The document provides an outline for a report on preterm babies. It includes sections on definitions, categories of preterm birth, statistics, signs and symptoms, characteristics, etiology, risk factors, complications, management, and recommendations for caring for preterm infants. Characteristics discussed include appearance, size, behavior, and physical signs such as skin quality and lanugo hair. Management involves medication, specialized care in an incubator, and addressing challenges with feeding and breathing. Risk factors include health issues in the mother as well as induced causes like diabetes or preeclampsia.

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Dr/ Nema Fathy
Dr/ Laila Ahmed
Dr/ Asmaa Abdel Majed
Dr/ Mona
Elham Ali Ahmed Ali

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Title Page
 Introduction
 Definition
 Categories of preterm baby
 Local and global statistics on Preterm births
 Sign and symptoms
 Characteristics of premature baby
- The survival rate for a premature baby
- a premature baby weigh
- premature baby look when she’s born
(appearance)
- behavior for premature baby
 Etiology
 Risk factors
 Complication
 Short term complication
 Long term complication
 Prevention
 Diagnosis
 Management
- Medication
- Management
- Nursing management
 Recommendations from the American Academy of
Pediatrics to limit the risk of death for infants from
zero to 1 years old.
 Caring for preterm babies after leaving hospital
 Reference
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Introduction
When a woman is pregnant they can calculate when their baby
is due.
“[women] may go into labor around two to three weeks before
[their expected due date.]”
The average pregnancy is calculated at 40 weeks from
The last menstrual period.
Premature babies, especially those that are born very early,
often have complicated medical problems.
Usually, the complications of prematurity vary, but the earlier
a child is born, the higher and more dangerous the risk of
complications are.
The earlier a baby is born, the higher the risk of death or
serious disability
Preterm birth and low birth weight accounted for about 17% of
infant deaths.
Babies who survive can have breathing issues, intestinal
(digestive) problems, and bleeding in their brains.
Long-term problems may include developmental and lower
performance in school.

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Definition
Preterm baby, also known as premature baby,
Is when a baby
Is born too early before 37 weeks of pregnancy have been
completed.
These babies are known as preemies or premies.
*****************
Categories of preterm baby
Premature babies fall into categories, based on how soon
they’re born:
 Early term. Babies born between 37 and 39 weeks
 Late preterm. Between 34 and 36 weeks, 6 days (most
premature births occur at this stage)
 Moderate preterm. Born between 32 and 34 weeks of
pregnancy
 Very preterm. Born between 28 weeks and 31 weeks (or
less than 32 weeks)
 Extremely preterm. Before 28 weeks of pregnancy

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Local and global statistics on
Preterm births:
➢ Globally:
15 million babies are born prematurely every year (before the
37th week).
➢ Locally:
According to the WHO, one in every 100 births were premature
in 2010
(6%of births).
 In 2020, 1 in 10 babies was born too early in the United
States.
 In preterm birth and low birth weight accounted for
about 17% of infant deaths.
 Reducing preterm birth is a national public health
priority.
 The preterm birth rate declined 1% in 2020,
From 10.2% in 2019 to 10.1% in 2020.
 However, racial and ethnic differences in preterm birth
rates remain.
 In 2020, the rate of preterm birth
Among non-Hispanic black women (14.4%)
Was about 50% higher than the rate of preterm birth
among non-Hispanic white women (9.1%)
or Hispanic women (9.8%).

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 Every year, an estimated 15 million babies are born
preterm (before 37 completed weeks of gestation), and
this number is rising.
 Preterm birth complications are the leading cause of
death among children under 5 years of age,
responsible for approximately 1 million deaths in
2015.
 Across 184 countries, the rate of preterm birth ranges
from 5% to 18% of babies born.
SGA= small for gestational age
AGA= appropriate for gestational age
LBW= low birth weight

