Premature Babies: All You Need to Know

Premature babies (also known as “preemies”) are babies who didn’t get the memo about their due date – they’ve come into the world a little earlier than expected.

About 1 in 10 babies in the US are born premature each year.

So what is considered a premature birth in medical terms?

Well, it’s when your baby is born 3 weeks before your due date or earlier.

That’s before the 37th week of pregnancy.

In medical speak, giving birth before 37 weeks is also called a “preterm birth”.

Depending on how early your baby is born, your doctor might use one of these terms to describe them:

• Late preterm: born between 34 and 36 weeks
• Moderately preterm: born between 32 and 34 weeks
• Very preterm: born at less than 32 weeks
• Extremely preterm: born at or before 25 weeks (these babies are also called micro preemies, because they’re so tiny)

Premature babies might need special care, as their bodies aren’t always ready to cope with life outside your uterus.

They may need to stay in the hospital for a while.

And there’s no denying this can be a tough experience when you’re a new mama, and all you want to do is to take your babe home with you.

Let’s take some time to talk about premature babies and the care they need to give them the best start in life.

In this article: 📝

Why are babies born premature?

First, do we know what causes premature babies to be born early?

In many cases, frustratingly, it’s not possible to pinpoint an exact reason why a preemie baby has arrived.

However, there are some factors that can increase the risk of premature birth:

• A health issue with the mama, such as diabetes, high blood pressure, or an infection
• Being a younger (under 19 years old) or older (over 40 years old) mama
• Being pregnant with multiples, such as twins or triplets
• Conceiving through in vitro fertilization (IVF)
• Being underweight or not gaining enough weight during pregnancy
• Drinking alcohol, smoking, or taking illegal drugs while pregnant
• Experiencing a stressful life event during pregnancy, such as a bereavement

With around 1 in 4 premature births, the birth is actually planned (as an induced labor or a C-section) because the mama or baby’s life is at risk from pregnancy complications.

What do premature babies look like?

Premature babies are generally smaller than full-term babies (babies born around their due date at 40 weeks), and the earlier they’re born the tinier they’ll be.

Their head will look larger in proportion to their body, and they don’t have much body fat yet.

Their skin may look quite transparent, so you can see the blood vessels underneath it, and they might not have the creamy vernix coating (as this develops later in pregnancy).

They may also have fine hair (lanugo) on their back and shoulders.

What health issues do premature babies have?

Premature babies haven’t had as much time in the comfort of the uterus as they would like.

Because of this, some of their organs might not be as well developed as they should be (especially if they’re extremely preterm), and this can lead to health issues.

They may need to spend some time in the hospital’s neonatal intensive care unit (NICU), where they can be closely monitored as they grow, and they can be given any medical treatment that they need.

Here are some of the health issues that a preemie baby might need help with:

• Body temperature. They might be placed in an incubator to keep them warm, if they aren’t able to regulate their own body temperature yet.
• Breathing and heart problems. Their heart rate and breathing will be monitored while they’re in hospital. They might need help to breathe (with oxygen or a ventilator) while their lungs develop. Doctors will also look out for a heart issue called patent ductus arteriosus (PDA), which can cause too much blood to flow to the lungs.
• Infections. Antibiotics might be needed to treat infections and prevent sepsis.
• Blood problems, including anemia and newborn jaundice.
• Eye problems. Premature babies can get a condition called retinopathy of prematurity (ROP) where their retinas (the nerve tissue at the back of their eyes) don’t develop properly in the first few weeks after birth. This is often mild, but more severe forms might need surgery to prevent long-term eye damage.
• Gastrointestinal problems – in particular, necrotizing enterocolitis (NEC), a serious issue affecting premature babies, where tissue in the intestines becomes damaged and starts to die.
• Trouble feeding. A preemie baby might not be able to feed by mouth straight away. Instead, they may be fed intravenously or with milk (your expressed breast milk or formula) through a feeding tube into their stomach.

You can see that some premature babies have a challenging journey ahead of them, before they’re strong enough to face the big wide world, but expert medical care can make all the difference to their prospects.

At what age can a premature baby survive?

This is a difficult, but important, question to ask.

Essentially, the later a preemie baby is born, the better their chance of survival.

But with advances in medical care, even early premature babies’ survival rates are rising and they have a greater likelihood of living and thriving than ever before.

The earliest that a premature baby can survive is about 22 weeks, with a 10% survival rate.

This increases to 60% at 24 weeks and 89% at 27 weeks.

By 34 weeks, premature babies have the same survival rate as full-term babies.

How long do premature babies stay in the NICU?

The length of stay in the NICU (neonatal intensive care unit) is different for every preemie baby.

A rough rule of thumb is that they can go home when they:

• Reach a certain weight and are continuing to put on weight steadily (neonatal intensive care unit)
• Can regulate their own body temperature (neonatal intensive care unit)
• Can breathe alone (although they might need oxygen at home for a while) (neonatal intensive care unit)
• Can breast- or bottle-feed

And don’t worry: once you take your preemie baby home, you’ll still have regular check-ups to monitor their health.

Do premature babies have problems later in life?

Despite the best efforts of the NICU team, some premature babies do grow up to experience health and developmental issues.

The risk is increased for babies born earlier: while 1 in 10 premature babies, as a whole, will have a permanent disability, that rises to 1 in 2 babies born before 26 weeks.

But this includes “mild” disabilities, such as needing glasses to see clearly.

Ongoing health conditions linked to premature birth include: cerebral palsy, lung disease (such as asthma), sight and hearing issues, and learning disabilities.

Premature babies might also take longer to reach some of the key baby milestones, like walking and talking. But in the majority of cases, they’ll get there in their own good time.

You and your preemie baby

Being the mama of a preemie baby, particularly during those early days in the NICU, can bring a rollercoaster of emotions.

One minute you’re filled with love and pride for your little warrior, the next you’re tearful and frustrated that they’re in an incubator rather than your arms.

It’s not easy.

Remember that you’re still doing an amazing job as a mama – just by being there at their bedside, talking to them, or gently holding them when that’s possible.

And when you’re not at the NICU, remember to get plenty of rest, eat well, and spend some quality time with people who care about you.

We hope you get to bring your babe home very soon.