A premature baby is considered to be a child born before the 38th week of pregnancy, weighing less than 2500 grams, and body length less than 45 centimeters.
The viability of a premature baby depends not only on body weight and timing of birth, but also on how the mother’s pregnancy proceeded.
A premature baby is born more weakened if the mother suffers from cardiovascular, gynecological, endocrine diseases, kidney diseases, suffered infectious diseases during pregnancy, smoked, drank alcohol.
The rate of preterm birth among women who smoke is twice as high as among non-smokers. Smoking causes oxygen starvation of the fetus and slows down its growth; such women may have a premature baby.
The first days of life are a critical period for a premature baby. Usually, premature baby required special conditions, and he is transferred from the maternity hospital to the hospital. But the child has grown stronger and can be taken home. Now it all depends on caring for him!
It is clear that a premature baby is more susceptible to any disease than children born at term. Therefore, it is immediately necessary to protect the baby from contact with adults or children who have even a hint of a cough, runny nose, or sore throat.
The highest demands are placed on the cleanliness of the room - be sure to clean using a wet method, since dust is often a carrier of staphylococcus that has settled on it; use a vacuum cleaner more often, try to remove from the room excess furniture, curtains, drapes that absorb dust.
Do not cool or overheat!
One of the features of a premature baby is the imperfection of thermoregulation mechanisms; such children are very sensitive to both cooling and overheating. Therefore, in hospitals, the weakest, very premature children are nursed in special incubators, where a constant temperature and humidity are maintained.
By the time of discharge, thermoregulation is usually improved, but still remains imperfect. The most suitable room temperature for a child is plus 20 - 22°. Don't be afraid of ventilation - it is necessary! In summer, you can keep the window open almost all the time; in winter, ventilate the room at least three times a day for 10 - 15 minutes. The child must be taken out of the room during this time.
Gradually accustom your child to temperature changes. Bathe your baby every day, preferably at the same hours - this is also a hardening procedure. At first, the water should be warm enough (37°); by the end of the first half of the year, its temperature should be reduced to 36°, and when the child is six months old - to 35°. Walking is also necessary. If a premature baby was discharged from the hospital in May - August, the very next day he can be taken out into the air for 15 - 20 minutes, and, increasing the duration of the walk every day, bring it up to one and a half to two hours 3-4 times a week. day.
In winter, it is allowed to walk at a temperature not lower than -10°, on windless days, but provided that the child’s body weight has reached 2800 - 3000 grams. Extend the duration of your walk in winter carefully, gradually: starting with 15 minutes, walk every day 5 - 10 minutes more, but no more than an hour 2 - 3 times a day.
In spring and autumn, when the temperature outside is above 0° and there is no wind, walks can be started if the child’s body weight is more than 2500 grams.
How to feed?
Of course, the best food for a premature baby is mother's milk; it provides the growing body not only with adequate nutrition, but also with protective substances, enzymes, and hormones that are urgently needed in this situation. But the trouble is that after premature birth, some women experience hypogalactia - insufficient milk production. We must try to strengthen it. But if there is still not enough milk, you have to switch the baby to mixed or artificial feeding.
You can give a premature baby the Robolact formula, specially designed for weakened and premature babies. The acidophilic mixture “Malyutka”, the dry milk mixture of the same name, and the mixture “Malysh” are quite complete. "Detolact", "Linolak".
To replenish the diet of a premature baby with vitamins and mineral salts, from three weeks to a month, start giving him fruit and vegetable juices (apple, lemon, carrot, blackcurrant). The first servings of juice are 3-4 drops. Every day, add a few drops and gradually increase the amount of juice to 30 - 50 milliliters.
From 2 to 3 months, fruit purees should also be given - from a quarter of a teaspoon to one or two spoons, 3 to 5 times a day.
Complementary feeding is recommended for a premature baby from 4 months, and vegetable puree is preferable as the first complementary feeding. If a premature baby does not have a tendency to allergic diathesis, add the yolk of a hard-boiled egg, mashed in a small amount of milk, to the puree. The yolk should first be very crumbly, then 1/8, then 1/4 and only gradually brought to half. At the age of 5 - 5.5 months, a second complementary food is added - porridge, buckwheat or oatmeal. These cereals are more complete in their composition than semolina.
From 7 months, a premature baby is given vegetable puree soup. You can include ground and then pureed minced meat in the menu (1 teaspoon per day); by the age of 8 months, the child should receive up to 2 tablespoons of minced meat for lunch along with vegetable puree. By 10 months, minced meat is replaced with meatballs, and the child begins to be given dry cookies and crackers.
Gymnastics, massage, regime.
A premature baby is born weaker and less developed than full-term babies. To overcome this lag, it is necessary to specifically engage in its physical development.
Gymnastics and massage complexes for a premature baby will be prescribed in a children's clinic. They are a must! And in addition, before feeding, you need to lay the baby on the stomach for 2 - 3 minutes, first - 1 - 2 times a day, and then 3 - 4. This position strengthens the muscles of the back of the head, abdomen and limbs, it also helps to relieve abdominal pain due to the accumulation of gases, which often affects children in the first months of life.
Premature babies are especially prone to anemia and rickets. The local pediatrician, taking into account this threat, usually prescribes preventive medications - vitamin 0, iron supplements. His recommendations must be followed carefully.
The doctor also decides on the issue of preventive vaccinations. Children who were born with a body weight below 1500 do not receive preventive vaccinations in the first year; they are postponed to the second year.
With well-organized care and education, and the correct daily routine, a premature baby develops at an even more intensive pace than his full-term peers, as if catching up. Research by specialists conducted in recent years has established that more than half of very premature children, whose body weight at birth was within 1000 grams, by the age of 3-5 years were completely equal in terms of physical and mental development with their full-term peers.Children with a higher birth weight reach normal values by one year or even earlier, if they have not suffered any serious illnesses during the newborn period or later.
But this leveling, we repeat once again, is achieved by unremitting parental attention, a careful, reasonably gentle, but also reasonably hardening and training regime.
G.V. Yatsyk, Doctor of Medical Sciences. S.G. Gribakin, Candidate of Medical Sciences.
Your child's development
It is important to understand that the development of premature babies is somewhat different from the development of full-term babies.
A child who developed in the mother's body for only 6-8 months cannot be compared with a child who had a full 9 months to grow and develop.
When assessing a child’s development, it is necessary to focus on his “corrected age.” This age can be determined by subtracting the number of months the child was born earlier from his actual age.
