Causes of prematurity. Maintain temperature mode. Premature children: frequency and causes of premature births. Anatomy-physiological and neuropsychic features of premature children

26.04.2019

Usually the child is considered to be prevented, born on a period of less than 37 weeks, as well as with the weight of the baby less than 2500 grams, regardless of the period of pregnancy. Presence is 4 categories. Consider what external signs of a premature child.

possessing small sizes. All premature babes have a little growth, the length of their calf is proportional to the degree of prematurity: the growth of the child is the less, the more degree;
reduced food. If the child is deeply prett, then it is characterized by significantly reduced food, in which almost completely absent is the subcutaneous layer. At the same time, looking at them, there is no impression of exhausted, as noticeable in infants with hypotrophy 2-3 degrees. It is noted that nutrition of premature children quite harmonizes with their growth. The presence of wrinkled in the form of skin folds and sharp exhaustion, which is striking immediately, is observed only if the patient's premature baby, as well as if a child has congenital hypotrophy,;
the presence of adamas characteristic of deeply premature babies. The manifestation of Adinamia is the development of general lethargy, a decrease in muscle tone, a weak cry, underdevelopment of a sucking reflex, no feeling of hunger. With an external inspection of such a baby, short legs and a big head are visible;
possession of disproportionate physique. If the child is prettier, then it is characterized by a relatively big head, a short neck, in relation to its own growth - a relatively big torso, a low layout of the navel and short legs. The head of the docking child is ¼ from the length of the body, and the premature infant - 1/3;
the presence of a large rolling abdomen with the discrepancy of direct muscles;
always open small spring. The discrepancy is distinguished, and quite often the discrepancy of the cranial seams. For the bones of the skull is characterized by compliance, mobility, they can find each other;
the predominance of the brain skull over the facial;
soft ear sinks that are easily embarrassed, converted inside and often stick together;
pronounced lano, under which it is understood by the presence of soft hair with a flutter character. They are peculiar to newborns and are located, mainly on the back and shoulders, and in case the child is prettier, then the lano is developed more abundantly and they are covered not only back and shoulders, but also forehead, cheeks and hips;
the gaping of the germ. For premature girls, it is characteristic that small sex lips are not covered by large, as a result of which the floor slot gaps, and the clitoris is clearly visible;
the presence of empty scrotum. The testicles in boys are in the inguinal canals or abdominal cavity. This feature is not characteristic of all premature children, and more often occurs in children with a weight of up to 1200 grams;
lack of physiological swelling of the chest glands. This feature is not very common and is observed in children with a low degree of prematurity;
the presence of Exophthalma under which Pucheglasie is understood. This external sign is not present at all premature babies and, as a rule, appears on 2-3 months of life. Perhaps its combination with megacephalus (increasing the frontal and dark bugs);
understanding the nails when the nails on the fingers and hands are developed weakly and may not reach the fingertips. This feature is the most impermanent and is extremely rare.

Even the babies born are often forced their parents to worry strongly regarding their health. What can we talk about those baby-"sticking", which hurried to "go into the light" before the deadline. Indeed, parents of premature babies lie down serious potential childhood diseases and complications that they are at least worth to have a presentation. As in the excellent and accurate saying: "aware, it means already armed" ...

Often premature babies are placed in special arrow-incubators, where special temperature, humidity and oxygen mode are supported.

Features of premature children

Children born to the 37th week of pregnancy are premature. Such kids will have to be very difficult in the first months of its "early" life - because they have to not only catch up with their peers, but also bravely resist the set of potentially dangerous pathologies. About the most common ones - we will tell in detail.

Often, after birth, premature children are placed in a hospital for some time, in the department of intensive therapy, where non-station specialists are closely monitored by their health, and also carry out measures to push premature children.

The time that the baby born ahead of time will spend in hospital on growing and hazing, directly depends on how little he was born. On average, in Russian clinics, in the departments of intensive therapy are premature, children spend from 15 to 45 days.

Many premature babies have no sucking reflex - the nutrition of such baby is carried out using a special probe. Some cannot breathe independently - they are connected to the appropriate equipment.

To the most Important features of premature babiesrelate:

immature central nervous system (CNS), which is expressed in the lethargy of the child, chaotic movements of the handles and legs, the absence of a sucking reflex;
uncorded gastrointestinal system, excessively small volume of the stomach and underdeveloped intestinal muscles;
unripe thermoregulation ability (which is why most of the premature babies need stay in warm and wet loudsters);
the underdeveloped respiratory system (in highly premature babies, as a rule, at the moment of birth, the lungs are not able to open independently and filled with air), which is expressed in the superficial "torn" breathing and in respiratory stops during overload (for example, due to crying);
immature skin, which is very vulnerable to microbes and is easily injured even with a conventional touch.

Under the constant observation of neonatologists doctors, the intensive care unit is a premature child under its vital and physical indicators to come close to the norms of the child.

And, of course, along with the sticking and the creamy of premature babies in hospitals, they are also a thorough medical examination for the identification of serious diseases. So, premature children most often manifest the following pathologies:

Underdeveloped lungs and respiratory pathology

Most children have lungs form at the 36 week of pregnancy. Although there are exceptions, because the development of each child passes individually. If the mother already knows that the child will be born ahead of time, it can order an amniocense procedure (taking on a sample of arrogant water for a laboratory study), with which you can check the level of maturity of light fetus. In some cases, in order to accelerate the formation of the lungs by the fetus, the steroids can be injected before the mother's birth. A premature child, the lungs of which have not yet been formed, risks to face the following complications:

Respiratory Distress Syndromewhich causes a sharp, irregular breathing in a child. In this case, the chipping of the premature child is carried out by means of feeding into light oxygen (respiratory support apparatus), or using the respirator, or the creation of constant positive pressure in the respiratory tract, or the tracheal intubation. In severe cases, the infant is introduced doses of the surfactant, which is not enough light.
Transient Tahipne Newborn, that is, fast surface breathing. This condition can be observed both in premature and babies of full time. Cutting the premature child in this case, as a rule, passes without medical intervention and takes up to several days. While the breath of the newborn has no normalized, use intravenous feeding.
Bronchildren's light dysplasia It occurs when light newborn is damaged. Unfortunately, when premature is treated with an artificial ventilation apparatus, their lungs, by virtue of their weakness, can not always withstand constant pressure injected by the device. Premature children who were placed in an artificial ventilation apparatus by more than twenty-eight days are highly at risk of BLD.

Pneumonia of premature children

Another difficult consequence, with which premature babies are often faced - pneumonia. It is caused by infection in the area of \u200b\u200bthe lungs, which is involved in the exchange of carbon dioxide and oxygen. The resulting inflammation reduces the amount of space available for air exchange. This may lead to the fact that the child's body will not receive oxygen in the desired quantity.

