If you’re pregnant, then you’re probably wondering what is considered a premature baby. Around nine percent of all babies are born prematurely. For parents of premature babies, this often marks the beginning of a time of worry and anxiety. But not every premature birth has consequences for the other life of the child.
What Is Considered a Premature Baby
Typically, pregnancy lasts around 280 days, i.e., 40 weeks, starting from the first day of the last period. The expected date of birth is calculated either by employing an ultrasound scan in the first trimester of pregnancy or based on the first day of the last menstrual period, depending on the length of the menstrual cycle.
How early is early?
However, only four percent of all children are born on the calculated date (ET). Everyone else sets off in the course of the three weeks before (from 37+0 weeks gestation) or up to two weeks later (42+0 weeks’ gestation). This period is referred to as a full-term pregnancy. If the delivery occurs before the 37th week of pregnancy, one speaks of premature birth or a prematurely born infant. A distinction is made between three different cases:
- Moderate to late premature babies: In this case, the pregnancy ends between the 32nd and 37th week of pregnancy. Among other things, these children are more susceptible to infections and must be closely monitored after birth. Developmental delays can also be a result of this early birth.
- Very premature babies: This means babies born between the 28th and 31st week of pregnancy and weigh less than 1,500 grams. With the proper medical care, these premature babies have a good chance of surviving their early start in life without drastic long-term consequences.
- Tiny premature babies: These infants are born around the end of the 27th week of pregnancy or earlier and usually weigh less than 1,000 grams. This situation is rare and requires a very high level of medical supervision. The less time the baby has in the womb, the higher the risk of complications, long-term effects, or even the chance of survival. If the baby is born in the 24th week of pregnancy, the probability of survival is 30 percent. However, the exception can also prove the rule here.
How do you calculate the age of a premature baby?
Some parents of premature babies may wonder what age their offspring is now? Do you only start counting on the day of the ET or on the birth itself? A distinction is made here depending on the situation:
- The chronological age is the actual age since birth. Chronological age is mainly used to schedule doctor appointments and check-ups.
- The corrected age subtracts the weeks from the chronological age that the child was born prematurely. For example, if the baby was born 8 weeks early and has just turned 12 weeks old, one would speak of a 4-week-old infant. The corrected age is commonly used when looking at the baby’s development.
- The gestational age also includes the actual degree of maturation of the infant. That is the number of weeks spent in the womb up to the time of birth (from the first day of the last menstrual period) plus the infant’s maturational characteristics at the time of delivery.
Myths about Preterm Birth
Most preterm parents question whether they are partly to blame for the preterm birth and often feel unnecessarily plagued with guilt. Most of the time, nothing can be done to prevent premature birth. In over 40 percent of all cases, the cause remains unclear.
However, some myths about the reasons for premature birth persist, even though they are not scientifically proven. These include:
- Care for
- negative thoughts
- Quarrel with partner
- air travel
- bad food
- To swim
- sex during pregnancy
Especially the latter is entirely harmless in normal pregnancy and does not cause premature birth. This risk only exists in women who have already had a premature birth or show signs of one in their current pregnancy. In these cases, you should always consult your doctor.
The causes of premature birth
The real reasons for premature birth – if there are any – are varied, and usually, several factors play a role.
Multiple births are rarely carried out until the 40th week of pregnancy. Twins have a 25 to 50 percent higher risk of preterm birth. The risk increases as the number of unborn babies in the womb increases.
Reasons could then be, for example, a premature rupture of membranes or a weakened cervix due to the increased pressure of the baby. Special attention is paid to whether the cervix is still sufficiently closed during the regular check-ups.
An ultrasound examination can determine whether there are any irregularities in the unborn child’s development and whether an early delivery may need to be initiated. If the unborn child requires medical intervention before the expected due date, scheduling a due date may be considered.
Malformations of the uterus or cervix, chronic diseases such as kidney disease, preeclampsia (a pregnancy-related illness associated with high blood pressure), diabetes, or a dysfunctional or damaged placenta necessitate early delivery.
The birth can be by cesarean section or induced in the interests of the mother’s and/or child’s well-being. The delivery mode also depends on the week of pregnancy the child is in.
In general, women are more at risk which:
- have had a premature birth in the past.
- Are pregnant very quickly.
- Are very young or older than average.
- Do heavy physical work or are exposed to severe physical or mental stress.
Risk factors for preterm birth
In many cases, however, there is no identifiable cause from a medical point of view. However, there are several known risk factors for preterm birth. These include:
- Nicotine and alcohol consumption
- socially and economically tricky conditions
- previous preterm births
- gum disease
- Infectious diseases of the urinary tract or genital organs
If you have any symptoms, you should always see a doctor as soon as possible. Targeted tests can then be used, for example, to identify a pathogen and initiate therapy. Treatment before or during labor can prevent diseases from passing on to the unborn child.
