Premature baby with low weight. All stages of development of a premature baby occur somewhat later. Caring for a premature baby at home

Every mother is always eager to look at the miracle that has been hidden in her belly for nine months. However, sometimes she can see hers much earlier. Childbirth ahead of schedule, that is, those that occur before 37 occur for various reasons, sometimes even unidentified. If the child survives, then he is considered premature or. People affectionately call such people “hurry-ups.” The characteristics of premature babies and the possible consequences for their development in the future will be discussed in our article.

Premature babies: features

A premature baby is considered to be a child who came into this world before the 37th week, with a body weight from 1 kg to 2.5 kg, with underdeveloped systems and organs. Babies weighing less than 1 kg are considered extremely premature.

Typically, such children cannot breathe on their own - due to the immaturity of the lungs, eat - due to unformed sucking and swallowing reflexes, they are weak, and they have practically no subcutaneous fat layer.

The success of survival and the absence of future health problems depends on the period at which the baby was born, on the quality of medical care provided in the first hours after, and on the availability.

Nursing of such babies takes place in special conditions. Did you know?

The world's smallest baby to survive was born in 2006 in the United States. The girl, born at 22 weeks and six days, was named Taylor. Her body weight at birth was 284 g, height - 24 cm. Three months spent in the hospital after birth, she was able to go home weighing more than 2 kg.

Classification The degree of underdevelopment in each child may be different. Depending on the degree of underdevelopment, body weight and gestational age, four degrees of prematurity are classified..

The main criterion is the weight of the baby.

First degree

The diagnosis of “prematurity of the first degree” is made if the baby was born between the 35th and 37th weeks with a weight of 2.1 to 2.5 kg.

Second degree

Babies of the second degree of prematurity are born at 32 weeks of pregnancy with a weight of 1.51-2 kg.

Third degree

Extremely premature babies are born between the 29th and 31st weeks. In the medical card they are given the diagnosis “degree of prematurity - third.”

Children born at less than 28 weeks with a critically low weight, less than one kilo, are assigned a fourth degree.

Nursing of such babies takes place in special conditions. In the medical records of babies, the gestational age is most often prescribed, and not the degree of prematurity.

Today, the survival rate of children born with low body weight in countries with developed medicine is 96%, with critically low birth weight (less than 1 kg) - 90%.

What does a baby look like: anatomical and physiological signs

The anatomical and physiological characteristics of a premature baby will vary depending on the degree of underdevelopment.

“Toropyzhki” look very small and fragile. Some of them can easily fit in the palm of an adult. They scream weakly, move slowly, and often cannot breathe, eat, or defecate on their own. During sleep, they may grimace and tremble violently.

Usually a baby born weighing less than 1.5 kg has thin and wrinkled skin of a dark red color. The entire body may be covered with fuzz and grease. The size of the head is equal to one third of the entire length of the body. At the same time, the arms and legs look short.

The sutures of the skull are not overgrown, just like the large and small fontanelles. The navel is low. In boys, the testicles are absent from the scrotum; in girls, the labia are not fully formed. The nipples are practically not expressed. Nails, eyebrows and eyelashes may be missing. Babies born at the 33rd week or later already have pink skin without fluff, a head measuring ¼ of the body length, and a normally located navel. In boys, the testicles are located in front of the entrance to the scrotum. The genital slit in girls is almost closed.

• Premature babies are born with abnormalities that affect the respiratory, cardiovascular, endocrine, digestive, central nervous systems, brain, kidneys, muscles, eyes. A number of similar deviations can be identified: Respiratory system
  • . Most children have an incompletely formed respiratory system - newborns are diagnosed with narrow passages in the upper respiratory tract, a high location of the diaphragm, and compliance of the sternum. Because of this, their breathing is weak, rapid and shallow.
  • The following respiratory problems are common for such babies:
  • sudden short-term cessation of breathing;

• pneumonia; respiratory distress syndrome. The cardiovascular system heart (open foramen ovale and Botall's duct), hemorrhages in the brain, other internal organs, anemia.

• Gastrointestinal tract Almost all parts of the gastrointestinal tract in a prematurely born child are not fully formed. They may experience frequent regurgitation, flatulence, and dysbacteriosis.

• Endocrine system. Newborn babies suffer from impaired excretion and hypothyroidism.

• Liver, kidneys. From these bodies You may experience problems such as:
  • bilirubin encephalopathy;
  • disturbances in electrolyte balance;
  • swelling;
  • dehydration.

• Organs of vision. Many newborns have strabismus (persistent or short-term), retinal detachment, and retinopathy.

Causes of prematurity

Childbirth ahead of schedule can be provoked by several factors:

• socio-biological (a very young or elderly couple; unhealthy lifestyle of parents; ignoring preventive medical examinations and registration with antenatal clinic; work associated with contact with harmful emissions, heavy physical activity);
• in the anamnesis;
• the difference between children is less than two years;
• health problems in the expectant mother;
• complications ;
• improper development of organs responsible for bearing a baby;
• by using .

Is it possible to diagnose a deviation in the womb?

Often premature birth occurs due to premature aging placenta, development (late). Therefore, it is important to undergo routine checks to identify the problem in a timely manner.

Increased activity of the fetus in the womb may indicate oxygen starvation. Therefore, if the mother feels that the child is too mobile, this is a reason to seek advice from a gynecologist.