In this case, the treatment of premature children will include antibiotics, as well as the supply of an organism with additional oxygen and intubation. If the pneumonia does not start treated in time, it can develop in a fatal infection or lead to sepsis or.

Apnea and bradycardia

The apnea and bradycardia also belong to very common diseases of premature children. Apnea is short-term respiratory stops. In hospitals to this situation, experts are always ready: if the premature child develops irregular breathing and pauses reach 10-15 seconds, in the separation of intensive therapy, where it is on the healing, the alarm will sound, calling for physicians to help.

Bradycardia is a reduction in heart rate. The script is the same: if the pulse of the premature crumbs falls below 100 shots per minute, alarm is also triggered.

Special equipment in the departments of the hazing of premature babies roundly monitors all vital infants.

Usually, easy patting on the back of a newborn helps "remind" him to start breathing again, and also increases the frequency of heart abbreviations. But sometimes baby requires more serious specialized assistance.

Infections in premature babies

Ordinary children born on time, from most infections protects not only Mamino breast milk and partial momming immunity, but also two vital organs - leather and respiratory system. Both are in the norm in the norm impede the penetration of the vulnerable organism in the vulnerable organism of the set of viruses and bacteria. But the premature child has a certain underdevelopment - and the respiratory systems, and the maturity of the skin.

The high risk of developing infections in premature babies is the second reason why these babies contain some time in the clocks. These incubator cribs are not only created around the kids favorable climate, but also protect them from infections.

Outdoor hemorrhage (GWK)

The children born earlier than the 34th weeks face an increased risk of intraventricular hemorrhage in the brain. The fact is that during childbirth, the pressure in the blood vessels changes so abruptly that weak vessels can not cope with it. In the future, GWC can lead to such complications as cerebral paralysis, mental retardation, difficulty learning.

Intracranial hemorrhage occurs approximately every third child born on the 24-26 week of pregnancy. If premature birth is inevitable, the doctor may prescribe a pregnant woman with medicines that will reduce the risk of severe intracranial hemorrhages in newborns.

Retinopathy premature

This is an extremely dangerous disease that is striking underdeveloped vessels and capiles in the eyes of premature children. Retinopathy premature can pass gently, without visible defects, or can pass in severe shape to form new blood vessels (neovascularization) and lead to retinal detachment, and even sometimes - to blindness.

Retinopathy, which in the future can develop into high myopia in a child - one of the most dangerous and common diseases among premature babies.

In the treatment of light retinopathy, the doctor may prescribe a course of special drops (vitamin or hormonal drugs). In difficult cases, they resort to surgery, the purpose of which is to stop the retinal detachment of the eye. and.

There is no reason to sweeten reality - in most cases a premature baby and his parents are waiting for serious tests in the first year of the baby. But this does not mean that the premature child is doomed to painful existence, chronically weak health and many pathologies.

With careful and reverent care, in the presence of patience and love, with the help of adequate and timely medical intervention, premature children not only quickly "catch up" in the development of their peers, but in the future they do not differ from them.

Judge for yourself: in modern Russia for each hundred newborns accounts for 7 premature. And if you meet these children aged older than two years, you will probably not be able to determine - which of them was born on time, and who - a little hurried towards a new life ...

Nine months of pregnancy ... Waiting for the baby, the future mother considers days, but here is a surprise - the child decided to be born before!

Fortunately, for modern medicine, the birth of premature children is not such a problem as before. What are they, premature children, and what are their features?

According to WHO's criteria, the kid, born after 22 weeks of pregnancy and with a body weight above 500g, is viable, the exhausting of premature children is possible.

What children are considered premature?

A premature child is a kid who was born in the gestation period from 22 to 37 weeks having a body weight less than 2500g and a length of less than 45 cm.

Guided by these indicators, determine various degrees of severity of prematurity:

The newborn weighing 900-500g is premature children with an extremely low body weight, most often it is deeply premature children for the term of gestation. For such children, it is most likely possible to problems with health and consequences in the future.

Even if the weight of the premature child is more or less normal, gestational period is considered a more reliable and sustainable indicator.

Why the crumb is born ahead of time

The question is why premature babies are born, and how to find them - one of the most discussed in obstetric and neonatological practice.

The main etiological factors of prematurity include:

the age of a pregnant woman under 18 years or the first birth of a woman over 30;
oddly enough, the age of father affects this - under 18 or over 50 years old (in European countries);
break between childbirth less than 2 years;
inflammatory acute or aggravation of chronic mothers diseases;
emotional stress;
pathological course of pregnancy;
defective nutrition or unbalanced diet of the future mother;
harmful habits of both the future mother and father - smoking, alcoholism, drug addiction);
professional harm - physically hard work, a monotonous stay in forced position, standing, the effect of toxic substances;
unsatisfactory material and domestic living conditions for pregnant women;

Also a significant role is played by the absence or inferiority of medical care before and during pregnancy.

External manifestations of prematurity

In addition, the prematurity differs in weight and gestation age, there are also external manifestations.

Raising weight and growth.

So, the main signs of a premature child:

toddler skin wrinkled, dark red;
there is almost no subcutaneous fatty fiber (its absence just explains the color of the skin of the baby);
own sinks are soft, pliable;
many powder hair, which cover face, limbs and back;
low navel location;
the underdevelopment of the genital organs is small sexual lips are not covered with large, boys are not omitted in the scrotum;
noise of cranial seams;
large, small and lateral tephions are open.

The norms of the premature child, naturally, differ from those with which children are usually born, but over time this difference decreases, and then completely disappears.

Features of early children

The physical condition of premature newborns.

In the children who appeared ahead of time, all organs and systems are lagging behind in the development. Therefore, treatment of premature children takes into account all age features.

Since the formation of pulmonary fabric is not completed, it is necessary to introduce a surfactant - a drug that prevents the decline in the pulmonary alveoli, and helps them to dealt. If the dose of surfactant is insufficient, the baby can be manifestations of respiratory failure.

Since the natural surfactant begins to produce in a child with a mass of at least 500g, respectively, for each degree of prematurity there is its own dosage. The smaller the gestational age of a newborn, the higher the shortage of a surfactant, which means that the likelihood of lung pathology is higher.