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Sign and symptoms
Body:
 Size of body is small with relatively large head
 Crown- heel length is less than 47cm
 Head circumference is less than 33 cm
 But exceeds the chest circumference by more than 3 cm
Activity and posture:
 General activity is poor
 Automatic reflex response such as moro response,
sucking and swallowing are sluggish or incomplete
 Baby assumes an extended posture due to poor
Face and head:
 Face appears small
 large head size
 Sutures are widely separated
 Fontanels are large
 Small chin
 Protruding eyes
 Optic nerve is usually unmyelinated
 Ear cartilage is deficient or absent with poor recoil
 Hair appears woolly, and fuzzy and individual hair fibres
can be seen separate

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Skin and subcutaneous tissues:
 Skin is thin, gelatinous, Shiny and excessively pink
 Abundant lanugo
 Very little vernix caseosa
 Edema may be present
 Subcutaneous fat is deficient
 Breast nodule is small or absent
 Deep sole creases are often not present
Genitals:
MALE:
 testes undescended
 scrotum poorly developed
FEMALES:
 labia majora widely separated exposing labia minora
 hypertrophied clitoris

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Body:
 Size of body is small with relatively large head
 Crown- heel length is less than 47cm
 Head circumference is less than 33 cm
 But exceeds the chest circumference by more than 3 cm

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Activity and posture:
 General activity is poor
 Automatic reflex response such as moro response,
sucking and swallowing are sluggish or incomplete
 Baby assumes an extended posture due to poor tone

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Face and head:
 Face appears small
 large head size
 Sutures are widely separated
 Fontanels are large
 Small chin
 Protruding eyes
 Optic nerve is usually unmyelinated
 Ear cartilage is deficient or absent with poor recoil
 Hair appears woolly, and fuzzy and individual hair fibres
can be seen separately

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Skin and subcutaneous tissues:
 Skin is thin, gelatinous, Shiny and excessively pink
 Abundant lanugo
 Very little vernix caseosa
 Edema may be present
 Subcutaneous fat is deficient
 Breast nodule is small or absent
 Deep sole creases are often not present

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Genitals:
MALE:
 testes undescended
 scrotum poorly developed
FEMALES :
 labia majora widely separated exposing labia minora
 hypertrophied clitoris

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Characteristics of premature baby
- The survival rate for a premature baby
- a premature baby weigh
- premature baby look when she’s born
(appearance)
- behavior for premature baby
The survival rate for a premature baby:-
 A baby’s survival rate, also known as fetal viability,
(Is an infant’s ability to live outside the mother’s womb).
 In general, doctors consider 24 weeks to be the tipping
point in terms of viability, but even babies born at this
age aren’t guaranteed to survive.
 Fetal viability at 24 weeks can range from 42 percent to
59 percent, according to the American College of
Obstetricians and Gynecologists (ACOG).
 Babies can survive when they're born before 24 weeks,
but the rates aren’t encouraging.
 Indeed, every extra week in utero matters a great deal,
statistically.
For example,
 At 25 weeks, a baby has a 67 to 76 percent chance of
viability.
 If the fetus makes it to 26 weeks, the odds of viability
are even better, falling somewhere between 86 and 89
percent.

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A premature baby weigh
 A premature baby’s weight is another important factor
that’ll impact her care and the chance of complications.
 According to premature baby size categories that often
determine how long she’ll need to stay in the NICU.
 As a general rule, the smaller the baby, the longer the
hospital stay tends to be.
Premature baby size categories
 Low birth weight: This is considered less than 5 pounds,
8 ounces. ( >2,493 kg )
 Very low birth weight: These babies weigh less than
3 pounds, 5 ounces. ( >1,502 kg)
 Extremely low birth weight: Less than 2 pounds,
3 ounces.(> 992g)
 Micro preemies: The tiniest and youngest (born before 26
weeks), these babies weigh less than 1 pound, 12
ounces.(>793g)
Notices
1 pound = 453.59237 gram
1 ounce = 28.3495 gram
(5pounds = 2,267 kg, 8 ounces = 226 g)
(3pounds = 1.361 kg, 5 ounces = 141 g)
(2 pounds = 907 g, 3 ounces = 85 g)
(1 pound = 453 g, 12 ounces = 340g)

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Premature baby look when she’s born
(Appearance)
Depending on the category they fall into, preemies share some
common characteristics, including in their appearance.
The good news is that these distinctions usually fade as the baby
ages.
Here are some specific physical differences you may notice:
Baby may seem bird-like.
 Late preterm babies tend to look like smaller versions of
full-term newborns.
 But preemies born at 32 weeks or younger haven’t
developed much body fat, so they seem
thin
fragile,
small chest
skinny,
Bird-like arms and legs.

