From the moment a baby is born, it begins to grow rapidly. During this period, children become very sensitive. Especially premature babies are very weak and vulnerable.
Risk factors for premature birth are socio-demographic (family instability, low social life, young families) and medical (previous abortion, multiple births, hemolytic diseases of the fetus - as a result of rhesus conflict) caused by chronic diseases of the mother). In addition, premature birth can be caused by occupational damage, harmful habits, physical and mental injuries during pregnancy. As a premature baby, the interval from 22 weeks to 37 weeks of gestationbabies born in and weighing more than 500 gr. These indicators are included by WHO.
There are several levels of premature birth. Their classification is determined by the body weight of the newborn. If the child weighs less than 1 kg - a child born with extreme weight, children under 1,5 kg - low birth weight, and children born 1,5 kg - are called normal premature babies.
What do premature babies look like?
The appearance of premature babies is different from that of babies born on time. The subcutaneous fat layer is thin or absent in premature infants. The skin is thin, dark red, wrinkled. The umbilicus is located in the lower abdomen, while in healthy births the umbilicus is located in the center of the abdomen. Their head is very large relative to their body, the joints in the skull and the small pelvis are open, while the large pelvis is small in size because the bones are not fully in place. The ear supra is very soft. The nails are thin, not completely covering the phalanges of the fingers. In premature girls, the labia majora do not completely cover the labia minora and a reddish cleft can be seen in the genital area, while in boys the testicles do not fall on the pelvis and the pelvis itself is dark red will be in color. The umbilical cord becomes difficult to detach and the wound also heals in 8-9 days.
In premature infants, adaptation to the external environment is also difficult to achieve because the organ system is not fully formed and functionally immature during pregnancy. Diseases that do not pose a risk to healthy, premature babies can be severe in premature babies.
Nervous system of premature infants
The formation of the brain begins in the early stages of pregnancy. Therefore, even in premature infants, parts of the brain are formed, but the maturation of the conducting system of the brain is incomplete, ie - the membrane covering the surface of the nerve fibers, melinization is not fully formed, therefore, nerve impulses do not reach the various organs and defects in the function of the organs occur. The process of melinization also continues in the postnatal (postpartum) period. The brains of healthy, premature babies are also subject to intense stress during childbirth. Due to the strong pressure on the meninges, spasms, circulatory disorders in the brain, hemorrhages into the brain can occur. However, such processes are more pronounced in premature infants.
There are problems with the nervous system, the ability to move and muscle tone is low in premature infants, reflexes are weak or absent, arm and leg twitching, eyeball twitching and dizziness are also observed. possible.
The most basic reflex that is formed during the embryonic period is the sucking reflex, which is preserved in premature infants, but is weak. Babies born prematurely may not have a sucking reflex. In such children, special measures are taken to stimulate the sucking reflex. It uses glass jars to massage the muscles around the mouth and special suction.
In addition, the thermoregulatory function of premature infants is also incomplete: they easily dissipate heat, but find it difficult to generate and retain it. Their sweat glands cannot function, and as a result, children become overheated. With this in mind, premature babies are cared for in the most comfortable conditions, they need to be warm and not freeze. Similar favorable conditions are in the special swings in the neonatology departments, where the same temperature is always maintained (36 degrees). The sensory organs of premature infants begin to function as early as 1 day after birth.
Premature babies give more convulsions than babies born on time. This is due to organic damage to the brain, epilepsy, high body temperature, changes in metabolism. However, the incidence of seizures in premature infants is different from that in preterm infants, for example, in healthy infants the seizures are clonic-tonic (muscle contraction, followed by seizures). (continued with convulsions), and in premature infants it is often manifested in a clonic form, i.e., when the muscles are relaxed. In any case, treatment of convulsions is required, because the cause of convulsions is a violation of blood circulation in the brain, which can lead to subsequent brain damage.