Also, in practice, the following features are often found:

Frequency of breathing in premature babies. When the crumb is worried, he may have a tachypan (rapid breathing) - about 60-80 sighs per minute, in a state of rest, the baby breathes less often. It is so unstable that sometimes stops can occur.
Children born ahead of time do not know how to adapt to environmental changes, so the temperature of the premature child is unstable, they are susceptible to supercooling or overheating.
From the environment, the heart activity of the baby depends on the environment - in too hot room, the child becomes restless, heart cuts are rapidly, tachycardia can increase to 200 hd. / Min. If the baby is cold - the heart slows down too.
The imperfection of the nervous system leads to the emergence of various neurological symptoms. If the baby is in the future developing well, neurological symptoms gradually disappear. The development of premature babies is approximately 1-2 months from the tricks.
The weight gain in premature babies is also different. The physiological loss of body weight is reduced slower, this process can take 2-3 weeks, since such children have unconditional swallowing and sucking reflexes weakly or even may be absent. In the future, kids are also slower than their "urgent" peers, gain weight.
In addition, due to the immaturity of the digestive system, it is quite often its violations arise, which is manifested by dyspecia, colitis, intestinal dysbiosis. Food is digested slowly, so kids are tormented by constipation and meteorism.
The retina of the eye in premature babies is also immature and finishes the formation only by the 4th month of life. Due to a number of reasons, the normal development of the retina can be impaired, in this case there is a severe disease - retinopathy or retrolental fibroplasia premature.
Violations of normal blood supply to the retina contribute to the formation of new vessels that are not entirely full and have very thin walls that tend to rupture. Because of this, hemorrhages often arise in the eye, both small and extensive. In addition, insufficient net feed causes the growth of fibrous tissue in its thickness and on the surface, which leads to detachment and in severe cases, the child may lose sight. Therefore, all the kids who appeared on the gestational age under 30 weeks, must be inspected by an ophthalmologist.
In the body of premature babies, hemangiomas are sometimes present - these are dark red spots, which consist of extended blood capillaries. Hemangiomas are not dangerous, but they should still be controlled by a pediatrician and oncologist. Such stains become less intense to the 12 months of the child's life, then gradually disappear. This usually happens to 4-5 years.

Features of premature children are that they have much more often arise in brain and asphyxia, anemia is often developing.

Diseases of premature children have direct dependence on the environment and care.

These kids are most susceptible due to the imperfection of the immune system, therefore require more thorough care and close attention.

Why kid yellowing

Particularly premature should be considered separately, since most of the moms, seeing that the skin of the baby is yellowed, they begin to panic and immediately accuse doctors, they say, unawrs.

In fact, jaundice can be physiological, i.e. It is in the normal place in absolutely healthy children, and may be a pathological, which indicates the presence of diseases.

The liver of the newborn is not fully developed, it is characterized by significant vascularization, the defective differentiation of parenchymal tissue, the weak development of the connective. Histologically mature (such as adults) The liver is only by 8 years of life of the kid.

Since the liver is still "did not learn" to fulfill all its functions as you need, for 2-3 days, the baby begins to yellow. This is a physiological jaundice - an increase in the body of the amount of bilirubin, which normally passes in a few days.

If the child's skin began to turn yellow on the first day and this condition continues for more than 10 days, jaundice is regarded as pathological, and therefore is a symptom of some disease and requires careful diagnosis.

Physiological jaundice is observed in more than 80% of premature babies and about 60% of the docking. Visually, it manifests itself when the value of the bilirubin in the blood of a premature child is 85-100 mkmol / l.

Why is the premature children of jaundice occuring more often? All very simple - organs of such a child are severely underdeveloped and they need more time to adapt and correction.

The main thing is to save the crumb

Calculation of premature babies heavy, long and emotionally stressful process. With the smaller weight, the child was born, the harder and more dangerous situation. Stages of kids, depends on gestational age, weight and individual adaptation features of a tiny newborn body.

Immediately after the birth, the baby is placed in a closed closet ("incubator"), in which the optimum temperature prevents the babble in the supercooling or overheating. Then purify the respiratory tract and restore breathing.

If the situation requires, then resuscitation activities are carried out - artificial ventilation of the lungs and initiation of cardiac activity.

After that, the child is transferred to the ward of intensive therapy, where it is in the kuvezé with constant, round-the-clock monitoring. Here the baby is as long as its body needs to restore and correct vital functions.

When the lizals of crumbs are normalized, the child begins to gain weight, it can be translated into a normal branch for newborns. An impatient grandmother, grandfathers and other relatives are waiting for acquaintances with a new family member, constantly interested in when, finally, you can pick up mom with a baby home. It depends on how the child reacts to the environment, eats and recovers.

What weight is given premature babies? You can write a premature newborn when it drops 2500g weight. However, if the child feels good, he has no pathological abnormalities, they can write out and weighing in 2000.

So quite often happens if the pregnancy was multiply and the mother was born twin or triple on the time, just had little kids at birth with smaller sizes than their peers from unionless pregnancy.

If a newborn premature child is poorly gaining weight, he can spend several weeks in the walls of therapeutic establishment and even more. Babies with IV degree of prematurity after 3-4 weeks can only restore the physiological weight loss, and only then start adding.

Most of the kids born ahead of time are developing absolutely normal, they simply need more time.

When, finally, the child will be at home, still standing with frequent visits of relatives and give it the opportunity to quietly adapt in a new setting.

Care of premature houses

Since the nervous system of such kids is immature, it is natural that they are late from their peers in motor development for about 6-8 weeks. It depends on that when premature children begin to keep their heads, to grow, ingur, turn over, wondering toys, crawl, walk. You do not need to push and rush the child, all skills will come at one time.

When patronage, the doctor or nurse must control how quickly premature children are gaining weight.

As a rule, an increase in the weight of the premature child begins from two months, in three he learns to hold his head and its weight increases almost one and a half times.

At this time, it is still very important to maintain the temperature of the room optimal for the baby (air temperature +24).

At the fourth month of life, the kid is already well holding his head, fixes the glance and begins to make sounds. Just at this time, it will be useful to start a lung massage course, air baths.

Five months old, the baby learns to smile, pay attention to toys, try to grab them with handles.

After half a year, the immaturity of the child is less pronounced, and by the 2nd year they can no longer be distinguished from the docking.

Pretty often premature babes "confused" motor skills - begin to crawl late, first gets up, and then they learn to sit down, long run on tiptoe.

Strengthening procedures

Water procedures are perfectly strengthened by all the organism systems of the premature child, so the daily swimming of these children is not only desirable, but also necessary. Depending on the situation, the first bathing can conduct a neonatologist, procedures are necessarily carried out under the reflector. Then learn to bathe babies parents.

The water temperature for swimming should be not lower than 37, but it is also impossible to do it very high.

From the first week of life, the child is beginning to carry out the prevention of rickets: UV irradiation, vitamin D, then massage and gradual hardening.

From two months old, premature babes allow winter walks if the air temperature outside the window is not lower than -8. In the summer you can start walking before. First, walks last for 15 minutes, then their duration gradually increases to 1-2 hours in winter and 2-3 hours in summer.

The Pediatrician Pediatrician necessarily establishes a dispensary observation for up to 7 years with periodic consultations of a neuropathologist, as well as other narrow specialists.