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Her head will appear big.
 Preterm baby heads may look larger in relation to their
bodies.
Baby may have pale or yellow-ish skin.

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 Mottling,
Which may look blue, pale or blotchy,
 Acrocyanosis
With acrocyanosis, the baby’s hands and feet are
blue.
 jaundice
a yellowing of the skin, isn’t uncommon in premature
babies in the NICU.

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Her skin is thin and glassy.
 Some premature babies are born with skin that’s so thin,
it's translucent because the extra fat barrier hasn’t formed
yet.
 It can even make it possible to see the blood vessels under
the skin’s surface.
Baby’s hairy
 Her back and shoulders may be blanketed in tiny hairs
called lanugo.
 These are usually shed before birth, but in many
premature and some full-term babies, they’re still there.

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Behavior for premature baby
You can hardly hear her cry.
 Many premature babies are born with immature
respiratory systems, which means they might not
have the hearty cry of a full-term infant.
 In fact, their cry may sound more like a whimper.
Preterm baby’s super sleepy.
 Premature babies tend to snooze
 The quality of sleep.
 Preterm babies spend less time in deep sleep and are
rarely fully awake— so expect your preemie to
snooze for an hour, be drowsy for 20 minutes and so
on (that drowsiness is another reason why it’s tough
to feed a preemie).
Preterm baby will hardly eat.
 Chances are, you won’t be able to feed the baby right
away by breast or bottle.
 preemie to snooze for an hour, be drowsy for 20
minutes so cannot eat
 Younger preemies especially don’t have the muscle
tone and coordination to suck,
 Expect the doctor to insert a nasogastric (NG) tube
through the baby’s nose to her tummy so she can
receive small amounts of special preemie formula or
expressed breast milk.
 But she’ll still eat frequently.

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 Once the preemie is
- able to suck more efficiently,
- keep in mind that she’ll need to eat more,
- about every hour to hour-and-a-half (versus
every two hours),
- Whether you’re nursing or bottle-feeding,
because she’ll be taking in such small amounts
at each feeding.
Many reflexes may be absent.
 Because preemies have underdeveloped muscles and
nerves, several reflexes, including grasping,
sucking, rooting and the startle reflex, might not be
there at birth.
Preterm baby will need an incubator.
 Because of her lack of body fat, the preterm baby will
feel chilled in a room where full-term babies won’t.
 To help warm her up and keep her body temperature
on an even keel, she’ll likely be placed in an incubator
(sometimes it’s called an isolate).
Preterm baby will have labored breathing.
 Preemies may also have trouble getting oxygen to
their internal organs and might be prone to having
periods where they stop breathing, called apnea of
prematurity.
 Doctors can help with special equipment like a
ventilator or CPAP (continued positive airway
pressure).

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Preterm baby has vulnerable to germs.
 Preterm babies aren’t able to fight bugs easily, so they
are prone to infections during and after birth.
 That’s why it’s necessary to be scrupulous about
washing your hands before you touch your baby.
 (In the NICU, it’s required of staff and visitors upon
arrival.
 You may have to follow other protocols established
by the hospital, such as wearing a mask.)
 Later, when go to home, limit the number of visitors
your baby is exposed to (of course keep away anyone
who’s sick) and have anyone who’s going to touch her
scrub their hands before they do so.

