What is premature birth?

Premature birth is classified as a birth before 37 weeks of gestation. Because it is by far the most common cause of prematurity, preterm birth is the major cause of neonatal mortality in developed countries. Significant progress has been made in the care of premature infants. The cause for premature birth is in many situations elusive and unknown; many factors appear to be associated with its development.

Understanding medical procedures

You will be in a better position to join in with looking after your baby once you understand what the doctors and nurses are doing. Feel free to ask questions. You may want to keep a small notebook with you so that you can jot down any questions as they come into your mind. Some people find this helps them to remember questions that they want to ask the staff at another time. You may also find it helpful to write down their answers. It is better for you to be satisfied and happy than to go away with unnecessary worries.

Some doctors are happy for you to tape record appointments so that you can listen again to what they said about your baby’s progress and think it through. If you would like to have another member of staff, a member of your family or close friend with you when you meet with your baby’s doctor, it is quite alright.

What you will need for your baby

To begin with, and for a short while, the hospital will provide you with everything your baby needs, but you will likely be asked to bring in some of your own equipment including premature baby nappies, cotton wool balls and clothes. The staff will be able to advise you on what you will need.

Information about feeding

In the womb, your baby will have got all nutrients and fluid via the placenta and umbilical cord. When a baby is delivered prematurely, he or she will need to receive these nutrients in a combination of the following ways, depending on his or her maturity and health.

Total Parenteral Nutrition (TPN)

Placing a long, fine tube into a vein in the arm or leg means that mixtures of nutrients can be dripped directly into a baby’s blood stream. Initially the mixture may contain glucose, salts and water, with amino acids, fats, vitamins and minerals being added in due course.

This TPN is particularly useful for babies who are very unwell or whose stomach and gut are not developed enough to digest food.

Tube feeding

Babies who are doing a little better can start to take food into their stomachs. Many very premature babies can’t co-ordinate all of the muscles needed for swallowing, so a tube is passed through their nose (a naso-gastric tube), or their mouth (an oral-gastric tube), and down into their stomachs.

You will be encouraged to express milk and feed this via the tube using a syringe. Giving the baby early breastmilk helps stimulate his or her immune system and gut activity.

This is a great way of boosting your baby’s ability to fight infections. The nurses and Family Centred Care Co-ordinator can give you guidance on expressing milk.

Because the tube passes through your baby’s nose, it is quite possible for your baby to practise suckling at the same time as receiving a tube feed once he or she is mature enough.

Research shows that this not only teaches the baby to feed properly, but it also helps digestion. When you are ready, you can help tube feed your baby if you wish to.

Breastfeeding

Deciding whether to breastfeed
The fact that your baby is in a neonatal unit will have come as an enormous shock to you. However, the good news is that you can still do many of the things you planned, including breastfeeding. Even if you have decided against breastfeeding, you could express your breastmilk for a little while. Giving this to your baby will help to protect him or her from many different illnesses.

If you choose to breastfeed, you should express your milk as soon as possible, and it can be stored in a fridge on the unit until your baby is ready to feed. As with all newborn babies, some find breastfeeding easier than others. This can depend on factors such as the baby’s age, maturity and his or her medical condition.

The unit provides breast pumps, sterilisers, bottles and a milk bank to freeze expressed milk. There are two private rooms on the unit for mothers who wish to express their milk and we also have portable breast pumps to enable you to express at your baby's cotside, if you prefer. Please ask one of the nurses or Family Centred Care Co-ordinator if you need any help or advice with expressing.

Providing breastmilk may help you to feel closer to your baby. But you must feel happy with whatever you decide to do.

Advantages of breastmilk

Breastmilk boosts a baby’s defences against infections and protects him or her against gastroenteritis and chest infections.

Mother’s milk also provides nutrients, growth factors and hormones that help your baby grow and develop during the vital early months after birth.

Breastmilk is also very easy to digest and is absorbed more easily than formula milks.

First milk

The first milk mothers produce is called colostrum. This is thicker and more yellow in colour than breastmilk, and contains a lot of infection-fighting proteins and cells. You may find it easier to hand express colostrum than to use a breastpump. Even if your baby is not going to be fed for some time, the colostrum can be frozen until your baby is ready to have it.

Supplemented feeds

It may be necessary to supplement colostrum in the early days with formula milk to ensure that your baby receives enough energy and fluid to get well quickly. Don’t worry, you will always be consulted about this and it is just a temporary measure, since you will soon be able to produce enough milk for all your baby’s needs.

Fortification

Your milk is produced to meet a baby’s dietary needs, but the needs of some premature babies can be different. Some very premature babies grow more quickly if they get extra protein, minerals and vitamins. If so, you may need to add fortifiers to your expressed milk. These fortifiers are only used until your baby is strong enough to breastfeed.

Breastfeeding and drug use

Whilst almost all drugs and chemicals are passed from a mother’s blood to breastmilk, it can be safe to breastfeed if you are still taking drugs depending on which drugs you are taking and how much. It is recommended that you seek advice as to which drugs are safe to breastfeed with and which aren’t.

* Copy courtesy of Bliss

Look after your baby

Your baby will always benefit from having you close by

Reach out to family and friends for support

Reach out to family and friends for support