An ultrasound specialist can also tell you that a child is not gaining weight well or is lagging behind the norm in this indicator. scheduled inspection. A gynecologist may suspect fetal growth retardation when monthly weighing a pregnant woman and measuring her abdominal circumference. The woman will gain poorly or not gain it at all, and her belly will stop growing.

Features of caring for premature babies

Immature babies demand special care and conditions for ripening. If the baby can breathe on his own, then he and his mother are admitted to the neonatal pathology department, where the child is carefully examined, and if there are no problems, he is kept in a medical facility under observation until he gains 2.5 kg.

• weight gain of at least 2.5 kg;
• persistent sucking reflex;
• absence of serious illnesses requiring hospital treatment.

At home

After discharge infant from the emergency department, he, like his other peers, will be observed by a local pediatrician. He will also undergo regular examinations by a neurologist, ophthalmologist, cardiologist, urologist, gynecologist, surgeon, and orthopedist. Before the fontanel is completely overgrown, you will need to undergo an ultrasound of the brain.

Usually, minor deviations in the form of mild, non-critical heart defects, retinopathy, with appropriate therapy, go away in a child by the age of three. If there are problems with the eyes of the child, he will be registered with an ophthalmologist, whom he will be forced to visit regularly until his visual acuity is determined. Physiotherapeutic treatment for myopia, glaucoma, astigmatism, and optic nerve atrophy. As a rule, premature babies with extremely low body weight have many more health problems than those born with a weight close to a normal baby.

If you look at the statistics, the frequency of cerebral palsy diagnosed in two-year-old children in prematurely born babies is 14-16%, while in all newborns this figure is 0.5%.

Premature babies constitute a group at high risk of developing abnormalities in mental development. Approximately 60% have neurological and sensorineural problems. These children are more susceptible to viral diseases. Girls who are born prematurely may have problems with pregnancy in the future.

menstrual cycle

, conception and bearing offspring.

Modern medicine has successfully learned to save and care for almost all premature babies. With proper medical care and further care provided in the first hours of life, the prognosis for the baby is generally positive. In terms of body weight and length, some “rushers” catch up with their mature peers by the age of one year, but most often this happens by the age of two or three years.

Alignment in terms of psychomotor and speech occurs depending on what stage of prematurity the child was diagnosed with and what abnormalities were diagnosed with him. Most often this happens for about two years, but it can take up to five or six. In the future, premature babies are no different from the same age. However, it should be noted that there is a large percentage of “hurry people” who remain disabled for life. According to statistics, about a third of cases end this way., as well as the health status of the expectant mother, her obstetric history. Newborn premature babies, regardless of the degree of underdevelopment, need special care, especially in the first weeks of life.

Who are premature babies?

A baby born between 22 and 37 weeks of pregnancy, weighing from 500 to 2500 grams and body length from 27 to 45 cm is considered premature. Such children differ from full-term newborns in the incompetence and immaturity of almost all systems and organs of the body, as a result of which special care is required for premature infants.

Signs of prematurity

The main clinical external signs of an immature newborn include disproportionate body build, open fontanels (lateral and small) of the skull, undeveloped fatty tissue or its complete absence, hyperemia skin, underdevelopment of the external and internal genital organs, physiological reflexes characteristic of full-term peers. In severe cases, apnea, weakness or absence of muscle tone.

Anatomical and physiological characteristics of the child

Depending on the severity, a baby who was born prematurely has the following anatomical and physiological features:

1. The cardiovascular system is characterized by the presence of tachycardia (150-180 beats/min), muffled tones, and functional hypotension of the newborn. In grades three and four, cardiac septal defects (patent foramen ovale) are often present.
2. Respiratory system. Premature infants have narrow upper respiratory tracts and a high diaphragm, which leads to apnea and respiratory failure. Children with third and fourth degrees of prematurity long time are on artificial ventilation, because organs are not mature and cannot perform their function.
3. Skin and subcutaneous tissue. In newborns born prematurely, subcutaneous fat is almost completely absent, sweat and sebaceous glands do not function, as a result of which the body is not able to independently regulate body temperature.
4. Gastrointestinal tract. In premature infants, there is functional insufficiency of all parts of the gastrointestinal tract, low enzymatic activity of the pancreas and stomach.
5. Excretory system. Immaturity of the urinary system leads to an imbalance in the electrolyte balance in the body, decompensated metabolic acidosis and a tendency to edema and rapid dehydration.

Causes of prematurity

Statistically, there are several groups of risk factors, in the presence of which women have a high risk of giving birth to a baby prematurely:

1. Socio-biological factors. It is assumed that it is too early or late pregnancy(parents' age is less than 16-18 or more than 40-45 years), availability bad habits the woman has bad living conditions, presence of occupational hazards. In addition, the risk of having a premature baby is higher for those girls who are not observed in the antenatal clinic during pregnancy.
2. Unfavorable obstetric and gynecological history and pathological course current or past pregnancy. This includes a history of abortions, miscarriages, multiple births, placental abruption, etc. High risks premature birth may occur in women whose birth interval is less than two years.
3. Chronic extragenital diseases of the mother: hypertension, endocrine disorders, chronic infections.

