What is a premature baby?
Premature babies are defined as those born between twenty four and thirty seven weeks of gestation. The chances of survival for a baby born before twenty four weeks of pregnancy are rather slim. Premature babies are even more vulnerable than full-term babies and need to be treated with special care. These tiny, frail creatures are often born with problems, as many of their faculties are not fully developed.

What are the problems associated with premature babies?
The common problems associated with premature babies are:
Respiratory distress syndrome. Premature babies have difficulty in gas exchange as a result of protein and fluid collection within the small air sacs and the collapse of the sacs themselves.
Difficulty in feeding because of weakness.
Greater likelihood of contracting jaundice and increased vulnerability to its effects.
More susceptible to infection.
Congenital defects, including those that affect the heart.
Danger of bleeding in the brain leading to the development of hydrocephalus (dilatation of the fluid-filled cavities or ventricles in the brain).

These babies are so fragile that doctors must tread gingerly when it comes to taking care of them. Sometimes the solution can lead to a further problem. There have been cases of a baby's lung been blown out or scarred as a result of over-inflation of the lung by a respirator. Oxygen therapy has been known to cause blindness or impaired vision in these premature babies.

The smaller and less mature the premature baby is at birth, the greater will be its problems in the long run. These babies can develop cerebral palsy, mental retardation, learning disorders, and vision, speech and hearing problems.

Premature babies require special care
Premature babies are put straight into intensive care. They are usually kept in incubators. They require round-the-clock nursing. They are fed intravenously and sometimes put on the respirator to help them breathe if necessary. Their vital signs like blood pressure, heart rate, breathing and pulse are closely monitored. Premature babies are kept in intensive care till the doctors are of the opinion that they are out of danger. Even after they have been discharged from the hospital, these babies will require periodic evaluations from paediatricians, neonatologists, ophthalmologists and psychologists to nip any problems that crop up in the bud.

A life and death decision
If premature labour could not be arrested, the next best thing the doctors can do is to make sure that these frail babies survive and have a normal life as far as possible. The advances in neonatal care have increased the chances of survival of premature babies. The catch is that the babies that survive are often severely handicapped. Faced with a tiny, sick, premature baby, doctors are in a quandary whether to do their utmost to ensure the baby's survival or let nature take its course. While the baby may survive there is no guaranteeing the quality of her life. She may be physically or mentally handicapped. At the same time, it is very difficult for both parents and doctors to take a decision to let the baby die.

The doctors can help the parents make an informed decision about their baby's life. The pros and cons of her survival should be discussed threadbare because whichever way the decision goes there is no turning back. Parents should also keep in mind that deciding to save the baby could be a cruel decision if the baby is going to be severely handicapped. In addition, they should consider how caring for a handicapped child could exact a terrible toll on their lives. They will also need to think about who will look after the child if they are not around any longer.

 

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