Other Health Problems
Anaemia
Premature babies often have a lack of red blood cells (anaemia) for several reasons:
- a baby's red blood cells have a shorter life span than an adult's red blood cells
- babies do not make many new red blood cells in the first few weeks after birth
- many blood samples are taken from premature babies to be used in essential laboratory tests
Treatment may include a blood transfusion or medication to increase red blood cell production. The baby may also need to take iron drops after discharge.
Infections in the Blood
Premature babies are at a greater risk of having a serious blood infection because their immune systems are not fully developed at birth. Newborn sepsis caused by group B streptococci (GBS) bacteria is nearly always passed from the mother around the time of delivery. However many preterm infants develop further infections during the first weeks of life and may require one or more courses of antibiotic treatment. Hand hygiene is particularly important to reduce the risk of infection.
Intaventricular haemorrhage (IVH)
Many premature babies undergo a head ultrasound, usually within a week after birth, in order to detect IVH and other problems. IVH is abnormal bleeding into the ventricles, or chambers, surrounding the brain. Minor degrees of bleeding usually don't cause long term problems. Major bleeding can result in increased pressure in the ventricles which can develop into hydrocephalus. Babies at risk of this condition have frequent ultrasounds to monitor the size of the ventricles.
Periventricular Leukomalacia (PVL) and parenchymal brain damage
These conditions are thankfully uncommon. There is damage to the tissue of the brain which is detected by formation of cysts or fluid filled spaces in the brain tissue.They can be caused by lack of oxygen, or haemorrhage or inflammation in the brain tissue. They usually only occur in premature infants. Problems before delivery such as prolonged rupture of the membranes and intrauterine infection can increase the risks. They can be detected by way of a head ultrasound. However, it may take several weeks to detect changes on ultrasound from PVL. These conditions can cause long-term problems with muscle movement and coordination, vision, or intellectual development.
Low Blood Sugar
The amount of sugar in the blood may be too high or, more frequently, too low in premature babies. In most cases, blood sugar levels are easily corrected by increasing or decreasing the sugar concentration of the baby's IV fluids.
Blood sugar problems at this stage do not mean that your child will develop diabetes later.
Jaundice
Many babies develop jaundice, or yellow skin, in the first few days after birth. This is caused by high levels of bilirubin, which is produced when red blood cells are broken down.
Bilirubin is normally processed by the liver for elimination, but sometimes premature babies are not able to process it quickly enough. In any event, jaundice can be treated with phototherapy, a process using special lights to help break down bilirubin.
Low Blood Pressure
Premature babies often develop low blood pressure just after birth. This can be caused by blood loss during delivery, fluid loss after birth, infection, or medications given to the mother before delivery.
Treatments include the provision of extra fluid to the baby, medication to increase blood pressure, or blood transfusion.
Necrotizing Enterocolitis (NEC)
Some premature babies have swelling in part of the bowel, causing the tissue to die in that area. Symptoms of necrotizing enterocolitis (NEC) include:
- general signs of being unwell
- green vomit after feeding
- increased stomach size
- red or abnormally coloured stomach
- blood in the faeces (bowel movement)
NEC can be a very serious condition. Doctors will immediately stop regular feeding and start feeding intravenously if this illness is suspected. The baby will also need X-rays, medication and frequent blood tests. Most babies with NEC recover and do not have any further difficulties, but some need surgery and may have future bowel problems.
Patent Ductus Arteriosus (PDA)
The blood vessel which connects the pulmonary artery (the main blood vessel in the lungs) to the heart, before birth, is known as the ductus arteriosus. This opening is necessary before birth, and usually closes up in the first few hours or days after delivery.
When it doesn't close by itself, the condition is called patent ductus arteriosus (PDA). If this happens, the doctor will prescribe medication to close it. If this is not successful, a simple operation will be needed. This may sound alarming but do not worry- PDA in premature babies is easily corrected.
Retinopathy of Prematurity (ROP)
Overgrowth of blood vessels in the eye, called retinopathy of prematurity (ROP), sometimes occurs in premature babies, especially in those born more than 10 weeks early.
An eye test is used to check for ROP. Doctors will decide whether the ROP will go away by itself or if treatment is needed. Severe ROP can lead to vision problems and even blindness. Treatment may involve surgery to stop the blood vessels growing any further.
Temperature Regulation Problems
It is not unusual for a premature baby to be unable to maintain a regular body temperature for several days or weeks. During this time, extra care and attention are required to help control the baby's temperature, and during this time infants are usually nursed in incubators.
