Physical Features of a Premature Newborn
It’s important to be able to distinguish an early baby from a full term so that you can understand the newborn’s behaviour in the first few weeks of life. A full term baby will suck and swallow well, be wakeful and be soaking diapers by Day 3. The premature baby will likely get jaundiced (yellow skin), be sleepy and uncoordinated with breastfeeding. The premature baby needs constant warmth (kangaroo care on the mother’s body is best) and must be fed by dropper, syringe or tiny cup until the sucking reflex develops. Even if the baby is sleeping, it must be dropper fed and encouraged to swallow by stroking the cheeks or lips. Dehydration is a real danger with premature infants.
Signs of prematurity
Signs that you have an early baby (under 38 weeks gestation)
Small size
Large head relative to rest of the body
Little fat under the skin; lots of vernix (cheesy coating) at birth
Thin, shiny, pink skin
Veins visible beneath the skin
Few creases on soles of feet (heel will be smooth, not printed).
Fine hair (lanugo) on the shoulders and back (often called “monkey hair”)
Soft ears, with little cartilage
Underdeveloped breast tissue
Boys: Small scrotum with few folds. Testicles may be undescended. Girls: Labia majora not yet covering labia minora
Rapid breathing with brief pauses (periodic breathing), often apnea spells (pauses lasting greater than 20 seconds)
Weak, poorly coordinated sucking and swallowing reflexes
Reduced physical activity (a premature newborn tends not to draw up the arms and legs as does a full-term newborn)
Sleeping for most of the time Here’s a pdf of newborn reflexes and characteristics that might be helpful to you and your clients.
http://www.birthsource.com/pdffiles/ReflexesCharacteristics.pdf
The definition of term is 37 to 42 completed weeks as far as I know. I have also found that 35/36 weekers rarely have a problem with suckling well although 35 weekers have more temp issues. I totally agree that the early babies need calories and fluid regularly even if their sucking is not yet efficient. Donated ebm is worth thinking about in these cases.
Interesting. My 2nd was def “premature” in that she fit the descriptions above, except she had no troubles nursing at all. No rapid breathing/apnea episodes, either. She was 36wks gest. at birth.
Hi R., it definately helps if the mother has had experience nursing. Usually the 36 week baby gets very jaundiced and sleepy and it can be difficult to keep it hydrated adequately.
Back in 1975 in my Mid Training we were taught the Duberwitz Assessment to assess maturity. It looks at lots of aspects of the whole baby and each is scored and total gives gestation estimation to guide care plan.
Do you see some things from that assessment on this photo, Rosey?