Food mode is premature

In premature babies their feeding features. At first, they do not know how to suck the chest and swallow milk, then when they learn to do it - they are very tired, even in the second-third month of life. And since the feeding during this period should be frequent, then they must be sought with recliner breast milk.

Of course, maternal milk is the most optimal product for a newborn. But in the case of the Agalact of the mother or the presence of any contraindications to breastfeeding, they begin feeding a premature baby with a mixture, which is adapted to the immature organism, for example, "premature", "pretrimon", "Alprem", "Natal", "Pre-Nan" other.

The rules of the first feedings depend on the gestational age of Baby:

* The baby gets breast milk only if, after receiving a 5% glucose solution, there were no joins.

If the feeding is artificial, then how much the mixture should eat a premature child, a neonatologist or pediatrician defines. On average, the baby must obtain 150 ml of a mixture per 1 kg of weight per day. The result obtained needs to be divided into 8 feedings (one feeding every three hours), then a one-time dose will be known.

The kid, which at birth weighed less than 2500g, should eat 60 ml of milk or mixture in the first day. Then the total portion is increased daily by 20 ml, until the daily rate is reached 200 ml. These are average nutritional standards. Since each child is individual, it is necessary to consult an neonatologist.

When the weight of the baby reaches 3.5 kg, you can gradually move the hexide mode of feeding.

When to introduce an unsuccessful child's dust? What products are better to start?

The deadlines for the beginning of the introduction of the premature kid's babies to calculate very simply - add to the actual age that the time for which he used to be born.

For example, if the child was born ahead of time for 2 months - Introduction not in 6, but at 8 months and so on.

In principle, the luxurious children do not differ from the docking dust. At first, the kids are gradually introducing cereals from cereals rich in iron, zinc and vitamins. It is rice, buckwheat, corn. Sunflower or olive oil can be added to the pitch.

After the introduction of KASH, we gradually add vegetable puree. Exotic vegetables and fruits should not be abused. It is better to use seasonal fruits typical of your region. Beautiful zucchini, broccoli, cauliflower, carrots are perfectly suitable.

Two months after the beginning of the babies, the baby can offer kefir and gradually introduce yolks and meat products.

As for drinking, the child who is on breastfeeding in additional drink does not need. The need for drinking occurs no earlier than 10 months when the baby is already getting a sufficient amount of dust.

However, it will still be better if parents discuss the child's drinking regime with a doctor. If a premature baby, besides, the artificial, the driver must be given, but it is possible to use only boiled.

Separately about vaccinations

Recently, there has been a tendency of parental failure from vaccination even to dodden children. What to talk about the reactions to the word "vaccination" of parents of children born earlier! But all, the vaccinations of premature children are needed to protect without the weakened organism from external infections.

Even babies with very small weight are able to move well well, forming a sufficient amount of antibodies that can protect the children's body.

Conducting the BCG vaccination, laid by the long-lasting kids on the 3rd day of life, perhaps after a set of a premature body mass of the body more than 2 kg. A comprehensive vaccination of ADC + OPV + Hib for 2-3 months is better to hold premature babes in the hospital.

Rehabilitation of premature children is not only medical control and constant medical care, this is a whole range of events in which parents should take an active role.

Creating for a baby of optimal conditions, a comfortable external environment, psycho-emotional communication with mom and dad from the first minutes after birth, are the key to the success of the lying and the development of crumbs, which decided to appear ahead of time.

The child who was born earlier than 38 weeks of pregnancy was considered premature. A premature appearance to light can provoke many social factors, as well as the state of the health of the future mother, its obstetric anamnesis. Newborn premature children, regardless of degree of underdevelopment, need special care, especially at the first weeks of life.

Who are premature babies

The baby who was born in the period from 22 to 37 week of pregnancy, weighing from 500 to 2500 grams and a body length from 27 to 45 cm is considered premature. Such children are distinguished from the intricate newborn inconsistency, the immaturity of almost all systems and organs organs, as a result of the premature babies require special care.

Signs of prematurity

The main clinical external signs of an immature newborn include a disproportionate physique, open springs (side and small) skulls, undeveloped fatty tissue or its complete absence, hyperemia of the skin, underdevelopment of external and internal genital organs, physiological reflexes characteristic of full-time peers. When severe, apnea, weakness or lack of muscle tone occurs.

Anatomy-physiological features of the child

Depending on the severity, the kid who was born ahead of time, allocate the following anatomy-physiological features:

The cardiovascular system is characterized by the presence of tachycardia (150-180 UD / min), the mutedness of the tones, the functional hypotension of the newborn. At the third and fourth degree often there are defects of the heart partition (open oval window).
Respiratory system. The prematurests have narrow upper respiratory tract, high standing diaphragms, which has to appease apnea and respiratory failure. Children with a third and fourth degree of presence for a long time are on artificial ventilation of the lungs, because The organs are not matured and cannot perform their function.
Leather and subcutaneous fiber. In newborns born ahead of time, there are practically no subcutaneous fatty fiber, sweat and sebaceous glands are not functioning, as a result of which the body is not able to independently adjust the body temperature.
Gastrointestinal tract. In prevengent, there is a functional insufficiency of all sections of the gastrointestinal tract, low enzymatic activity of the pancreas and stomach.
Selective system. The immaturity of the urinary system leads to a violation of the electrolyte balance in the body, decompensated metabolic acidosis and the inclination to the occurrence of edema, rapid dehydration.

Causes of prematurity

Statistically allocate several groups of risk factors, in the presence of which women have a high risk to give birth to kid ahead of time:

Socio-biological factors. Support too early or late pregnancy (the age of parents is less than 16-18 or more than 40-45 years), the presence of bad habits in a woman, bad living conditions, the presence of professional harm. In addition, the risk of the premature baby is higher for those girls who are not observed in women's consultation during pregnancy.
Dysfunctional obstetric and gynecological history and pathological course of this or past pregnancy. This includes abortions in history, miscarriage, multiplot, detachment of placenta, etc. High risks of premature births can be in women who have an interval between childbirth less than two years.
Chronic Extractive Mother Diseases: Hypertensive Disease, Endocrine Disorders, Chronic Infections.

Degree of prematurity

Clinical classification on the ICD of premature babies for three criteria (weight, growth, pregnancy period) implies four severity:

The first degree of prematurity is assigned to a baby if the delivery occurs on a period of 36-37 weeks of pregnancy; The weight is at least 2000 g, and the length of the body from 41 cm. In this case, independent breathing is observed, the possibility of breastfeeding. However, the baby needs the observation of pediatrician and control the thermoregulation of the body.
The second degree of presence is assigned to the baby who was born on a period of from 32 to 35 weeks with a weight of 1501 to 2000 g, height from 36 to 40 cm. As a rule, such babies have a weak sucking reflex, so feeding the baby has a probe with special mixtures, There is a low muscle tone, immaturity of the respiratory system.
The third degree in children born on the period of 28 to 31 weeks of pregnancy, the mass of the body ranges from 1001 to 1500 g, and an increase of 30 to 35 cm. Such babies are considered deeply premature and need intensive therapy under the control of doctors. The baby is in a closed cuvez, feeding with breast milk or mixture is carried out through the probe due to the complete absence of a sucking reflex.
The fourth degree of presence is assigned at birth for a period of previously 28 weeks from the start of pregnancy, the body weight is less than 1000 gr, the length of the body is less than 30 cm. For such children, the term "newborns with an extremely low body weight" is used in neonatology.

