1 premature infants with neonatal respiratory distress syndrome need to breathe with immature lungs because their lungs are not yet mature. When alveoli can't keep expanding, they will easily collapse, leading to neonatal respiratory distress syndrome.
2 premature infants have apnea. Due to the immature brain development of premature infants, premature infants will have apnea, and often need external stimulation to restore spontaneous breathing.
The skin structure of premature infants is immature, and it is easy to lose too much water and body temperature from the skin, and it is often prone to hypothermia. Many premature babies live in incubators to keep their body temperature stable.
4 Immature gastrointestinal tract Take a premature baby under 800g as an example. His gastrointestinal tract is not mature enough to suck and swallow normally, so he can't eat by himself. At this stage, you need to eat by feeding with nutrition needles and nasal feeding tubes. At this time, a small amount of breast milk will be given to the baby, mainly to make the gastrointestinal tract of premature infants mature rapidly. In addition, the antibody components contained in breast milk will also enhance the resistance of premature infants.
5 Brain and eye problems Premature infants often have unstable blood pressure and insufficient blood oxygen, and need to be given high-concentration oxygen and drugs, which may cause damage to the growing brain and retina. In severe cases, it may cause intraventricular hemorrhage, retinopathy of prematurity and other problems. The hospital will provide retinal examination, tracking and treatment for premature infants.
Five common problems of premature infants &; 4 Home Care Principles When can premature babies go home? Different hospitals have different regulations. Take Guangtian Hospital as an example. When the premature baby weighs 2200 grams and has no disease or infection, he can eat by himself, and his breathing will not stop, so he can leave the hospital. Some foreign hospitals even think that if they weigh1700g, they can leave the hospital and go home without any special problems.
Premature babies will do some necessary examinations before leaving the hospital, such as brain ultrasound examination, which can detect whether there is severe bleeding in the brain or leukomalacia around the ventricle. Premature infants weighing less than1500g can have their retinas examined four to six weeks after birth and receive a comprehensive hearing screening before discharge. In addition, if you weigh more than 2 kg, you can get the first dose of hepatitis B vaccine.
However, some parents often delay the discharge of premature infants for various reasons because of their lack of confidence in nursing. In fact, as long as we grasp a few basic principles and make psychological adjustments, premature babies can be ready to go home.
The principle that premature infants can be discharged from the hospital is: 1 heavy enough (each hospital has different regulations).
You don't need an incubator to keep a stable body temperature.
You don't need intravenous injection, you can suck it yourself and eat it yourself. However, there are very few cases, such as babies with chronic lung diseases or unable to suck, who take nasogastric tubes home.
No serious medical and surgical diseases or infections.
There was no obvious apnea or bradycardia within one week. But there are still a few cases where you have to go home with a breathing heartbeat monitor.
Five common problems of premature infants &; The four principles and five principles of home care meet the needs of premature infants to prepare at home. Like other full-term infants, premature infants need to grow up with peace of mind accompanied by warm relatives, so parents will be encouraged to take their babies home as soon as possible. Dr. Xu Zongzheng said that the most common thing in hospitals is that parents have insufficient confidence in nursing and repeatedly delay the time for premature babies to leave the hospital and go home. For example, they are afraid that their petite babies will be injured and don't know how to hold them. I also have no confidence to help the baby bathe; And I think there will be problems with feeding.
In fact, in order to let premature babies leave the hospital smoothly, the hospital began to prepare very early. When the weight of premature infants approaches the discharge standard for about two or three weeks, the hospital will remind parents, hoping that parents can stay in hospital for a long time to learn baby care, such as holding babies, bathing and feeding methods. And let parents try it first. Having professionals around to guide you can increase your confidence in taking care of premature babies. Parents will have more confidence in taking care of them if you are proficient several times. Moreover, these intensive parent-child contact can enhance the relationship between parents and children, promote parents' understanding of the baby, and understand what the baby's needs are from the baby's expression after returning home. The following are some preparations for parents' reference:
1' s main caregivers must go to the hospital in advance to get ready and be familiar with the skills of caring for premature babies, such as bathing skills, umbilical cord care, diaper dressing, etc. More contact with your baby can train you to observe your baby and understand its development ability. Finally, we can operate independently and correctly, and establish nursing confidence.
Close contact with premature infants, such as kangaroo nursing, has a positive impact on the growth and development of premature infants through the gentle touch and hug of parents, and can enhance the attachment relationship between parents and children.
Breast milk is the best source of nutrition for premature infants, so mommy should learn the knowledge and skills of breast milk collection and how to use breast milk, including how to store and keep warm. Before premature babies can eat by themselves, the nursing staff will feed them through the mouth and stomach tube, and then they can eat by themselves. Mommy needs to learn feeding skills, such as how to pay attention to the baby's swallowing movements and how to help the baby exhaust after drinking milk.
4 help your baby to make records, which helps to record your baby's growth. If problems are found, doctors can also provide more detailed information for diagnosis and follow-up.
5. The environment at home can be pre-arranged with lights and temperatures similar to those in hospitals, so that premature babies can easily adapt; In addition, a clean, quiet and humid environment is also necessary.
Premature infants have the same needs for home care as full-term infants.
Five common problems of premature infants &; 4 principles of home care 4 understand the principles of home care for premature infants. In fact, the needs of home care for premature infants are the same as those for full-term infants, such as eating more milk and sometimes eating less, crying, flatulence, stuffy nose and so on. Parents of premature babies will encounter problems, and parents are more worried because their children are premature.