Premature infants (especially those with extreme low birth weight) often develop cerebral palsy (paralysis) in children. The diagnosis of cerebral palsy in children is made at the age of 1 year, but the symptoms of the disease begin to appear with the birth of the child, especially at 3 months of age. If a child has weak muscles, if the child is unable to move his legs and arms, and the result is not known even after 2-3 months of massage treatments, such children are at risk of cerebral palsy. If the child does not develop reflexes in a timely manner, lags behind in motor skills - they are diagnosed with cerebral palsy.
In cases involving the above nervous system, a neurologist will deal with premature babies. Such children are prescribed a therapeutic massage. Therapeutic massage can be performed by mothers independently, both at home, which also helps to restore the psychological connection with the child and stimulates the formation of the nervous system.
Respiratory system of premature infants
Premature babies have more breathing than healthy, premature babies: the lower the baby’s body weight, the greater their respiratory rate.
Because the nervous system and lipid (fat) metabolism are not fully formed, no surfactant is formed in the lungs. The surfactant ensures that the alveoli do not stick during exhalation. Deficiency of this substance often leads to respiratory failure syndrome in children and leads to the development of atelectasis.
Atelectasis is the inability of a particular part of the lung to fully form or participate in respiration. This results in respiratory failure in premature infants. Such children are transferred to artificial lung ventilation, and this continues until the lungs themselves function independently.
Against the background of respiratory failure, infectious diseases begin to appear (pneumonia), and this further aggravates the general condition of the child. Therefore, when pregnant women are suspected of premature birth, they are given glucocorticoid drugs, which stimulate the development of the respiratory system of the unborn child.
Cardiovascular system in premature infants
Like all organ systems, the cardiovascular system is not fully formed in premature infants. Studies have shown that any external influence increases the number of heartbeats, increases heart tones and raises blood pressure. During a normal pregnancy, all the elements of the cardiovascular system are fully formed in the period before the baby is born and the baby is ready for birth. Premature babies, on the other hand, have a variety of heart abnormalities, leading to heart palpitations and aggravation of the child’s general condition. Ultrasound (Ultrasound) echocardiography is performed to diagnose cardiac abnormalities.
Premature babies with deficiencies in the cardiovascular system should be protected from external influences, such as very loud noises.
The digestive system of premature infants and their nutrition
The digestive organs of premature babies also have their own peculiarities. First of all, such children have a deficiency of digestive enzymes. The glands in the digestive system cannot secrete enough enzymes, and gastric juice is also synthesized in small amounts. Small amounts of microorganisms entering the digestive system of premature infants also cause dysbiosis in the child. In healthy children, such bacteria die under the influence of gastric juice. Due to the defects observed by the nervous system, the motility (movement) of the intestines decreases, the mass of food remains in the intestines. However, even in premature babies, milk-breaking enzymes are produced, albeit partially. Therefore, the most optimal food for premature babies is breast milk.
Not only is breast milk nutritious, but the external environment also protects the baby from aggressive factors, i.e. immunity. It is therefore important to ensure that the baby receives breast milk even if he or she is in the intensive care unit at birth and has not developed suction reflexes. In this way, the growth of premature babies can be stimulated. If the baby has not developed a sucking reflex at all, breast milk is given through a special naso-gastral tube.
The skeletal system of premature infants
In premature infants, the skeletal system is fully formed, but in them the process of ossification is not fully formed. Therefore, such children are prescribed an additional calcium element. Vitamin D, phosphorus and calcium deficiency resulting in rickets. Premature babies are at risk. Rickets - occurs rapidly in premature infants and the symptoms are pronounced.
Especially in premature infants, the pelvic joint is not fully formed, so dysplasia and inability to move are observed in children.
What will be the future of children who are "in a hurry" to give birth? The prognosis depends on the duration of preterm birth. If the baby is born after 33 weeks and there are no birth defects, it will take about 70 days for the baby to fully develop. If the child is born too early, care is provided in special hospitals, neonatology departments. Such children are always under the supervision of a local pediatrician.
In practice, if premature babies are properly cared for and protected from additional diseases, they will continue to grow like their peers for a year.