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ETIOLOGY
 Spontaneous
 Induced
Spontaneous
 Health status of the mother (low socio economic status)
 Multiple pregnancy:
- Number of multiple pregnancies are increasing due
to advanced parental age from delayed child bearing
and ART.
 Pregnancy-induced hypertension (PIH):
- It is the most common complication of pregnancy
and is occurring in 6- 10% of pregancies and is rising
 Placental problems
 premature rupture of membrane
 Low maternal weight
 Chronic and acute systemic maternal disease
 Antepartum haemorrhage
 Cervical incompetence
 Maternal genital colonization and infections
 Cigarette smoking during pregnancy
 Threatened abortion
 Acute emotional stress
 Physical exertion
 Sexual activity
 Trauma
 Bi-cornuate uterus
 Congenital malformations

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Induced
 Maternal diabetes mellitus
 Placental dysfunction as indicated by unsatisfactory fetal
growth
 Eclampsia
 Fetal hypoxia
 Antepartum haemorrhage
 Severe rhesus iso immunization

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We can classificated the causes to 5 factors
maternal factors Placental
factors
uterine
factors
fetal factors other factors
-Pregnancy-induced
hypertension (PIH)
-Pre – eclampsia
-Maternal diabetes
mellitus
-Chronic medical
illness
diabetes mellitus
Renal disease
heart disease
-Antepartum
haemorrhage
-Low maternal weight
-Multiple pregnancy
-Infections
Listeria
monocytogenes,
GroupBstreptococcus
, UTI, bacterial
vaginosis etc
-Drug abuse(Cocaine)
-Placental
dysfunction
-Placenta previa
-Abruptio
placenta
-Bi-cornuate
uterus
-Incompetent
cervix
-Fetal distress
-Fetal hypoxia
-Multiple
gestation
-Erythro-
blastosis
fetalis
-Nonimmune
hydropes
-Premature
rupture of
membranes
(PROM)
-Polyhydramnios
-Iatrogenic
-Trauma
-Low socio
economic status
-Physical exertion
-Acute emotional
stress
-Sexual activity
causes
fetal
factors
uterine
factors
Placental
factors
maternal
factors
other
factors

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FETAL FACTORS
 Fetal distress
 Fetal hypoxia
 Multiple gestation
 Erythro- blastosis fetalis
 Nonimmune hydropes

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Erythro- blastosis fetalis
Nonimmune hydropes

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PLACENTAL FACTORS
 Placental dysfunction
 Placenta previa
 Abruptio placenta

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UTERINE FACTORS
 Bi-cornuate uterus
 Incompetent cervix

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MATERNAL FACTORS
 Pregnancy-induced hypertension (PIH)
 Pre – eclampsia
 Maternal diabetes mellitus
 Chronic medical illness
diabetes mellitus
Renal disease
heart disease
 Antepartum haemorrhage
 Low maternal weight
 Multiple pregnancy
 Infections
Listeria monocytogenes,
Group B streptococcus,
UTI,
bacterial vaginosis etc
 Drug abuse(Cocaine)

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Other factors
 Premature rupture of membranes (PROM)
 Polyhydramnios
 Iatrogenic
 Trauma
 Low socio economic status
 Physical exertion
 Acute emotional stress
 Sexual activity
PROM

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Risk factors
Often, the specific cause of premature birth isn't clear.
However, there are known risk factors of premature delivery,
including:
 Having a previous premature birth
 Pregnancy with twins, triplets or other multiples
 An interval of less than six months between pregnancies
 Conceiving through in vitro fertilization
 Problems with the uterus, cervix or placenta
 Smoking cigarettes or using illicit drugs
 Some infections, particularly of the amniotic fluid and
lower genital tract
 Some chronic conditions, such as high blood pressure
and diabetes
 Being underweight or overweight before pregnancy
 Stressful life events, such as the death of a loved one or
domestic violence
 Multiple miscarriages or abortions
 Physical injury or trauma