The adjusted age estimate gives parents and medical workers a real idea of the pace of development of a premature baby. 5 month old baby who was born at 3 months ahead of schedule, from a developmental point of view, should be considered 2 months old.
If a child has been in a serious condition for quite a long time, then during the first months of life he may lag behind in his own way. physical development or the development of motor skills and their adjusted age.
How premature babies behave
Most premature babies are discharged home about two weeks before their expected due date. But even if the child has reached this date, he still has some catching up to do. Perhaps he:
- shows no clear signs of being hungry or tired;
- still weak and having difficulty eating;
- sleeps or screams all day long, or goes from one state to another within a few seconds.
The child will begin to better express his needs, and you will learn to understand what certain signals mean. Like all babies, a premature baby will have periods of rapid development followed by long periods when nothing seems to be happening.
- You cannot force or “push” a child to develop if he is not yet ready for this. You should not try to stimulate him to activity if he is tired or actively resisting. Violence will only lead to the fact that both the child and the mother will be upset.
- It is necessary to focus on the baby's progress. Whether a child begins to walk at 12 or 20 months will no longer matter in a few years.
- When monitoring the neuropsychic development of a baby, when assessing his abilities, it is always necessary to take into account the corrected age.
Premature babies often exhibit uncoordinated movements. It is difficult to predict how your child will react to you and to the world.
- His reactions can be impulsive, sudden, as he tries to adapt to changes in the world around him and even to his own physical needs.
- The child may suddenly strain his arms or legs or pull them towards him.
- Periodically he becomes sluggish, and then quickly turns into a state of tension.
- keep his arms and legs close to his body;
- When moving the child, try to keep your movements slow and smooth.
Breath
A premature baby's breathing patterns and skin color may change quickly and unexpectedly. It is necessary to observe the child and try to catch his characteristic breathing patterns and “normal” skin coloring.
- Observe the baby's chest as he breathes.
- Count his usual number of breathing movements per minute.
- Listen to the sounds he makes when he is breathing normally.
A newborn baby sleeps most of the day. A full-term baby can sleep 15 to 22 hours a day. Premature babies tend to have longer periods of sleep and shorter periods of wakefulness. When a child goes home from the hospital, his perception of day and night is impaired.
It must be remembered that a familiar environment during sleep is important for a child. Although some babies just discharged from the neonatal unit learn to sleep easily in a dark, quiet room, others struggle with noise and light. If your child has trouble sleeping:
- turn on the night light. Give him the opportunity to hear background sounds, such as soft piano playing or other quiet melodic music;
- gradually eliminate additional noise and light, which will help the child adapt to the home;
- Resist the urge to play with your baby during night feedings. During this time, try to keep the child's attention focused on food.
Cry
At first, a premature baby will not cry much. Apparently his ability to express his emotions by crying develops as his expected birth date approaches.
The first episodes of crying may be short. You can easily calm your baby down by gently stroking him or letting him suck on your breast or pacifier. As he grows, he will begin to scream more often. The ability to cry is a good sign of normal baby development.
Crying serves as a signal to the mother that the baby is hungry, uncomfortable or tired. If his cries are responded to, this helps the child develop a sense of trust and the feeling that he can already communicate with other people.
In these first months, the child should be held as often as possible, as soon as there is time and “free” hands for this. This will not spoil the child. The more attention is paid to the baby, the more you communicate with him, the better he develops and the faster he will “catch up” with his peers.
In some cases, calm down crying baby it can be difficult. Prolonged episodes of crying may be a sign that the baby is unwell or in pain.
If your baby cries for an unusually long time, you should call a doctor. As a rule, nothing bad will be found, but it is necessary to have this confirmed by a specialist.
- Full-term newborns may cry for 2–3 hours in the first months of life.
- Some premature babies, especially the youngest ones, are very fussy and may cry for 6 hours a day or more.
Typically, fussiness and crying peak at the corrected age of 3–4 months. As your baby gets older, he or she will cry less and have more regular sleep periods.
How to calm a crying baby
First, make sure your baby isn't hungry and doesn't need a diaper change.
- Place your child where he can see you. Talk to him kindly.
- Bring your baby's hand to his mouth or give him a pacifier.
- Keep your baby's hands close to his chest.
- Swaddle your baby. His shoulders should be free, and his torso should not be tightly, but tightly wrapped in a baby blanket.
- Raise the child. Movement is usually calming, so try rocking your baby rhythmically or walking with him.
- Resist the urge to entertain your child. Maybe he doesn't tolerate stimulation well. Instead, give him peace.
- Give your child a warm bath (unless the child does not like water).
- If all of these methods are ineffective, put your baby back in the crib and give him a chance to cry. Sometimes that's exactly what you need crying child to calm down.
- Never shake your baby to try to get him to stop crying. This can lead to brain damage or even death to the baby.
When premature babies are hungry, they may not cry like full-term babies. Due to the immaturity of the nervous system, the child may not know that he is hungry. And since his stomach is very small, he should be fed little by little, but often (approximately every 2.5–3 hours, and sometimes more often).
As your baby grows and becomes more physically developed and can better coordinate his sucking, swallowing and breathing, he will take longer to become satiated.
A premature baby requires a large number of energy. Its mouth is small and the muscles used for sucking are weak.
If the baby is breastfed, you need to provide additional support for his head and shoulders. If your baby is bottle-fed, you may need a special soft nipple designed specifically for premature babies, which makes sucking less tiring. The child will eat better if he is fully awake, so he needs to be helped to concentrate on eating.
Until the baby learns to suckle properly, he should be fed in a quiet room without bright lighting, with minimal distractions, even talking and rocking. It is necessary to establish eye contact with the child, supporting his head and neck with your hand or forearm. The baby should be comfortable, he should not stretch out or shrink too much. Feeding should be a pleasant and relaxing pastime for both the baby and the mother.
It is important to monitor how often your baby has bowel movements, as many feeding problems occur when your baby doesn't have bowel movements regularly. There may be stool after every meal, or maybe just once in 1 or 2 days. If the baby is breastfed, his stool will be soft, yellowish in color, similar in consistency to cottage cheese.
If the baby is receiving formula milk, the stool may also be soft and yellow to brownish-green in color.
Note the normal frequency and consistency of your child's stools to recognize signs of constipation or diarrhea.
If your child has difficulty passing stool, or suddenly has frequent, watery stools, you should call a doctor.