Degrees of prematurity

Clinical classification according to the ICD of premature infants according to three criteria (weight, height, gestational age) involves four degrees of severity:

1. The first degree of prematurity is assigned to the baby if delivery occurs at 36-37 weeks of pregnancy; the weight is at least 2000 g, and the body length is from 41 cm. In this case, it is observed spontaneous breathing, opportunity breastfeeding. However, the baby needs observation by a pediatrician and control of body thermoregulation.
2. The second degree of prematurity is assigned to a baby who was born at a period of 32 to 35 weeks, weighing from 1501 to 2000 g, and height from 36 to 40 cm. As a rule, such babies have a weak sucking reflex, so the baby has to be fed using a tube with special mixtures, there is low muscle tone, immaturity of the respiratory system.
3. The third degree in children born between 28 and 31 weeks of pregnancy, body weight ranges from 1001 to 1500 g, and height from 30 to 35 cm. Such babies are considered very premature and require intensive care under the supervision of doctors. The baby is in a closed incubator, feeding breast milk or the mixture is administered through a probe due to the complete absence of the sucking reflex.
4. The fourth degree of prematurity is assigned at birth earlier than 28 weeks from the start of pregnancy, body weight is less than 1000 g, body length is less than 30 cm. In relation to such children, the term “extremely low body weight newborns” is used in neonatology.

Weight of a premature baby by month

The body weight of a premature baby increases maximum in the first six months of life (from 500 to 700 grams per month). By the end of the first year, the weight of a healthy newborn should be 9-10 kg. The rate of weight gain depends on the degree of miscarriage, concomitant diseases, congenital pathologies of organs and systems, and, especially, on the type of nutrition of the baby.

Age, months	Average weight of a child at various degrees of prematurity, grams

Development of premature babies by month

Modern medicine cannot accurately draw the line between the consequences of prematurity and pathological conditions, which occur in a baby born prematurely. The frequency of neurological, mental and physical disorders is due to the harmful effects of the internatal period, their negative impact on the immature central nervous system. However, as babies grow and develop, birth defects are corrected. The table shows the development of a premature baby by month up to a year.

Premature age	Neuropsychic development
1-3 months	During the first three months of life, the baby experiences increased drowsiness, rare, weak crying, lack of periods of activity, and decreased appetite. Children who were born with a body weight of more than 2000 grams, in the second month of life, are actively awake after feeding, actively sucking breast milk a lot.
4-6 months	At the age of 4-6 months, the premature baby further develops the functionality of the analyzer organs (the newborn looks for an object by sound, looks at bright, colorful toys), manipulates objects (first they feel, grabs hanging toys), and begins to rest their feet. During this period, the baby lies on his stomach for a long time, responds to the parents’ voice with a long smile, and actively moves his arms and legs.
7-9 months	During this period, the baby develops the first speech reactions (he hums for a long time, pronounces individual simple syllables). He rolls over from his back to his stomach and vice versa, trying to crawl. While awake, the child plays with toys a lot, examines them, taps them, and holds them in his hands for a long time. Children begin to eat from a spoon and drink from a cup held by an adult.
10-12 months	At the age of 10 to 12 months, the baby actively crawls, can sit down on his own, and stands up to the barrier with support. As a rule, he walks freely, slightly holding on to objects. Children react to adults’ speech addressed to them, babble a lot, coo themselves, and begin to pronounce simple monosyllabic words.

Survival rate of premature babies by week

The chances of survival of a baby born prematurely depend directly on how many weeks it has been developing in the womb. According to the World Health Organization, a fetus is considered viable if it is born no earlier than 22-23 weeks and weighs at least 500 grams. The survival rate at this period is only 10-12%. Those born at 25-28 weeks recover in 60-70% of cases; at 29-30 weeks this figure is already 90%. Babies born at 31 weeks or older have a 95% survival rate.

What are the dangers of being born before 37 weeks?

If a baby is born before 37 weeks of gestation, then he has functional immaturity of all organs and systems. Seven-month-old children typically suffer from acute respiratory failure and central nervous system failure. Such children lag behind their peers not only physically, but also mental development. In addition, underdevelopment of the excretory system can lead to the accumulation of toxins in the body and prolonged physiological jaundice.

Future consequences

The immaturity of the organs of children who are born prematurely can negatively affect their health in the future. The most common complications:

• rickets;
• heart failure;
• hydrocephalus of the brain;
• retinopathy of prematurity;
• early anemia;
• serious illnesses internal organs;
• chronic renal failure;
• psychomotor disorders;
• insufficiency of the endocrine glands.

Care of premature newborns

Nursing of children born prematurely in the maternity hospital is carried out regardless of the degree of prematurity and consists of additional heating of the newborn from the moment of birth, rational oxygen therapy, and dosed feeding. In the delivery room, the baby is immediately dried with warm, sterile diapers and immediately placed in an incubator to prevent heat loss. Premature infants weighing less than 1800 g at birth require supplemental heating for several weeks. The temperature in the room should be 24-25°C.

Bathing of children born prematurely begins every other day at two weeks of age. Weighing is carried out daily; height, head and chest circumference are measured at least once a week. Placing a premature baby on his stomach begins as early as possible, which helps increase the concentration of oxygen in the blood and helps reduce regurgitation and normalize muscle tone.

A healthy premature baby who is able to maintain normal body temperature without additional heating, is constantly gaining weight and reaches 2000 g, can be discharged home if good healing umbilical wound, normal indicators hemograms and others laboratory tests. As a rule, discharge is made no earlier than 7-9 days after birth.

