Newborns - Premature Birth and Its Trials

It's common knowledge that human pregnancy lasts nine months. But that figure is really just an average. While the official figure is pegged at 266 days, it's still widely recognized that a normal gestation may be anywhere from 1-2 weeks less or more than that.

One of the reasons is that it's difficult in most cases to know the exact day on which conception occurred. So, the number of days until birth is usually calculated using the last menstrual period. An equally important reason is simply the fact of individual variation. It's perfectly normal and healthy for a gestation to last 260 days or 270.

But as that distance from the average grows greater, the potential for certain problems increases. In particular, a birth that takes place three weeks or more prior to the full gestation period represents increasing risk of developmental problems for the newborn.

The earliest survival from premature birth on record is roughly 21 weeks. But even 24-26 weeks carries with it substantial likelihood of problems. These cover an underdeveloped brain and nervous system, inadequate lung development and others. These all may result in difficulties immediately after birth and later in life.

Some consequences may be as serious as mental retardation. Others are much more manageable, such as lower surfactant in the lung tissue, which can lead to Respiratory Distress Syndrome. The former requires lifelong care for the child. The latter, thanks to modern medicine, can often be compensated for by a simple treatment.

Any of these (and many other) issues are, of course, heavily dependent on just how premature the newborn is. There are individual factors as well. Some babies who are 3-4 weeks early may do just fine with normal neonatal care. Others will require more extensive assistance and longer term professional treatment.

But, there are many things that parents can do to help their newborn during those early, sometimes trying weeks and months.

Prevention is the first line of defense. To whatever degree possible, and consistent with the health of mother and child, premature birth can be delayed. 'Whatever possible' is getting better and better as medical practice improves. Everything from a better diet to lowered stress and full bed rest to courses of glucocorticoids to stimulate development of the fetus are possible.

Early treatment in the hospital is frequently very high caliber. Premature babies may have a breathing tube, heart and blood pressure monitors, careful temperature control, frequent in-person visits from nurses and other care to ensure their well-being. Once babies can breath normally on their own, regulate and maintain a stable body temperature, breastfeed or bottle feed normally, and gain weight steadily they'll be ready to go home.

Managing certain neurologic disorders such as Retinopathy of Prematurity (ROP) and Hypoxic-Ischemic Encephalopathy (HIE) that may result from premature birth are outside the scope of this article. Seek professional advice. But there are less serious conditions that can be dealt with by parents, with advice from the obstetrician.

Infections are more common in 'preemies', owing in part to their even more immature immune system than that of the usual newborn. But extra care to avoid disease causing organisms takes only vigilance. Dietary supplements that help boost the immune system can be safe and effective, if provided under professional care. Too many are just placebos and some are potentially harmful. The literature is vast and regrettably there are unfounded claims made sometimes.

Apnea - episodes of stopped breathing, especially during sleep - can occur. Extra vigilance can be provided for by a baby sound-and-video monitoring system. Jaundice, a yellowing of the skin or whites of the eyes due to improper liver function or bile duct blockage, is easy to spot. It results from a buildup of bilirubin in the bloodstream. Usually it's harmless. Special lights are available to help treat the condition. Exposure to sunlight can help, but it carries risks. Again, when in doubt, call your doctor.

Parents can help themselves and their child by getting rest and getting educated. Establish a milk supply. Get assistance from friends and family members for those first critical weeks or months. Keep careful records of the baby's progress. Try to keep the stress level down as much as possible.

Today, except in the most extreme cases, premature birth is much less a problem than in generations past. Many highly accomplished individuals (such as Charles Darwin and Albert Einstein) were born prematurely. Some say they never stop overcompensating!