Also pay attention to how often your baby's diaper gets wet. The number of urinations should at least match the number of feedings. If the number of wet diapers is lower, it may be a sign that the baby is not getting enough milk or formula.
Breast-feeding
Breastfeeding has many special benefits. Some components breast milk help protect the baby from infection. Breast milk is the optimal source of nutrients for a premature baby.
After discharge, a premature baby may tire quickly during feeding and may not breastfeed fully. To ensure adequate milk supply during the first weeks, you may need to pump your breasts and feed your baby the expressed milk or store the milk.
In addition to breast milk, some premature babies require a supplement to promote their growth - a breast milk fortifier, a vitamin and mineral supplement, or a special formula. Your doctor will tell you if your baby needs any of these products.
- Before you leave hospital, make sure you are familiar with all aspects breastfeeding.
- Work with your doctor or lactation specialist to create a plan that includes how often you will need to feed your baby and whether any supplements will be needed.
- Early checkweighing, done at home or in the doctor's office, will give you the information you need to make sure your baby is getting the amount of food he needs to thrive. adequate growth and development.
Bottle feeding
If for some reason the mother does not breastfeed the baby and cannot express milk, the doctor prescribes a special infant formula. The Nutrition Committee of ESPGHAN (European Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists) recognizes that after discharge from hospital it is better to use special mixtures for premature babies, which contain higher concentrations of nutrients than standard full-term infant formulas.*
Typically, premature and low birth weight babies are discharged from the hospital when their condition is stable. However, even after discharge, these children still have special nutritional needs. Good nutrition plays an important role throughout the first year of life, when the child grows especially quickly. While staying in a hospital with a child or visiting him, parents must master special feeding techniques and learn how to determine how much formula the child needs within 24 hours.
Due to the fact that a premature baby is at risk of developing iron deficiency, iron should be present in his diet: either in the food itself or in the form of an iron supplement in drops. This is due to the fact that by the age of 2 months, the baby's iron stores may be depleted, which can cause the development of anemia.
Upon discharge from the hospital, the doctor will give the necessary recommendations not only on feeding, but also on the use of vitamins.
It should be remembered that vitamins are also medicines, so you can give these drugs to your child only on the recommendation of a doctor.
Development of sense organs
Vision
At the corrected age of 0 months, preterm infants can see objects at a distance of 20–30 cm, which is approximately the distance from their eyes to the face of the person feeding or holding them.
By a corrected age of about 6 months, premature babies can see almost as far as adults.
All children distinguish between dark and light.
- At first they like simple black and white designs, such as diagonal stripes.
- As children get older, they become attracted to more complex and subtle designs and bright colors.
- Like adults, children become bored if they look at the same object for a long time.
- Most of all, children love to look at faces.
- The constantly changing expression of the human face is a subject of continuous interest for them.
- During the first weeks and months of being at home, your face-to-face contact with your child, brief at first, will become an important source of learning.
- At a corrected age of 0 months, the baby is able to imitate smiles, frowns, and other facial expressions. He may even try to imitate you if you stick out your tongue!
- You will become the main object of interest and attention of your baby. Your smile, the sound of your voice and the comfort you provide play a key role in a child's development. The increasing frequency of his reactions to you can be considered an important indicator of progress.
Children appear to hear sounds that change, such as voices or music, better than sounds that remain the same.
- The easiest way is for your child to “tune in” to the sound of your voice and enjoy it.
- Children like calm music, especially a person singing, even if he is out of tune.
Even a child with normal hearing may not respond to some loud noises. However, a persistent lack of reaction to sound should serve as a signal for concern and should be brought to the attention of a specialist.
Touch
It is natural that you touch and stroke your child. Touch is a calming force that makes him feel safe.
Babies who like to be hugged (which is most babies) tend to relax and cuddle up to the person holding them. Enjoy these minutes.
Children love to touch everything. Let your child feel the things he encounters every day: a towel, a diaper, water, clothes and your skin.
Taste and smell
The child can taste and smell. Of course, newborns prefer the taste and aroma of mother's milk. They often wrinkle their nose if they are offered stale expressed milk or formula.
Communication
One of the first achievements of a child is a smile, which appears at the corrected age of 2–3 months.
- To inspire your baby to smile, smile at him yourself. Smile at your child when you talk to him or take him out of the crib, and always when he smiles at you.
- Although in the first months the child does not understand words, he learns to “maintain” a conversation.
- It is very important to talk to your child.
- This helps him learn the language and serves as the basis for developing many other skills.
- Feel free to talk to your baby about everything you do.
- Don't hesitate to express your love for him through words.
Signs indicating a comfortable condition of the baby
In the process of communication, premature babies give signals of “readiness”, which show others that they are in the mood for communication or play. When a child is ready to interact, he is characterized by the following:
- pink skin color
- cheerful, cheerful facial expression
- eyes wide open, maintaining eye contact
- arms folded crosswise on chest
- fist in mouth
- arms and legs are relaxed.
Children also have signs of fatigue that indicate when the child needs a break. If too many things happen, the child may:
- look away
- be capricious and cry
- hiccup
- vomit (be careful if you vomit! This is a reason to consult a doctor)
- arch your back
- squeeze your arms and legs.
Interaction with the pediatrician
It is important that the doctor you speak with knows that your baby is premature and is being treated in the neonatal intensive care unit (NICU).
The most complete contact is established with the pediatrician, who will best be able to understand and share the natural feelings of fear, confusion and love for you in the process of caring for your child.
First doctor visits
Find out the number and telephone number of your children's clinic in advance so that medical staff from the hospital can inform the local doctor about your discharge. The local pediatrician must examine the child at home within the first two days after discharge. Give your pediatrician all recommendations and results of examinations performed in the hospital. Be sure to keep all copies for yourself to provide to other consultants if necessary. You should create a special folder where you will put all the child’s medical documents.
During the first month, all examinations of the child are carried out at home. In the future, visiting a doctor is recommended only on infant day in order to reduce contact with sick children in the children's clinic. When the child grows up, it will be possible to visit places where there are concentrations of children more freely, since the immune system The baby will mature and be able to cope with the disease more easily.
When visiting a doctor, you need to discuss the progress in the child's development and ask about anything that worries you. We encourage you to write down your questions in advance using the space at the end of this booklet. What a mother tells the doctor about her child is very important. Be sure to discuss problems related to activity, attention levels, sleep, nutrition, and individual characteristics. Don't let your baby's weight and bowel movements be the only issues discussed with your doctor. You need to ask your doctor or nurse explained everything that you do not understand, and also for them to write down their recommendations.