Incubator

At the initial stage of nursing a premature baby, an incubator or incubator is used to maintain a constant body temperature and optimal feeding using a tube. There are several types of incubators:

1. Resuscitation. Such an incubator, in addition to heating, has a system for regulating the concentration of oxygen in the air, an ECG, an EEG, and a heart rate monitor. Thanks to modern incubators of this type in nursing departments, it is possible to carry out therapy for newborn children even with minimal vital signs at birth.
2. Transport. Necessary for transporting a newborn, incl. and at low temperatures, equipped with heating, supplied with oxygen. This incubator is lightweight due to the absence of a metal frame; the baby is secured with special belts.
3. Open. Used for nursing children of the first degree of prematurity. Helps maintain a constant body temperature for the newborn. In the absence of complications and constant weight gain, the stay in such an incubator is 7-10 days.

Features of feeding

The first feeding depends on the degree of prematurity, birth weight and general health. In the absence of severe pathologies, a premature baby receives nutrition already on the first day of life: in the first degree, feeding begins 2-3 hours after birth, placing them on the mother’s chest. For grades 2-3, feed from a special horn or tube. A premature baby of the fourth degree with low weight is fed first parenterally, then using a tube with a special mixture.

Feeding with milk or colostrum is optimal. mammary glands women, because it is characterized by a high content of essential protein, electrolytes, polyunsaturated fatty acids (linolenic acid promotes high rates of myelination and prostaglandin synthesis), low lactose content, and a huge amount of antibodies and immunoglobulins that protect newborns from infections.

Clinical examination

Premature babies should be especially carefully observed by doctors after discharge from the maternity hospital to reduce the risk of developing severe pathologies in the future, normalize the rate of weight gain in low birth weight infants when fed on artificial feeding, performance improvement physical development. Examination by a pediatrician during the first month of life is carried out 1 time per week, from 2 to 12 - 1 time per month. Consultation narrow specialists necessary only in the first month of life, after only 2 r/year. Preventive vaccinations are administered according to individual plan.

Video

If the baby is born prematurely - up to 37 weeks of pregnancy– he is considered premature.

There are several degrees of prematurity in newborns. Mild ones, as a rule, do not pose a danger to the baby’s health; severe ones require serious medical care.

Mild prematurity

If the baby is born between 32 and 36 weeks of pregnancy, modern health care allows him to avoid health problems.

Breast milk for premature babies

Full breastfeeding is not always available. Thus, premature babies, as a rule, do not have a sucking reflex - they are fed through a tube. Does not necessarily transfer the baby to artificial feeding. Pumping is the way out.

In some cases, children with mild prematurity do not have time to fully mature their lungs. They require additional assistance with breathing: artificial ventilation or supplemental oxygen in the first days of life.

Many mildly preterm babies have feeding problems. Babies born before 34-35 weeks are not able to suck on their own - they have to be fed with a tube.

Therefore, babies born at this time are forced to stay in the children's ward of a hospital or maternity hospital for several more weeks until they can begin feeding themselves.

Additionally, all premature babies may have trouble maintaining their body temperature for several weeks. In this case they are left in kuveze– a special box for newborns – to maintain optimal temperature and monitor cardiac activity and respiration.

In the future, after discharge, parents should Monitor your child's body temperature carefully. Premature babies can easily become overheated or catch a cold.

Average degree of prematurity

The child is born at 28-31 weeks of pregnancy. In children born at this time, the lungs are not yet fully mature for breathing. They usually require assistance in the form of mechanical ventilation or a constant flow of oxygen-enriched air to maintain positive airway pressure.

Most children with average degree Prematurity requires such assistance for a fairly short time.

If the child is on artificial ventilation, he is fed through an intravenous catheter. Children who breathe on their own can feed on mother's milk through a tube until they learn to suck on their own.

Severe prematurity

The baby is born before the 28th week of pregnancy. Previously, such children survived extremely rarely, but modern medicine makes it possible to care for such babies.

Almost all children born at this stage have not yet developed lungs - most of them require artificial ventilation or a flow of air enriched with oxygen.

The lungs can support respiratory functions from 22-24 weeks intrauterine development, but the alveoli, necessary for the normal absorption of oxygen, develop only at 28-30 weeks of pregnancy.

In addition, severely premature babies cannot feed themselves and maintain their body temperature. Parents of such children need to understand that the child will stay in the children's department for a long time.

What are the dangers for children being born prematurely?

Babies born before the 37th week of pregnancy may experience problems associated not only with the lack of a sucking reflex.

The shorter the period at which a child was born, the higher his risk of developing various diseases, characteristic of premature babies.

Undeveloped lungs

Pulmonary disorders pose the greatest danger. For example, newborn shortness of breath syndrome, in which the baby’s immature lungs cannot fully expand. To inhale, the child has to make significant efforts.

Such children require artificial respiration.

Stopping breathing

In premature babies, the respiratory center of the brain is not yet fully formed. If a person does not breathe quickly enough, commands from the brain stem compensate by breathing deeper.

Newborn babies, on the other hand, breathe shallowly and unevenly, and have periods of too slow breathing. If they occur too often, doctors say development of respiratory arrest, or apnea.

A baby with this disorder needs constant monitoring in the first weeks of life. As the child grows, the risk of sleep apnea decreases.

