Having a premature baby
Having a premature baby means giving birth to your child before the 37-week mark of your pregnancy.
Health risks depend on just how early a baby is born – the earlier it arrives, the more at risk a child is. Those born before week 26 are at the most risk.
Giving birth to a premmie baby
Without doubt, giving birth is one of the most challenging aspects of a woman’s life. It doesn’t always go to plan and it’s best to try and be as best prepared for and aware of all the different things that can happen on the day – however early that may be.
Babies born prematurely generally spend extended periods of time in hospital care. Mothers, fathers, and siblings – all members of families – will have to orientate their lives around the baby unit in hospital. The duration of a premmie baby’s hospital stay depends on its gestational age.
Gestational age: A baby’s gestational age is the age of your baby on the day of their birth. So it is the number of weeks your baby has been in your womb since conception – for example a baby conceived on January 1 and born on July 1 has a gestational age of about 25 weeks.
For this to be as accurate as possible, you need to remember the dates of your last period, have a regular 28-day period cycle and have ovulated half way though the cycle.
For obvious reasons this does not always happen or is not possible. In these scenarios, doctors will use your ultrasound results to determine your child’s gestational age.
Some women have advance warning that their babies are coming early and can prepare for the birth and think about a birth plan and potential pain relief options. The most common are options such as:
Transcutaneous electrical nerve stimulation (TENS) machines;
Mixtures of oxygen and nitrous oxide gas (also known as Entonox);
Standard pethidine injections – although these are not as frequently used for premature births;
Epidurals; and,
General anaesthetic (for caesarean deliveries).
What are the signs or preterm labour?
Many women can confuse early labour with other things, so it is important to be aware of the particular symptoms and know when to call someone. It goes without saying that women who go into early labour are, more often than not, not expecting it to happen.
Did you know? Less than 20 per cent of cases of suspected premature labour actually result in the baby being born.
If you are concerned, the safest thing to do is to call your hospital or doctor immediately for advice on how to proceed. If you do fall into the under 37-week category, you will be told to go straight to hospital.
This tiny early bird is all decked-out, from romper to beanie.
Symptoms include:
A slow trickle or gush of clear/pinkish fluid from your vagina – this is a sign of Preterm premature rupture of the membranes or PPROM;
An increase in vaginal discharge;
Backache;
Strong cramps, which feel like period pains;
A need to urinate a lot;
A feeling of pressure in your pelvis; and,
Nausea, vomiting or diarrhoea.
Keep in mind that contractions alone do not necessarily mean that you are entering early labour. There is such a thing as ‘Braxton Hicks’, which are also known as practice contractions. It’s very easy to mistake these for the real thing, because they can be quite strong and painful – pretty much identical to proper contractions.
If you have PPROM, it does not guarantee that you will have to give birth prematurely. Sometimes, if you are not having contractions as well and your baby is otherwise healthy, doctors can treat you with antibiotics to prevent infection and continue the pregnancy for longer.
Premature labour is usually different to full-term labour. Firstly because it can start naturally or be induced, and secondly because it can be much faster and shorter in total duration. Sometimes natural birth is not an option for mothers delivering prematurely, and a C-section is the preferred or only option.
Percentage survival rate for babies born prematurely, based on week of pregnancy they are born.
What will my premature baby look like?
Giving birth to a premmie baby is a rollercoaster event in itself, but especially for first-time premmie mums, the first time seeing their child is a very emotional time, and can also be very confronting.
For some mums, early bonding with their babies can be difficult – especially if their baby needs to stay in an incubator. Newborn premature babies do not look like the babies you see on television, and they don’t look like full-term babies. They usually have red skin and can be covered in very fine hair – almost like a down. These do go away with time, because your baby still has a fair bit of growing to do until it reaches a full, healthy size.