Vaccinations
IN Russian Federation A system has been established to begin vaccination of premature infants according to their corrected age. Typically, premature babies begin to be vaccinated when their body weight reaches 2200 grams.
It is necessary to discuss the child’s vaccination schedule with the pediatrician and not miss scheduled visits. Vaccinations are very important for a premature baby, since severe infections (against which vaccinations are carried out) most often affect weakened children.
World practice insists that premature babies, more than others, require vaccinations, and as early as possible, especially if the child is forced to frequently visit a children's clinic or hospital. At the same time, remember that vaccination is not a neutral procedure for the body of any child, especially a premature one. You need to ask what kind of vaccinations the child will be given, how to prepare him for them, what to watch for, what side effects there may be, and what to do in this situation.
On the day of vaccination, the child may experience slight malaise, a pain reaction, eat worse and be capricious, and may have a fever. This is all normal, but requires careful observation and understanding. On the first day after vaccination, it is advisable to create a “protective” regime, reduce contact with other children and protect the baby from excessive fatigue. Typically, the reaction to the vaccine can last 1-2 days.
Cosmetic problems
Premature babies often have congenital spots at birth called hemangiomas. These "strawberry spots" are soft, raised, red areas made up of dilated blood vessels (capillaries). Towards the end of the first year of life they begin to gradually disappear and usually disappear by 4 years.
In the case when hemangiomas begin to grow ahead of the overall growth of the child, or if the spot becomes lumpy and raised above the surface of the body, it is necessary to consult a doctor to resolve the issue of cryocoagulation of these areas, which not only has cosmetic value, but also prevents pathological growth of blood vessels in site of hemangioma.
Another cosmetic concern may be scars from operations and procedures, which in some tiny children appear very large and unsightly. In most cases, over time, as the child grows, they become less noticeable.
Cardiopulmonary resuscitation
A feature of the development of a premature baby is its susceptibility to viral infections. Swelling of the mucous membrane of the respiratory tract and nasopharynx associated with a viral infection, obstruction of the airways and difficulty in producing an effective cough can lead to severe breathing problems, even stopping it. In this regard, it is advisable to have an idea of how to provide first aid to a child before the ambulance arrives. Such knowledge will allow parents to restore the functioning of the child’s heart and lungs in the event of an emergency.
Cardiopulmonary resuscitation is a skill that every parent and caregiver should master. It involves clearing the airways by suctioning out mucus, reflex action (slapping the chest, back, cheeks), mouth-to-mouth breathing, and chest compressions.
The sequence and technique of carrying out these activities must be learned in a calm environment, preferably by trying to do all the actions yourself on a special children's mannequin.
Most likely, this knowledge will not be needed, but if something happens, parents will not be confused and will not miss precious minutes to save the baby.
Does the child need examination?
Metabolic screening of newborns
All newborn children are required to be tested for some rare hereditary diseases. If left untreated, these diseases can have serious adverse effects on a child's development. To test, a few drops of blood are taken from the baby's heel area or finger. Although all children are tested in the hospital, in some cases repeat testing may be necessary after discharge home. When you are discharged or during your first visit, make sure your child is tested for these rare but serious illnesses.
Follow-up vision assessment
All premature babies weighing less than 1500 grams at birth and children who have had medical complications during their hospital stay should be seen by an ophthalmologist.
If a child undergoes an eye examination in a hospital, the results and recommendations should be noted in an extract from the medical history, which is given to the parents.
Follow-up hearing assessment
Before discharge from the hospital, the child's hearing is assessed. Repeated examinations are often recommended. The test results and recommendations should also be included in the medical history extract.
Practical advice
Car safety seats
Before driving anywhere, always place your child in an approved child seat in the back seat of the car. Even the smallest children need to be transported in a child seat. Use a five-point child car seat or a five-point folding safety seat.
Do not use hard or slippery plastic mats. Remember that a child seat should never be placed on a seat protected by an airbag. A premature baby in a child seat will need additional support, so that his torso is positioned straight so that he can breathe easier. Folded blankets and clothes with a diaper can provide extra padding to help keep your baby from slipping and prevent excessive movement.
Diapers and clothes
There are diapers designed specifically for premature babies.
Since the child will soon outgrow these clothes, you should not buy too many of them. Nowadays, ready-made clothes for premature babies are sold in specialized stores and on Internet sites, but you need to make sure that they meet mandatory safety standards.
Crib
Never use a spring net in your baby's crib; Make sure that the distance between the crib bars is no more than 6.5 cm. If this distance is greater, the baby's head may get stuck between the bars.
- The mattress should be firm and fit snugly against the crib frame.
- Only a thin, tightly stretched sheet should be placed between the mattress and the child.
- Do not place soft bulky objects in the crib that may interfere with the baby's breathing.
In the children's room it is necessary to maintain a comfortable temperature within 22–24 °C.
As a precaution, the baby's skin temperature should be monitored. A temperature of 36.6–37.4 °C is considered normal for a premature baby.
- If your baby has cool, pale, or bluish hands and feet, warm him up.
- If your baby's skin is warm and excessively red, he may be dressed too warmly.
Infection Control
In some countries, colds and respiratory diseases are common in autumn and winter, or during the rainy season. Common and severe respiratory infections in premature infants are usually caused by respiratory syncytial virus (RSV).
Before leaving the hospital, you should consult with your doctor about how to protect your child from developing severe respiratory diseases caused by respiratory syncytial virus (pneumonia, bronchospasm, shortness of breath and suffocation).
Currently, in the world and in the Russian Federation, it is possible to protect a child from severe RSV infection by administering protective antibodies to him.
After the child is taken home, you need to give him and yourself a few weeks to adapt before inviting relatives and friends.
Anyone should wash their hands with warm water and soap before touching a child. We must remember that respiratory syncytial viral infection can be transmitted by kissing.
No one should be allowed to smoke near the child. Newborns and children who are exposed to tobacco smoke have an increased risk of respiratory infections.
Bath time
Bathing time should be as short as possible: premature babies are characterized by rapid heat loss.
- Before placing your baby in the bath, test the temperature of the water with your wrist or elbow. The bathroom should be warm and draft-free.
- Wash your baby with soft, caressing movements. After bathing, wrap him in a soft towel.
If possible, try to sleep when your baby falls asleep. Caring for a premature baby is a real job, and not just for one person, so don't hesitate to ask for help if you need it. Take turns caring for your baby.