Can you prevent premature birth?
The following applies to every pregnancy: the woman’s health is the top priority! This includes eating well, gaining weight appropriately, and avoiding cigarettes, alcohol, and drugs.
It is not possible to completely eliminate the risk of preterm birth, but good health care during pregnancy can reduce the risk. Therefore, make sure you take advantage of the preventive medical check-ups planned for you by your doctor or midwife.
Most of the time, the body sends out warning signals before premature birth. These can be preterm labor, bleeding, or changes in the cervix. Women who have a risk factor or an acute or chronic disease are usually monitored more closely.
If despite all preventive measures, premature birth is announced, the pregnancy can possibly be prolonged with the administration of anti-labor drugs. Antibiotics may be advisable to prevent or treat infections in children. Lung maturation can be accelerated by administering cortisone, which can reduce later complications.
A premature baby is born.
About 30 percent of all preemies are born after a premature rupture of membranes, and about half are simply because labor starts too soon.
The right hospital
However, if premature birth is already apparent in advance, it is crucial to think about the delivery and the choice of the hospital at a good time.
The pregnant woman can give birth in a maternity clinic for high-risk pregnancies. If the delivery is around the 29th week of pregnancy or even earlier, a Level 1 perinatal center offers all the care options, even for tiny premature babies. If giving birth beyond 30 weeks of gestation, the woman should deliver in a Level 2 perinatal center.
Normal birth or cesarean section?
If the water has already broken, a vaginal birth will usually occur. If labor doesn’t start within 24 hours after the membranes rupture, labor inducements will likely be given.
In premature babies, the baby’s head is still very soft. If the baby is still very immature, it is precisely why a cesarean section is often performed. sense.
The time in the hospital
Premature babies are usually treated in intensive care immediately after birth and placed in an incubator. This enables a constant temperature and humidity. Some small patients must also be supplied with oxygen and fed through a gastric tube and/or infusion.
But mom and dad are just as necessary for the further development of their little newcomer. With the so-called “kangaroos,” the baby is placed on their bare chest for a certain period. This skin contact conveys warmth and security and has a proven positive influence on further treatment.
As soon as the baby can then drink milk on its own, it is carefully supplied with pumped breast milk through a skinny tube. In many ways, breast milk is now the best medicine: For example, it stimulates intestinal flora development and strengthens the immune system of the little ones who are so susceptible to infections.
The first time after the birth of a premature baby is very stressful for parents. They worry about the health of their little darling and suffer from the separation. The hospital staff can allay fears and prepare them for everyday life at home.
The time after the release
Premature parents probably start their everyday life with the newborn less relaxed than other parents. Worrying about her protégé will cost her a few sleepless nights. It is essential to look for support to recharge your batteries in between. If necessary, you should also take advantage of physiotherapy, ergotherapy, or early intervention offers.
Parents should undoubtedly have the most petite size diapers and correspondingly small clothes at home, but special baby equipment is unnecessary. An exception is a rare case where the baby still needs to be supplied with oxygen at home. Then the hospital will prepare the parents well for handling a portable oxygen device.
About the development of a premature baby
Most premature babies are discharged from the hospital around their due date. However, they are likely still quite a bit lighter than an average-born child. In the first few months, the main focus will be gaining weight.
Very few premature babies reach the average weight of 3,000 to 4,000 grams at their calculated initial birth date. A prematurely born child will spend the first few weeks adapting to the new circumstances and, if necessary, fighting against possible complications.
A little later, length growth will also play a role. Premature babies also have to catch up here. This usually happens within the first and second years of life. Until then, they may still be below average on the growth curve. According to the calculated ET, a well-developing premature baby grows about six centimeters per month. After that, growth slows by half.
The head circumference receives special attention because it says a lot about the development of the brain. The brain grows fastest after the 36th week of pregnancy, including the third month after birth. Therefore, a healthy premature baby should increase head circumference by around one millimeter per day in the first few months.
Understandably, premature babies reach the milestones of child development a little later .The corrected age must always be considered here – i.e., the time that the child was born prematurely is deducted.
It is difficult to tell whether a preemie is prone to developmental problems. Babies who are born very early can also develop entirely normally later on. However, the risk of developmental abnormalities is still increased in premature babies.
For example, many babies have trouble staying awake, processing stimuli with their eyes and ears, and responding positively to touch. A premature baby may spend most of their energy eating, growing, and turning off strong lights and sounds, leaving little energy for social interaction.
Parents sometimes feel inadequate when they fail to make eye contact or feel the special bond from positive responses to touch and looking at one another. These initial difficulties are entirely normal.
