What It Is: Brief cessation of breathing (apnea), sometimes accompanied by slowed heart rate (bradycardia).
Treatment: A massage may stimulate breathing, or compression of a handheld bag can temporarily administer air. If spells are repeated or prolonged, a doctor may attach a CPAP (continuous positive airway pressure) device to the baby’s nose or insert a tube down her throat into the lungs for mechanical ventilation. An apnea monitor attached with electrodes may be used at home. As the baby grows, her monitor will need to be adjusted, but it’s usually no longer necessary after six months.
Problem: Bronchopulmonary dysplasia (BPD)
What It Is: Chronic lung disease due to damage to the immature lung development after premature birth.
Treatment: Increased oxygen, supplementation of breast milk or premature infant formula with extra calories, and, occasionally, restriction of fluid or using a bronchodilator to reduce buildup of fluid and maintain open breathing tubes in the lungs. As the lungs mature and the baby gains weight, her lungs heal; the condition resolves over months or occasionally years.
Problem: Intraventricular hemorrhage
What It Is: A rupture of still-developing blood vessels in the brain of premature infants, with blood going into the fluid spaces of the brain, which occurs within the first few days of life.
Treatment: The bleeding usually stops quickly without treatment. Cranial ultrasounds, CT scans, or MRIs (magnetic resonance imaging, a specialized brain scan) may be used to make this diagnosis. Occasionally, the bleeding may result in blockage of fluid drainage from the brain, which leads to hydrocephalus (a buildup of fluid surrounding the brain); a surgical procedure may be needed to place a shunt in the brain to relieve pressure. The prognosis depends on the extent of bleeding and amount of other brain injury noted on MRIs.
What It Is: An excess of bilirubin (the waste from normal red blood cell breakdown) in the blood due to the inability of a baby’s immature liver to process it or to blood group incompatibility (Rh factor, ABO, and others).
Treatment: Phototherapy in which a baby is placed under blue spectrum lights called bililights. Extreme amounts of bilirubin in the blood may necessitate a partial or complete blood transfusion, called an exchange transfusion.
Problem: Respiratory syncytial virus (RSV)
What It Is: A virus that causes what looks like a cold, with symptoms such as coughing and inflamed mucous membranes, but which may cause difficulty breathing or become a serious lung infection in very young infants. Premature infants are especially susceptible to this virus.
Treatment: Antiviral drugs or treatment of the symptoms. A preventive measure is the Synagis vaccine, which insurance should cover; it’s recommended for premature infants during winter months. (For more information, go to synagis.com.)
Problem: Respiratory distress syndrome (RDS)
What It Is: A common condition in which a baby has difficulty breathing caused by a lack of elasticity in her lungs.
Treatment: Tubes inserted in the nose or mouth or extra oxygen via an oxygen hood administer continuous positive airway pressure (CPAP) and may be necessary to prevent the lungs from collapsing. Given time and treatment, most babies develop normal elasticity. In severe cases, a heart-lung machine may be used to provide support. Premature infants are much more vulnerable to RDS than full-term infants.
Problem: Retinopathy of prematurity (ROP or retrolental fibroplasia)
What It Is: Damage to the retina, perhaps caused by an imbalance in the blood’s oxygen level or extreme prematurity.
Treatment: Examination by a pediatric ophthalmologist. If progression of ROP is observed, surgery by a pediatric ophthalmologist may be required to prevent blindness.
This is an excerpt from THE BABYTALK INSIDER’S GUIDE TO YOUR BABY’S FIRST YEAR by the Editors of Babytalk Magazine. Copyright © 2008 by The Parenting Group, Inc. Published by Grand Central Publishing, New York, NY. All rights reserved.