- Although family members and friends may be asked to refrain from visiting at first to give you and your child time to adjust, do not refuse their help with cooking, cleaning, and running errands if they offer it.
- Parents need to spend some time apart from their child. Take time outs. You need personal life and rest.
- Many parents report that their anxiety and stress decrease when they talk to other parents of premature babies.
- You may be concerned about whether premature birth will affect your mental development Your child. Most premature babies develop normally. Only some babies born prematurely develop serious, long-term problems.
- Many famous people were born premature. These are, for example, Mark Twain, Albert Einstein, Anna Pavlova and Winston Churchill.
- One of the most important factors in the development of premature babies is the home environment. Love, attention and care will help develop your child's full potential.
- Parents often try to overprotect their premature baby, even if the doctor reassures them that everything is fine. In such families, the child can become dependent and demanding. As parents of a premature baby, you must help your baby develop normally, both emotionally and physically. As your child grows, you can help him adapt by setting schedules and norms.
- Continue to contact your pediatrician. He will confirm whether your baby is developing normally and give useful recommendations. Daily life plays an important role in creating the right parent-child relationship that you both want.
I.I. Ryumina, Doctor of Medical Sciences, Head. Department of Pathology of Newborns and Premature Children of the Scientific Center for Gynecology and Pediatrics named after. IN AND. Kulakova Ministry of Health and Social Development of the Russian Federation,
E.S. Keshishyan, Doctor of Medical Sciences, Professor, Head of the Scientific Department of Neonatology and Pathology of Children early age, head of the Center for Correction of Development of Premature Children.
After discharge, many parents are at a loss, what to do with a small lump, how to properly care for it? There is no need to be scared; it is important to understand the main thing: your child requires special attention. Additional conditions are added to the usual rules for caring for a newborn, which we will discuss in detail.
Bathing a premature baby
If swimming is allowed, the water should be at least +38°C, and environment+25OS. The process of water procedures itself is no different from bathing full-term babies.
For convenience, you can use special devices: circles, support collars. Cosmetics for bathing in the first six months of a baby’s life are not needed; herbal preparations are enough: chamomile, lavender, oak bark, celandine, etc. The duration of water procedures is on average 5-7 minutes, gradually increasing the bathing time.
After bathing, be sure to treat the umbilical wound and skin with special children's cosmetics: oil, powder. Remember that all folds of the baby need to be treated!
How to dress a premature baby?
Due to the immaturity of the nervous system, the baby’s thermoregulation is unstable, so you need to dress the baby according to his comfortable state.
Mandatory are: socks, mittens, hat. Accessories (clasps, hooks, buttons, etc.), rough seams on the inside of clothes are not welcome, as they can damage the baby’s skin. Since in the first months the baby spends more time lying on his back, the fasteners can be on the side or in front.
Baby clothes should be made only from natural fabrics!
Sample kit for home:
- seamless vest or bodysuit made of cotton fabric;
- blouse made of flannel or knitwear;
- diaper;
- sliders;
- socks;
- mittens;
- seamless cap.
If you are dressing your baby for a walk in cold weather, in addition to the above list, the child should wear warm overalls and a warm hat. When the weather outside is warm, just throw on a light blanket.
Walking with premature babies
The question of the possibility of walking with a prematurely born child is decided individually. If the child is healthy and there are no contraindications to walking, walking can and is beneficial, but the mother must make sure that there is no hypothermia.
Walks are always necessary, even if there is bad weather outside, it strengthens the baby. The exception is if the baby is sick - in this case, festivities are not recommended. If there is snow or rain outside, the stroller can be covered with special devices. In hot weather, you should take your baby out for a walk in the morning or afternoon.
At first, the duration of walks is 10 minutes in winter and 15-20 minutes in summer period. Gradually, the walking time is increased in accordance with the baby’s condition and weather conditions.
When walking, monitor the temperature of your baby's hands and nose. If the child’s limbs are cold, he should be wrapped up or taken indoors!
Many mothers use the balcony as an alternative to walking outside. This option does exist, but it is not comparable to walking in the park or in the yard. In the latter case, the baby receives a dose of fresh air, and the mother regains her shape.
Vaccinations for premature babies
The baby must be vaccinated in the maternity hospital:
- Hepatitis B.
Children born prematurely are under constant medical supervision. This is necessary in order not to miss pathological changes that may occur at any time.
After discharge from the hospital, a premature baby, as a rule, requires further rehabilitation, so you should strictly follow the doctor’s recommendations after hospital treatment.
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2. Body length is at least 45 cm.
5. Pronounced muscle hypertonicity.
9.The body is proportional.
2. Breathing is rhythmic.
Apgar scale . Apgar score
Cardiac activity;
Breath;
Muscle tone;
Reflexes;
Skin coloring.
Well expressed 2 points;
1 point is not enough;
Missing 0 points.
Features of organs and systems.
The cardiovascular system.
Extrauterine circulation is established, and two circulation circles begin to function. The batalli duct, oval window, and Arani duct (remnants of the umbilical vessels) close. The heart is relatively large and occupies 0.8% of body weight. The heart rate of a newborn is 120-140 beats per minute.
Respiratory system.
Pulmonary breathing is established. The lungs are not sufficiently formed.
Interstitial tissue is loose, contains few elastic fibers, and is rich in blood vessels and fiber. Emphysema and atelectasis often occur in newborns. The tendency to atelectasis increases due to a deficiency of surfactant (surfactant that coats the inner surface of the alveoli and prevents them from collapsing during exhalation).
Breathing in newborns is shallow and frequent. Respiration rate per minute is 40-60. Arrhythmia is characteristic. Inhalation is shorter than exhalation. Sometimes breathing may be intermittent (imperfect respiratory center). Abdominal breathing type.
Leather.
The skin is smooth, velvety, the blood vessels are wide and easily permeable.
Protective function underdeveloped, the skin is easily vulnerable, easily infected, and is often the entry point for infection.
Thermoregulatory function is imperfect . Children easily become overheated or hypothermic. Sweat glands do not function (immaturity of the sweat center).
Respiratory function is well developed.
Vitamin-forming function.
To perform this function, it is necessary to maintain a daily routine with sufficient exposure to air (vitamin D is formed under the influence of ultraviolet radiation).
The skin is covered with vernix, which contains the secretion of the sebaceous glands. The hair is well developed, but by 6-8 weeks it falls out. The subcutaneous fat layer is developed evenly.