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Complications
 While not all premature babies experience complications.
 Being born too early can cause short-term and long-term
health problems.
 Some problems may be apparent at birth.
 While others may not develop until later.
Short-term complications Long-term complications
- Breathing problems
- Heart problems
- Brain problems
- Temperature control
problems
- Gastrointestinal problems
- Blood problems
- Metabolism problems
- Immune system problems.
- Cerebral palsy
- Impaired learning
- Vision problems
- Hearing problems
- Dental problems.
- Behavioral and psychological
problems.
- Chronic health issues

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Short-term complications
In the first weeks, the complications of premature birth may
include:
Breathing problems.
 A premature baby may have trouble breathing due to an
immature respiratory system.
 If the baby's lungs lack surfactant — a substance that
allows the lungs to expand —
 May develop respiratory distress syndrome because the
lungs can't expand and contract normally.
 Premature babies may also develop a lung disorder
known as bronchopulmonary dysplasia.
 In addition, some preterm babies may experience
prolonged pauses in their breathing, known as apnea.

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Heart problems.
 The most common heart problems premature babies
experience are patent ductus arteriosus (PDA) and low blood
pressure (hypotension).
 PDA is a persistent opening between the aorta and
pulmonary artery.
 While this heart defect often closes on its own, left
untreated it can lead to a heart murmur, heart failure as well
as other complications.
 Low blood pressure may require adjustments in intravenous
fluids, medicines and sometimes blood transfusions.
Brain problems.
 The earlier a baby is born, the greater the risk of bleeding
in the brain, known as an intraventricular hemorrhage.
 Most hemorrhages are mild and resolve with little short-
term impact.
 But some babies may have larger brain bleeding that
cause permanent brain injury.

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Temperature control problems.
 Premature babies can lose body heat rapidly.
 They don't have the stored body fat, and they can't
generate enough heat to counteract what's lost through
the surface of their bodies.
 body temperature dips too low (hypothermia)
 Hypothermia in a premature baby can lead to breathing
problems and low blood sugar levels.
Gastrointestinal problems.
 Premature infants are more likely to have immature
gastrointestinal systems, resulting in complications such
as necrotizing enterocolitis (NEC).
 This potentially serious condition, in which the cells
lining the bowel wall are injured, can occur in premature
babies after they start feeding.
 Premature babies who receive only breast milk have a
much lower risk of developing NEC.

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Blood problems.
 Premature babies are at risk of blood problems such as
anemia and newborn jaundice.
 Anemia is a common condition in which the body doesn't
have enough red blood cells.
 Newborn jaundice is a yellow discoloration in a baby's
skin and eyes that occurs because the baby's blood
contains excess bilirubin, a yellow-colored substance,
from the liver or red blood cells.
Metabolism problems.
 Some premature babies may develop an abnormally low
level of blood sugar (hypoglycemia).
 This can happen because premature infants typically have
smaller stores of stored glucose.
 Premature babies also have more difficulty converting
their stored glucose into more-usable, active forms of
glucose.
Immune system problems.
 An underdeveloped immune system, common in
premature babies, can lead to a higher risk of infection.
 Infection in a premature baby can quickly spread to the
bloodstream, causing sepsis, an infection that spreads to
the bloodstream.

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Long-term complications
In the long term, premature birth may lead to the following
complications:
Cerebral palsy.
 Cerebral palsy is a disorder of movement, muscle tone or
posture that can be caused by infection, inadequate blood
flow or injury to a newborn's developing brain either
early during pregnancy or while the baby is still young
and immature.
Impaired learning.
 Upon school age, a child who was born prematurely
might be more likely to have learning disabilities.
Hearing problems.
 Premature babies are at increased risk of some degree of
hearing loss, so must be hearing checked before going
home.

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Vision problems.
 Premature infants may develop retinopathy of
prematurity, a disease that occurs when blood vessels
swell and overgrow in the light-sensitive layer of nerves
at the back of the eye (retina).
 Sometimes the abnormal retinal vessels gradually scar
the retina, pulling it out of position.
 When the retina is pulled away from the back of the eye,
it's called retinal detachment, a condition that, if
undetected, can impair vision and cause blindness.