Features of the heart

During intrauterine development, a child's blood practically does not pass through his lungs due to the structural features of the heart. The fetal heart pushes blood from the right ventricle not into the pulmonary artery, but into the aorta through an opening called the ductus arteriosus.

Soon after birth in full-term babies it closes, but in premature babies it may remain open. This leads to increased stress on the lungs and heart. This condition requires medical or even surgical treatment.

Infections, metabolic problems and blindness

Infections affect premature babies more often than babies born at term. One of the reasons for this vulnerability is immaturity of the immune system, in which antibodies in the child’s blood are produced in insufficient quantities.

Also dangerous for premature babies and viral infections, which cause only mild cold symptoms in other babies.

In addition, children born prematurely may have problems with the absorption of nutrients, as well as a lack of hemoglobin associated with the low rate of formation of red blood cells - erythrocytes.

Premature babies may also develop retinal damage - retinopathy of prematurity, without early treatment leading to blindness.

That is why premature babies should remain under the supervision of neonatologists from birth until the moment when their body is ready for independent life.

The most important

A child born even before the 28th week of pregnancy can not only survive, but also over time catch up in development with full-term children.

All premature babies require careful care and medical supervision to avoid diseases caused by the immaturity of their body.

The birth of a child is a great joy in the family. And there is no need to create a tragedy if the event occurred ahead of schedule. Of course, the development of a premature baby month by month in the first years of life will differ from usual, but not in all cases this difference will be colossal.

Born prematurely

According to established tradition, children born in the 37th week or earlier of pregnancy are considered premature. The American Academy of Pediatrics has now revised this period to 39, but for now the rest of the world adheres to the previous classification.

The most common period when a premature baby is born is 7 months, which is why in everyday life such children are often called seven months old.

When determining the necessary measures aimed at preserving the life and health of the baby, they are more focused not on the time of his birth, but on the degree of development. The main criterion is weight, which does not exceed 2.5 kg. Depending on this indicator, babies born prematurely are divided into categories:

• I degree - 2 - 2.5 kg.
• II degree - 1.5 - 2 kg.
• III degree - 1 - 1.5 kg.
• IV degree - up to 1 kg.

In the first two cases they speak of moderate prematurity, in the rest - of deep and extreme prematurity.

Modern medicine has reached so high level, which can save the life of even a half-kilogram baby - but this, unfortunately, was not a triumph of science. Almost all of these children have huge health problems, and society is faced with a big moral and ethical dilemma.

In the post-Soviet space, the chances of survival appear for babies whose birth weight is at least 800 g, and with an increase in this indicator, concern for the further well-being of the baby decreases.

According to statistics, about 80% of prematurely born children have a minimum of problems and are considered practically healthy. If the weight of a premature baby is 2 kg or more, the standard vaccination schedule for him is not revised, and in general the care is not much different.

Significant differences

If you carry out comparative characteristics, it should be borne in mind that, in addition to the weight, which in a full-term baby is more than 3 kg, there are a number of other differences characteristic of children born prematurely:

1. Condition of the skin: not pink and elastic, but flabby, translucent, with a yellowish or reddish tint.

2. Almost complete absence of subcutaneous fat.

3. Poorly developed unconditioned reflexes- sucking, swallowing, etc.

4. Instead of loud demanding screams - quiet, sometimes completely silent crying.

5. “Increased shaggyness” (however, full-term babies are also born with fluff).

6. Different proportions of the body - the head is larger, the legs are shorter, the navel is not in the center of the abdomen, but closer to the womb.

Of course, the differences don't stop there external signs. An immature liver, too elastic and permeable intestines, a small volume of the stomach, insufficient secretion (digestive juices, saliva, tears) - all these invisible to the eye, but very significant features of premature babies dictate their own conditions for caring for them.

Mom, of course, is primarily interested not in the composition and quantity of enzymes, but in very specific questions: how to walk, feed, dress, bathe - in general, how to live with him?

Fur coats-warmers-blankets

With severe (less than 1.5 kg) and extreme (less than 1 kg) degree of prematurity, the child will spend the first weeks of life in the hospital, in the intensive care unit and/or intensive care unit. Body functions of a baby born on such early stage development is very limited. He cannot eat, stay warm, breathe, etc. on his own.

When the staff of the medical institution considers the baby’s condition satisfactory in order to limit himself to home care, the mother will receive the most detailed instructions on handling it. It must be said that often these instructions are somewhat contradictory - here you will have to rely on your own common sense.

First of all, you need to keep in mind that since premature babies weigh little and have no subcutaneous fat, their ability to retain heat is minimal. Such babies really need to be warmed and wrapped up at first. In the hospital, the temperature and humidity conditions are maintained in special boxes - incubators, or babies are warmed using a radiant heat source (lamp).

At home, there will be enough heating pads and blankets. The recommended air temperature in the bedroom is 25 degrees. If the child is warmly dressed and covered, and his weight has exceeded 2.5 kg, it makes sense to gradually reduce this temperature - to 20-22 degrees. The famous doctor and TV presenter E. Komarovsky generally recommends putting the child to sleep at a temperature of 16-18. For a baby who has reached 3.2 kg in weight, this is completely normal, and of course, a premature baby (7 months) should not constantly be wearing a fur coat and bathing in boiling water.

