The following are conditions that are seen commonly in late preterm infants. It is important to know the signs and what to expect if your infant has issues with any of these conditions
Breathing problems
Because the lungs are not fully developed at this time, breathing problems can occur. Even if your infant might look fully grown, they can still have immature lungs. Call 911 if your baby is having trouble breathing or your health care provider if it is not an emergency. It is very important that your new baby's lungs not be exposed to smoke. Secondhand smoke is linked to Sudden Infant Death Syndrome (SIDS), asthma, and ear infections. Make your home smoke- free! 4
Signs of breathing problems
- Fast breathing (The normal rate of breathing for a newborn is 30-60 breaths per minute)
- Nasal flaring
- Retractions (there are many different types of retractions, but follow this link to see a video to get an idea of what retractions look like, watch the chest: https://www.youtube.com/watch?v=NBA9iigiDgk)
- Pale or blue color
- Grunting
Apnea
Breathing is often irregular with premature infants because the part of the brain that controls breathing isn't fully developed. Short pauses in regular breathing is normal, but a pause that lasts longer than 20 seconds is called apnea. This can usually be corrected with gentle rubbing or tapping on the baby's arm or leg to "remind" them to breathe. Report this to your health care provider immediately if it lasts for greater than 20 seconds.4
RSV
RSV stands for respiratory syncytial virus. This respiratory infection is most common from fall to spring, but a person can catch it at any time of the year. Almost all babies get RSV sometime, most of them before they are 2 years old. For healthy babies, it is like getting a cold. But RSV can be very serious and is particular problem for late preterm infants. It can cause pneumonia, a serious lung disease or even death. Each year thousands of babies must be hospitalized because of RSV.1
Symptoms of RSV are cold-like symptoms, including cough and runny nose, and usually last one to two weeks.
You should call your baby's doctor if you notice any of the following symptoms:
- Difficulty breathing
- High fever.
- Thick discharge from the nose
- Cough producing yellow, green, or gray mucus
- Unusual irritability or inactivity
- Refusal to breastfeed or bottle-feed
- Signs of dehydration, including lack of tears when crying; little or no urine in the diaper for six hours; cool, dry skin
RSV Prevention:
RSV is spread easily by touching people or surfaces infected with the virus. Taking measures to prevent RSV infection is important for all babies. But it's especially important for those at high risk for severe infection.
The following tips can help prevent the spread of the virus to your baby:
- Wash your hands frequently, particularly after contact with anyone with cold symptoms.
- Clean and disinfectant hard surfaces.
- Do not allow people to touch your baby without first washing their hands.
- Avoid kissing your baby if you have cold symptoms.
- Keep your baby away from crowds.
- Do not allow anyone to smoke around your baby.
- Limit the time high-risk babies and young children stay in day care, particularly from late fall to early spring when RSV is most prevalent.
- If possible, keep your baby away from anyone, including older siblings, with cold symptoms.
Jaundice
Jaundice in infants is usually caused by an excess of something called bilirubin. Bilirubin is a yellow pigment that comes from the breakdown of red blood cells. It is very common in infants and very treatable. Normally the liver filters out this bilirubin from the blood, but newborns livers are still immature and often cannot remove it quickly enough. Jaundice due to these normal newborn conditions is called physiologic jaundice, and it typically appears on the second or third day of life.
The more the bilirubin is excreted by the body, the less jaundice the infant will be. Frequent feedings will allow for more voiding and stooling of the infant, which is how the body gets rid of the bilirubin.4
Risk factors:
Major risk factors for jaundice, particularly severe jaundice that can cause complications, include:
- Premature birth. A baby born before 38 weeks may not be able to process bilirubin as quickly as full-term babies do. Also, he or she may feed less and have fewer bowel movements, resulting in less bilirubin eliminated through stool.
- Significant bruising during birth. If your newborn gets bruises from the delivery, he or she may have a higher level of bilirubin from the breakdown of more red blood cells.
- Blood type. If the mother's blood type is different from her baby's, the baby may have received antibodies through the placenta that cause his or her blood cells to break down more quickly.
- Breast-feeding. Breast-fed babies, particularly those who have difficulty nursing or getting enough nutrition from breast-feeding, are at higher risk of jaundice. Dehydration or a low calorie intake may contribute to the onset of jaundice. However, because of the benefits of breast-feeding, experts still recommend it. It's important to make sure your baby gets enough to eat and is adequately hydrated.2
Most hospitals have a policy of examining babies for jaundice before discharge.If your baby is discharged earlier than 72 hours following birth, make a follow-up appointment to look for jaundice within two days of discharge.