Weight of a premature child by month

The body weight of the premature baby is maximized in the first six months of life (from 500 to 700 grams per month). By the end of the first year, the weight of a healthy newborn should be 9-10 kg. The velocity of the body weight depends on the degree of inconvenience, concomitant diseases, congenital pathologies of organs and systems, and, especially, from the type of baby's nutrition.

Age, months	Middle weight of the child with different degrees of prematurity, gram
Age, months

Development of premature children

Modern medicine cannot accurately draw the border between the consequences of pretimacy and pathological conditions, which arise from the kid who born ahead of time. The frequency of neurological, mental and physical disorders is due to harmful effects of the internet period, their negative impact on the immature central nervous system. However, as infants are growing and developing innate defects. The table shows the development of a premature child by month to a year.

Age is premature	Nervous
1-3 months	During the first three months of life, the baby has increased drowsiness, rare, weak crying, no periods of activity, reduced appetite. Children who were born with a body weight more than 2000 grams, in the second month of life, actively wake up after feeding, actively, many breast milk suck.
4-6 months	At the age of 4-6 months, the premature baby occurs a further development of the functionality of the analyzer organs (the newborn the sound is looking for an object, considers bright, multicolored toys), carry out manipulations with objects (first feel, capture suspended toys), begin to sleep with legs. During this period, the baby lies for a long time on his stomach, the voice of the parents meets a long smile, actively moving his hands, legs.
7-9 months	In the infant during this period, the first speech reactions are developing (a long-term gulitis, pronounces individual simple syllables). He turns from his back on his stomach and vice versa, trying to crawl. During the wakefulness, the child is engaged in a lot of toys, look, tapping, hold in their hands. Children begin to eat from a spoon, drinking from a cup, which is holding an adult.
10-12 months	At the age of 10 to 12 months, the baby actively crawls, he can sit down himself, gets up to the barrier with a support. As a rule, he walks freely, slightly adhering to the items. Children respond to adult speech addressed to them, mischievous, aguca themselves, begin to pronounce simple single words.

Survival of premature children for weeks

Chances to survive the child who was born ahead of time, directly depend on how many weeks he developed in the womb. According to the World Health Organization, the fruit is viable, the fruit that appeared not earlier than 22-23 weeks and weighing at least 500 grams is considered. Survival at this time is only 10-12%. Born on 25-28 weeks are recovered in 60-70% of cases; In 29-30 weeks, this indicator is already 90%. The kids who were born on the period of 31 weeks survive 95%.

Than dangerous birth earlier than 37 weeks

If the baby is born earlier than 37 weeks of gestation period, then he has the functional immaturity of all organs and systems. Seven-month children, as a rule, suffer from acute respiratory failure and insolvency of the central nervous system. Such children are lagging behind their peers not only in physical, but also mental development. In addition, the underdevelopment of the excretory system can lead to the accumulation of toxins in the body, long-term physiological jaundice.

Consequences in the future

The immaturity of children's bodies who appear ahead of time, in the future may adversely affect their health. The most common complications:

rickets;
heart failure;
brain hydrocephalus;
retinopathy premature;
early anemia;
severe internal organs;
chronic renal failure;
psychomotor disorders;
insufficiency of the endocrine glands.

Care for premature newborn

Calculation of children born ahead of time, in the maternity hospital is carried out independently of the degree of presence and is an additional heating of the newborn since the appearance of on-light, rational therapy with oxygen, dosage feeding. In the maternity hospital, the baby is immediately dry by warm sterile diapers and immediately placed in an incubator to prevent heat loss. Premature body weight at birth with less than 1800 g needed additional heating for several weeks. The temperature in the ward must be 24-25 ° C.

Bathing of children born ahead of time, start from two weeks a day. Weighing is carried out daily; Height, head and chest circumference is measured at least once a week. Laying the premature baby on the stomach begins as early as possible, which helps to increase the concentration of oxygen in the blood and contributes to the rejection, normalization of muscle tone.

A healthy premature child who is able to maintain a normal body temperature without additional heating, constantly adding weight and when achieving 2000 g, can be discharged home in the event of a good healing of umbilical wounds, normal hemogram and other laboratory tests. As a rule, the extract is made not earlier than 7-9 days after birth.

Incubator

At the initial stage of the imputation of a premature baby, an incubator or cuvez is used to maintain a constant body temperature, optimal feeding with a probe. There are several types of incubators:

Resuscitation. Such a cuevez, except for heating, the system for regulating oxygen concentration in air, ECG, EEG, pulsometer. Thanks to modern incubators of this type in the healing offices, there is conducting therapy of newborns even with minimal life indicators.
Transport. We are interested in transportation of a newborn incl. And at low temperatures, equipped with heating is supplied with oxygen. Such an incubator is facilitated by the absence of a metal frame, the toddler fixation is made by special belts.
Open. It is used to push the first degree of prematurity children. Helps support the newborn constant body temperature. In the absence of complications, a constant weight gain, staying in such an incubator is 7-10 days.

Features of feeding

The first feed depends on the degree of presence, weight at the birth and general health status. In the absence of severe pathologies, the premature baby gets food already in the first day of life: with the first degree, feeding starts 2-3 hours after the appearance of the world, attaching them to the mother's chest. At 2-3 degrees are fed from a special horn or probe. The premature child for the fourth degree with a small weight is fed first parenterally, then with the help of the probe with a special mixture.

Optimal is feeding with milk or browse of the breast glands of the woman, because It is characterized by a high content of an indispensable protein, electrolytes, polyunsaturated fatty acids (Linolenic acid contributes to the high pace of myelinization and synthesis of prostaglandins), low lactose content, a huge number of antibodies and immunoglobulins that protect newborns from infections.

Dispensarization

The premature babes should be especially carefully observed by doctors after discharge from the hospital to reduce the risk of developing heavy pathologies in the future, the normalization of the pace of the mass of the body mass of low-handed babies when nutrition on artificial feeding, improving physical development indicators. Inspection of the pediatrician during the first month of life is carried out 1 r / week, from 2 to 12 - 1 r / month. Consultation of narrow specialists is necessary only in the first month of life, after only 2 r / year. The formulation of preventive vaccinations is carried out according to an individual plan.