Possible late effects
In some cases, longer-term consequences can be identified:
- movement disorders
- in rare cases, epileptic seizures
- Problems of perception and perception processing (seeing, hearing, feeling)
- decreased intelligence
- Behavioral issues (lack of concentration)
Much of this will only emerge gradually or not at all. Every child is different, and the level of complications during and after birth is the deciding factor here!
Hereditary dispositions of the parents and the child’s support later have an influence on the development of a premature baby. By providing targeted support for the premature baby, you can definitely try to minimize the risk of long-term effects.
The diet of a premature baby
Especially after a difficult start in life, the motto is: grow, grow, grow!
Jump-start with additional nutrients
That’s not easy because a premature baby initially does not tolerate food very well. Of course, it always depends on how far developed the baby was at birth.
- Moderate to Late Prematurity: The goal is to get the baby used to breastfeed. It is, therefore, regularly placed on the chest. To give the child additional strength, a complementary solution is offered.
- Very immature premature babies: Most likely, the vital nutrients will be given to the premature baby via an IV. A feeding tube also supplies the baby with a milk substitute solution. The digestive system should be trained.
- Tiny premature babies: As with the very immature premature babies, these children are supplied with an infusion and a stomach tube. The training of the intestinal activity is in the foreground here.
The goal in all cases is to increase food intake and thus growth. Premature babies tolerate breast milk particularly well. However, they need more protein, calcium, phosphorus, trace elements, and vitamins than breast milk contains. In most cases, this is mixed into a bottle with breast milk, or you use a milk formula specially developed for premature babies.
Breastfeeding premature babies can be difficult when the little ones are still too weak to suckle hard enough. However, breast milk contains necessary antibodies that can support a premature baby’s very vulnerable immune system.
By around 29 weeks of gestation, a preemie may be able to lick the first few drops of breast milk from the breast. With the so-called kangaroos, you can start the first attempts. A breast pump will help provide the baby with enough breast milk. Regular pumping can be exhausting and sometimes frustrating. But it’s worth it!
Despite the breast pump, you should still try to put the child on the breast. Premature babies need a lot of closeness, and the mother will also enjoy this cuddle time.
Tips on how to support a premature baby
Breast milk is just one of many ways to support a premature baby. There are so many things that early parents can do to put their little darling under their arms.
A calming environment
The baby may be sensitive to light, noise, or new stimuli. So care should be taken when they are tired of focusing on complex tasks like eating or listening to the voice.
Certain places or situations can overwhelm a premature baby. It is therefore essential to avoid these. A simple purchase at the supermarket can mean excessive stimuli for a sensitive infant. He may need more time and maturity to process the stimulation that occurs.
Uniformity and predictability
Like most adults, babies want to know what’s coming next. It takes away their fear and helps them achieve success. A regular daily routine with constant caregivers and the same sleeping environment creates a structured and predictable world for the infant. This gives him the confidence to learn new skills in a relaxed manner.
support in the effort
As babies grow older, they learn to do more and more tasks themselves, and they take pleasure in the sense of accomplishment. Even the most minor achievements, like sucking on a hand to calm oneself, lead to self-affirmation and satisfaction.
A weak baby may need extra help. A little help with the arm is enough to grasp their feet and gain more stability. These little things have a significant impact on the baby’s development.
the rhythm of the baby
The baby’s need to wake up on its own should be respected. Babies born prematurely have to find their sleep-wake cycle and, at the same time, have to cope with being cared for by constantly changing people. The baby sends out signals when it is ready to play. You should always give him enough breaks when he needs rest or a nap.
The baby should be moved as gently as possible. It takes a lot of effort to move fluently and not overextend or dangle your arms and legs. The child loves to be held so that they can feel the warmth and support of the parent’s body. Also, being wrapped in a blanket can be soothing until his movements become more purposeful and controlled.
Rapid movements can cause problems for premature babies. One may notice frequent “I’m overwhelmed” signals in situations where the child is being moved too quickly or lacks the mother’s support or a blanket.
Let the baby guide you.
It may look away at first, fall asleep, or become limp when you talk to it and look at it. This is how the baby signals that it is not yet ready to look, listen and move simultaneously. A premature baby should not be pressured. Baby signs should be respected when it’s getting too much, and a break from interactions is essential.
Meals are a difficult moment for many preterm babies. Eating, looking, and listening simultaneously requires a lot of concentration and coordination. Rest at mealtimes is therefore essential. The baby signals when it can tolerate stimulation.
Babies have individual strategies to bring themselves into harmony with their environment. These include the following:
- Reaching for blankets, fingers, or other objects
- clasping feet on the bed
- Covering face with hands or putting hands in mouth
- Sucking on a pacifier or fingers
- Curving the body by bending the arms and legs forward
But you quickly become familiar with the unique way babies communicate and can then give them the support they need to get in touch with the world around them.
