Premature baby care routine

Babies who are born before their full term are called 'premature babies'. Premature babies are generally weaker in constitution and some of them will be sent to incubators when they are just born. Children in incubators must be cared for correctly, and their body temperature must be measured at regular intervals and their vital signs must be monitored at all times. The following introduces the general care knowledge for premature babies. Let’s take a look.

Three points to note when caring for premature babies

Newborn premature babies should be kept quiet for 4 hours after entering the room, with their heads tilted to one side to allow mucus in their mouths to flow out. Then, their positions should be gently changed every 2 to 3 hours. Measure body temperature once every 4 hours. The difference between the daily maximum and minimum temperatures should not exceed 1°C. If the temperature has been stable between 36 and 37 degrees Celsius for more than three times, you can change to measuring once in the morning and once in the afternoon every day. If the body temperature is higher than 37℃ or lower than 36℃, it still needs to be measured once every 4 hours.

The use of oxygen is limited to those who have difficulty breathing or cyanosis, or are in poor condition. Do not use oxygen inhalation as a routine. Generally, the procedure can be stopped after a few hours of oxygen administration when the cyanosis disappears and breathing becomes normal. For premature babies weighing less than 1000g, it can last for 1 day and night. Continuous oxygen administration should not exceed 3 days. It is forbidden to release oxygen excessively, at too high a concentration, or for too long a time to avoid damaging the baby's eyes and lungs. Infants who are prone to cyanosis when feeding can be given oxygen inhalation for a few minutes before and after feeding.

Premature babies should be bathed only after the umbilical cord falls off and the wound heals. When not bathing, the upper body is given a sponge bath in the warm box, and then the upper body is wrapped and taken out to wash the buttocks. For those weighing less than 1000-1500g, you can use sterilized vegetable oil or talcum powder to gently rub the wrinkles to protect the skin.

The following three points should be emphasized in nursing care:

1. Keep warm: Premature infants have difficulty regulating their body temperature, so the requirements for temperature and humidity during care are very important.

Clothing for premature babies should be light, soft, warm, simple and easy to wear. Diapers should also be soft and absorbent. All clothes should be tied with belts, and pins and buttons should be avoided. For those sleeping in an incubator, except for measuring body weight, nursing work should be done in the incubator as much as possible. Enter through the side door when operating, and open the lid only when absolutely necessary to avoid excessive temperature fluctuations in the box.

Babies whose weight has increased to about 2,000g or more, are in generally good condition, maintain normal body temperature in an unheated incubator when the room temperature is maintained at 24°C, and who are fed with a bottle once every 3 hours and who suckle well and whose weight continues to increase, can be removed from the incubator.

2. Because premature babies grow and develop faster, correct feeding is more important than for full-term babies. Time to start feeding after birth: Generally, premature babies can be fed sugar water 2 to 4 hours after birth. If there is no vomiting after 1 to 2 trial feedings, they can be fed milk after 6 to 8 hours. For patients who have experienced cyanosis, dyspnea, low body weight or who underwent surgery, 10% glucose solution can be given by intravenous drip at 60 ml/kg/d, or full intravenous and partial high-nutrient solution can be used, and oral administration can be switched after the condition improves.

Feeding interval: It can be arranged according to different weights. Babies below 1000g can be fed once an hour, those weighing 1001-1500g can be fed once every 1.5 hours, those weighing 1,501-2,000g can be fed once every 2 hours, and those weighing 2001-2500g can be fed once every 3 hours. It can be extended appropriately at night. If you encounter a baby with insufficient intake, poor general condition, poor sucking ability, poor appetite and prone to vomiting, it is better to feed small amounts and multiple times during the day and night.

Feeding method: depends on the specific situation of the premature baby.

1) Direct feeding with breast milk: This method can be tried for babies with a larger birth weight and the ability to suck.

2) Bottle feeding: It can only be used for premature babies who are heavier and have the ability to suck. Use a small bottle so the milk doesn't get cold easily. The rubber nipple should be soft and have 2 to 3 holes, the size of which should be such that milk can drip out when it is inverted. If the milk flows too quickly, the baby will not have time to swallow and may suffocate; if the milk flows too slowly, sucking will be difficult and the baby may become tired and refuse to eat.

3) Gastric tube feeding: suitable for premature infants with incomplete sucking and swallowing abilities and low body weight. Do not be too hasty when inserting. First use forceps to insert the gastric tube 1 to 50px, and then insert 1 to 50px. Generally, there is not much resistance after passing through the superior nasal concha. After insertion, check the throat to see whether the tube is seen going straight down. Then place the tube end outside the body into warm water to check for bubbles and whether the bubbles are related to breathing. If not, try injecting 2 ml of warm water into the tube. The above three steps can be used to check whether the nasogastric tube is inserted into the stomach. The end of the external section of the gastric tube is led to the outside of the incubator and connected to the outer tube of a 20 or 30 ml syringe, which is then hung on the milk rack for feeding. After the air in the gastric tube is expelled upwards, the milk can flow in automatically and gradually. After each milk flow, pour 2 to 3 ml of warm water to flush the lumen.

For those whose gestational age is less than 32 weeks and whose body weight is less than 1,500g, various amino acids and lipids similar to those in human milk, 10% glucose, various vitamins and electrolytes should be transfused at 65-100ml/kg/d for no more than 3 days. For those who are temporarily unable to feed after surgery for gastrointestinal malformations, those with severe respiratory diseases, low-birth-weight babies, and other people whose intake is insufficient, nutrition can be supplemented through the external jugular vein of the digestive tract.

Breast milk is the most suitable way to feed premature babies, and mothers should be encouraged to maintain breast milk as much as possible. In the case of insufficient breast milk, artificial feeding with premature infant formula can also be considered. Premature babies have the best digestion and absorption of sugar, followed by protein, and the worst digestion and absorption of fat. Therefore, semi-skimmed milk is more ideal.

3. To prevent infection, the premature baby room should be equipped with air conditioning equipment to maintain constant temperature, humidity and fresh air.

After birth, the baby should sleep on the right side to prevent inhalation of vomit. Change sleeping positions frequently to help lung circulation and prevent pneumonia. Generally, you can turn to the right after feeding, and to the left after changing diapers. When feeding with a bottle, it is best to hold the head, back or hold the baby with your left hand. After feeding, pat the baby's back gently to help him breathe out and then lie on his side. Children who are prone to vomiting can sit in a semi-lying position for a while to prevent milk from being inhaled into the respiratory tract or flowing into the external auditory canal after vomiting and causing infection. Once infection is detected, the child should be isolated.

Prevention of premature birth

Among the various causes of premature birth, most are maternal factors, and except for congenital reproductive malformations, most of them can be prevented through prenatal care. Prenatal examinations should be taken seriously to actively prevent and control pregnancy-induced hypertension, reduce the incidence of early placental abruption, and provide early treatment and correction of anemia after placenta previa is discovered. Strengthen the management of pregnant women with heart disease, popularize knowledge of health care during pregnancy, do a good job in health education, pay attention to the combination of work and rest, and avoid infection.