Should be given Special attention and room humidity, especially when it is warm: the hygrometer should show at least 50-60%. The salivary glands of a prematurely born baby work poorly or do not work at all, and the mucous membranes are not sufficiently developed. Nothing good can be expected from their drying out, so it is better not to allow it.

Try to establish breastfeeding

Experienced parents often laugh at their past selves: “We only had two problems: cold or hungry.” Having dealt with the first point, it would be good to resolve the issues with the second.

The global medical community has decided on the main recommendation: the best food for a newborn baby is mother's milk. Dot.

No formula, even the most expensive and “specially developed” one, can replace it, and feeding premature babies is no exception. The benefits and convenience of breastfeeding cannot be overestimated.

In matters of nutrition, insufficiency of reflexes (sucking, swallowing), general weakness and deficiencies come first. digestive system. It is extremely rare that mothers are allowed to put their premature baby to the breast immediately after birth.

Usually the first feeding of the baby occurs 4-6 hours after birth - and here it is important to assist the staff in organizing natural feeding. If there is milk in the breast, there is no need to rush to offer the newborn formula for premature babies: it is better to express and feed the mother's milk - through a tube or bottle.

In the first ten days, the required dosage of milk is calculated using Rommel’s formula: number of days of life + 10 = amount of milk per 100 g of weight. Then it will be easier: the child eats approximately one-fifth of his body weight per day.

Calm down in time

It is recommended to breastfeed a very premature baby (1.5 kg at birth) only in the third week of life. Experienced moms They will say that in most cases this is futile: a child accustomed to a bottle can “switch to his mother” only at the cost of incredible efforts, which not every woman is capable of.

The reason is that milk still needs to be extracted from the breast, and a premature baby gets tired very quickly. There is no need to despair: millions of children grew up on artificial feeding and became healthy, smart and beautiful. If the child refuses to breastfeed, pumping does not bring results, or there is no milk at all, you need to purchase a special formula for premature babies (or any other, but high-quality) and calm down on this. A calm and happy mother is much more important than any, even the most healthy food.

In the first month, prematurely born babies may not gain weight well, but then the pace increases so much that you just have to hold on: it seems that they know very well that they need to catch up. Monitor weight gain, height, circumference chest and heads are a must. To do this, it is enough to visit your local pediatrician every month. For especially nervous mothers, we can recommend purchasing (or better yet, renting) special scales. Parents will be able to weigh the baby on their own, and their souls will be calm.

Walking

A baby born prematurely is protected even more fiercely than others. It cannot be said that all the endless precautions are beneficial to both. Yes, a premature baby should not be thrown into an ice hole and kept in the cold for hours (like the most ordinary one), but some recommendations that “you can only walk with premature babies at a temperature of at least 25 degrees” look not only strange, but also irresponsible . Official pediatrics responsibly declares that a baby weighing 2.8 kg or more can easily walk in frost of no more than 10 degrees.

Local pediatricians, as a rule, are cautious: “minus five” for each month of life.

So if a premature baby was born in November, you don’t need to sit within four walls, waiting for the first spring thunderstorms - after the first fear has passed and the necessary fat layer has appeared, you need to gradually teach him to breathe fresh air - first on the balcony, 2-3 minutes, 5, 10. If it’s 5-10 degrees below zero outside, there are different solutions: organize walks on a glassed-in balcony or closely pressed to your mother’s body (there are special suits). In general, walking is useful, but staying locked up is harmful. Based on this postulate, you should plan your stay in the fresh air.

Bathing

Bathing a newborn is a necessary procedure both from the point of view of hygiene and from the point of view of hardening. In this regard, one should focus on the real development of a premature baby month by month: if it corresponds to six months of age, no matter how much it is “according to the passport”, it does not matter.

At first, children are bathed in warm water and a warm (25-28 degrees) room. For extreme and profound degrees of prematurity, boiled water is recommended during the first three months. Doctors approach this differently, but in general it won't hurt.

Hardening procedures must be present as soon as the child gains sufficient weight and reaches the development level of a “normal” newborn. The water temperature should be reduced gradually from warm to cool.

Developmental delay is not critical

As a rule, the development of a premature baby month by month occurs in the same sequence as that of a full-term baby. The only difference is the lag for a more or less long period. On average, this is 1.5-2 months, if we are talking about children with a moderate degree of prematurity.

So, if an ordinary cub begins to hold its head at 2 months, then one born prematurely - at 4, spin - at 5 and eight, respectively, etc. The older the baby, the faster the situation will level out. For this category, it is considered a common situation when a premature baby is one year old - and he is practically no different from a one-year-old baby. Of course, if a child was born much prematurely, he will need more time to catch up with his peers, but it is very gratifying that by the time the standard maternity leave absolutely everyone will be fine - including those who were born one and a half kilograms.

Of course, the month-to-month development of a premature baby greatly depends on parental efforts. Everything that is recommended for “ordinary” babies is mandatory for those born prematurely. Talk, touch, feed properly, dress adequately.

Effective aids: massage and gymnastics

Massage and gymnastics are rightly considered one of the ways to speed up the process of growth and development and catch up with peers. It is important to emphasize that extreme and profound degrees of prematurity should be handled by professionals. In this case, it is not recommended to start homework before the child turns six months old (calendar).

In other cases, you can start massage at 2-3 weeks of life, and physical education - from one to one and a half months.

