain adequate oxygen levels.
3. Sepsis (Infection)
“Premature babies are at higher risk for infections due to their immature immune systems and the various stressors they face in the Neonatal Intensive Care Unit (NICU). Infections can stem from maternal sources or be introduced through frequent handling and invasive procedures,” added Dr Reddy.
Management
To control infections, strict hygiene protocols are essential, including frequent hand washing and the use of incubators. If an infection is suspected, blood cultures guide appropriate antibiotic therapy. Additional complications like hypoglycemia or apnoea may also be addressed during treatment.
4. Nutrition and Feeding Issues
Very premature babies often struggle with feeding due to incoordination in sucking and swallowing, along with an underdeveloped gastrointestinal tract.
Management
“Initially, these babies receive nutrients through intravenous feeding known as Total Parenteral Nutrition (TPN). As they grow and their ability to suck and swallow improves, they may transition to tube feeding with breast milk. Eventually, direct breastfeeding or spoon-feeding can be introduced as the baby matures,” said Dr Reddy.
5. Hyperbilirubinemia (Jaundice)
Jaundice is common in premature babies, typically peaking between 3-7 days after birth. This condition results in yellowing of the skin due to elevated bilirubin levels.
Management
Treatment for jaundice often involves phototherapy, where the baby is placed under special blue lights that help break down bilirubin in the skin. The baby’s eyes are covered to protect them from the light.
Bottomline
Dr Reddy concluded, “Due to their underdeveloped systems, premature babies are at risk for several health conditions. Understanding these conditions, such as the inability to maintain body temperature, respiratory distress syndrome, infections, feeding issues, and jaundice is vital for effective management and care. Healthcare providers can significantly improve the outcomes for these vulnerable babies, ensuring they receive the support they need to thrive by implementing appropriate treatments and interventions.”
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your own professional if you are dealing with any health issues to avoid complications.]