Getting used to the baby unit
Depending on the gestational age of your baby, it could mean days, weeks and possibly months spent in between units. Parents are usually allowed to visit their babies almost 24 hours a day, but there are set periods where the rooms must be cleared. This usually occurs when the nurses change shift. The newborns spend basically all of their time in these units – and when they have to sleep, the room surrounding needs to be a quiet area.
Do different units denote different levels of care? In short, yes. The three different types of special care units are all required at different stages of premature babies’ lives.
The SCBU provides the simplest level of care for babies. It’s all conducted in their own area and aimed to stabilise a baby’s condition before they are transferred to another unit or emergency care.
The LNU provides special care for babies in their own area, unless they are extremely unwell and need more complex and long-term intensive care. Most babies over 27 weeks will receive their care in an LNU.
The NICU is a specialist unit that provides the highest level of care for babies that are critically ill.
Hygiene is extremely important within all of these units and with babies in general. Premature babies are especially vulnerable to infection, as their immune systems are not fully developed. This means all visitors and parents need to wash their hands every time they enter the unit. Unfortunately if you have a cold, you will not be allowed to visit.
Most hospital facilities will have overnight accommodation for parents, as understandably most parents want to be with their child for most of the day.
New parents eventually learn not to be afraid of the humming, beeping and flashing of the baby units – all of these quirks of the equipment are working to keep your child healthy. Baby units are made up of:
Earlybirds owner Lynda Day and son Jackson at 30 weeks.
An incubator;
An overhead heater;
Monitors;
An ambient oxygen analyser;
An intravenous (IV) drip;
A feeding pump and tubes;
Power supply; and,
A ventilator monitor and a ventilator.
They all work together to help your baby breathe, remain nourished and stay warm, because these are the things that most premature babies struggle to do on their own. Hopefully your baby reaches a point where they can do all of this on their own and it is at this point where your little (or big) family is ready to go home!
Bringing your premmie baby home
The most important thing is: don’t be afraid. Despite what you think, taking your baby home is fantastic for both you and your baby. It can help with bonding and feeding and reduce the risk of infection.
Remember the doctors and nurses would not let you take your premmie home unless they were absolutely certain everyone involved was ready – especially your little one.
There is a massive support network available for mothers who are new at home with their premature babies. From midwifes, health visitors and neonatal nurses to your GP, there is a plethora of help available, so you should never feel alone. If you have been discharged and allowed to take your child home, but still need help (especially if your baby still requires some machinery day-to-day) the hospital will assign a health visitor to your premmie baby that will come to your house to help and check up regularly.
It’s actually very common for premature babies to go home still on oxygen. Some children can still be on oxygen support for months, even years after. This is called oxygen therapy and your baby will only be considered for it if:
Your baby’s oxygen needs are stable.
Your baby has not displayed symptoms of sleep apnoea for at least two weeks.
Your baby can cope with short periods without oxygen if required.
Your baby is otherwise medically stable.
Your home is suitable and you have a reliable phone; and,
You have told your home and car insurers.
Temperature is another key focus for premmie babies that are newly at home. Usually the best way to do this is through layers of clothing, because premmie babies can get cold very quickly.
You also need to be aware of sudden infant death syndrome (SIDS), which occurs to apparently healthy babies during their sleep. Unfortunately premmie babies are at risk for slightly longer compared with full-time babies. Some tips to reduce the risk of SIDS are:
Lay your baby on their back, with their feet facing towards the end of the crib.
Use lightweight blankets and keep bedding away from the baby’s face.
Do not smoke inside.
Keep your baby in its own crib in your room for the first six months.
Don’t fall asleep with your baby on the couch or on your bed.
Make sure your baby doesn’t sleep near heaters and in direct sunlight.
How to wash your premature baby
Earlybirds little booties are a lovely addition to keep tiny feet warm and snug.
Plain water is the best method of washing the majority of premature babies for the first few months, as their skin often can’t handle anything stronger. Even when changing a nappy – you should use water and some cotton wool.
