Anemia
Anemia is a condition, where not enough red blood cells to carry oxygen from the lungs to all the tissues in the body. Premature infants often are unable to make enough red blood cells and are at risk for becoming anemic. Babies with anemia show signs of poor
feeding, poor weight gain, appear pale and may have frequent episodes of apnea and bradycardia. Blood transfusions may be necessary to treat infants with severe anemia. Vitamins and iron are given to premature babies to help increase their iron stores in their blood.
Apnea
Apnea is a pause in breathing that lasts 20 seconds. Premature babies sometimes forget to breathe. Occasionally, your baby will need to be stimulated to 'remember' to breathe. This stimulation may be a gentle stroking on their back, a light tapping of their foot or ventilator support. Medications such as aminophylline or theophylline may be given to help stimulate your baby to breathe. In time, your baby will outgrow this problem.
Bradycardia
Bradycardia is a condition in which the heart rate is slower than normal, usually less than 80 beats per minute. Bradycardia often occurs with apnea and is treated the same way.
Bronchopulmonary dysplasia (BPD) / Chronic Lung Disease (CLD)
BPD or CLD is a lung disease that commonly occurs in infants who are on a breathing machine for some period of time. It involves damage to the lungs that is usually temporary and will heal with time. Infants with BPD or CLD require oxygen therapy and/or ventilator support until their lungs have healed. Medications such as steroids and diuretics may be required to help improve lung function. Special attention is given to nutrition to help repair lung tissue and promote growth.
Feeding intolerance
Premature babies often have problem digesting feeding. When they first begin feeding, they are not mature enough to use a nipple and will need to be fed through a feeding tube. The initial amount of feeding is small and is gradually increased based on your baby's ability to tolerate nourishment. During this time, careful monitoring of
your baby's feeding progress is important. The nurse will measure around your
baby's abdomen with a tape measure and will check for partially digested food
left in the stomach from the last feeding. A large increase in the size of your
baby's abdomen, a large amount of aspirate, vomit or abnormal stools may mean
your baby is not tolerating his or her feeding.
Hernia Hernias are a weakness in the muscle wall of the abdomen. Many premature babies develop hernias in their belly buttons called an umbilical hernia. Umbilical hernias do not require treatment, but some babies need surgery to repair the hernia. Some premature babies develop a hernia in one or both groins called inguinal hernia. Inguinal hernias require surgery to repair. Most babies tolerate surgery very
well. The hernia becomes noticeable when the infant is a couple of months
old. Surgery will be arranged after the baby has grown at home.
Growth restriction or intrauterine growth
restriction (IUGR) IUGR refers
to the inappropriately slow rate of growth of your baby before birth.
Often these babies are much smaller for their gestational age.
Hyaline membrane disease (HMD) / Respiratory
Distress Syndrome (RDS)
HMD or RDS is the major lung problem that occurs in babies, especially those born
premature. Because the lungs have not fully developed, the tiny air sacs in the lungs collapse between each breath. HMD is caused by the baby's inability to produce surfactant, a substance that lines the lungs and prevents the air sacs from collapsing. Depending on how premature your baby is, he or she may require an artificial surfactant and will need to be on a ventilator to assist him or her with breathing.
Intraventricular hemorrhage (IVH) Infants with IVH have a bleed within the brain that can range from mild to severe in nature. A premature baby's
blood vessels in their brain are very fragile and may rupture easily. For those infants at greatest risk for IVH, head ultrasounds will be performed to detect and/or follow up infants with IVH.
Jaundice Jaundice is the yellow coloration of the skin. Jaundice is due to the build-up of bilirubin in the blood. Bilirubin levels increase when
red blood cells break down. The infant's liver is too immature to get rid
of this waste product.
Jaundice is treated with special lights called phototherapy if the intensity
of jaundice is more than expected. This treatment with lights helps break
down the bilirubin in your baby's blood. It will be eliminated in his or
her urine or stool.
While your baby is under the special lights, a mask will be used to protect
his or her eyes. We sometimes use a biliblanket instead of overhead
lights. This blanket serves the same purpose as the lights. If the
bilirubin level becomes very high, it can become dangerous to your baby.
In this case, a special type of blood transfusion is performed, called an
exchange transfusion. This transfusion may be needed to help 'cleanse'
your baby's blood of excess bilirubin.
Necrotizing enterocolitis (NEC)
NEC is an inflammation of the bowel wall. In order to function properly, the bowel must have an adequate supply of oxygen. When an infant is having respiratory difficulty, the
bowel may be deprived of oxygen because the oxygen that is available is shunted
to the body's major organs, the brain and the heart. This shunting may
cause damage to the bowel wall, which becomes easily infected by bacteria that
are normally present in the intestine. This sets up the disease process of
NEC.
Patent ductus arteriosus
(PDA)
A PDA is small blood vessel within the heart that fails to close after birth. Premature infants are at greatest risk of PDA. Babies with PDA are treated with a medication called Indomethacin to try to close the vessel. If medication attempts do not
close the PDA, surgery may be required to 'tie off' the vessel. This
surgery is called a PDA ligation.
Pneumothorax
A pneumothorax occurs when air escapes from the lung into the chest cavity, which causes the lung to collapse. Pneumothorax may occur spontaneously or as a complication of being on a ventilator. If a pneumothorax occurs, a needle is inserted into the chest
cavity for the purpose of removing free air and re-expanding the lung. It may be necessary to place a chest tube to help in re-expanding the lung.
Retinopathy of prematurity (ROP) ROP is a condition that
affects the retina of the eyes of infants who are born prematurely and/or
exposed to high concentrations of oxygen. The retinal vessels grow rapidly
and irregularly. Infants at risk for ROP are closely followed for
progression of the disease. In some instances, laser surgery may be
required to repair the retina. Whether the infant's sight is affected will
depend on how severe the problem is and how well the treatment works.
Sepsis/Infection Infants, especially premature babies, are at
high risk for infection due to their immature immune system. Babies have
difficulty fighting off infection. Signs of infection include temperature
instability, feeding intolerance, frequent episodes of apnea and bradycardia,
breathing difficulty, irritability, sleepiness, poor muscle tone and changes in
skin color. The treatment for sepsis in most instances is antibiotics.
If the sepsis is very severe, your baby may require additional support to
protect all his or her body systems. In some instances depending on the
type of infection, your baby may be moved to an isolation room to prevent the
infection from spreading to other babies.
Weight gain/loss It is normal for babies to lose weight the
first week of life, then start to gain. The smaller the baby, the longer
it may take to get back to get back to birth weight. We would like to see
your baby gain 10 to 30 grams (or up to approximately one ounce) per day.
This may vary from day to day. Measuring your baby's weight daily will
enable us to adjust the treatment plan based on your baby's needs. We
measure the baby's weight in grams. A conversion chart in the back of the
book will help you convert grams to pounds and ounces.
Apnea