Newborn massage includes all the elements - stroking, tapping, rubbing and kneading, but all this is done much more carefully (especially when the object is premature babies). First you just need to stroke - without pressure, bypassing the joints and spine, then - proceed to more intense touches.

Movements should be directed from bottom to top. The muscles are carefully and carefully warmed up, the ribs are tapped with the tips of the fingers. Each change of elements is preceded by stroking. At first, the massage will last no more than 2-3 minutes. Over time, the duration needs to be increased to 10 or more (this is how the baby perceives it - there is no need to force it).

When introducing your child to physical education, you should call on your reflexes to help. When mom presses the pad under her toes while massaging her tiny feet, she can watch in amazement as her baby's toes clench. And if you run along the outside of the foot from the heel to the little toe, they will spread out funny.

You can also use the crawling reflex: place the baby on its stomach and place your palm under its feet. He will push off quite noticeably - it is important to make sure that there is no wall directly ahead or that the table does not suddenly end: the ability of some children to overcome significant distances in this way is amazing.

The grasping instinct will also be useful - try putting a finger in your palm: the baby will definitely try to grab it. If you do this with both hands at the same time, you can be moved by how he strives to rise above the surface of the table.

At first, you need to limit yourself to harmless exercises. You should not be active, intensively bend, twist, etc. The importance and benefits of massage and gymnastics have long been proven - in order to spur the development of a premature baby up to one year old, they are often prescribed by a pediatrician, and parents are forced to negotiate with a specialist or visit a clinic at a strictly established time.

Let the professionals do their job, but daily massage performed by a mother has innumerable benefits, so it is definitely worth learning.

Important points

There is nothing particularly tragic about giving birth to a child prematurely, and it should not be a source of constant stress and self-criticism for a young mother. Anything can happen, the main thing is that he is alive, healthy and will definitely catch up with his comrades.

In order not to miss anything alarming during the development of the baby, it is necessary to work closely with a qualified specialist. The role of the doctor is all the more significant, the more serious the degree of prematurity of the child. And in this case there is no need to trust in heaven. If the local pediatrician does not suit the parents for objective reasons, it will be much better if they exercise their legal right and choose another doctor.

The possible occurrence of problems that premature babies most often encounter must be monitored especially carefully: the consequences of early birth, unfortunately, do occur.

The nervous system, vision, hearing, and musculoskeletal system must be under constant supervision. Early detection of insufficient development of vision, hearing, etc. will make it possible to correct the deficiency as much as possible and minimize further damage.

How does a premature baby develop? Are there any differences in caring for a baby born prematurely? These and other questions are of interest to parents who want to ensure maximum comfort for the baby.

Useful information from neonatologists and pediatricians will help you understand how a premature baby develops month by month in the first year of life. Find out more about bathing, walking, complementary feeding rules, and vaccination schedule for your baby.

Physiological and psychomotor development

Peculiarities:

• a premature baby is born ahead of schedule and has individual organs that are not fully formed;
• early babies are weak, often cannot breathe on their own and receive milk;
• The baby spends the first weeks after birth in a special incubator, receiving oxygen and food through special tubes;
• a premature baby is under the supervision of neonatologists who control the vital processes and development of the little person;
• The immune system is very weak, the baby is sensitive to the penetration of infectious agents. At first, staff and parents should exercise maximum caution and carefully monitor hygiene: illnesses in such early age negatively affect the development of a tiny organism.

What factors influence the development of a premature baby in the first year of life? The date of birth, weight and height at birth are important.

Neonatologists distinguish four categories of prematurity:

• category 1. Birth weight: 2100–2500 g;
• category 2. Birth weight: 1500–2000 g;
• category 3. Birth weight: 1000–1500 g;
• category 4. Newborn body weight – up to 1000 g.

Note! The earlier the baby is born, the less body weight, the less developed the organs. It is more difficult for a newborn to adapt to new conditions and requires more attention from doctors. Weak children later catch up in the psychomotor and physiological development of their peers born in due date. In the absence of negative factors, pathologies, skills, abilities, emotions, speech, physical activity in both categories of babies are compared by 12 months.

Development of a premature baby by month

Focus on the main indicators that characterize a child at a certain stage of life. Over the course of a year, the baby grows up, gains sufficient weight, and acquires many useful skills.

First month

Characteristic:

• the newborn is weak, especially when weighing less than 1000 g;
• At this stage, sucking and swallowing reflex, feeding is carried out through a tube;
• if breathing is unstable, the child receives oxygen through special tubes;
• body weight increases slowly;
• infectious diseases are severe;
• most difficult period in life premature baby.

Second

Peculiarities:

• reflexes for eating have been formed;
• the ventricle is tiny, the premature baby gets tired quickly, feedings at short intervals;
• weight gain begins;
• The baby does not yet hold his head while lying on his tummy, unlike babies born on time.

Third

Characteristic:

• body weight doubles one and a half to two times;
• The baby sleeps for almost 16 hours;
• the best room temperature is from +23 degrees;
• bright light irritates a premature baby;
• a prerequisite for proper psycho-emotional development is care, the soft touch of mommy’s hands;
• muscles are poorly developed, massage is necessary;
• The baby reacts to sounds, facial expressions and basic reflexes develop.

Fourth

Peculiarities:

• the muscles become stronger, the baby learns to hold his head;
• height and weight gradually increase;
• the gaze becomes more conscious, the child briefly focuses on bright objects;
• the first incomprehensible sounds appear;
• The condition of the digestive system improves, colic bothers the baby less often and gradually goes away.