Interpret the signals correctly
“I’m overwhelmed” signals that indicate a premature baby is moving too fast or needs a break include:
- Accelerated or stopped breathing
- hunching over (like having a bowel movement)
- Paling or flushing of the skin
- Changes in muscle tension, such as stretching out or relaxing your arms or legs
- Sudden, jerky movements, jerking, or startling
- Arching the back backward
- sticking out the tongue
- Nervousness and whining that can last longer
- Averting gaze during social interaction
- Falling asleep when the baby should be awake
“I’m ready” signals that indicate that a baby is “collected” and able to process incoming stimuli or information include:
- Regular breathing
- Skin color staying the same
- Flowing movements of arms and legs
- quiet attention
- Gazing steadily at a face or object
- Falling asleep and undisturbed sleep at appropriate times, so the baby has the energy to absorb information when awake
Many parents are a bit unsure about dealing with their premature baby at first. The child was monitored at all times in the hospital. This is no longer the case at home. Therefore, it is vital to establish a normal everyday life and respond to the offspring’s particular needs.
Tips for parents of premature babies
Premature birth is stressful for parents. Mothers sometimes struggle with guilt, and the pregnancy ends so abruptly.
This can also lead to tensions in the couple’s relationship. Everyone handles a crisis situation differently. Therefore, it is essential to stay in touch with your partner to process the events of the early birth together. A time out together helps to gather new energy. Nobody should shy away from entrusting the child to someone else during this time.
Discussion groups in which you can exchange ideas with other affected parents are also helpful. The maternity hospital can provide the parents with initial information on which options for early support for the child are useful. Some institutions offer a wide range of services for premature babies and their parents.
Extended maternity leave
Maternity leave usually begins six weeks before the birth and ends eight weeks after. An exception is made here for premature births. After the actual birth, early mothers are entitled to at least 12 weeks of maternity leave after the birth, as the child has an increased need for care.
This period can be extended to include the weeks that the child was born prematurely. If the premature baby was born in the 35th week of pregnancy, for example, you would only have taken one of six weeks of maternity leave before the birth. The missing five weeks are not lost but are counted on top of that. In this case, the mother would be on maternity leave for 18 weeks after giving birth. All you have to do is submit a certificate from the pediatrician to the employer.
Caring for a premature baby can also become a financial burden for some families. However, there is also support here that can be requested from the health insurance company:
- Travel expenses to visit the child while in hospital.
- If another child lives in the household and needs to be cared for during the hospital stay, an application can be made for household help or childminder.
- If the premature baby requires intensive care, you may be entitled to home nursing care, reimbursement of therapy costs, or a family support service.
- In most cases, the costs of medicines and aid are also covered.
Contact your health insurance company for more information if you also have a premature baby at home. You can find sample applications for cost reimbursement at the Federal Association “The Premature Child.”
Everyday life with a premature baby can be exhausting, and the thoughts of early parents often revolve around just one topic: Is my baby doing well? Mother-father-child cures should help to deal with the new situation.
The statutory health insurance companies are obliged to pay the costs of such a cure if it is prescribed by a doctor. Everyone should use this opportunity. In most cases, the family doctor has more information and can help.
Frequently Asked Questions
If a baby is born before the 37th week of pregnancy, it is called premature birth.
A distinction is made here between moderate to late premature babies (born between the 32nd and 37th week of pregnancy), very immature babies (born between the 28th and 31st week of pregnancy), and tiny premature babies (born at the end of the 27th week of pregnancy and earlier).
In the case of premature birth from the 24th week of pregnancy, a baby already has a 30 percent chance of survival with intensive medical care.
This increases with each additional day in the womb.
The average weight of a premature baby born in the 28th week of pregnancy is 1200 grams. The length is between 34 and 41, and the head circumference is around 26 centimeters.
In the 36th week of pregnancy, a premature baby could be twice as heavy and up to ten centimeters longer.
Premature babies also differ significantly in their growth.
In many cases, no specific reason can be identified.
However, the abuse of alcohol, cigarettes, or drugs, previous premature births, heavy physical work, or previous illnesses of the mother increase the risk of premature birth.
Premature babies have the best possible care in a maternity clinic specially designed.
In some cases, a cesarean or episiotomy is performed to prevent head injuries.
After birth, they are oxygenated in an incubator and fed through a stomach tube and/or IV.
Nevertheless, physical contact with the parents is essential.
In the so-called “kangaroos,” the baby is placed on the bare chest of the mother or father for a certain period.
There are various contact points where premature parents can get financial and emotional help.
The statutory health insurance companies cover the costs of some of the services that a premature baby needs for support.
Mother-father-child cures or self-help groups are a valuable addition to mastering the often tricky everyday life with a premature baby.
A premature baby does not develop within the standard development chart. It needs time and the support of its parents to grow and thrive.