Premature Baby 101


To mark my 6 week anniversary at the hospital (gah!), I thought we’d do another “class time with Andrea”. It’s been awhile since I’ve dropped some wisdom on you! hahaha

In all seriousness, I wanted to pass along some information about micro preemie’s. I suspect some of you out there have found yourself thinking “Man, she’s so lucky. She gets to sit around all day and watch TV while nurses wait on her hand and foot. It’s like a vacation!”

Let me tell you, far from it.

To start, completely losing your independence sucks. I feel like I’m annoying everyone when I need more water, a fork, a napkin, or my reading glasses. I feel like a burden asking to have my humidifier refilled twice a day, asking for someone to come into my room to pick up the colored pencil I dropped on the floor, or asking for someone to get my mid morning snack out of the fridge (turns out diabetics need to eat constantly….).

Laying in bed 23.5 hours a day is difficult on the body. I’ve lost muscle tone and mass. I’ve developed gestational diabetes (I’m blaming lack of exercise/movement), and I’m just really sore in general. As the baby grows, the weight of my belly makes laying really difficult.

Trust me, I’d rather be at home, taking care of Nora, Paul and Maisey. I’d rather be having a normal, uneventful pregnancy. I’d rather be reveling in the fact that this is the last time I’ll be pregnant – and stuffing my face with ice cream!

Instead, I lie here for BBS and do the only thing I can to help him. I remain as calm and stress free as possible. I keep weight off my cervix in hopes that the cerclage will continue to hold. I track my daily contractions like a watchdog. I’ve learned all the lingo there is to know in the perinatology world. I keep an open dialogue with my doctors and nurses. I try to push out of my mind the terrifying information about preemies that I’m about to share with you.

Once you understand what micro preemies have to face, you’ll understand why I haven’t written about this until now. I was admitted at 22 weeks and 3 days when BBS wasn’t viable outside the womb. If he had been born in the first week and a half of my stay here, doctors wouldn’t have tried to resuscitate him. Let that sink in for a second….that’s extremely painful to think about.

End of day, I just want the best life possible for BBS. But I can’t control what’s ultimately going to happen. As the person who’s growing this life, I feel guilty that my body isn’t doing a better job. But, I try to focus on the fact that he’s safe right now and we’ve gotten to 28 weeks and 3 days together!

The information below was gathered from https://penut-trial.org/node/1

Prematurity is defined as a birth that occurs before 37 completed weeks of gestation. It is associated with about one-third of all infant deaths in the United States and accounts for approximately 45 percent of children with cerebral palsy, 35 percent of children with vision impairment, and 25 percent of children with cognitive or hearing impairment.

Approximately 50,000 infants per year (961 per week) are born at less than 28 weeks of gestation in the US.

The risk for problems associated with prematurity increase with decreasing gestational age and birth weight. The most immature infants (those born before 28 weeks of gestation) have the highest mortality rate, and if they survive, are at the greatest risk for long-term problems.

The chronic medical and neurodevelopmental problems of children born prematurely often require additional health care and educational services.

 

 

Birth at 23 Weeks of Gestation

What happens at birth If full resuscitation is chosen, at birth the doctors will dry and warm the baby, and then check the heart rate, breathing, oxygen levels, and movement. A breathing tube may be placed to help the baby breathe. Some babies will receive a medicine called surfactant in the delivery room. This helps keep the lungs expanded so the baby can breathe.

It is important to realize that even with the medical team’s best efforts to resuscitate the baby, he/she may not survive to be admitted to the NICU.

Long term medical issues. Some complications of being born early can last throughout life, but usually problems are most severe early on. After going home, most former 23 weekers (85%) require special medical care for at least a couple of years. Rehospitalization for medical problems is common in the first two years of life.

Survival

In the US, of 100 babies born at 23 weeks gestation, an average of 70 will die (black figures), and 30 will live to go home (blue figures).

 

 

Neurodevelopment

Babies born early are at high risk for developmental disabilities like cerebral palsy (CP), learning disabilities or mental retardation, hearing, and vision problems. Bleeding in the brain while in the NICU increases these risks, but problems can also occur in the absence of bleeding. The baby may have one or more of these problems.

Developmental outcomes for the 30 survivors at 11 years of age are shown by the colored figures

  •  Severe Disability (23%)
  •  Moderate Disability (26%)
  •  Mild Disability (39%)
  •  No Disability (13%)

 

Definitions:
Severe Disability: Likely to be dependent on caregivers, may be unable to walk or control muscles, very low IQ, deafness, or blindness.

Moderate Disability: Reasonable independence likely, spastic muscles, but can walk with help, low IQ, hearing loss corrected with hearing aid, or impaired vision without blindness.

Mild Disability: Learning disabilities, mild impairments such as need for glasses. Autism and ADHD are more common in premature babies.

Vision: Most will have normal vision, but 25% will need glasses, and about 8% will be blind.

Hearing: Most will hear normally, but (7%) will have severe hearing loss in one or both ears.

Breathing: Many need extra oxygen when they go home. Sometimes, a breathing machine is needed. Most babies get better with time, but breathing problems such as asthma are common.

Birth at 24 Weeks of Gestation

Long term medical issues. After going home, most former 24 weekers (75%) require special medical care for at least a couple of years. Rehospitalization for medical problems is common in the first two years of life.