Video

Premature - these are children born in the period from the 28th to 38th week of intrauterine development with a mass of body 2500 g and less and length 35-45 cm.

What weight is the child prematurely?

The fetus with a body weight is less than 1000 g, born under the period of pregnancy less than 28 weeks, is regarded as a miscarriage.

In determining the signs of prematurity, the indicators of the physical development and the period of gestation (the duration of pregnancy), as the newborn, premature and domestic, can be born with a mass of body that does not correspond to the gestation age. For example, the body weight can be reduced due to intrauterine hypotrophy or delays of intrauterine development (small children for this period of pregnancy), as well as increased, which is observed in born from mothers, patients with diabetes. Given the large range of indicators characterizing presence, for practical purposes, the latter is divided into four degrees. The degree of presence reflects the maturity of the newborn, the possibility of adapting it to the external environment, the frequency and features of the pathology, the probability of survival. So, they are diagnosed with prematurity:

the degree of presence is the mass of the child's body at birth 2500 - 2001

the degree of presence is the mass of the child's body at birth in 2000-1501

the degree of prematurity - the mass of the child's body at birth 1500-1000

the degree of prematurity is the mass of the child's body at birth to 1000

The frequency of premature births in different countries varies widely (from 3.1 to 16.6%). There is no tendency to reduce this indicator. Among the prematurely born children, the highest incidence is observed (generic injury of the central nervous system, sepsis, pneumonia, rickets, anemia, hypotrophy) and the highest mortality rate. Up to 75% of all dead newborns are premature. Therefore, the priority task of medical workers in the struggle to reduce morbidity and child mortality is prematurity prepance. And in the event of its occurrence, the provision of proper care for premature newborn children.

The reasons for the birth of premature children

The main causes of premature birth of children are as follows:

Socio-biological factors. Too young or too old age of parents. If the elderly age has a negative impact on the roughening of biological changes in an aging body, the birth of premature children in young mothers is due to unplanned pregnancies.

There is an impact on the low level of parental education and the associated unhealthy lifestyle during pregnancy and misunderstanding of the importance of permanent medical observation. Among the children born with women who were not observed throughout the pregnancy in women's consultation, the level of perinatal mortality is higher than 5 times.

Professional harmfulness, bad habits, heavy physical work play a big role in unbearable. Negative effect on the health of the child is having smoking not only mother, but also the Father. Heavy defects in children from men who smoke for many years and / or smoking a large number of cigarettes, arise 2 times more often than children from non-smoking fathers.

Causes of prematurity of children

The causes of prematurity can be various factors that violate the intrauterine development of the fetus and the physiological course of pregnancy. Self-premature, children in mothers with infectious diseases are often born, including those flowing latent. Premature births may cause a mycoplasma infection, cytomegaly, diseases caused by herpes viruses, adenoviruses and other pathogens, which pass through a placental barrier, damage the placenta and violate its function.

Often premature births occur as a result of severe somatic diseases, vegetative dystonia, pregnant anemia. Infantilism and anomalies of the development of female sexual sphere, neuro-endocrine pathology, immunological incompatibility for antigenic systems also predispose. Children with multiple pregnancy are born premature.

The preceding medical abortions are of great importance, which cause functional and morphological changes of the endometrium and increasing the contractile ability of the uterus, chromosomal aberrations, the age of pregnant and its bad habits, professional harm.

Signs of premature newborn children

Clinical signs of a premature baby

The appearance of the premature child depends on the degree of prematurity.

Signs deeply premature children

A deeply premature baby (body weight is less than 1500 g) has the following signs: thin-red skinny skin, richly covered with a raw lubricant and a fly (Lanugo). Simple erythema holds up to 2-3 weeks.

The subcutaneous fat layer is not pronounced, nipples and the near-slip mugs of chest glasses are barely noticeable; Own sinks are flat, shapeless, soft, pressed to the head; Nails are thin and do not always reach the edge of the nail bed; The navel is located in the lower third of the belly. The head is relatively large and amounts to 1/3 of the body length, the limb are short. Seams of skulls and springs (big and small) are open. The bones of the skull are thin. In girls, the floor slot gaps as a result of underdevelopment of large sexes, the clitoris acts, the boys are not omniced in the scrotum.

Signs of more mature premature babies

More mature premature appearance and signs of prematurity other. Here are their signs: the skin of pink color, no gun on the face (at birth at the 33rd week of gestation), and later on the body. The navel is located slightly above the Lona, the head is approximately 1/4 part of the body length. In children born on the period of more than 34 weeks of gestation, the first bends appear on the ear sinks, the nipples and the near-block mugs are more noticeable, the testicular boys are at the entrance to the scrotum, the girls have almost closed.

For premature children, such signs are characterized as muscle hypotension, a decrease in physiological reflexes, motor activity, a violation of thermoregulation, a weak cry. A deeply premature child (less than the 30th week of gestation) lies with their hands and legs, sucking, swallowing and other reflexes are missing or poorly pronounced. The body temperature is non-permanent (it can decrease to 32-34 ° C and easily rises). At birth after the 30th week of gestation, the prematurely detect the partial bending of the legs in the knee and hip joints; sucking reflex good.

At the child born on a period of 36-37 weeks. Gestation, flexion of limbs full, but unstable, is called a clear enough reflex. In the premature 2-3 weeks of life, there may be a non-permanent tremor, not a rough and non-permanent squint, horizontal nystagm when changing the position of the body.

The premature boys and girls do not differ in anthropometric indicators, as these differences are formed in the last month of pregnancy (dunned boys larger girls).

Features of internal organs in premature babies

The morphological and functional immaturity of the internal organs is also in accordance with the degree of presence and expressed particularly sharply in deep premature children.

Breathing in premature babies superficial with significant vibrations of CDD (from 36 to 76 per minute), with a tendency to Tahipne and apnea duration 5-10 s. In children who were born on a period of less than 35 weeks of gestation, the formation of a surfactant, which prevents the alvetol falling on exhalation is disturbed. They are easier for SDRs.

The heart rate in premature children is characterized by a large lability (from 100 to 180 per minute), the tone of the vessels is reduced, systolic blood pressure does not exceed 6070 mm Hg. Increased permeability of vascular walls can lead to a violation of cerebral circulation and hemorrhage into the brain.

Due to the insufficient maturity of the renal tissue, its function is reduced to maintain KSPS.

All GTS enzymes needed to digest breast milk are synthesized, but differ in low activity.

In premature babies, there is no relationship between the intensity of the jaundice and the degree of transient hyperbilirubinemia, which often leads to the underestimation of the latter. The immaturity of the liver and associated with the insufficient activity of the enzyme glucuroneltransferase, the increased permeability of the hematorecephalic barrier (GEB), as well as the rapid decay of the erythrocytes can lead to the accumulation of indirect bilirubin in the first days of life and the development of bilirubin encephalopathy even with a relatively low bilirubin concentration (170-220 ichmol / l).

