You must have a lot of worries of your preterm babies. Being afraid of bad things may become your friend. When your babies get better you may feel relief but it is not over yet. There are still some medical complications that may occur. However, you must not worry about that too much. Generally, they only cause a temporary setback and only a few may lead to a return to NICU. Below are some of the medical conditions that may occur.
Apnea and Bradycardia
Babies who are born under 32 weeks’ gestation are common have apnea, bradycardia and desaturation. Those conditions may continue during the intermediate care. The frequency, intensity, and duration of the conditions episodes will be monitored. If the episodes increased; tests will be conducted to identify the causes. One of the probable causes is immaturity. It can be healed by medication like theophylline and caffeine. Checking on the drug levels in the blood may also be conducted along with the medication. The dosage of the medicine may increase as your babies grow. Around your babies due date, the apnea and bradycardia will be resolved, and you can bring them home with you. However, maybe there will be a need to continue monitoring your babies in the hospital, to do a test with pneumogram, or to do home monitoring/ medication. It depends on your babies’ condition. If your babies have to be monitored at home, you will have to learn of how to use the monitor and how to do infant CPR.
Besides apnea and bradycardia, preterm babies are also susceptible to infection. The hospital, the doctors, the nurses, and the other aspects may have guarantee a healthy place and give the best precautions, but your babies may still get infected. It is important to know that there are some infections which are minor and easy to deal with, but there are also those that are more serious.
One of the minor infections that may occur is a yeast infection in babies’ mouth or so called thrush. It occurs as thick white patches on the tongue or gums. It can be treated with oral medication. Babies who are infected by this infection usually have feeding problems.
- Other Infections
If the thrush is a minor infection that responds to treatment rapidly, there are also other infections that are stronger. They are characterized by feeding difficulties including intolerance, vomiting, abdominal swelling, or poor feeding. The babies usually also do not do much movement, and their temperature is unstable. These infections are also signed by the increase of apnea and bradycardia frequency and work of breathing. When these symptoms are found, blood work, a spinal tap, a urine culture, or x-ray should be done to find the cause of the infections. After that, your babies may be given intravenous antibiotics and NPO. Being transferred back to the NICU may also be possible for monitoring, supporting respiratory, etc. However, infections usually respond well to treatment, and they will be resolved in 2 or 3 days.
Preterm babies are also susceptible to hernias. Hernias itself is a protrusion of the body parts through a muscle weakness or opening inside the babies’ body. Different from the previous conditions that are easy to treat, most hernias need surgical repair.
- Inguinal Hernia
Inguinal hernia usually occurs on boys as a bulge in the groin caused by crying and straining during a bowel movement. Normally, boys’ testicles go to their place which is the scrotum when the boy is already 32 weeks’ gestation. Before that, the testicles are stay in the inguinal canal. In preterm babies, part of their intestine may take the gap in the scrotum that supposed to be for the testicles. It then occurs as a swelling above or in the scrotum. If it still can be given first treatment that is by pushing it back then there is no need to do the surgery. The surgery can be done after your babies weight reach 2 kg or until the babies get older, and the hernia gets worse. Getting worse means the hernia is trapped in the scrotum, and it makes the scrotum blue and painful. It can only mean that immediate surgery is needed. Although this hernia usually occurs in boys, it also does occur on female in the form of the bulge or swelling above or along the mouth.
The other hernia that may occur in babies is the umbilical hernia. It is caused by the muscle around the belly button hasn’t properly closed so the belly button may be pushed outward when your babies cry. It usually resolves on its own as your babies grow. You do need to worry as long as there is no unusual occurring like redness or discoloration. Surgery is also not needed before your babies 3 or five years. So, you must not in a rush to treat this hernia. You have to do things carefully for the better of your babies.
Gastro esophageal Reflux
Many preterm babies undergo this medical condition. It is marked with vomiting 3 to 4 times a day and having problems in feeding. Babies with these symptoms may also bear the episodes of apnea, bradycardia and desaturation during feeding. Gastro esophageal Reflux (GER) itself is a condition in which the opening at the entrance of the stomach is still immature, and it makes the food may get back to the esophagus. It is caused by respiratory distress. Just like the other symptoms, this symptom also resolve on its own in most cases as your baby grow older and reach their due date. However, there are also who need medication and surgery (fundoplication). If the condition is not too bad, you can help your babies to overcome this by feeding your babies in small amounts or by pumps and placing them in their tummy after they eat. You can also raise the head of the bed as part of the treatment.
When your babies are in NICU, their blood is usually taken for testing and evaluation treatment. Meanwhile, the system of the body that is responsible for producing red blood cells (RBCs) is still immature. Therefore, your babies are likely to have anemia. Babies with anemia usually have their tissues and organs function improperly because the anemia decreases the oxygen and glucose level in the blood. Doctors will usually give blood transfusion or Epogen to stimulate the RBCs production to babies with anemia.
Doing blood transfusion is important for babies with respiratory support to keep the blood count normal. It is because the blood count affects the oxygen levels and helps them to free themselves from the oxygen support. When they already able to maintain their oxygen without a help, blood transfusion is not needed anymore. It is okay for babies in intermediate care to have lower blood counts. It is because the low level is hoped to stimulate the production of RBCs by the body’s system.