Fifth

Characteristic:

• the baby understands where the sound is coming from and turns its head;
• the baby recognizes loved ones, smiles when he sees his mother, gurgles, actively moves his legs, waves his arms;
• the child holds the rattle and slightly waves the sounding object;
• the chattering becomes longer, the child reacts to events by “talking” in his own language;
• muscle tone has not yet returned to normal, sometimes there are cramps;
• The role of communication between adults and children, expressions of love and care is strengthened.

Sixth

Peculiarities:

• gradually the premature baby catches up with his peers;
• body weight increases 2.5–3 times;
• the baby becomes more active and develops at a rapid pace;
• the child reacts joyfully to familiar faces and communicates warily with strangers;
• if mommy had massage from the first months of life, the baby can probably roll over onto his tummy and back onto his back;
• With support in the armpit area, the baby jerks his legs and pushes off the surface.

Seventh

Characteristic:

• rollovers from back to tummy are confident and easy;
• the baby holds toys well with a comfortable handle, tries to crawl;
• the child often babbles and readily communicates with adults;
• a good help is an educational mat for young children;
• it is important to monitor the growing baby: at this age, children often fall off the sofa, it is worth turning away for a minute;
• The baby's activity is increasing. At proper nutrition, massage, gymnastics, the baby develops no worse than peers born on time.

Eighth

Peculiarities:

• an older child tries to get on all fours, sways from side to side, squats slightly;
• most children crawl well and learn to sit independently;
• premature babies are practically no different from babies born on time;
• at the request of the parents, the baby looks for a toy, a familiar object, a beloved adult (“Show me the bear”, “Where is mommy?”);
• The child eats well from a spoon. The diet is the same as for full-term babies;
• It's time to learn the first syllables. Nursery rhymes, songs for little ones, and short fairy tales will help.

Ninth

Features of development:

• the baby tries to stand up, tries to sit down, leaning on the adult’s hand;
• toys interest the baby more and more. Increased attention to boxes and jars in which “valuables” can be placed: scraps, rings, balls, cubes;
• for some time the baby can play with toys without the involvement of adults;
• the young researcher takes pieces of food with his fingers and tastes them. In premature babies, teething often begins later, often only at 10–11 months;
• the number of syllables increases, the first ones appear short words. The more actively parents communicate with the baby, the richer the vocabulary will be.

Tenth

Characteristic:

• the child observes moving objects, concentrates attention well on bright details;
• the baby actively explores the world, is interested in everything that is in the apartment and on the street;
• The child imitates adults and loves to communicate. Psychologists advise talking to the baby more often, naming actions and objects, singing songs, playing ladushki, “magpie-crow”;
• The baby cannot be left alone for a long time: before the parents have time to look back, the young researcher climbs into the most unexpected corner;
• strengthened muscles hold a grown-up child on his feet well. The baby moves with support from the hands of an adult.

Eleventh

Peculiarities:

• the child is actively developing;
• the baby crawls quickly, tries to walk without support, leaning on furniture;
• the child recognizes his name, loves communicating with familiar people;
• the baby is interested in toys of various types;
• with categories 3 and 4 of prematurity, baby teeth appear only by this period;
• Children like massage, gymnastics, exercises on a fitball.

The baby is one year old

Peculiarities:

• in 12 months, the premature baby overcame the lag in height and weight, catching up with the babies born on time;
• the child tries to pronounce short words and also communicates in his own language;
• The baby begins to walk and actively explores the surrounding space.

Features and rules of the mode

• bathing. If your body weight is less than 1500 g, postpone bathing for 20–22 days. If you weigh more, bathe your baby within a week. For the first three months, use only boiled water, heat the liquid more strongly. The optimal water temperature when swimming reaches + 38 degrees;
• lure. The diet changes a little later than for full-term babies. Before six months, you cannot supplement with “adult” food: there are not enough enzymes, new foods irritate the stomach, and linger in the intestines for a long time. Introduce complementary foods by seven months, first give high-calorie cereals for sufficient weight gain;
• walks. Be careful with the air temperature: the baby is very weak in the first weeks of life, easily gets hypothermic, and catches a cold. If thermoregulation is imperfect, temperature changes are harmful. If the baby weighs 1500 g or more, walk in summer at a temperature of +25 C. In spring and autumn, go out with a baby who has reached a weight of 2500 g, if it is +10 degrees Celsius outside, no less.

Take note:

• premature babies require increased attention, especially immediately after birth;
• underweight and minimal immune strength explain the shift in the vaccination schedule;
• doctors take into account the characteristics of each baby and develop a “personal” vaccination schedule;
• with a weight of up to 1500 g, all vaccinations are carried out in the second year of life;
• if the newborn weighed less than 2000 g, BCG vaccination against tuberculosis is not given in the maternity hospital. It is allowed to vaccinate when the baby gains another 500 g.

The development of a premature baby from month to month to one year old occurs with some peculiarities. In the first six months, there is a noticeable lag in many parameters; later, differences between peers born in different dates pregnancy, are erased.

By 12 months, psychomotor and physiological development children corresponds to the level of full-term babies. The optimal approach to caring for a child born prematurely will ensure the proper development of the little person.

A specialist about the developmental features of premature babies in the following video: