Preterm Baby

Recognizing the specialized health needs of premature infants.

Hundreds of thousands of babies surprise their parents each year by being born earlier than anticipated. Most of the time, the initial shock of this unexpected event is a distant memory once the bundle of joy has left the hospital and settles in at home. Yet, although they’re born just a few weeks ahead of schedule, these premature infants are susceptible to health risks associated with an early arrival.

Premature infants— or “preemies”— are babies born at 36 weeks or less gestational age. Most premature babies are born between 34 and 36 weeks gestation and are called “late-preterm” infants. Nationally, there were 373,652 late-preterm births representing more than 9 percent of all live births in 2005, according to the March of Dimes. This number is an 18 percent increase since 1990.

The increased health problems often associated with these late-preterm infants and their greater needs for healthcare services are often overlooked or misunderstood because the child seems close to a full-term baby in general appearance. Any baby born prematurely, however, is more vulnerable to health and developmental complications than full-term infants.

In fact, a study published in a recent issue of Pediatrics found that late-preterm infants may have a small increased risk for developmental and school-related problems through the first years of life, and as late as the 3rd grade. Overall, the risk found was very small, with about 4 percent of late-preterm children having a developmental problem in kindergarten.

Premature infants have specialized health needs because their full development in the womb is disrupted. This leaves them more susceptible to a variety of problems, such as jaundice and difficulties with breathing, feeding and maintaining their temperature.

The lungs of infants born at 32-35 weeks gestational age are less developed than those born at full term. Therefore, these babies are at risk of experiencing later respiratory problems, even up to 6 or 7 years of age. 

Late preterm infants tend to have more infections throughout their first year of life than babies born close to their due dates. For example, preterm babies are more vulnerable to seasonal infections like respiratory syncytial virus (RSV), a common virus during the fall and winter months. The leading cause of infant hospitalization, RSV is responsible for one in every 13 outpatient visits to physicians each year by children under age 5, and one in 38 emergency department visits, according to a study in the New England Journal of Medicine. Though mild in most children, RSV can be more serious among premature infants.

RSV usually causes symptoms that mimic a cold, including a runny nose or a low fever, and the symptoms generally run their course. Parents of premature infants should be especially aware of what might be more severe symptoms of RSV, such as breathing problems like rapid or gasping breath and wheezing, as well as listlessness and difficulty in feeding. If your preterm infant exhibits these symptoms, consult the child’s medical care provider. 

Currently no vaccine exists for RSV. Thus, the most effective way to prevent the spread of RSV is by good hand washing before you and others touch your baby. Washing toys and other objects with which your baby comes in contact and avoiding people with colds and unnecessary exposure to crowds may also help.

Findings suggest that most late preterm infants do very well. But parents should ensure that their child has consistent and close follow-ups with a physician. Such a relationship promotes an early detection of RSV and potentially the prevention of any health-related problems that might develop with a preterm infant. Also keep in mind that consistent communication with a medical care provider and routine follow-up visits are important for the health of every child, regardless of how early he or she was born.

Every Preterm Baby Needs Special Care

  • Be your baby’s advocate; ask questions.
  • Seek a medical setting where your questions are answered.
  • Network with other parents of preemies.
  • Trust your parental instincts.