Muscular system.
The flexor tone prevails over the extensor tone.
Skeletal system.
The basis of the skeleton is cartilage tissue. Head relatively large sizes and is ¼ of the body length. The brain region is more developed than the facial region. The seams are easy to feel. The small fontanelle has triangular shape, located between the parietal and occipital bones. The large fontanelle has a diamond shape and is located between the frontal and parietal bones. Closes at 12-16 months of age. The spine is straight.
Urinary system.
The kidneys are relatively larger than those of adults. The pelvis and ureters are wide, the walls are hypotonic. Bladder located higher than in adults (at the level of the navel when full). Capacity 50 ml. The urethra in boys is 5-6 cm, in girls 1-1.5 cm. The processes of reabsorption, secretion and diffusion are imperfect, so the ability to concentrate urine in newborns is limited. In the first days, the child secretes 10-20 ml. urine, number of urinations 4-6 times. then the amount is 20-25 times a day in the first month of life. The urine reaction is sharply acidic, relative density 1003-1005.
Blood.
Increased content of hemoglobin and red blood cells (er.6-10x10/l, hemoglobin 170-240 g/l). 60-80% fetal hemoglobin. This hemoglobin binds oxygen faster than adult hemoglobin. Color index 1.3. Red blood cells of different sizes (anisocytosis), different colors (polychromatophilia). Increased content of reticulocytes. ESR 2-3 mm/h. The leukocyte formula is dominated by neutrophils (60-65%), lymphocytes 16-34%, by 5-6 days neutrophils are compared with lymphocytes (first crossover), by the end of the month the number of neutrophils decreases, and lymphocytes increase. At 5-6 years, their number is compared again (second crossover). And after 6 years, neutrophils again predominate over lymphocytes.
Physiological (borderline, transient states).
Meconium (original feces) – It is released in the first days of life and is an odorless, thick, viscous mass of dark green color. It consists of secretions of the embryonic digestive tract, epithelium, ingested amniotic fluid. Later it becomes more frequent, heterogeneous in consistency and color (watery, dark green, with yellow and whitish lumps). Such feces are called transitional. After 2-3 days it becomes mushy and yellow, up to 8 times a day, depending on feeding.
Transient, physiological loss of initial body weight.
In the first 3-4 days of life, all newborns experience a loss of body weight and it is 10%, in premature infants it is 12-14%. Mass restoration occurs by 7-10 days of life. In premature, large babies - later.
Causes:
Malnutrition;
Loss of water in urine and feces;
Regurgitation;
Drying of the umbilical residue.
Necessary:
Early breastfeeding;
Feeding on demand;
Maintaining an optimal drinking regime.
Transient skin changes.
1)simple erythema – hyperemia of the skin, sometimes with slight cyanosis in the area of the hands and feet. The reason is the expansion of skin capillaries due to environmental conditions. Lasts from several hours to 2-3 days. In premature infants it is more pronounced and lasts 5-7 days. As the erythema fades, small or large-plate peeling is observed, which is especially pronounced in premature infants.
Necessary lubricate the skin with sterile vegetable oil.
2)toxic erythema.
Occurs in 20-30% of newborns on days 2-5. Red spots appear on the skin, sometimes with a papule or vesicle, located on the extensor surface of the limbs, around the joints, on the chest, buttocks, less often on the face, torso. After 2-3 days, the rash fades away, the child’s condition is not disturbed.
Necessary drinking plenty of water.
3)transient jaundice.
Associated with the accumulation of free bilirubin in the blood and tissues, which is formed during the breakdown of fetal hemoglobin. Since the child’s functionally immature liver cannot convert bilirubin into a non-toxic form and excrete it from the body, bilirubin turns the skin and sclera yellow. It is observed in 2/3 of newborns. It appears on the 2nd day of life and disappears by 7-10 days; in premature infants it persists for 2-3 weeks. The general condition is not disturbed.
Necessary drink plenty of fluids, activated carbon.
Milia (whiteheads).
Occurs in 60% of newborns on the 3rd-4th day of life. Whitish-yellowish nodules 1-2 mm in size, rising above the skin and localized on the wings of the nose, bridge of the nose, forehead, and chin. They go away in 1-2 weeks without treatment.
Transient hyperthermia.
An increase in body temperature to 39-40 degrees (in 17%) occurs on the 3-4th day of life and lasts for several hours. Children can be restless. The main reason insufficient fluid intake into the body.
Necessary Give the child something to drink and administer antipyretics as prescribed by the doctor.
Newborn care.
A midwife provides care in the delivery room. This work includes:
Newborn's first toilet;
Anthropometry;
Swaddling.
A healthy newborn stays in the delivery room for 2 hours. Then the nurse in the neonatal department comes for the child, checks the documents (text of bracelets, medallion, history of the child’s development), notes in the development history the exact time of the baby’s admission, his condition, and transfers him to the children’s department. Healthy children are in the ward with their mother.
The following requirements must be met in the children's department:
The temperature in the room should be 22-24 degrees;
Before starting work, all medical personnel must shower and change their gown daily;
Replaceable shoes should be washed and wiped with disinfectants;
Masks are changed every 4 hours:
Do not work with long, varnished nails.
The work of a nurse in a children's department includes:
1. Washing the child.
2.Thermometry (twice a day - morning and evening).
3. Anthropometry (before the first feeding).
4. Daily toilet for a newborn.
5.Care for umbilical cord remnant and umbilical wound.
6. Swaddling and putting to bed.
7. Vaccination with BCG and hepatitis B.
8.Feeding children.
Features of care.
Premature babies are cared for taking into account physiological characteristics: imperfect thermoregulation, reduced tolerance (endurance) to food, a tendency to asphyxial conditions, insufficient resistance to infection, immaturity of organs and systems.
When caring for premature babies, it is necessary to create comfortable microclimatic conditions. Cooling a premature baby in the delivery room often dooms all further care for him. The temperature in the room should be 24- 26 °C, humidity - 60%. In the first days and weeks of life, very premature babies or premature babies in serious condition are nursed in incubators. They maintain a temperature from 36 ° C to 32 ° C, air humidity on the first day is up to 90%, then 60-55%, the concentration of humidified oxygen is about 30%: The optimal temperature regime is the regime in which it is possible to maintain body temperature within 36.5-37 °C and exclude overheating and cooling of the child. The level of oxygenation is selected individually: it is advisable to ensure a minimum excess oxygen concentration, at which the signs of hypoxemia disappear (cyanosis of the skin and mucous membranes, low motor activity, rare breathing with prolonged apnea, bradycardia). It is not recommended to create an oxygen concentration of more than 38% in the incubator due to the possibility of damage to the lungs, retina and central nervous system. The duration of oxygen supply should also be monitored.
