Question

The Late Preterm Infant

Marie is a 32-year-old G3 P2002 who arrived at the hospital in active labor at 35 weeks. She is 7 cm dilated and quickly progresses to delivery of a 5-pound male infant with Apgar scores of 9 and 9.

1. What additional risk factors does this infant have compared with an infant born at 39 weeks?

2. What nursing interventions are indicated in the delivery room with the late preterm infant?

3. What should the mother be taught regarding infant feeding?

4. Marie states she would like to go home the next day. She states that her other children need her and it seems like the baby is doing fine. She states the baby has breastfed a couple of times, but he is just tired. What education is appropriate at this time?

5. Marie is now being discharged home with her infant at 2 days postpartum. The infant has been feeding well and has experienced no complications. What is priority teaching for this family?

Answer 1

1.Premature babies born at 35 to 36 weeks are called "late preterm infants." These babies are about 20 inches long and usually weigh between 5 1/2 and 6 pounds. 35 and 36 weekers look just like full-term babies, but they are still premature and may face some problems of prematurity.

But late preterm babies are still at risk for:

•respiratory distress syndrome (RDS)
sepsis
•patent ductus arteriosus (PDA)
jaundice
•low birth weight
•difficulty regulating temperature
•developmental delays or special needs. In some case death also.

2.Compared with full-term infants, late-preterm infants experience more medical complications after birth, such as respiratory distress, temperature instability, hypoglycemia, jaundice, inadequate feeding and a variety of infections.nursing intervention is to prevent the risks Such interventions may include kangaroo care, or holding the infant in skin-to-skin contact on the parents chest; helping moms breast-feed within the first hour of life; assessing vital signs frequently; and avoiding early bathing.

3.Breastmilk offers preemies wonderful benefits to help them grow and develop properly. Preemies are at a higher risk for medical problems than full-term babies. Your milk is the only food that contains antibodies and other substances that protect your baby from disease

your milk will be slightly different from full-term milk. This is because your baby’s needs are different from those of a full-term baby.

Because premature babies need more proteins for growth than full-term babies, your colostrum will have more protein than the colostrum of full-term mothers.

Your breastmilk will also have more of an enzyme called lysozyme. Lysozyme attacks certain bacteria and helps protect your baby from infections. And your breastmilk will have more fat and less lactose, because premature babies find lactose hard to digest.

your premature baby is 35 weeks or older, he’ll probably be able to suckle some breastmilk from your breast. But if your baby is younger, it might be weeks before he’s able to breastfeed fully.

During this time your baby can still have your breastmilk, either through a tube that runs from her nose down her throat into her stomach or by bottle or cup.

You’ll need to express your breastmilk either by hand or by using a hand-held or electric pump.

It’s helpful to express breastmilk soon after your baby’s birth – within an hour if you can – and then express every 2-4 hours to keep your supply up. Expressing at least once overnight also helps to keep your supply up.

Like breastfeeding, expressing breastmilk is a skill you have to learn. If you have trouble expressing, the midwives, nurses or the hospital’s lactation consultant will be able to help you. Don’t be afraid to ask for help.Pump early. If your baby was born early, you may feel overwhelmed by your birth experience and your baby's condition.
Pump often. Healthy newborns breastfeed often, Pump well.

4.premature baby needs more care after birth. Because overall health was not like a full term baby. Premature developments of all system will cause serious health problems. So observe the baby for 48hrs after birth for any serious complication. It is important to observe baby for following

You also may notice that your premature baby will cry only softly, if at all, and may have trouble breathing. This is because her respiratory system is still immature.

If she's more than two months early, her breathing difficulties can cause serious health problems, because the other immature organs in her body may not get enough oxygen. To make sure this doesn't happen, doctors will keep her under close observation, watching her breathing and heart rate with equipment called a cardio-respiratory monitor.

If she needs help breathing, she may be given extra oxygen, or special equipment such as a ventilator; or another breathing assistance technique called CPAP (continued positive airway pressure) may be used temporarily to support her breathing.

Breast feed every ry 2hrly and with the need of newborn. It is important for her health.

5.

Expect to live quietly with your preemie at first. Because their immune systems are still developing, preemies are at risk for infections. So, you'll need to take precautions.

Here are some things to do in the early days to help your baby thrive:

Limit visits. Visits outside the home should be limited to the doctor's office for the first several weeks, especially if your baby is discharged during the winter months. Because doctors' offices commonly have several kids with viral infections, try scheduling your appointment as the first of the day or request to wait in an examining room instead of the main waiting area. Ask the doctor how limited your baby's contact with other kids and adults should be during these first weeks.
Avoid public places and some visitors. Most doctors recommend not visiting public places with preemies. And limit visitors to your home: anyone who is ill should not visit, nobody should smoke in your home, and all visitors should wash their hands before touching the baby. Talk to your doctor about specific recommendations — some family visits may need to be postponed to allow your little one's immune system to grow stronger.
Put your baby to sleep on the back. Babies' success at feeding and sleeping is important to their health. Expect your preemie to sleep more than a full-term baby, but for shorter periods. All babies, including preemies, should be put to sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS).
Practice kangaroo care. Take advantage of these quiet weeks together to enjoy skin-to-skin contact, also known as kangaroo care. Most intensive care nurseries encourage parents to begin kangaroo care before discharge; the nursing staff can show you how. In a warm room at home, dress your infant in only a diaper, then place the baby on your chest and turn your baby's head to one side so that his or her ear is against your heart. Research shows that kangaroo care can enhance parent-child bonding, promote breastfeeding, and improve a preemie's health.