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Dental problems.
 at increased risk of developing dental problems, such as
delayed tooth eruption, tooth discoloration and
improperly aligned teeth.
Behavioral and psychological problems.
 Children who experienced premature birth have certain
behavioral or psychological problems, as well as
developmental delays.
Chronic health issues.
 Premature babies are more likely to have chronic health
issues.
 Infections, asthma and feeding problems are more likely
to develop or persist.
 Premature infants are also at increased risk of sudden
infant death syndrome (SIDS).

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Prevention
Although the exact cause of preterm birth is often unknown,
there are some things that can be done to help women
especially those who have an increased risk to reduce their
risk of preterm birth, including:
 Progesterone supplements.
Women who have
a history of preterm birth,
a short cervix or both factors
may be able to reduce the risk of preterm birth with
progesterone supplementation.
 Cervical cerclage.
This is a surgical procedure performed during
pregnancy in women with a short cervix, or a history
of cervical shortening that resulted in a preterm
birth.
During this procedure, the cervix is stitched closed
with strong sutures that may provide extra support
to the uterus.
The sutures are removed when it's time to deliver
the baby.
Ask your doctor if you need to avoid vigorous
activity during the remainder of your pregnancy.

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 Respect hospital appointments during your pregnancy to
check both mother and baby are healthy.
 Limit preterm birth risk factors (e.g. smoking, using
drugs, etc.).
 Avoid heavy lifting or standing for long periods of time
as they may increase the risk of preterm birth

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Diagnosis
After your premature baby is moved to the NICU, may undergo
a number of tests.
Possible tests for your premature baby may include:
 Breathing and heart rate, blood pressure, blood sugar ,
saturation
 Blood tests. including calcium, glucose and bilirubin
measure the red blood cell count and check for anemia and
infection
 Echocardiogram.
 Ultrasound scan. Ultrasound scans may be done to check
the brain for bleeding or fluid buildup or to examine the
abdominal organs for problems in the gastrointestinal
tract, liver or kidneys.
 Eye exam. To check for problems with the retina
(retinopathy of prematurity).

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MANAGEMENT
Medications
 Medications may be given to your baby to promote maturing
and to stimulate normal functioning of the lungs, heart and
circulation.
 Depending on your baby's condition, medication may
include:
Surfactant, a medication used to treat respiratory distress
syndrome
Fine-mist (aerosolized) or IV medication to strengthen
breathing and heart rate
Antibiotics if infection is present or if there's a risk of
possible infection
Medicines that increase urine output (diuretics) to
manage excess fluid
An injection of medication into the eye to stop the
growth of new blood vessels that could cause retinopathy
of prematurity
Medicine that helps close the heart defect known as
patent ductus arteriosus
Management of preterm baby
Induction of premature labor
 Maturity of fetus by examination of amniotic fluid or
phosphatidyl glycerol or L/S ratio
 Corticosteroids should be administered
 Inj Betamethasone 12mg IM every 24 hours- 2 doses •
Dexamethasone 6mg IM

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Arrest of premature Labor
 Bed rest and sedation
 Tocolytic agents
- Magnesium Sulphate
- Indomethacin
 Sympathomimetic agents
- Isoxsuprine (Duvadilan)
- Ritodrine
- Salbutamol and Terbutaline
Optimal management at birth
 Give vitamin K 1mg to prevent hemorrhage
 Promptly dry and kept warm with gentle handling
 The cord is to be clamped quickly to prevent
hypervolemia and development of hyperbilirubinaemia
Maintain body temperature
 Keep the baby in incubator with temperature and
humidity maintained
Positioning
 Change the baby’s position from prone position; it relives
abdominal discomfort by passage of flatus and prevent
aspiration
 Change position 2 hourly
Kangaroo mother care
 Encourage KMC and exclusive breastfeeding

