What kind of care do preterm babies need?

Babies who are born preterm need the same care that other babies get and a little more. This includes:

• Good pregnancy care:
• All pregnant women should receive good care, including at least four antenatal visits with a health worker.
• Mothers at risk of preterm birth (e.g. those who have had a preterm birth before) need to be aware that it may happen again, and plan accordingly.
• Health workers caring for pregnant women need to assess their risk of delivering preterm and be able to recognize and manage conditions that can lead to preterm birth (e.g. pre-eclampsia, a condition in pregnancy that causes the mother to have high blood pressure).
• Women in preterm labour should give birth at a health facility where they and their babies can get the care they need. They may need to be referred to a hospital where more advanced care is available, and the safest time to do this is when the baby is still in the womb.
• Delivery by caesarean section or early induction of labour that is not medically necessary should be avoided.
• Women in preterm labour, before 34 weeks of pregnancy have been completed, should receive steroid injections to speed up the development of the baby’s lungs.

• Essential newborn care:
• All babies need to be protected from infections: everyone who touches the mother or the baby should have clean hands. Medical examinations and procedures should only be done if necessary. Sterile gloves and cutting devices should be used for clamping and cutting the umbilical cord.
• All babies need to be kept warm: right after birth, they should be dried thoroughly and placed on their mother’s abdomen. If they breathe normally, and after the umbilical cord has been clamped and cut, they should be put on their mother’s chest, with skin-to-skin contact, until after the first breastfeed. They should not be bathed right away.
• Most babies will breathe normally after thorough drying. Those who do not start breathing on their own need help: ventilation with a bag and mask will usually put them back on track.
• Breast is best: just like full-term babies, breast milk is the best nutrition for preterm babies. Babies should be breastfed as soon as possible after birth. Most premature babies who are unable to coordinate the suck and swallow reflex can be fed their mother’s expressed breast milk by cup, spoon or nasogastric tube.

• Extra care for small babies:
• Preterm babies, and full-term babies with low birth weight need extra warmth and support for feeding.
• Kangaroo Mother Care is a good way of doing this.

• Care for preterm babies with complications:
• Babies who have infections need treatment with antibiotics.
• Babies who do not breathe when they are born need basic newborn resuscitation; if breathing problems persist, they may need additional support from a machine (ventilator) and extra oxygen.
• Babies who have additional complications may need to be kept in neonatal intensive care, where that is available.

Kangaroo Mother Care is a technique by which the baby is held on an adult’s chest—usually the mother—with skin-to-skin contact, for extended periods of time. It is suitable for preterm and full-term babies weighing less than 2kg who do not have other serious problems (breathing well, normal heart rate). The baby is placed on his/her mother’s chest and stays there, day and night, held in place by a cloth that is wrapped and tied at the mother’s back. Kangaroo Mother Care could save an estimated 450 000 preterm newborns a year.

Kangaroo Mother Care is an effective way to meet a premature baby’s needs for warmth, frequent breastfeeding, protection from infection, stimulation, safety and love. It has also been shown to improve bonding between mothers and babies.