This week, Memorial Hospital Neonatal Unit Chief Pediatrics Specialist Dr.. We talked with Gökhan Mamur about “Premature babies”.
: What are the causes of preterm birth?
Dr. Contact Gökhan directly The two main causes of preterm births are infectious diseases and the lack of supportive tissue of the cervix. In addition, multiple pregnancies and the water surrounding the baby (polyhydramnios) increase the risk of premature birth. It should be noted, however, that fifty percent of preterm births cannot be attributed to any cause.
: When is a baby considered premature?
Dr. Contact Gökhan directly Babies born in time are babies born between 37 and 42 weeks of gestation. In this case, the baby who did not complete 37 weeks of gestation was born prematurely. However, babies who have completed 34 weeks of gestation are generally mature enough to adapt to the outside world and therefore do not generally require a neonatal intensive care unit.
: What are the statistical data about preterm babies?
Dr. Contact Gökhan directly Premature infants are those who have not completed 37 weeks of gestation. In this classification, babies born below 2500 grams are called-low birth weight-DDT ”and babies born below 1500 grams are called“ very low birth weight-MDCT ”. As you can imagine, the lower the baby's birth week and birth weight, the greater the dangers. DDT babies account for 2/3 of all deaths in the neonatal period, and half of this number is MDCT babies. Mortality rates of DDT babies in the first month increase 40 times compared to term babies and this rate is 200 for MDCT babies. The survival rates according to gestational week in neonatal intensive care units with high level approaches; 50% at 25 weeks of gestation, 60% at 26, 70% at 27, 80% and above and beyond. When all gestational weeks are combined in these units, survival rates are 90% and above.
: What treatment methods are applied in neonatal intensive care units?
Dr. Contact Gökhan directly The treatment methods applied in neonatal intensive care units mainly aim at life support for infants. For example, if we talk about a premature baby, the newborn team welcomes the baby from the first moment of birth. Here special resuscitation techniques are used for newborn babies. Once the baby's vital functions are brought to a certain line, the infant is connected to the breathing apparatus through a tube due to immature lungs, and a drug, which facilitates the operation of the surfactant lung, is then administered directly to the respiratory tract. Furthermore, sedatives are administered to prevent the baby from struggling with the breathing apparatus. It is tried to create an environment close to the environment in the mother's womb. This is provided by a heated bed. Since the veins of the baby are still very thin and delicate, a thin tube is placed in the same vein where the mother feeds the baby and the blood vessels are taken and blood samples are taken for the laboratory. Antibiotics are used if there is a possibility of infectious disease. Since premature babies are more likely to have cerebral hemorrhage, approaches and treatments are performed. In general, there is a minimal handling approach during this period. This means as much monitoring as possible and as little contact as possible. In this way, both the baby is less stimulated and the chance of catching germs is reduced. Such infants are very susceptible to germs, so their defense systems are very, very inadequate compared to us adults. Therefore, the cleanliness of the neonatal intensive care unit and, most importantly, the hand cleaning of the employees is perhaps one of the most important rules in the unit. It is very important that parents stay away from their babies. It is especially necessary for the production of breast milk of the mother and development of the bond with the baby. For this reason, parental access to these units should be kept very free and they should be able to receive information with their babies at any time. Apart from this, mother and father should be in sensual contact with their babies. This style of care is called kangaroo care. As the baby's health improves a little more, he leaves the breathing apparatus, reduces intravenous treatments and serum, and feeds through the stomach, where the importance of breast milk is revealed. Basically, it is seen that many procedures performed by the teams in neonatal intensive care units aim to respond to the problems that arise during certain periods of the baby's life. But aside from all the latest models and high-tech equipment, the most important thing to me is the team. From the doctor to the nurse, from the patient consultant to the cleaning staff, everyone has a vital role in the team. Working together in an environment that works together and where everyone knows their own responsibility is the most important element for achieving the healthy development of the baby.
: Turkey "s neonatal unit are sufficient in terms of capacity and technical equipment?
Dr. Contact Gökhan directly In our country, neonatal intensive care units are available in private and public sector. However, there is no specific standard. Some units are worldwide and can cure even the most severe cases, while others may be inadequate for such cases. What is important here is to determine the capacity of each team to look after the patient and work in this direction. When it comes to cases where the team cannot provide adequate services, it is very important to transfer them to hospitals that can handle such cases under appropriate circumstances. After all, the goal is to heal the babies and we are there for them.
: What are the criteria for sending the premature baby home?
Dr. Contact Gökhan directly Many people believe that premature babies should remain in intensive care for a certain period of time. But this is not true. The control is actually in the baby's hands. If a baby is able to maintain body temperature at room temperature, can be fed by mouth and weighs, and breathing is completely natural, then we can say that the baby's time to go home is very close.
: What are the points that the family should take care of in the care of the baby sent home?
Dr. Contact Gökhan directly There are many points to consider. A healthy, timely baby should suck his mother whenever and whenever he wants. No bottle or pacifier should be used and the physician should be consulted without giving food. Room temperature should be around 21-24 degrees and the baby should not be dressed too thick. If possible, the baby should take a bath every day and if the skin is not dry, there is no need to use any moisturizing product. Remember that sleep is a skill that is gained and the baby will want to continue to sleep the same way he falls asleep. Therefore, your baby should pay attention to sleep in bed. Unfortunately, there is a condition called sudden infant death syndrome and in this case completely healthy infants can sometimes be found dead in their beds. The factors that will reduce this situation are as follows; the room temperature of the baby is not too hot, not lying on the soft bed, no pillow or soft toy on the bed, the baby's face does not lie on the sheep and if possible, the baby's feet touching the lower end of the bed. Finally, it is useful to keep in mind the three things that could be an emergency: if your newborn baby sleeps for 5-6 hours non-stop, refuses to suck up even though you wake, it is like pale and pellet; jaundice on your baby's skin goes down to your feet; If your baby's fever is 38 degrees or higher, be sure to talk to your doctor.
: When is premature baby considered normal?
Dr. Contact Gökhan directly In fact, preterm infants are as normal as term infants and are very common in life. Therefore, the baby is normal from birth, but needs special conditions for a certain period of time. However, if the preterm baby is able to maintain body temperature at room temperature, breathing is completely natural and can be weighed by oral feeding, we can say that it is close to the term of the newborn. Other than that, there are special cases. For example, the scales, height and head circumference of the preterm baby take approximately six months to reach the newborn at term. Although premature babies can go to their homes for a certain period, they are more receptive to some germs and they approach “normal iyle with the passing of this period. Even after the first age of the baby, most experienced eyes cannot distinguish the preterm baby from the term.
Mr. Dr. To Gökhan Mamur thank you for enlightening us about the premature baby.