Laboratory studies of a premature baby

In the first days of the life of premature children to a greater extent than dadish, characteristic of hypoglycemia, hypoproteinemia, hypocalcemia, hypoplication, hypercalemia, decompensated metabolic acidosis. The content of erythrocytes and ny at birth is almost the same as in the docking, but the HBF content is higher (up to 97.5%), with which the intensive hemolysis is associated with.

On the second day of life, the red blood indicators change with a faster pace than the docking, and at the age of 6-8 weeks the typical deviation in the hemogram appears - early anemia is premature. The leading cause of anemia is considered the low production of erythropoietin.

Features of the development of premature children

Physical development is characterized by a higher rate of weight of mass and body length during the first year of life. The smaller the body weight and the length of the premature birth at birth, the more intensive increase in these indicators during the year. By the end of the first year of life, the mass of the premature child's body increases as follows:

when the body is mass of a newborn 800-1000 g - 8-10 times

"" "" 1001 - 1500 g "6-7"

"" "" 1501-2000 g "5-7"

"" "" 2001-2500 g "4-5"

In the same age period, the growth of premature 65 - 75 cm, i.e., increases by 30 - 35 cm.

Body mass increases unevenly. The first month of life turns out to be the most difficult period of adaptation, especially for a deeply premature child. The initial mass of the body decreases (in a 5 - 7% intimidated); Recovery occurs slowly: in prematched signs of III - IV degree often the mass of the body reaches the initial digits only by the end of the 1st month of life and more intensively begins to increase from the 2nd month.

Despite the high pace of development, the first 2nd lifestyles of premature children in terms of body weight and growth are lagging behind the peers born of duplicate. Later in children born prematurely, asthenia and infantility are more often observed, but a number of children have indicators of physical development corresponding to the docking peers.

Children from the II - III degree of prematurity are beginning to record the eyes, hold their heads, turn over, to get up and walk on their own, pronounce the first words on 1 - 3 months later, and catch up with them for the 2nd year of life (children with 1 degree of presence to The end of the 1st year).

What does a premature child look like?

Eyes. If your child was born earlier than the 26th week of pregnancy, his eyes can be tightly closed.

Genitals. Your child may have underdeveloped genitalia. For boys, this will appear in the presence of testicles; Girls are that the big sex lips (exterior sexual lips of the vulva) will not be larger enough to cover small sex lips (internal floor lips of the vulva) and the clitoris, and the flavors can be seen from the vagina (do not worry, it will disappear over time) .

Extreme thinness. Your premature child may look shy and skinny, because his body lacks fat layers, which usually accumulate by the end of pregnancy (after 30-32nd). When he starts to gain weight, this alkaline will appear, and it will begin to remind an ordinary donkey child more.

Transparent leather. Cutting fat also affect the color of the skin of the premature child. Vienna and artery are clearly visible through the skin, and the skin has a pinkish-purple shade, regardless of the child's racial affiliation. (This is because the skin pigmentation usually appears after the eighth month of pregnancy.)

No hair. Highly premature children may not have any hair on the body, except for a soft gun. On the other hand, children who were born non-empty period can be covered - a thin fluff covering the body. This cannon can be especially upheld on the back, top of the hands and shoulders.

No nipples. Usually nipples appear after the 34th week of pregnancy, so your child may not be nipples, if he was born before this period. However, some children have fully formed mugs - dark circles that usually surround nipples.

Low muscular tone. Premature children worse can control their body than docking. If you put a child on the spin), its limbs can tremble or blame. Strongly premature children sometimes almost do not move: their movements are limited to a slight sipping or compression of cams. Children who are born earlier than the 35th week of pregnancy may lack the muscle tone required for the adoption of embryo poses, ordinary for duplicate children.

Underdeveloped lungs. Premature children have more problems with breathing than donosheny, because their lungs are not fully formed. Fortunately, light child as it matures can continue to develop and outside the maternal uterus.

Comment: If your child is born in the interval between the 22nd and 25th weeks of pregnancy, you should be prepared for the fact that it will be more reminiscent of the fruit in the mother's womb than an ordinary newborn. His eyes can still be tightly closed, the skin can look shiny, transparent and too gentle to touch it. His ears can be soft and folded in those places where cartilage has not yet seal. You will notice how your child will change in the coming weeks, how his skin becomes thicker and how his eyes will open for the first time. It will begin to remind an ordinary newborn.

Evaluation of the development of premature children

When analyzing the development of a premature infant of the first year of life from the child's age, the term of prematurity (if the term of prematurity is 2 months, the development of a 7-month-old child is estimated as a 5-month). In assessing the development of a premature child of the second year of life from the age of the child, half the deadline (if the term of prematurity is 2 months, the development of a 14-month child is estimated as a 13-month). After the premature child reaches the age of 2 years, its development is estimated without amendment for prematurity.

Let's learn how to evaluate the development of premature children.

Signs of violation of speech and delay in the development of language skills in preschool children

6 months - does not react or inadequately reacts to sound or voice;
9 months - does not respond to the name;
12 months - the cessation of laying or stupid was not at all;
15 months - does not understand the words "no" and "bai-bah", does not react to them;
18 months - does not pronounce other words, except for "mother" and "dad";
2 years - it does not constitute doubtic phrases;
after 2 years - still uses the "children's" jargon and overly imites the sounds;
2.5 years - the child's speech is incomprehensible even to family members;
3 years - it does not constitute simple proposals;
3.5 years - the child's speech is understandable only by family members;
4 years - persistent articulation errors (in addition to sounds P, C, L, W);
5 years - experiences difficulties in drawing up structured proposals;
after 5 years - a noticeable constant violation of the smoothness of speech (stuttering);
6 years old - unusual shyness, permutation of words, difficulty with the selection of suitable words when conversation.

At any age, the monotony of pronounced sounds or witness voices.

Signs of violation of cognitive function

2-3 months - does not show much interest in relation to the mother;
6-7 months - does not turn head towards the fallen object;
8-9 months - does not show interest when they are trying to play hide and seek with him;
12 months - not looking for a hidden object;
15-18 months - does not show interest in causal games;
2 years - does not share the surrounding objects in the category (for example, animals are one, cars are different);
3 years - does not know his full name;
4 years - can not say which of the two lines is shorter, and how longer;
4.5 years - it does not know how to consistently count;
5 years - does not know the name of letters, the colors of the objects;
5.5 years - does not know the dates of its birth and home addresses.

Care for premature newborn

Features feeding and care

Freshing premature children has significant features. These features are due to the increased need of nutrients due to intensive physical development, as well as the morphological and functional immaturity of the gastrointestinal tract, requiring cautious food intake.

