Newborn health: Challenges facing preterm babies

The earlier in a pregnancy that babies are born, the less prepared their bodies are for the outside world. They need special care to overcome the following challenges:

Staying warm: Preterm babies lose body heat more easily, putting them at risk of life-threatening hypothermia. They need extra energy and care to stay warm and grow.

Feeding: Preterm babies can have trouble feeding because the coordinated suck and swallow reflex is not yet fully developed. They may need additional support for feeding.

Breathing: Many preterm babies start breathing on their own when they are born, but others need to be resuscitated. If the lungs are not fully developed and lack surfactant (a substance that helps keep the lungs expanded), preterm babies may have difficulty breathing. Sometimes, premature babies that start off breathing are not strong enough to continue on their own. They exhaust themselves and may stop breathing (apnoea).

Infections: Severe infections are more common among preterm babies. Their immune systems are not yet fully developed, and they have a higher risk of dying if they get an infection.

Brain: Preterm babies are at risk of bleeding in the brain, during birth and in the first few days after birth; about 1 in 5 babies weighing less than 2kg have this problem. Preterm babies can also have brain injuries from a lack of oxygen. Bleeding or lack of oxygen to the brain can result in result in cerebral palsy, developmental delays and learning difficulties.

Eyes: Preterm babies’ eyes are not ready for the outside world. They can be damaged by abnormal growth of blood vessels in the retina. The condition is usually more severe in very premature babies and if they are given too-high a level of oxygen. This can result in visual impairment or blindness.

Preterm babies are at risk of developing disabilities that will affect them for their entire lives. The extent to which this will affect their life strongly depends on how early they were born, the quality of care they received during and around birth and the days and weeks that follow.