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Oxygen therapy
 It should be administered only when indicated
 O2 should administer with head box when O2 saturation
falls below 85%
Feeding and nutrition
 Babies < 1.2 kg gestation <30 weeks and sick babies
should start IV dextrose solution
 10-20 ml EBM 2-3 hourly through NG can be started to all
babies irrespective of age and weight 2 hourly <1 kg and
3 hourly > 12kg
Nutritional supplement
 When the baby is stable and tolerate eternal feeding, EBM
fortified multivitamin and folic acid can be given
 Iron supplementation (2-3mg/kg elemental iron ) after 2-
3 weeks
 Calcium supplementation (220mg/day ) and phosphorus
(100 mg/day) to prevent osteopenia for < 1.5 kg
Gentle rhythmic stimulation
 Gentle tactile stimuli by the mother
 Soothing auditory stimuli as family voice, music
 Eye to eye contact, colored object provide visual inputs
Prevention of nosocomial infection
 Strict handing washing before and after touching the
baby
 Minimal handling

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Phototherapy
 Early phototherapy is advice to keep the serum bilirubin
level within safe limit to prevent need for exchange
transfusion usually premature develops hyper
bilirubinaemia
Factor to be avoid for pre-term babies
 Routine O2 administration without monitoring
 Prophylaxis antibiotics
 Formula feeding
 Rough handling
 Excessive light and sound the behavior of preterm
neonate
 Assessment of common problems

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Nursing Management
1. Provide respiratory support (see Drug Chart)
2. Perform the following assessments.
 Assess heart sounds for presence of murmurs.
 Assess pulse and perfusion.
 Monitor blood pressure, heart rate, and pulse pressures
and Wight, blood glucose.
3. Provide adequate fluids and electrolytes and nutrition.
4. Maintain a neutral thermal environment.
5. Prevent infection.
6. Assess for readiness for selected interventions.
 Provide stimulation when appropriate to infant state and
readiness.
 Encourage flexion in the supine position by using blanket
rolls.
 Provide the newborn with body boundaries through
swaddling or using blanket rolls against the newborn’s
body and feet.
7. Promote parent-newborn attachment.
8. Initiate phototherapy as required.

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Recommendations from the American Academy of Pediatrics
to limit the risk of death for infants from zero to 1 years old:
 Infants should receive all recommended vaccinations.
 Breastfeeding is recommended for at least six months.
 Always place your baby on his or her back for every sleep
time.
 If the infant is awake, you can allow him/her to sleep on
the stomach (tummy time) to strengthen stomach
muscles and reduce flat headedness on the condition that
the infant’s parents or adults are supervising.
 Use a firm mattress (covered by a tightly fitted sheet) to
prevent gaps between the mattress and the sides of the
crib.
 The baby should not sleep in the same bed as the
parents.
 Avoid excessively covering the baby with clothes or
covering its face and head.
 Make sure the baby’s crib is placed in a risk free area (e.g.
not containing any wires).
Caring for a preterm baby after leaving the hospital:
 Make sure to breastfeed your baby.
 Make sure the baby remains in an appropriate
temperature.
 Help the baby sleep in a calm and dim room.
 Do not sleep next to the baby but rather place the infant
in its own bed.
 Avoid direct sunlight.
 Pay attention to the baby’s hygiene.
 Avoid using any type of moisturizer without first
consulting with a doctor.
 Ask a doctor for advice when needed.

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References
https://www.mayoclinic.org/diseases-conditions/premature-
birth/diagnosis-treatment/drc-20376736
https://www.mayoclinic.org/diseases-conditions/premature-
birth/symptoms-causes/syc-20376730
https://www.who.int/news-room/fact-sheets/detail/preterm-
birth
https://www.marchofdimes.org/complications/premature-
babies.aspx
http://www.msrblog.com/science/medical/preterm-birth-
symptoms-diagnosis-and-treatment.html
https://itcaonline.com/prematurity-and-sids-awareness/
https://emedicine.medscape.com/article/975909-clinical
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prematurity-awareness-month?page=4
https://www.marchofdimes.org/complications/premature-
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https://www.cdc.gov/reproductivehealth/features/premature-
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https://www.whattoexpect.com/first-year/having-a-premature-
baby.aspx
https://www.whattoexpect.com/first-year/preemie-
categorization/

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