• Nursing of premature babies
  • Prematurity is the birth of a child before the end of a full term pregnancy (between 28-38 weeks of fetal development) with a weight of 1000 to 2500 g and increased from 35 to 45 see the Birth of a fetus weighing less than 1000 g and growth of less than 35 cm is considered as a late miscarriage. However, some of these children survive with proper care. Children with a weight of 1500 g or less are considered to be largely premature. Precisely to establish the cause of nedvishimosti is often very difficult. The most common causes of prematurity are: childishness mother, inflammatory diseases of female genital organs, pathologic pregnancy and disease, pregnant, previous abortions, multiple pregnancy, the incompatibility between the mother and fetus on RH and blood groups. Signs of prematurity: weak cry baby, surface, weakened irregular breathing, insufficient development of the subcutaneous fat layer, and therefore the skin is red, dry, wrinkled, covered with fluff; open the small side and a little springs, ear soft and close to head, nails do not reach the edge of the phalanges, the umbilical cord is located below the mid-length of the body, the sexual organs are underdeveloped - boys testicles is not lowered in the scrotum, girls labia minora is not covered large; movement scarce, hypotension muscles, physiological reflexes decreased, may not even sucking and swallowing reflexes. The definition of prematurity only on weight and growth cannot be considered as absolutely correct, especially when the duration of pregnancy is difficult to determine. Meet children born with great weight and height, but with obvious signs of prematurity. For correct determination of prematurity is necessary to consider the pregnancy and the totality of these signs of prematurity.
    During the neonatal period (see the Newborn ) in premature infants has some features and depends on the degree of physiological maturity. In premature neonates noted lethargy, drowsiness, weak cry, physiological erythema expressed sharply. Physiologic jaundice is usually detected later in connection with the bright coloring of the skin and often delayed up to 3-4 weeks of life. The umbilical cord in premature infants thick, juicy, no later than (8-14-th day of life), the umbilical wound healing slow. Many premature 1-2 weeks of life swelling, which are located mostly in the legs and abdomen. Thermoregulation insufficiently stable, Nude child is cooled quickly, the body temperature may drop below 36 degrees at elevated ambient temperature quickly comes overheating ("Covasna fever").
    Respiratory rate is variable, with movements reaches 60-80 per 1 min., alone in a dream significantly slows, may be prolonged apnea (breathing), especially during feeding. In premature infants during the first days of life is often observed lung atelectasis. Heart sounds may be subdued, heart rate varies depending on conditions and the condition of the child (120 - 140). When anxiety and increase the ambient temperature, the frequency of cardiac contractions can reach up to 200 beats per 1 min. of Physiological weight loss is restored to the 2-3rd week of life. Weight gain in the first month low (100-300 g). On 2-3 months of life, when it comes to intensive weight gain, premature often develops anemia (see). Proper nutrition with sufficient introduction of protein and vitamins, it gradually passes. The reduction of hemoglobin below 50 units require special treatment.
    When caring for a premature baby, great attention should be paid to the warming. The ambient temperature must be constant (36-30 degrees), which is best accomplished by the placement of a child in the incubators (see Incubators). In the absence of incubators you can warm the child heaters with water temperature of 40-45 degrees. Heating pad is placed in quilted cotton covers and change as cool. It is necessary to watch, that heating pad did not leak, and to protect the child from overheating. Given respiratory failure, children, largely premature, in the first days of life, you must give humidified oxygen, especially before feeding. If there is no centralized oxygen supply, it gives the child a pillow through Bobrov's apparatus.
    Oxygen can be assigned for long term with breaks to 1 hour or just before feeding before the appearance of pink color of the skin. With the improvement of the status and child adjusts to the new conditions of life warm and oxygen should be gradually discontinued. Very important for premature children is correct feeding (see Feeding children).
    Bathing premature babies under the age of 1 month to start after deciduation of funic, the water temperature should be 38 degrees. The first time bathing is held under the reflector.
    Walking in the winter in the street can start after two months of age (on achieving weight 2700-2800 g) and at temperature of air not below -8, 10C, starting from 15 minutes to 1-2 hours. in the day. In the summer you can make a walk premature babies with lower weight and they may stay longer in the fresh air.
    Premature babies born weighing more than 2000 g, in satisfactory condition can be discharged home after 2 weeks of life. Children with less weight or having deviations in health desirable to transfer to a special Department for further care.
    In premature infants during childbirth often arise asphyxia and intracranial hemorrhage. In the future, such children often develops pneumonia and sepsis, which is a result of the root causes of premature birthand poorly developed adaptive reactions.
    Nursing of premature infants requires good organization and knowledge of their physiological characteristics.