The following signs or symptoms may indicate severe jaundice or complications from excess bilirubin. Call your doctor if:
- Your baby's skin becomes more yellow
- Your baby's skin looks yellow on the abdomen, arms or legs
- The whites of your baby's eyes look yellow
- Your baby seems listless or sick or is difficult to awaken
- Your baby isn't gaining weight or is feeding poorly
- Your baby makes high-pitched cries
- Your baby develops any other signs or symptoms that concern you
- Jaundice lasts more than three weeks 2
Treatment:
A technique called phototherapy is the most common way to treat jaundice. The baby's skin is exposed to special high power lights, or "bili-lights" to speed up the removal of bilirubin. Sometimes, a phototherapy blanket is used for treatment in the hospital or at home.
Picture References: Top Left: www.njadvocates.com, Top Right http://scienceline.org, Center Left: phoenixmedicalsystems.blogspot.com, Center Right: en.wikipedia.org, Bottom Left: pediatrics.aeroflowinc.com, Bottom Right: www.reddit.com
Infection
Late preterm infants have immature immune systems and may be more likely to develop infections. Your babies immune system is still developing, so it can be hard to fight off infection, don't let family or friends who aren't feeling well visit your baby. Avoid places with large numbers of people and young children.
Signs/symptoms of infection:
Controlling Body Temperature
Late preterm infants have less body fat and may be less able to control their own body temperature. Holding your baby in "Kangaroo Care" or skin to skin can help them keep a stable temperature. You can check your baby's temperature by placing a thermometer underneath their arm. Normal temperatures range from 97.7 to 99.3 degrees Fahrenheit. You may need to add or remove a layer of clothing or a blanket. Kangaroo care has also been shown to improve the health of premature infants and may even help to reduce certain risk factors for health issues.4
Feeding and Balancing Blood Sugar Levels
Late preterm infants tend to eat less, but need to be fed more often than a full-term baby. A late preterm infant may be sleepier than most full-term babies. Wake to feed if your infant sleeps beyond 4 hours. The work of breathing, eating, and keeping a normal body temperature can lead to low blood sugar in the first days of your baby's life. Your nurse may get a small sample of your baby's blood by a heel prick to check his blood sugar levels.
The video below provides a short description of how body temperature can fluctuate and how the blood sugar is checked. The video also shows an assessment of an infant soon after birth.4
Late preterm infants have immature immune systems and may be more likely to develop infections. Your babies immune system is still developing, so it can be hard to fight off infection, don't let family or friends who aren't feeling well visit your baby. Avoid places with large numbers of people and young children.
Signs/symptoms of infection:
- Listlessness (low energy)
- Fever or low temperature
- Breathing problems 4
Controlling Body Temperature
Late preterm infants have less body fat and may be less able to control their own body temperature. Holding your baby in "Kangaroo Care" or skin to skin can help them keep a stable temperature. You can check your baby's temperature by placing a thermometer underneath their arm. Normal temperatures range from 97.7 to 99.3 degrees Fahrenheit. You may need to add or remove a layer of clothing or a blanket. Kangaroo care has also been shown to improve the health of premature infants and may even help to reduce certain risk factors for health issues.4
Feeding and Balancing Blood Sugar Levels
Late preterm infants tend to eat less, but need to be fed more often than a full-term baby. A late preterm infant may be sleepier than most full-term babies. Wake to feed if your infant sleeps beyond 4 hours. The work of breathing, eating, and keeping a normal body temperature can lead to low blood sugar in the first days of your baby's life. Your nurse may get a small sample of your baby's blood by a heel prick to check his blood sugar levels.
The video below provides a short description of how body temperature can fluctuate and how the blood sugar is checked. The video also shows an assessment of an infant soon after birth.4
Picture references: Left: www.whattoexpect.com, Right: www.telegraph.co.uk
References
1. http://www.webmd.com/parenting/baby/rsv-in-babies
2. http://www.mayoclinic.org/diseases-conditions/infant-jaundice/basics/symptoms/con-20019637
3. Sun, H., Xu, F., Xiong, H., Kang, W., Bai, Q., Zhang, Y., .Zhu, C. (2013). Characteristics of respiratory distress syndrome in infants of different gestational ages. Lung, 191(4), 425-33. doi:http://dx.doi.org/10.1007/s00408-013-9475-3
4. Your Late Preterm Infant: A Parent's Guide. (2011). Ohio: Abbott Laboratories.
References
1. http://www.webmd.com/parenting/baby/rsv-in-babies
2. http://www.mayoclinic.org/diseases-conditions/infant-jaundice/basics/symptoms/con-20019637
3. Sun, H., Xu, F., Xiong, H., Kang, W., Bai, Q., Zhang, Y., .Zhu, C. (2013). Characteristics of respiratory distress syndrome in infants of different gestational ages. Lung, 191(4), 425-33. doi:http://dx.doi.org/10.1007/s00408-013-9475-3
4. Your Late Preterm Infant: A Parent's Guide. (2011). Ohio: Abbott Laboratories.