When a baby is born alive before 37 weeks of gestation, they are termed as a premature baby/infant or preemie. In some cases, the baby is extremely preterm (born in 28 weeks itself).
According to the World Health Organization (WHO), nearly 152 million premature babies were born in the last decade (as of 2023). That means, 1 in every 10 babies is born preterm (and of those, one dies every 40 seconds).
The cause of premature birth is largely unknown but is more likely to happen when a mother suffers from underlying health conditions like diabetes. It may also result from harmful activities during pregnancy (like alcohol or smoking). Even stress increases the risk of preterm delivery.
Premature babies are like little warriors because they must fight for survival. Due to underdeveloped organs, these newborns are at greater risk of serious (life-threatening) conditions. In this article, we will discuss three major complications that preterm infants are vulnerable to developing.
Necrotizing Enterocolitis (NEC)
Necrotizing enterocolitis is considered to be the most serious (yet most common) gastrointestinal disease among preterm infants. The baby’s small or large intestinal tissue becomes inflamed.
As per the Cleveland Clinic, the inflammation can lead to a perforation or hole in the organ. As a result, bacteria can easily leak out of the gut into the bloodstream, causing severe abdominal infections. Usually, the early symptoms start showing just within two to six weeks of birth.
NEC may be mild in some preterm babies, whereas others may develop serious complications. Many die because of an underdeveloped immune system, and those who survive may have to live with long-term health risks.
Some common symptoms of this condition include –
- Swelling and abdominal pain
- Lethargy
- Blood stool and diarrhea
- Yellow or green color vomit
- Changes in blood pressure, breathing, and body temperature
- A lack of weight gain
- Loss of appetite
While some babies require IV feedings, others need extensive surgery to remove the perforated intestine. The biggest concern is that this condition is typically caused due to commercial formula feeding.
Bovine milk-based baby formulas are said to have all the necessary nutrients for an infant. However, the reality seems to be far from such claims. Formula manufacturers like Mead Johnson and Abbott Laboratories have been heavily criticized by preemie parents for manufacturing products that increase the risk of NEC.
They have even filed a lawsuit, alleging that these companies were aware of the health risks but chose to keep profits over the most innocent. According to TorHoerman Law, all cases (over 450) have been consolidated into multi-district litigation (MDL) for faster and easier settlements.
The latest NEC lawsuit update is regarding the trials that were set to begin on February 20th, 2024. Once the jury verdicts are out, individual payouts will be determined. As of now, the criticized baby formulas like Enfamil and Similac have not been recalled.
Yet, parents are recommended to avoid feeding their preterm infants with commercial formulas. Instead, they can choose human donor milk from reliable milk banks.
Intraventricular Hemorrhage (IVH)
A condition mostly observed in preterm infants, Intraventricular hemorrhage or IVH affects the brain. John Hopkins Medicine states that symptoms begin to appear within one month of age (beyond which occurrence is extremely rare).
What happens is that the baby’s fluid-filled areas of the brain (known as ventricles) begin to bleed. This is usually because a premature baby’s blood vessels are highly fragile. This condition is most commonly found among preterm babies who have undergone some form of physical stress.
This may include high blood pressure, respiratory distress syndrome (RDS), and pneumothorax. The unmistakable symptoms of this condition include –
- Excessive sleep
- Apnea or pauses in breathing
- Decreased reflexes and muscle tone
- Weak suck
As of now, no therapy exists to stop the bleeding. Healthcare providers will try to keep the baby as stable as possible and treat their symptoms. The most common treatment given is a blood transfusion to stabilize blood pressure and blood count.
In the case of hydrocephalus, a spinal tap may be needed. If even that fails to work, surgery will be required to drain the fluid. IVH prognosis depends upon the severity of bleeding and how well the baby responds to treatment. In severe cases, the child may have to live with long-term movement issues and developmental problems.
Respiratory Distress Syndrome (RDS)
This is another condition that mostly affects premature infants. It is caused because a baby’s lungs are underdeveloped, and hence, unable to supply sufficient oxygen. As a result, they face breathing difficulties.
The primary cause for inadequate oxygen supply is due to the lack of surfactant production in the lungs. It is a compound comprising fats and proteins which keep the lungs inflated. Surfactant is also responsible for preventing the lungs from collapsing.
Normally, a baby’s body will start producing surfactant at around 24 to 28 weeks of pregnancy. Premature birth interferes with this process. According to the National Health Service (NHS), RDS is a condition that affects nearly half of all babies born prematurely.
The common symptoms of this condition include –
- Rapid and shallow breathing
- A distinct grunting sound while breathing
- Flaring nostrils
- Blue coloration on the fingers, lips, and toes
The treatment methods extend before and after birth. In the case of the former, steroid injections may be administered to the mother to stimulate the baby’s lung development. After birth, the infant may be transferred to a neonatal unit.
If the situation is mild, an incubator should provide the baby with the necessary oxygen. In more severe cases, a ventilator or breathing machine may be needed. RDS carries with it serious complications like internal bleeding, air leakage, developmental disabilities, and lung scarring.
Early treatment (within two hours of birth) shows a good prognosis. However, many babies require external breathing support for weeks or months till their lungs have fully developed.
The Mayo Clinic states that the exact cause of preterm birth is largely unknown. However, the mother can take certain steps to lower the risk of this happening. These include ingestion of progesterone supplements and cervical cerclage.
The former is generally given to women with a short cervix or those who have already had a preterm baby before. As for the latter, it is a surgical procedure to provide the uterus with extra support.
Besides this, the mother must take part in regular physical activity as extended bed rest increases the risk of blood clots, reduced muscle strength, and weak bones.
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