Pediatric Transitional Care

What is Gestational Age/Cycle?

Gestational age is the period that pregnancy takes. It is counted in weeks and days. Usually, this period is 37-40 weeks in human beings. Here, it is pertinent to mention that the early a baby is born, the less likely it is to survive. However, developments in medical science have decreased the mortality ratio of preterm babies.

What is Extreme Prematurity in Babies?

A birth that occurs before 37 weeks of pregnancy is called premature birth. The babies born earlier are preterm, near-term, or preemie. Most premature births take place a few weeks earlier than usual. It is worth mentioning that babies born earlier may have various health issues and need intensive care in the earlier days. However, their survival chances are greater than extremely premature babies.

Extreme prematurity refers to the births taking place before 28 weeks of pregnancy. Extremely premature babies are under 2 pounds of weight and may have less developed organs like the heart, lungs, digestive organs, and others. Development under intensive care can only increase the chances of survival of such babies.

Causes of Preterm Birth

Research shows that African-American women have a higher risk of premature birth than women in other areas. However, medical science seems unable to identify the causes of preterm birth. Still, many facts can increase the risk of premature birth. Some of these are:

• Smoking
• Long term or persistent health issues like heart or kidney diseases
• Less than 20 years or greater than 35 years of age
• Expecting multiple babies at a time
• Any preterm labor or birth
• Abnormality in cervix or uterus
• Drug addiction
• Poor child spacing intervals

There is no specific time for premature birth. However, certain conditions during pregnancy increase the likelihood of premature birth. These include high blood pressure, infection, diabetes, blood clotting issues, vaginal bleeding, complications with the placenta, and a short time-lapse between pregnancies.

How to Diagnose Extreme Prematurity?

As said earlier, any birth taking place before 28 weeks of the pregnancy cycle may have various complications; healthcare professionals take several diagnostic and monitoring tests in the Newborn Intensive Care Unit (NICU). These tests are:

• Heart rate monitoring and breathing
• Input and output of the fluid
• Blood tests
• Echocardiogram
• Eye examination
• Body and brain ultrasound

However, they may also recommend several other tests depending on the complications arising during a premature birth.

Complications Emerging from Preterm Birth

The sufferings of the preterm babies do not end here. They have to face mental retardation, cerebral palsy, hearing and visionary impairments, retarded growth, and much more at later stages of their development. Some neonatal may suffer from severe breathing and other life-threatening issues. Survival is always hard for such babies during their adolescence.

Extreme Prematurity Treatment

Earlier, there were no treatments for premature births. Nowadays, Newborn Intensive Care Units (NICU) are operational in hospitals to treat premature births. The treatment depends on the symptoms and general health of the premature baby. Specialized supportive care units provide the facility of:

• Placement in an incubator
• Monitoring of vital signs
• Use of feeding tube
• Replenishment of fluids
• Blood transfusion
• Staying under bilirubin lights for some days

The pediatrician may also suggest some medication to improve and stimulate lungs, heart, and blood circulation. In some rare cases, surgery is also the only possible solution.

Modern Day Interventions

Modern-day interventions have enabled doctors to save the lives of preterm babies. For example, the neonate is shifted to the Newborn Intensive Care Unit (NICU). Healthcare professionals in these facilities administer fluid, blood composition, echocardiogram, blood pressure, breathing, ultrasound, vision tests, and many others to decrease or remove the complications. After these tests, their staff shifts your babies to an incubator or specialized supportive care for further development and growth.

NICU Supportive Care and its Benefits

Preterm neonates suffer from more complications than normal infants who are born after 37 weeks of pregnancy. Usually, these babies are underweight and underdeveloped. Therefore, the chances of their survival are rare.

However, specialized newborn care units provide their staff with equipment to monitor your preterm’s growth and development. They arrange ventilators on an urgent basis to remove the vital signs of breathing. They also provide feeding support to the newborn. The caregivers use intervenous tubes to administer liquid and nutrients to the neonates. Breastfeeding is encouraged after the baby is strong enough to suck.

Newborn Supportive Care units have the latest machinery to provide your premature babies with conducive conditions for growth. It cures jaundice in your neonate through bilirubin lights in incubators.

NICUs are expensive enough that even it becomes difficult for wealthy people to hire their services. Therefore, most people prefer home care.

Home Care-When A Child Can Leave NICU?

After your neonate completes 37 weeks after pregnancy, the hospitals allow you to shift it to home. However, babies with severe issues take longer. Home care demands extra effort, energy, and commitment. Parents have to spend hundreds of dollars on medical supplies and other services, including:

1) Health Coaching Service

Health coaches train the parents with specific nursing skills to keep their neonates in good health. They not only support you regardless of the time but also boost you emotionally by cushioning your fears and concerns. Investing low in low-quality services will always endanger your preterm baby’s life.

2) Identifying a Pediatrician and Choosing Right Medical Approach

You cannot neglect the role of a pediatrician in saving the life of your new baby. Therefore, it is good to search for a doctor near your residence and book appointments with him from time to time. Always choose a skilled neurodevelopmental person to provide you support for the long term.

3) Maintain Hygiene

As preterm neonates are underdeveloped, they have a greater risk of contracting diseases. Primarily, they are more prone to respiratory issues. Therefore, it is vital to maintain Hygiene to keep your baby safe from dust and other allergies. Avoid smoking in the room also for the better health of the baby.

4) Catalog Medication

Proper and timely medication is also a necessary part of home care. Try to catalog all the medication to avoid any confusion and always follow the doctor’s instructions to administer medicines. If you are untrained, seek the help of a long-term health care facility.

5) Update Immunization Schedule

Immunization is vital for the health of babies. It saves them from various infectious and viral diseases. Therefore, get your baby vaccinized from a certified medical facility and update the schedule and vaccination card in consultation with your pediatrician

6) Feeding

Feeding your premature baby is another critical responsibility that you will have to fulfill being a homecare person. Pediatricians recommend breast milk or infant formula for the first four months. Therefore, always take care of the cleanliness of feeding bottles and pots containing milk.

7) Regular screening

Extremely premature babies take two years to adjust because these are undergrown and underdeveloped. However, you can take it to any healthcare facility for regular screening. It will help you track health issues in the beginning.

8) Enroll in Early Intervention Programs

Most of the neonates return to normality once they complete pregnancy cycle of 37 weeks. Still, some continue to suffer life-long issues like disability due to premature birth. If your baby also has any disability, it is better to enroll it in an early intervention program. Various therapies and exercises in that program may also prove beneficial to bring it to normality.

Can We Prevent Extreme Prematurity?

Although we cannot prevent extreme prematurity, we can minimize prematurity risks by avoiding smoking, drinking, extending the interval between babies, and timely marriages. Moreover, eating healthy and balanced food and proper medication during pregnancy can also decrease the risks.

Summary

To close the entire discussion, we can say that prematurity creates many complications. However, proper care and hiring the services of NICU can help control the difficulties. The parents should always take the assistance of trained healthcare professionals for homecare.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533283/
https://pubmed.ncbi.nlm.nih.gov/26676379/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721965/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5621851/