trawling the internet i couldn't find a really useful A-Z of
common problems found in preemies so i have devised my own. Please feel
free to contact me if you feel that something should be added. Thankyou.
© Copyright Cath Stannard
Some common terms and their meanings
Anaemia - Fewer red blood cells than normal. In Preemies, anaemia can cause breathing problems, low energy and poor growth. If babies have too few red blood cells and become 'anaemic', the amount of oxygen carried to the body organs may be below what the baby actually needs. Finding that a baby has anaemia opens the possibility of doctors giving a blood transfusion.
Apnea - During an apnea spell, a baby stops breathing, the heart rate may decrease(bradycardia), and the skin may turn pale, purplish, or blue. Apnea is usually caused by immaturity in the area of the brain that controls the drive to breathe. Almost all babies born at 30 weeks or less will experience apnea. Apnea spells become less frequent with age.
In the NICU, all premature babies are monitored for apnea spells. Treating apnea can be as simple as gently stimulating the infant to restart breathing. However, when apnea occurs frequently, the infant may require medication (most commonly caffeine or theophylline) and/or a special nasal device that blows a steady stream of air into the airways to keep them open.
BPD(Bronchopulmonary Dyspasia) - Sometimes referred to as Chronic Lung Disease(CLD). Bronchopulmonary dysplasia (BPD) is a lung reaction to oxygen or a ventilator needed to treat a preemie with a lung infection, severe RDS, or extreme prematurity. Preemies are often treated with medication and oxygen for this condition
Bradycardia(Brady) - A slower than normal heart rate, in preemies it most often results from apnea.
Cerebral palsy - Very low-birthweight babies are the most likely to develop brain damage leading to cerebral palsy, and an ultrasound or MRI (magnetic resonance imaging) scan can identify those most at risk. The severity and signs of cerebral palsy vary, but it usually shows up as stiffness, involuntary movements, or poor co-ordination and balance.
CPAP - Short for Continuous Positive Airway Pressure, it is a method to keep the air sacs in a baby's lungs open, by preventing them from collapsing after each breath. This is usually given through prongs in the nose.
Cystic Fibrosis - Cystic fibrosis (CF) is an inherited condition. It affects organs in the body, particularly the lungs and digestive system, which become clogged with sticky mucus, making it difficult to breathe and digest food. Cystic fibrosis affects over 7,500 people in the UK and is most common in Caucasian people. People with cystic fibrosis have a shorter life expectancy, with the average being around 31 years
Dysphagia - People with dysphagia have difficulty
swallowing and may also experience pain while swallowing. Some people
may be completely unable to swallow or may have trouble swallowing
liquids, foods, or saliva. Eating then becomes a challenge. Often,
dysphagia makes it difficult to take in enough calories and fluids to
nourish the body.
Endotracheal(ET)Tube - A tube inserted into the nose or mouth into the windpipe(trachea), that can then be attached to a ventilator, to send air directly into the lungs.
Hernia - a small, soft lump or protrusion - is usually found near the tummy button or groin area. It develops in a weakness or gap in the muscle wall of your baby's abdomen. During the first few weeks of your pregnancy, this gap is quite large, to enable the intestines to develop outside the body. By the end of the first trimester, the intestines have moved back inside the abdomen and the muscle wall closes up, allowing just enough space for the umbilical cord to come through. The hernia occurs when layers of tissue, fluid or, if big enough, even organs, such as the intestine, push through the gap, causing a bulge and preventing it from closing.
Hydrocephalus - Hydrocephalus is an abnormal buildup of the brains normal water-like fluid (cerebrospinal fluid or CSF).
Cerebrospinal Fluid is a clear fluid that bathes the brain and spinal cord, providing a cushion, nutrients and carrying away waste.
This fluid is made in the ventricles of the brain. The fluid then flows through a canal-like pathway over the upper surface of the brain where it enters the veins through tiny openings called arachnoid villi.
Hyperbilirubinemia - A common treatable condition of premature babies is hyperbilirubinemia. Infants with hyperbilirubinemia have high levels of bilirubin, a compound that results from the natural breakdown of blood. This high level of bilirubin causes them to develop jaundice,
a yellow discoloration of the skin and whites of the eyes. Although
mild jaundice is fairly common in full-term babies, it's much more
common in premature babies. Extremely high levels of bilirubin can
cause brain damage, so premature infants are monitored for jaundice and
treated quickly, before bilirubin reaches dangerous levels. Jaundiced
infants are placed under lights that help the body eliminate bilirubin.
Rarely, blood transfusions are used to treat severe jaundice
Gastroesophageal Reflux - Often referred to as 'GE Reflux', or just 'Reflux', this is a condition in which food in the stomach comes back up the oesophagus, amd sometimes all the way out of the mouth.