The beginning of the feeding of the child is determined by the state and the degree of its prematurity. The feeding method is established depending on the severity of the state.

In the I degree of prematurity of the child, it is possible to begin to feed in breast milk or its substitutes after 6 - 9 h, with II degree - after 9 - 12 hours, with III degree - after 12-18 hours, fruit - after 24 - 36 hours. During this period A 5% glucose solution of 3-5 ml is introduced in 2-3 hours. A longer "starvation" is undesirable, since it leads to hypoglycemia, hyperbilirubinemia, hypoproteinemia, enhances metabolic acidosis.

Children with prematurity of III - IV degree, as well as all respiratory disorder syndrome, asphyxia, a weak sucking reflex receive breast milk through a gastric probe, permanent or disposable (permanent probe change every 3 to 4 days for sterilization and warning beds). With a satisfactory general condition and a fairly pronounced sucking reflex, feeding the first 3 - 4 days is made through the nipple. Previously, it is impractical to apply it to the chest, since breastfeeding is a heavy exercise and secondary asphyxia or intracranial hemorrhage may occur.

Premature babies with a mass of body less than 1500 g are applied to the chest from the 3rd week of life. Power calculations are made in accordance with the need of a child's body per 1 kg of mass per day: 1-2 day of life - 30 kcal, 3rd day - 35 kcal, 4th day - 40 kcal and then daily by 10 kcal more 10th day; On the 14th day - 120, from the 21st day - 140 kcal. During the care of premature newborn and when determining the amount of nutrition, the individual features of the newborn should be taken into account: deeply premature children from the 2nd month of life sometimes absorb the volume of breast milk, corresponding to 150-180 kcal / kg. Most are premature, being on natural feeding, are developing well.

Children with an insufficient weight gain at the end of 1st month are sometimes prescribed a concentrated additive in the form of cottage cheese, solid kefir with 5% sugar. In addition, most prematurely receive parenteral solutions of glucose and albumin. From the 2nd month of life instead of drinking a vegetable decoction, as well as fruit and vegetable juices. Instead of breast milk, milk mixtures can be used during the care period of a premature baby.

Calculation of premature children

Calculation of premature children is carried out in 2 stages: in the maternity hospital and in a specialized department for newborns. Then the child comes under the observation of the clinic. In the maternity hospital, prevented in the aim of preventing aspiration from the upper respiratory tract sucking the mucus. In the first days and weeks of life, deeply disheveled children or prematurely in serious condition are contained in Küwese ("Incubators"). They maintain a temperature of from 30 to 35 ° C (taking into account the individual characteristics of the child), humidity in the first day to 90%, and then up to 60 to 55%, oxygen concentration of about 30%. The body temperature is prematurely can also be maintained in a crib with heating or with a height of the roof in a regular bed. The optimal air temperature in the room should be about 24 C.

Oxigenotherapy is carried out, correction of acid equilibrium and bases by administering glucose solutions with ascorbic acid and cocarboxylase. The elimination of hypoglycemia, hypoproteinemia is provided with solutions of glucose and albumin. In case of acute need, plasma and hemotransfusion is transfused.

Most children with prematurity of III - IV degree are obtained during antibiotic care. An indication of their appointment is the heavy overall condition of the child, purulent-inflammatory diseases in the mother, premature influence of spindlewater waters, childbirth outside the medical institution.

What should be care for a premature child ??

The main features of the body of the premature child are very bad thermoregulation and superficial breathing. The first can lead to a drop in the child's body temperature up to 35 degrees or rise to 40, the second to oxygen starvation or even stopping the breath.

As soon as the doctors decide that the condition of the child is satisfactory, mom and baby discharge home, having previously provided with important instructions on hygiene, clothing, walks and swimming a premature child.

It is very important to protect such a child from people who are carriers of colds, ORZ and ORVI. For premature babies, both overheating and supercooling are vital. The temperature in the room where the child is located, should not fall below 22 degrees, under the blanket - not lower than 33 degrees. The water temperature for swimming should be higher than for a daddy child (not lower than 38 degrees), while in the bathroom should also be warm enough - not lower than 24 degrees.

It is clear from the foregoing that care for a premature child includes constant monitoring of its body temperature. He needs warmer clothes than his dundar peers. It is very important to constantly change the air in the room, during the ventilation it is worth making a child from the room.

The child is gaining weight

As soon as the weight of the child exceeds three kilograms, it can be taken for walks. It is not necessary to go outside if the air temperature on the street is lower than minus 5 - for a child up to a month, below minus 10 - for a child up to the year. You should start walking from 5-10 minutes, and gradually increase the walk time up to 2-3 hours (exit immediately after feeding and walking until the next feeding).

Also, the problem is that the kid simply cannot suck the chest, and therefore it is forced to eat from the bottle (and sometimes there is no strength on it). As soon as the child is growing so much that he can suck, you should completely switch to breastfeeding. This will help to quickly score the right weight and catch up with development peers.

From the maternity hospital home is discharged only 8-10% premature cars - these are healthy children with body weight at birth over 2000, the rest are translated into specialized agencies for the second phase of sticking. In these institutions, children receive the necessary treatment, hygienic baths, they are carried out by Rahita and anemia prevention. A complex of medical measures includes massage and gymnastics. A healthy premature child can be written home when they reach the body weight of more than 2000 g, its positive dynamics and a good sucking reflex.

The correct development of premature children contribute to timely care for premature newborns, favorable home furnishings, individual classes, games, massages and gymnastics, rational food.

Remote consequences of prematurity

Children born prematurely grow healthy and become full of full members of society. It is known that I. Newton, Voltaire, Rousseau, Napoleon, Ch. Darwin, Anna Pavlova were born prematurely. However, among such a contingent of children, the percentage is mentally and physically defective than among born on time. Rough psychoneurological disorders in the form of cerebral children's paralysis, reducing the intellect, hearing impairment and vision, epileptic seizures are celebrated in 13 - 27% of prematurely born. Especially high, these indicators in the group born deeply, among them are more often observed by restless, children suffering from uncertainty, children's night fears. Prematurely born more often has disproportionate development of the skeleton, mainly with deviation towards asthenization.

In recent years, doctors of different specialties are studying the features of the development of children born ahead of time. It has been established that women who are born in deeplyonnenny are more often noted by disorders of the menstrual cycle, an infallible generative function, signs of sex infancelism, the threat of abortion and premature labor.

Prevention of premature birth of children involves:

The protection of the health of the future mother starting from early childhood;
Prevention of medical abortions, especially in women with impaired menstrual cycle and neuroendocrine diseases;
Creating favorable conditions for pregnant women in the family and in production;
Timely identification of pregnant women with the threat of premature birth and monitoring the course of pregnancy.