Survival

In the US, of 100 babies born at 24 weeks gestation, an average of 37 will die (black figures), and 63 will live to go home (blue figures).

Neurodevelopment

Babies born early are at high risk for developmental disabilities like cerebral palsy (spastic muscles), learning disabilities or mental retardation, hearing and vision problems. Bleeding in the brain while in the NICU increases these risks, but problems can also occur in the absence of bleeding. The baby may have one or more of these problems.

Developmental outcomes for the 63 survivors at 11 years of age are shown by the colored figures

  •  Severe Disability (21%)
  •  Moderate Disability (33%)
  •  Mild Disability (30%)
  •  No Disability (16%)

 

Birth at 25 Weeks of Gestation

Long term medical issues. After going home, most former 25 weekers (75%) require special medical care for at least a couple of years. Rehospitalization for medical problems is common in the first two years of life.

Survival

In the US, of 100 babies born at 25 weeks gestation, an average of 25 will die (black figures), and 75 will live to go home (blue figures).

Neurodevelopment

Babies born early are at high risk for developmental disabilities like cerebral palsy and learning disabilities or mental retardation. Bleeding in the brain while in the NICU increases this risk, but problems can also occur in the absence of bleeding. The baby may have one or more of these problems.

Developmental outcomes for the 75 survivors at 11 years of age are shown by the colored figures

  •  Severe Disability (11%)
  •  Moderate Disability (28%)
  •  Mild Disability (44%)
  •  No Disability (17%)

Birth at 26 Weeks of Gestation

Long term medical issues.

After going home, many infants born at 26 weeks of gestation require special medical care for at least a couple of years (50%). Rehospitalization for medical problems is common in the first two years.

Survival

In the US, of 100 babies born at 26 weeks gestation, an average of 14 will die (black figures), and 86 will live to go home (blue figures).

Neurodevelopment

Babies born early are at high risk for developmental disabilities like cerebral palsy and learning disabilities or mental retardation. Bleeding in the brain while in the NICU increases this risk, but problems can also occur in the absence of bleeding. The baby may have one or more of these problems.

Developmental outcomes for the 86 survivors at 11 years of age are shown by the colored figures

  •  Severe Disability (10%)
  •  Moderate Disability (34%)
  •  Mild Disability (33%)
  •  No Disability (23%)

Birth at 27 Weeks of Gestation

Long term medical issues.

After going home, many former 27 week preemies (35%) require special medical care for at least a couple of years. Rehospitalization for medical problems is common in the first two years of life.

Survival

In the US, of 100 babies born at 27 weeks gestation, an average of 12 will die (black figures), and 88 will live to go home (blue figures).

Neurodevelopment

Babies born early are at high risk for developmental disabilities like cerebral palsy, learning disabilities or mental retardation, hearing and vision problems. Bleeding in the brain while in the NICU increases these risks, but problems can also occur in the absence of bleeding. The baby may have one or more of these problems.

Developmental outcomes for the 88 survivors are shown by the colored figures

  •  Severe Disability (10%)
  •  Moderate Disability (10%)
  • Mild Disability (35%)
  •  No Disability (45%)

 

Birth at 28 Weeks of Gestation

Long term medical issues

After going home, many former 28 weekers (30%) require special medical care for at least a couple of years. Rehospitalization for medical problems is common in the first two years of life.

Survival

In the US, of 100 babies born at 28 weeks gestation, an average of 8 will die (black figures), and 92 will live to go home (blue figures).

Neurodevelopment

Babies born early are at high risk for developmental disabilities like cerebral palsy (CP), learning disabilities or mental retardation, vision and hearing problems. Bleeding in the brain while in the NICU increases this risk, but problems can also occur in the absence of bleeding. The baby may have one or more of these problems.

Developmental outcomes for the 92 survivors are shown by the colored figures

  •  Severe Disability (10%)
  •  Moderate Disability (10%)
  •  Mild Disability (35%)
  •  No Disability (45%)

 

Definitions:
Severe Disability: Likely to be dependent on caregivers, may be unable to walk or control muscles, very low IQ, deafness, or blindness.

Moderate Disability: Reasonable independence likely, spastic muscles, but can walk with help, low IQ, hearing loss corrected with hearing aid, or impaired vision without blindness.

Mild Disability: Learning disabilities, mild impairments such as need for glasses. Autism and ADHD are more common in premature babies.

Vision: Most will have normal vision, but 25% will need glasses, and 1% to 2% will be blind.

Hearing: Most will hear normally, but about 3% will have severe hearing loss in one or both ears.

Breathing: Some babies will need extra oxygen or a breathing machine when they go home. Most babies get better with time, but breathing problems such as asthma are common.

As you can see, BBS’ odds of surviving, and surviving without too many long term problems was dramatically increased since I was first admitted. Hopefully he won’t have a birthday anytime soon…..

 

2 thoughts on “Premature Baby 101

  1. Thanks for such an informative post about what’s going on, Andrea. And congratulations on another week completed! Woo hoo! Here’s to another twelve weeks of healthy development! Also, how do you continue to look so absolutely fabulous in every picture??? xoxoxo

  2. Congratulations on making it to this major milestone! Wishing you and BBS many more before you meet face-to-face.
    You have such strength and patience (one may come more easily than the other, but you certainly have both in high quantities).
    Please let us know if you (or Paul) need anything. At all. We’re just hanging out in the wings. We’d be thrilled to help out.

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