Disinfection and change of incubators is carried out after 2-3 days. A child in need of incubation is transferred to a clean incubator. Transfer to a crib is carried out in the absence of respiratory disorders, maintaining a constant body temperature, and the premature baby’s ability to cope with minimal oxygenation. For additional heating, use a thermal mattress, thermal protective film, and heating pads. When performing short-term procedures, heated changing tables and radiant heat lamps ("Ameda") are used. Children nursed in cribs are dressed in vests with sewn-up sleeves.
Special attention attention should be paid to monitoring the child’s condition, monitoring the temperature and humidity of the room, operating parameters and handling of the incubator, and observing the strictest sanitary, hygienic and anti-epidemic measures. The protective regime is of great importance: limiting painful stimuli, protecting the child’s sleep, careful toileting and manipulation, strict adherence to the sequence of diagnostic and treatment procedures. The mother must follow the rules of personal hygiene and maintain proper sanitary conditions when caring for the child.
Feeding premature babies has a number of features.
They are due to the child’s high need for nutrients and the immaturity of the gastrointestinal tract, which requires careful introduction of food. Depending on the stage of pregnancy, breast milk changes in composition. Therefore, mother's milk is most suitable for the needs of the child and ensures maximum success in nursing. The newborn should receive it, even if the amount of milk is minimal. To stimulate milk production, frequent pumping is recommended (at least 8 times a day). In the absence of milk, premature babies are provided with donor milk, in exceptional cases they use adapted milk formulas intended for feeding premature babies (Novolakt-MM, Detolakt-MM, Humana O, etc.), as well as Malyutka, "Alesya-1", mixtures enriched with biological additives.
The time of the baby's first feeding is determined individually. Depending on the severity; In premature babies, they are fed by breast, spoon or cup, through a tube. The frequency of meals depends on the method of feeding, the baby’s ability to hold milk in the stomach and sucking activity. Children with weak sucking and no swallowing reflexes receive milk through a gastric tube. The frequency of tube feeding is usually 7-8 times a day. When prolonged tube feeding using a syringe dispenser or infusion system, the time of milk administration should not exceed 3 hours.
Children with a swallowing reflex and a weak sucking reflex are fed from a spoon or cup. The spoon is partially filled and controlled so that the milk pours over the tongue and is swallowed without accumulating under the tongue. Feeding from a pacifier makes breastfeeding more difficult in the future.
As the general condition improves and the baby’s sucking reflex appears, the child is applied to the breast. Breastfeeding and close contact with the mother are even more important for premature babies than for babies born at full term. If the condition allows, it is recommended to place the naked baby on the mother’s chest as early and often as possible (the “kangaroo method”). The premature baby cannot suckle effectively and is supplemented with expressed milk. Babies with active sucking are breastfed. While breastfeeding, you should help your baby find correct position and warn the mother that milk should not remain in the newborn's mouth due to the risk of aspiration.
In the event of aspiration, immediately stop feeding, suction the contents from the upper respiratory tract, place the child in an elevated position, provide oxygen supply, and notify the doctor.
The amount of food per feeding on the first day of life is usually 5-10 ml of milk, on the second - 10-15 ml, on the third - 15-20 ml. The daily amount of food in the first 10 days of life can be calculated by Romell's formula:
(10 + p) x t: 100, where P -.number of days to live, T- baby's mass in grams.
For example, on the 4th day a child weighing 1600 g receives the daily amount of milk. (10 + 4) x 16 ==224 (ml)
Every day its quantity increases and by the 15th day of life the daily milk requirement is 1/7 of the body weight, by the end of the 1st month - 1/5 of the weight.
The daily amount of food can be determined using the calorie method. The calorie requirement up to the 10th day of life is (10 x P) kcal x kg body weight per day, where P - number of days to live; by the 15th day - 120 kcal/kg, at the age of 1 month - 140 kcal/kg, by 1 year - 120 kcal/kg. The calorie content of 100 ml of breast milk is 70 kcal (colostrum - 140 kcal). For example, a 1 month old child weighs 2500 g and therefore needs 350 kcal/day. The daily volume of food is 350 kcal x 100 ml: 70 kcal = 500 ml.
To meet the increased need of premature infants for vitamins and mineral salts, earlier introduction of corrective supplements is recommended. complementary foods.
Nursing at home.
When nursing premature babies, the room should be ventilated more often. maintain the air temperature in the room at 20-22 °C, when bathing - 22-26 °C, depending on the maturity of the child. Children are bathed daily at a water temperature of 38-39 °C. In the warm season, walks begin immediately after discharge, in the cold season - from 1-2 months of age with a body weight of at least 2500-3000 g and an air temperature of at least 1-3 ° C. Most premature babies no longer need special heating by the end of 1 month. The child needs a gentle sleep and wakefulness regime. Training methods of hardening (air baths, contrast dousing after bathing, etc.) are carried out in the second half of life. Of the physical exercises until physiological muscle hypertension disappears, only stroking and reflex exercises are allowed.
Proper development Premature babies are supported by a favorable home environment, individual classes, games, balanced nutrition, and strict adherence to sanitary and hygienic conditions.
Organization of nursing care for a full-term and premature newborn baby
Healthy newborn child is a child born at gestational age 40 + 2 weeks, with external signs of full term and functional maturity.
The maturity of the fetus and newborn is a state that is characterized by the readiness of organs and systems to ensure its extrauterine existence.
External signs of a full-term baby:
1. Body weight not less than 2500 g.
2. Body length is at least 45 cm.
3. Head circumference 34-36 cm and chest circumference 32-34 cm.
4.The skin is smooth, elastic, velvety, bright pink in color.
5. Pronounced muscle hypertonicity.
6. Reflexes are lively and well evoked.
7. Vellus hair only on the shoulders and upper back.
8. Umbilical ring at the midpoint of the body (the middle of the distance from the xiphoid process to the navel).
9.The body is proportional.
10. The cartilages of the nose and ears are elastic and keep their shape.
11. The large fontanel is open 2x2 cm, 3x3 cm, in 15% of newborns the small fontanel can be open up to 0.5 cm.
12. The seams of the skull are closed and dense.
13.Nails reach the edge of the phalanges.
