Prematurity Awareness Day

Did you know that November 17 is World Prematurity Awareness Day?

About 8% of babies born in Canada arrive too soon. The rate of premature births has increased by 23 % since the beginning of the 90s.1

Premature infants face increased health risks.

Be a part of the solution by bringing awareness of prematurity to Canadians!

Spread the word and celebrate this special day dedicated to improving the lives of premature babies.

1. http://www.cihi.ca/cihi-ext-portal/internet/fr/document/types+of+care/hospital+care/acute+care/release_29jan09

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Other Possible Health Problems

Anemia

Premature babies often have a lack of red blood cells (anemia) because:

  • 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 for blood tests

Treatment may include a blood transfusion. Your baby may also need to take iron drops before and after discharge.

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Infections in the Blood

Premature babies are at a greater risk of having serious blood infections because their immune systems are not fully developed at birth. Newborn sepsis (bacteria in the blood) caused by group B streptococci (GBS) bacteria is nearly always passed from the mother around the time of delivery. Special measures including antibiotic treatment may be required for several days.

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Intraventricular Hemorrhage (IVH)

Many premature babies (mostly ELBW and VLBW infants) undergo a head ultrasound, usually within a week after birth, in order to detect an IVH and other problems. An IVH is abnormal bleeding from fragile blood vessels into the ventricles or chambers, surrounding the brain. There may be little bleeding or a lot of bleeding. Major bleeding can result in increased pressure on the brain and/or insufficient blood supply reaching the brain tissues. If your baby has an IVH the doctors and/or nurses will talk to you about the size of the bleed and the follow-up your baby will need.

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Periventricular Leukomalacia (PVL)

PVL can be detected with a head ultrasound and generally only occurs in ELBW and VLBW infants. The term refers to a softening of brain tissues due to a temporary lack of oxygen. In a sick baby, PVL may be caused by a hemorrhage in the brain, a blood disorder, a brain infection such as meningitis, severe apnea or bradycardia or persistent low blood pressure. It may take several weeks to detect any damage from PVL which can cause long-term problems with muscle movement and coordination, vision or intellectual development.

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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 early stage of your baby's life do not mean that your child will develop diabetes later.

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Jaundice

Many babies develop jaundice, resulting in yellow skin, in the first few days after birth. Jaundice is caused by high levels of bilirubin which is produced when red blood cells are broken down. Bilirubin is normally removed by the liver for elimination, but in premature babies, the liver may not be able to remove it quickly enough. Jaundice can be treated with phototherapy, a process using special lights to help break down bilirubin.

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Low Blood Pressure

Premature babies often develop low blood pressure just after birth. This is caused by blood loss during delivery, fluid loss after birth, infection or medications given to the mother before delivery. Treatments for low blood pressure include giving the baby extra fluid, medication to increase blood pressure, or a blood transfusion.

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Necrotizing Enterocolitis (NEC)

A few premature babies develop swelling and inflammation in part of the bowel, causing the tissue to die in that area. This is called NEC. Symptoms include:

  • General signs of being unwell
  • Vomiting
  • Stomach is increased in size and tender to touch
  • Red or abnormally coloured stomach
  • Blood in the stool (bowel movement)

NEC can be a mild or very serious condition. Doctors will immediately stop regular feeds and start feeding intravenously if this illness is suspected. The baby will also need X-rays of the abdomen, antibiotics 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.

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Patent Ductus Arteriosus (PDA)

Before a baby is born there is a blood vessel connecting the pulmonary artery (the main blood vessel carrying blood to the lungs) to the aorta (the main blood vessel carrying blood from the heart to the body) which is known as the ductus arteriosus. This opening is necessary before birth, but usually closes up in the first few hours or days after delivery. When this vessel does not close by itself, the condition is called PDA. PDA can be detected by an ultrasound of the heart called an echocardiogram. If the PDA is still open, the doctor will prescribe medication to close it. In very rare circumstances, this opening may not close and a simple operation will be needed. This may sound alarming but do not worry—PDA in premature babies is easily corrected.

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Retinopathy of Prematurity (ROP)

Excessive growth of abnormal blood vessels in the eye, called ROP, sometimes occurs in premature babies (ELBW and VLBW). 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 laser surgery to stop the blood vessels from growing any further.

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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. This may be achieved by adding or removing covering blankets, the use of a device attached to the skin of the baby to closely control the skin temperature and using heat sources such as incubators and special overhead warmers.

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Congenital Heart Disease (CHD)

About 1 in 100 babies is born with some kind of congenital heart disease, and many need critical medical attention before they are one year of age. CHD or congenital heart defects may be so minor that they do not cause symptoms or so severe that they can be fatal. Defects may be small or very complex and may vary widely in complexity. The defect could be a simple hole in the wall between two heart chambers or a complicated set of malformations, such as blood vessels in the wrong places and underdevelopment of one side of the heart.

Many heart problems can be detected before birth by routine ultrasound and a special test called fetal echocardiography (a special ultrasound of the heart). Fetal echocardiography uses sound waves to create a picture of your baby's heart. If the heart is beating too slowly or quickly, medications can usually fix the problem before the heart starts to fail. If a heart defect can't be treated before birth, doctors can use the information from the ultrasound test to prepare for treatments that can be given immediately after birth if necessary.

Children born with CHD may have a limited ability to cope with a lower respiratory tract infection. For this reason, they are more likely to require admission to the intensive care unit and/or use of a ventilator to support breathing if they develop serious viral infections such as Respiratory Syncytial Virus (RSV) illness.

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