Indomethacin - This medication may cause a PDA to shrink and close.
IVH(Intraventricular Haemorrhage) - Bleeding occurring in an inner part of the brain, near the ventricles, where premature babies have blood vessels that are particularly fragile and prone to rupsture.
Kangaroo Care - A way to hold your naked baby skin-to-skin, against your bare chest, inside your shirt or covered by a blanket, like a kangaroo in his mothers pouch.
NEC(Necrotizing Enterocolitis) - This inflammation and destruction of the bowel lining is associated with a reduced blood flow and infection in the bowel. Sadly, it kills one or two in every five affected babies.
Several factors make it more likely, including:
Shortage of oxygen before birth (for example, with severe pre-eclampsia and an altered blood flow in the umbilical cord). This reduces the bowel's blood supply (because the body directs blood to the brain to protect it).
Low birthweight: four out of five babies with NEC weigh under 2500g (5lb 8oz), and up to 13 per cent of very low-birthweight babies are affected
Frequent 'stop-breathing' attacks
Frequent slowing of the heartbeat
Persistent ductus arteriosus (see below).
Staff carefully watch babies with any of these factors for the many possible signs of NEC. Treatment is with intravenous fluids or feeds, and antibiotics. Very few babies require surgery.
NG(Naso-Gastric)Tube - A soft tube that goes through a baby's nose down into the stomach. It can be used for feeding or emptying the stomach of gas.
Oscillating Ventilator - Also called a high-frequency ventilator, it works differently than a conventional ventilator. An oscillating ventilator keeps a baby's lungs continuously inflated by providing tiny quantities of air at extremely rapid rates.
OG(Oro-Gastric)Tube - Same as an NG Tube but inserted via the mouth.
PDA(Patent Ductus Arteriosus) - The ductus arteriosus is a short blood vessel that connects the main blood vessel supplying the lungs to the aorta, the main blood vessel that leaves the heart. Its function in the unborn baby is to allow blood to bypass the lungs, because oxygen for the blood comes from the mother and not from breathing air. In full-term babies, the ductus arteriosus closes shortly after birth, but it frequently stays open in premature babies. When this happens, excess blood flows into the lungs and can cause breathing difficulties and sometimes heart failure. Patent ductus arteriosus (PDA) is often treated with a medication called indomethacin, which is successful in closing the ductus arteriosus in more than 80% of infants requiring this medication. However, if indomethacin therapy fails, then surgery may be required to close the ductus
Periodic Breathing - An irregular breathing pattern. Because of immaturity, it's normal for a preemie to take some deep breaths, and then pause for 5 or ten seconds before taking the next one.
Pneumothorax - A tear in the air sacs of a baby's lung causing air to leak out into the space between the lung and the chest wall.
RDS(Respiratory Distress Syndrome) - One of the most common and immediate problems facing premature infants is difficulty breathing. Although there are many causes of breathing difficulties in premature infants, the most common is called respiratory distress syndrome (RDS). In RDS, the infant's immature lungs don't produce enough of an important substance called surfactant. Surfactant allows the inner surface of the lungs to expand properly when the infant makes the change from the womb to breathing air after birth. Fortunately, RDS is treatable and many infants do quite well. When premature delivery can't be stopped, most pregnant women can be given medication just before delivery to help prevent RDS. Then, immediately after birth and several times later, artificial surfactant can be given to the infant. Although most premature babies who lack surfactant will require a breathing machine, or ventilator, for a while, the use of artificial surfactant has greatly decreased the amount of time that infants spend on the ventilator.
ROP(Retinopathy of Prematurity) - The eyes of premature infants are especially vulnerable to injury after birth. A serious complication is called retinopathy of prematurity (ROP), which is abnormal growth of the blood vessels in an infant's eye. About 7% of babies weighing 1,250 grams or less at birth develop ROP, and the resulting damage may range from mild (the need for glasses) to severe (blindness). The cause of ROP in premature infants is unknown. Although it was previously thought that too much oxygen was the primary problem, further research has shown that oxygen levels (either too low or too high) play only a contributing factor in the development of ROP. Premature babies receive eye exams in the NICU to check for ROP
RSV(Respiratory Syntical Virus) - A common virus that gives most people a cold, but can be more serious in premature babies, causing infections such as pneumonia or bronchiolitis.
Surfactant - A natural substance in the lungs that helps keep the air sacs expanded, it is deficient in premature babies who suffer RDS. Replacement surfactant can be given to babies who don't produce enough of their own.
TPN(Total Parenteral Nutrition) - A nourishing solution - containing protein, vitamins, minerals and other nutrients - that is given to the baby intravenously.