Premature Birth

Diagnosis

A premature baby receiving care in the neonatal intensive care unit often needs multiple tests to closely monitor health and development. Some tests are done continuously, while others are performed only if the medical team suspects a specific health concern.

Common tests for premature babies include:

• Breathing and heart rate monitoring
  Breathing patterns and heart rate are monitored around the clock. Blood pressure is also checked frequently to ensure stable circulation.

• Fluid intake and output measurement
  The NICU team carefully tracks how much fluid the baby receives through feedings or intravenous lines, as well as how much fluid is lost through wet or soiled diapers.

• Blood tests
  Blood samples are usually obtained through a heel prick or a needle placed in a vein. These tests help monitor important substances in the blood, such as calcium and blood sugar levels. Blood tests are also used to detect conditions like anemia or infections.
  If repeated blood tests are required, a thin tube may be placed into a vein in the remaining portion of the umbilical cord. This reduces the need for repeated needle sticks.

• Echocardiography
  This ultrasound-based imaging test evaluates how the heart is functioning. It produces moving images that help identify structural or functional heart problems.

• Ultrasound studies
  Ultrasound imaging may be used to examine the brain for bleeding or fluid buildup. It can also assess organs in the abdomen, such as the digestive tract, liver, or kidneys.

• Eye examination
  An ophthalmologist may examine the baby’s eyes to check for retinal conditions that can affect vision.

Additional tests may be required if the baby develops other medical conditions.

Treatment

Premature babies receive specialized care in the neonatal intensive care unit or a special care nursery. Their condition is monitored closely to support growth, development, and recovery.

Supportive care

Supportive treatments are essential for helping a premature baby adapt to life outside the womb and may include several measures.

• Incubator care
  Babies are often placed in enclosed incubators that provide warmth and help maintain a stable body temperature. As the baby becomes stronger, caregivers may encourage skin-to-skin contact, also known as kangaroo care.

• Monitoring vital signs
  Sensors placed on the baby’s body track heart rate, breathing, blood pressure, and temperature. A ventilator or continuous positive airway pressure device may be used to assist with breathing.

• Feeding support
  In the early stages, fluids and nutrition may be given through a tube placed into a vein. Breast milk can later be delivered through a tube passed through the nose into the stomach. Once the baby develops enough strength, breastfeeding or bottle-feeding may begin.

• Fluid balance management
  Premature babies have specific daily fluid needs based on age and health status. The medical team closely monitors fluid, sodium, and potassium levels. If additional fluids are required, they are provided intravenously.

• Treatment for jaundice
  Babies with jaundice may be placed under special bilirubin lights. These lights help the body break down excess bilirubin. Protective eye coverings are used during treatment.

• Blood transfusions
  Some premature babies require blood from a donor due to medical conditions or frequent blood testing.

Medications

Medications are used to support various body systems and address specific medical issues. Depending on the baby’s condition, treatment may include:

• Surfactant to help treat respiratory distress syndrome

• Medicines delivered as a fine mist or through a vein to support breathing and heart function

• Antibiotics to treat or prevent bacterial infections

• Diuretics to help remove excess fluid from the body

• Eye medications to prevent abnormal blood vessel growth linked to retinopathy

• Medicine to help close a heart condition called patent ductus arteriosus

Surgery

In some cases, surgery is necessary to correct health problems associated with prematurity. The healthcare team discusses potential complications and explains which surgical procedures may be needed, along with their risks and benefits.

Taking your baby home

Certain signs usually indicate that a premature baby is ready to leave the hospital. These include being able to breathe without extra support, maintaining a stable body temperature, feeding by breast or bottle, gaining weight steadily, and having no major unresolved health problems.

Sometimes a baby may be discharged before meeting all of these criteria. In those situations, the medical team and family work together to create a clear plan for home care and follow-up visits.

Before discharge, parents receive guidance on caring for their baby at home. Hospital staff may ask questions about:

• Living arrangements and household members

• Other children in the home

• Family members or friends who can provide help

• The baby’s primary healthcare provider

This preparation helps ensure a safe transition from the NICU to home care.