In response to the needs of many parents of premature infants, the National Health Bureau of the Department of Health of the Executive Yuan has provided a home care manual for premature infants, which can be downloaded from the Internet. This manual lists in detail the general care of premature infants, such as feeding, thermoregulation, bathing, excretion, vaccination, infection prevention, sleep and sensory care. And special care for premature infants, such as observation and treatment of respiratory problems and gastrointestinal problems, medication methods, and when to take the baby back to the clinic. The following is a list of the most common home care problems encountered by parents and their solutions:
1 The reason and solution of baby crying is the language of babies who can't speak yet, and it is also the way they convey some information. Babies often cry because of physiological needs, such as diapers are wet, hungry, too cold or too hot, and they will remind caregivers of their needs by crying. At this time, parents should check whether the baby's diapers, clothes and quilts are too few or too many, and see if the baby wants to eat milk. Usually, after the above reasons are eliminated, the baby will not cry.
Besides physiological reasons, some babies are born with negative temperament. This kind of baby often cries to express his emotions. Parents facing such children need more patience, because such babies have a high demand for comfort and security. When crying, you can pick him up, pat him or shake him gently, or face the baby's face, look at the child with gentle eyes and talk to him with gentle tone.
In addition, we can't ignore the pathological situation, which will also cause the baby to cry, and the crying situation will be more serious and last for a long time. If the baby cries as soon as he drinks milk, it may be the problem of thrush. Thrush usually has mild symptoms and does not require special treatment. It disappeared by itself after a while. But if your baby's crying affects your appetite, you should take your baby to see a doctor. If the baby cried intermittently at night three months ago, it may be caused by colic and flatulence. Parents can hold the baby straight in the abdomen, or let it burp after feeding, which can improve this symptom. Usually the baby will disappear naturally after three months.
Five common problems of premature infants &; Family nursing 4 principles 2 Spilling and choking milk are common phenomena in infancy, especially in premature infants. The possible reason is that premature infants have poor congenital sucking ability, poor swallowing ability or immature esophageal sphincter, which leads to gastroesophageal reflux. It is also possible that the posture of drinking milk is not good (for example, let the baby lie down and drink milk), and the baby can't swallow it because of direct breastfeeding. When choking milk, the baby should stop feeding first, let the milk flow out from the side of the baby's head, wipe the milk in the mouth and nose with a clean towel or suck it with a suction ball, then pat the back until breathing is smooth, and then continue feeding until the skin color is rosy.
As for the way to prevent choking, you can squeeze out some milk in advance, so that the flow rate of milk will not be too fast when the baby sucks, and mommy can also feed on her back, so that the flow rate of milk will slow down due to gravity. If you feed with a bottle, you can turn the bottle upside down, and the speed of milk drops is two drops per second. If the milk is in a straight line, it means that the milk hole is too big and it is easy to choke milk. Remember not to lie on your back and feed your baby. The baby's upper body is 45 degrees better. Let the baby stand upright for five to ten minutes after feeding.
3 prevent premature infants from being born because their immunity is lower than that of full-term infants. Therefore, premature infants are more likely to get sick than full-term infants, so it is very important to prevent infection. Preventive methods include: washing hands before touching the baby; Nipples and bottles used by babies six months ago should be boiled and disinfected; Avoid taking your baby out of public places; Restrict visitors; Keep your baby's buttocks clean. When changing diapers, you should wipe it from the front urethral orifice to the back, so as to avoid repeatedly wiping it back and forth and bringing * * bacteria into the urinary tract; People with colds should not have close contact with their babies, wear masks and wash their hands if necessary.
Five common problems of premature infants &; 4 Principles of Family Care 4 Vaccination and examination of premature infants' resistance is worse than that of full-term infants, and it is more necessary to vaccinate on time to avoid serious diseases. Except that the first dose of hepatitis B vaccine must wait until the baby weighs 2200 grams, and the BCG vaccine must wait until the baby weighs more than 2500 grams, the rest of the vaccination is the same as that of a full-term baby born at the same time. Please vaccinate regularly according to the doctor's instructions and record it in the health manual.
In addition to retinopathy, premature infants are more prone to amblyopia, hyperopia, myopia and strabismus. Ophthalmic screening is recommended within four to six weeks. Even normal premature babies can have another check-up at the age of one. It is generally suggested that premature infants with high risk factors should receive the first hearing screening around the expected date of delivery or three to four months after the corrected age (that is, the number of weeks of premature delivery must be deducted); If the development is normal, you can do another examination at school age, but if you find that your baby's preschool language development is slow, you should also do a complete hearing examination.
Premature infants are also prone to amblyopia, hyperopia, myopia and strabismus.
The resources of premature birth help most premature babies to stabilize their physiological condition when they weigh 2000 grams, so they can be taken care of by their parents without going to hospital for treatment. Usually, the hospital will give parents a list of precautions, the schedule of vaccination and the items that must be followed up before leaving the hospital. Parents can take care of premature babies according to the schedule. If there are any problems, they can call the nurses and doctors immediately.
However, if the premature infants belong to the high-risk group, the hospital will hold a joint discussion with parents on medical social workers and their families before leaving the hospital to help parents understand the current situation, treatment plan, prognosis and preparation before home care; It will also refer to professional units for assistance, such as the Premature Infants Foundation and the case manager to track whether the patient's condition is stable, whether the medication is correct, the difficulties in home care, the activities and the follow-up after discharge. Some hospitals have specialized neonatal clinics. The whole body examination, mental evaluation, neurological function tracking, hearing test and eye tracking of newborns can be completed in special outpatient clinics to avoid complications.
Xu Education: Department of Medicine, University of Buenos Aires, Argentina Experience: Research Physician of Pediatric Cardiology, Veterans General Hospital of Taichung, Resident and Chief Physician of Pediatric Department of Guangtian General Hospital, Expert of Pediatric Medical Association of the Republic of China, Specialist of Pediatric Cardiology, Heart Association of the Republic of China Current position: Pediatric attending physician of Guangtian General Hospital.