Patient's question:
Because of severe bleeding from the placenta previa, I underwent a cesarean section at 7 months and 10 days. The baby was born weighing only 3 pounds and 2 ounces. The doctor said the baby's lungs were not mature enough and were very small, so they gave us a critical condition notice. Now the baby is in the intensive care unit. The baby cries quite loudly, which shows he is very strong. What is the survival rate, and what should we do? The whole family has sacrificed a lot for this child, and we don't want him to be gone like this. Please help.Doctor's answer:
Already being treated in the hospital, just trust the doctors. The survival rate is hard to say. The family can do is to find a good hospital, observe closely, and provide meticulous care.Premature Infant Warmth
Premature infants have underdeveloped central nervous systems for temperature regulation, making their ability to regulate body temperature inferior to that of full-term newborns. Their body temperature is easily affected by environmental temperature changes. Due to their limited muscle activity, low subcutaneous fat, and poor cold resistance, premature infants are prone to heat loss, resulting in lower body temperatures. Therefore, special attention must be paid to keeping them warm.
The room temperature for premature infants should be kept as stable as possible, and the air should remain fresh. In summer, the greenhouse temperature should not exceed 30°C, and ventilation should be ensured when the room is too hot. Newborn premature infants in the hospital sleep in incubators, while at home, their cribs or beds should be surrounded by cloth curtains (made of cotton in winter) to block drafts and keep warm. Hot water bags can be used if necessary, but precautions must be taken to prevent burns.
Premature infants have underdeveloped sweat glands and poor heat dissipation functions. In high-temperature environments, their body temperature may rise, leading to hyperthermia. It is important to measure their body temperature frequently under the armpits and monitor changes. If the temperature is too high or too low, measures should be taken to restore it to normal.
Premature Infant Feeding
In addition to poorer digestion and absorption than full-term newborns, premature infants also have weak sucking and swallowing abilities, often struggling to feed or unable to do so. Their stomach capacity is extremely small, and even a few extra mouthfuls of milk can be aspirated into their lungs, leading to fatal complications. Therefore, proper feeding is crucial for premature infants.
Starting Feeding Time:
Generally, sugar water is given 6–12 hours after birth, and milk is introduced 24 hours later. Premature infants weighing around 2 kg can be fed every 3 hours, while those under 1.5 kg should be fed every 2 hours.
Feeding Volume Calculation:
For the first 10 days, the daily feeding volume (ml) = (actual birth days + 10) × weight (kg) / 100.
After 10 days, the daily feeding volume (ml) = 1/5 to 1/4 of the weight (kg).
Feeding Methods:
Breast milk is the best option for premature infants, as it is easily digestible and less likely to cause diarrhea or indigestion. Premature infants with sucking ability and a weight of over 1.5 kg can directly breastfeed if their condition is stable. Start with 1–2 feedings per day, each lasting 5–10 minutes (2–3 minutes for the first feeding). If there are no signs of fatigue, gradually increase feeding time and frequency. For those with poor sucking ability, breast milk can be expressed into bottles, sterilized, and fed using bottles, spoons, or droppers.
When using bottles, the nipple holes should not be too large, as this can cause milk to flow too quickly, leading to choking or even asphyxiation. However, the holes should not be too small either, as this can make feeding difficult and cause fatigue. Premature infants with poor sucking and swallowing abilities can be fed using droppers with rubber tubes.
If breast milk is unavailable, specialized formula milk for premature infants is available on the market.
Lying Position:
Premature infants should not be laid flat but should be positioned on their sides, alternating between left and right. This allows both sides of their lungs to expand properly and improves blood circulation through positional changes. More importantly, side-lying reduces the risk of choking when vomiting, preventing aspiration pneumonia or asphyxiation.
Retinopathy of Prematurity (ROP)
Premature infants are weaker and more susceptible to diseases than full-term newborns, so special attention must be paid to preventing various conditions, especially retinopathy of prematurity. Oxygen is the cause of ROP. Undeniably, oxygen plays a vital role in maintaining the lives of premature infants, but it is a double-edged sword—while benefiting them, it also creates hidden risks: oxygen can lead to ROP.
ROP caused by oxygen can be classified into five stages:
- Stages 1 and 2: Some cases may resolve without treatment.
- Stages 4 and 5: These are retinal detachment stages, with severe disease progression.
Generally, children who undergo surgery for Stage 4 ROP have poor vision outcomes. By Stage 5, the best surgical results reported only restore vision to 0.01, meaning the child will have only light perception and will lose their ability to see colors permanently. Therefore, parents of premature infants must never forget to monitor their children’s retinas.
Experts recommend that premature infants and newborns who have been treated with oxygen undergo a retinal examination by a qualified doctor at one month of age. This examination is not difficult for ophthalmologists, as any facility equipped with indirect ophthalmoscopes can diagnose it. Treatment methods are relatively simple, with cryotherapy or laser therapy proving effective.