It’s also common for premmie babies to have extremely dry skin, but before you use any kind of moisturiser you have to consult your midwife to make sure it is safe for your baby’s skin. As your baby gets older, it may then be OK to introduce moisturisers.
Always remember to dry your baby off very quickly after any form of bathing, as premature babies do lose body heat very fast.
Adjusting to life after a premature birth
There is no easy fix or method of getting back to normal life after giving birth prematurely. Most of the time, a premature birth does change your life – and that is the reality of it. Unfortunately not all of the wonderful babies will survive, but do know that no matter how short a person’s life, they are all cherished and they have all left their footprint on the world.
You need to take time to slowly adjust, cope with emotions and even learn to live with things such as post-natal depression. The unfortunate reality is that premature birth is, and will always be, a traumatic experience.
What to buy – the ideal premature baby shopping list
Rock and play sleeper: to help your baby get to sleep.
Hands free bra: for breast pumping.
Breast pump, pumping parts and supplies.
BPA-free baby bottles with premmie nipples.
Medela nipple cream.
Premmie and newborn sized onesies and snap sleepers.
Sleep sound machine.
Lots of hats: premmie babies lose a lot of a heat through their heads.
Deep freezer: if you’re producing good milk, you’ll probably have a lot extra in the first few weeks as premmies have small appetites.
An appropriately-sized car seat.
Digital room thermometer.
A big, soft and breathable shirt for you: so bub and mum can stay close together.
A baby scale
There’s definitely support out there
The journey and experience of having a premature baby – no matter how long or short – is a trying time with many ups and down. Many mums and bubs, plus surrounding family, will feel alone at times. The important thing is to remember that there are many support networks available for advice, guidance, and general support.
These networks can make up the basis of life-long friendships for not only yourself, but also your baby. Being introduced to mothers group and the like can help you to realise that there are people out there going through very similar experiences.
Here are some great places to look for support:
Life’s Little Treasures Foundation: Australia’s leading charity dedicated to providing support, friendship and information, specifically tailored for families of children born premature or sick. Visit lifeslittletreasures.org.au or phone their 24 hour support line 1300 697 736.
Austprem: An incorporated, non-profit organization in Australia aiming Aims to support parents and caregivers of other premature infants and children. Visit austprem.org.au.
L’il Aussie Prems Foundation: A charity providing support and services to families of premature and sick newborns online and in the community, raising awareness of premature birth, providing equipment to Australian NICU/SCN’s and awarding selfless volunteers who make a difference each year. Visit lilaussieprems.com.au.
National Premmie Foundation: The peak body in Australia for charitable organisations that operate to provide support to families who experiences premature birth or neonatal loss. Visit prembaby.org.au.
Preterm Infants’ Parents’ Association: providing support networks for families dealing with premature birth in Queensland and New South Wales. Visit pipa.org.au.
Miracle Babies Foundation: Australia’s leading organisation supporting premature and sick newborns, their families and the hospitals that care for them. Visit: miraclebabies.org.au, or phone their 24 hour support line 1300 622 243.
Yasminah’s Gift Of Hope: Raising the importance of awareness and support within the community about miscarriage, premature birth, neonatal loss, stillbirth, infancy loss and congenital abnormalities. Visit ygoh.org.au.
Tiny Sparks WA: Not-for-profit charity run by local volunteer families, dedicated to improving the health and well-being of mothers enduring high-risk pregnancies, newborns requiring the neonatal intensive care unit (NICU) or special care nursery (SCN), and the communities supporting them in Western Australia. Visit tinysparkswa.org.au.
References:
PEARLS Heart Research Institute. Visit www.preeclampsia.org.au.
Australian Action on Pre Eclampsia. Visit www.aapec.org.au.
Tommy’s. Visit www.tommys.org.
Better Health Channel. Visit www.betterhealth.vic.gov.au.
The Royal Women’s Hospital. Visit www.thewomens.org.au.