14. The testicles are lowered into the scrotum in boys; in girls, the labia majora cover the labia minora.
Signs of functional maturity:
1. The cry is loud, demanding, emotional.
2. Breathing is rhythmic.
3.Able to maintain body temperature during the examination.
4. Sufficient physical activity.
Immediately after the birth of the child, the Apgar scale . Apgar score – a scoring system for assessing the child’s condition. It is based on identifying the most important clinical signs:
Cardiac activity;
Breath;
Muscle tone;
Reflexes;
Skin coloring.
Each feature is scored in points:
Well expressed 2 points;
1 point is not enough;
Missing 0 points.
Angar scale assessment is carried out at the end of the 1st and 5th minutes of life.
A healthy newborn is estimated at 8-10 points on the Angar scale.
Prematurity today is not a critical diagnosis for a baby. Modern equipment and qualified specialists are able to organize an effective process of caring for premature babies in the first days of life. In the future, caring for the child falls entirely on the shoulders of the parents, and his condition depends on compliance with the rules for caring for premature babies.
First of all, this is the creation of a favorable environment for the child; it is also necessary to protect him from external factors risks such as infection and stress.
Now let's look at this in more detail.
The first days of a premature baby
Pregnancy is almost always a joy. AND happy parents They begin to calculate the due date in order to have time to prepare. But it often happens that the baby, contrary to the expectations of parents and doctors, is born earlier than planned. Babies born before 37 weeks are called premature.
As a rule, such children have body weight and height much less than the established standards. Modern equipment available to doctors today, used when caring for premature babies, gives them a better chance of survival. But 15-20 years ago, it was practically impossible for such children to remain in this world.
The first days are the most critical and decisive. After all, his lungs have not yet fully expanded, and it is difficult to breathe on his own. At this time, the child needs specialized care, which must be provided by doctors in the maternity hospital. They place him in a special box - an incubator, where a special microclimate is organized for him.
The microclimate in the incubator is comparable to the climate in the mother’s womb, in which the baby has been in recent months. The air mixture supplied there has a high percentage of oxygen. Thus, the process of “growing up” the child occurs. Due to the fact that the baby's organs are not fully formed, his nutrition is also provided through tubes.
Some hospitals use the so-called "kangaroo care" method. Its essence is that constant physical contact is ensured between mother and child. The only requirement is that the baby should not have serious health complications.
The baby will seem to go back inside the mother's womb. He quickly gains back the missing weight. A prerequisite is that the mother expresses breast milk.
It has been noticed that premature babies who receive breast milk gain weight faster and become stronger.
But now the time has come for discharge, after which the child completely comes under the care of his parents. And if with hospital coverage necessary conditions There are no particular problems, then parents need to be taught the rules of caring for premature babies, because at home it is quite difficult to protect them from various infections.
Features of caring for a premature baby at home
Caring for a premature baby at home requires parents to be attentive and patient, as well as a number of knowledge and skills. The main problem is the insufficient weight of the newborn. It is in the last weeks of pregnancy that the baby’s weight increases and a protective fat layer is formed, providing sufficient nutrition to the skin. In this regard, parents have to pay great attention to caring for the newborn’s skin, combating diaper rash and irritation.
- It is necessary to examine the baby's thin skin every time you change the swaddling. You should also be careful when choosing diapers. Preference should be given to soft natural fabrics, and you should also carefully choose detergents and powders for washing children's clothes.
Elastic swaddling of a child is strictly contraindicated. This will avoid abrasions on the leather. But the main reason lies in the fact that the child’s bones and respiratory organs are still weak, it is simply difficult for him to breathe, and besides, the blood circulation is not yet functioning properly. - Next important point is to ensure optimal and comfortable temperature conditions in the house and the baby’s room in particular. The absence of a subcutaneous fat layer makes the baby vulnerable to the surrounding climate, which makes the risk of infectious diseases many times higher. For this reason, the temperature should be monitored using a thermometer.
Premature babies are raised in a special box called an incubator.
The baby should be changed as quickly as possible, using heated underwear and diapers. It should also be kept in closed spaces where it is easiest to ensure the desired temperature: strollers, cradles. Overheating your baby is also dangerous, which is why it is important to check the temperature around your baby regularly.
Feeding a premature baby: features and routine at home
Caring for a premature baby at home has a number of rules during feeding. This applies not only to compliance with the frequency of feeding procedures, but also to the features of the process. First of all, it is important to take into account that the sucking process for a premature baby is a lot of hard work. The lungs are still weak, and the process of sucking milk requires holding your breath. You first need to get the milk, and then it is important not to choke at the moment when it pours heavily.
During feeding, you should take a position that is comfortable for the baby. If a child chokes during feeding, he begins to turn pale and blue right before our eyes. At this point, it is important to quickly turn him over onto his tummy and hold him almost upside down. In this position, the baby will quickly return to normal.
As an alternative to breastfeeding, doctors often recommend expressing milk. Then feed it to the baby through a pacifier. But the significance and importance of breastfeeding also cannot be discounted, and in the situation with a premature newborn, the importance of the process doubles.
If possible, you can alternate feeding options for your baby, using both a pacifier and putting him to the breast.
After feeding, you should not immediately put your baby in a cradle or crib. The fact is that premature babies burp more often and more abundantly than healthy children. Moreover, this happens abruptly and almost like a fountain; in order to avoid choking during regurgitation, you should hold the child in your arms in an almost vertical position or placing it on your shoulder. The baby may burp two or three times. This is explained by the fact that his stomach is not yet ready to accept food.
Bathing procedures should be daily. If signs of infection are observed, they can be replaced by wiping with warm water and a weak soap solution. The water temperature should be at least 37 degrees, closer to six months, and as the baby gets stronger, you can reduce it to 35 degrees for the purpose of hardening.
You should be more careful with your walks. In summer, they can be started already on the third day after discharge, and in winter - no earlier than 7, or even 10 days. The duration of the walk is up to 15 minutes. The first way out can be limited to a 5-minute walk, and then gradually increase the time you spend walking with your baby on the street.
Let's conclude
In general, caring for premature babies, subject to all rules, parental care and support, will allow the child to quickly recover and return to normal in all respects. By the way, early birth is recommended for premature babies with a constantly low body temperature. As for the mental development of the baby, prematurity extremely rarely affects this moment of development.
Additional information that will help parents properly care for their premature baby and reduce their fears is in this video: