General Practice 2022

Bebê premature: development, care and nutritionção

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Bebê premature: development, care and nutritionção
Bebê premature: development, care and nutritionção

A baby is considered premature when it is born before 9 months, which is between 38 and 42 weeks of gestation, that is, before completing 37 weeks of gestation, and may have less than 1500 kg of body weight.

As the premature baby's organism is not yet developed, he may need to stay in the hospital in a warm crib or incubator, oxygen devices, have a feeding tube and receive greater hygiene care to avoid infections.

As soon as the baby gains weight, learns to breathe and breastfeed alone, he is released by the pediatrician and can go home. From this moment on, the baby can feed and take the same care as another child.However, if the baby has any he alth problems, the parents must adapt the care according to the pediatrician's indications.

It is important to remember that the characteristics of sleep, speech, favorite games and feeding happen at different rates for each baby. Therefore, in cases of doubts about the baby's development, it is recommended to consult a pediatrician.

Baby weight

The table below indicates the ideal weight of the baby at 37 weeks, as well as other important parameters such as height and head circumference, according to the World He alth Organization:

Boy 37 weeks

Girl at 37 weeks

Weight for age

2 to 3.6 kg 1.84 to 3.3 kg

Height for age

44 to 51.5 cm 42, 6 to 50 cm

Head circumference

31, 2 to 35, 4 cm 30.5 to 34.6 cm

If the baby has values ​​above or below these ranges, it is important to consult a pediatrician to assess the child's development.

Baby development

Premature babies may have difficulties in growth and cognitive development, requiring better monitoring by the he alth center and greater attention from parents and family. However, these delays can be corrected up to the age of 2 years.

To stimulate baby's senses and motor coordination, parents or guardians can talk in a soft, calm voice and looking into the eyes; sing some songs; get massages; and vary the child's positions. See other ways to stimulate baby's senses.

Does the baby need to be hospitalized?

Not all premature babies need to be hospitalized. However, as the child's organism is not yet fully developed, he may have difficulties swallowing, breathing or having a more delicate immune system. Because of this, some babies may need to stay in the hospital for a while. Understand better when and why the baby needs to be hospitalized.

When the baby is discharged

Usually the baby is released to go home when it reaches the minimum weight of 2 kg, showing weight gain for at least 3 days in a row, until its organs function well, without the help of devices, and that it can feeding without the use of probes.

The baby must undergo 3 consultations during the first week after hospital discharge, where the first is carried out in the maternity ward where he was born, 48 hours after discharge, and the other consultations are carried out in the he alth centers or in visits from the family he alth teams at home.

When to vaccinate the premature baby

The vaccination program for premature babies is indicated from the first days of life, with the exception of the BCG vaccine, which should only be administered when the baby weighs more than 2Kg.

However, in cases where the mother has hepatitis B, the pediatrician may decide to vaccinate before the baby reaches 2 kg. In these cases, the vaccine should be divided into 4 doses instead of 3, with the second and third doses being given one month apart and the fourth, six months after the second.

How to take care of a baby at home

Caring for a premature baby at home can be challenging and create a lot of anxiety and worry for the parents, but it is important to remember that the baby was discharged because he was better and more developed.Therefore, most care is similar to that of full-term babies (born after 37 weeks).

1. How to avoid breathing problems

During the first 6 months of life, a premature baby may have breathing difficulties, as the lungs are still developing. In addition, attention should be paid to the increased risk for sudden death syndrome. To reduce this risk it is important:

  • Lay the baby on his back, placing the baby's feet on the bottom of the crib;
  • Use light sheets and blankets in the baby's crib;
  • Avoid using pillows in the baby's crib;
  • Keep the baby's crib in the parent's room until at least 6 months of age;
  • Do not sleep together with the baby in bed or on the sofa;
  • Avoid having heaters or air conditioning near the baby's crib.

In addition, if the baby has any respiratory problems, it is important to follow the pediatrician or nurses' instructions.

2. How to ensure the correct temperature

Premature babies have a harder time keeping their body temperature balanced and, therefore, can get cold quickly after bathing or get very hot when they have too much clothes, for example. To check if the baby is cold, you can use a thermometer or touch the child's skin and see if it is cold, warm or warm and see if there are purple spots on the feet, hands and lips.

If the baby is cold, with a temperature below 36ºC, it is recommended to wrap the baby up, putting on a hat, coat, shoes and, if necessary, covering him with a blanket.

3. How to reduce the risk of infections

Premature babies have a poorly developed immune system and, therefore, in the first few months of age they are at a greater risk of infection. However, there are some precautions that help reduce the chances of infections, which include:

  • Wash your hands after changing diapers, before preparing food and after going to the bathroom;
  • Vaccinate the baby as recommended by the pediatrician;
  • Ask visitors to wash their hands before coming into contact with the baby;
  • Avoid contact of the baby with people who have the flu or colds;
  • Avoid going with the baby to closed and crowded places, such as shopping centers, supermarkets or parks;
  • Prevent smoking indoors;
  • Keep the house airy with doors and windows open.

Furthermore, if you need to leave the house, preference should be given to outdoor places with fewer people or at times when they are less crowded, such as squares and natural parks.

4. How to feed

To properly feed a premature baby, parents or guardians must receive guidance at the maternity ward, as it is common for the baby to be unable to breastfeed alone at the mother's breast, needing to be fed through a small tube in a technique called relactation.See how relactation is done.

However, when the baby is able to latch and suck the mother's breast, he can be fed directly from the breast. If he still cannot suck the breast, you can also give the milk in a small cup, it is not recommended to use bottles.

As the premature baby sleeps a lot, it is important that the mother wakes him up and stimulates him at the time of feedings, rubbing the nipple next to the baby's mouth, for example.

Premature babies have a higher caloric need when compared to other children, because they grow and develop very quickly in the first few months. Normally they breastfeed every 2 or 3 hours, 8 to 12 times a day and the duration of the feeding varies according to each baby, some can breastfeed for 20 minutes on each breast and others for 10 minutes. It is important to know that when the baby is full, he will release the breast himself.

During breastfeeding, a premature baby is slower and can be very tired. Therefore, it is important to take breaks during feedings so that the child can rest and start breastfeeding again.

The pediatrician may recommend the use of infant formula for some babies in cases where the mother is unable to breastfeed or when breast-feeding is contraindicated, such as in the case of contagious diseases or the use of certain medications. The amount of formula must be indicated by the pediatrician and the interval between meals must be 2 to 3 hours.

5. How baby sleeps

In general, premature babies sleep well and many sleep more than full-term children and therefore need more stimulation. If the baby is switching from day to night, you can make some adjustments to the house during the night to not wake him up, such as reducing noise, lighting and movement in the house when it is close to bedtime.

If you need to feed the baby at night, try to turn on just a lamp and speak very quietly so as not to wake the baby.

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