Premature delivery of babies often caught parents off guard, Because of their immature development, Can’t adapt to the outside world alone, Need to stay in the hospital for a long time. After the mother gave birth to the baby, she could not accompany the child. It was indeed a torment. When the doctor told her that she could be discharged from the hospital, she could finally take the child home. She could always look at his face and watch him grow up. Her mood was naturally joyful and excited, but she also had a lot of anxiety and worry.
It is normal for inexperienced novice parents to worry about delicate premature infants, especially those with gestational age less than 28 weeks. The fact is that the care and follow-up of premature babies after discharge are indeed very important. I hope this article can provide some help to these parents.
According to the statistics of the Chinese Medical Association in 2005, The incidence of premature infants increased from 5% to 8.1%, The incidence of premature infants in the United States ranges from 7.1% to 17.9%, Generally speaking, the incidence of premature delivery has a rising trend year by year. It was also found in the work that, With the development of IVF in recent years, Twins and premature delivery are also increasing, and the proportion of babies under 28 weeks of gestational age is also obviously increasing. With the development of medicine, some children who cannot be treated before have also been treated, and the survival rate of premature infants is also rising. The minimum gestational age of premature infants living in our hospital is 24 weeks, and the weight is only 600 g, which is accompanied by the increase of nursing difficulty.
Raising premature infants, especially those with gestational age less than 28 weeks, requires not only the doctor’s sense of responsibility, care and patience, but also the parents’ confidence and determination. The attitude of family members will also affect the doctor’s treatment plan.
Premature infants need to pass breathing, infection, jaundice, nutrition, anemia, intracranial hemorrhage and many other checkpoints in the hospital to stay out of the hospital, but discharge is not completely equal to complete peace. After parents happily took the baby home, there are still some babies readmitted due to feeding, infection and other problems.
Because premature babies have many characteristics of their own, There is a need for greater demands and more patience, Can’t be completely like full-term nursing. There is a very humane family kangaroo ward abroad, Before discharge from hospital, it should be a trend for parents to live in such wards to learn to take care of the baby, master the life rules of the baby, and give parents and the baby a transition period so as to better adapt to the life at home. However, in the absence of such conditions, doctors can only give more guidance and parents should also take the initiative to learn.
The following points are the precautions for premature babies after discharge from hospital. 1. Reasonable feeding
Breastfeeding is recommended, Breast milk not only has better nutritional advantages, It can also provide protective antibodies for babies, Reduce the chance of infection, necrotizing enteritis is a very dangerous disease, easy to occur in premature babies, breast-feeding can also reduce the risk of onset. However, unlike full-term infants, simple breast-feeding is not enough for some premature infants, and breast milk fortifiers need to be added, which needs to be used rationally under the guidance of doctors.
If there is no breast milk, it is recommended to feed premature milk powder, It has higher calories than normal infant formula, It can better meet the nutritional needs of the baby. It is now recommended to feed on demand. Instead of timing and quantifying, After returning home, the initial feeding amount is as recommended by the doctor. It will gradually increase in the future. As for how long premature milk is fed, It is generally recommended to drink infant formula milk powder until the height and weight of the corrected gestational age catch up with the normal weight and height of the same gestational age. Therefore, premature babies need regular follow-up in outpatient clinics. According to the growth and development of weight and height, decide whether to continue to drink premature milk. The nutrition of premature babies should not be acted on too hastily, and the catch-up growth should be completed around the age of 2.
2. Prevention of infection
Premature babies are premature because their organs are immature. Including the immune system, so more susceptible to infection. After the baby was discharged from hospital, the whole family was joyful, relatives and friends could not help visiting, some also like to touch the baby, kissing the baby, in fact, it is easy to cross infection. Nursing the baby must wash hands more, less to public places where there are many people, adults have respiratory diseases had better be isolated, and attention should be paid to ventilation at home.
Step 3 Breathe
Babies with relatively small gestational age often suffer from bronchopulmonary dysplasia. Even if they do not need oxygen inhalation, shortness of breath and cyanosis may still occur after eating milk. Once the baby has these symptoms after eating milk, it is recommended to take a rest and observe them. You can prepare an oxygen bag at home for emergency use, and it is better to see a doctor. Some may need to be hospitalized again.
Step 4 Watch your body temperature
The thermoregulatory center of premature infants is not yet fully developed. It is easy to be affected by the external ambient temperature, so the requirement of keeping warm is higher. If conditions permit, the room temperature can be controlled at 25 to 27 degrees Celsius. Before reaching the weight of full-term infants, one more piece should be worn at the same temperature than full-term infants, that is, two more pieces should be worn than adults. At the same time, the child’s hands, feet and back should be touched. If it is warm and does not sweat, it is more appropriate.
5. Neonatal Touch
Parents can watch some videos about touching before the baby is discharged from hospital, and can also learn the essentials of touching from nurses. Touching is simple and easy to learn, which is conducive to the physical and mental development of the baby and to the promotion of mother-child communication. Why not?
6. Fundus examination
The eyes are the windows of the heart. If you are blind, you will regret for life.
Retinal vascular growth in premature infants is not completed. Abnormal vascular growth after birth can lead to retinopathy. Most premature infants need oxygen inhalation during hospitalization. Oxygen is a double-edged sword, which can save lives and may also cause diseases. Oxygen inhalation will increase the risk of retinopathy in premature infants.
According to national regulations, premature infants with gestational age less than 34 weeks or weight less than 2,000 g or weight greater than 2,000 g have received mechanical ventilation or CPAP-assisted ventilation, and those with longer oxygen inhalation time need fundus screening. The initial screening time is 4 to 6 weeks after birth, and then follow-up is conducted according to the opinions of ophthalmologists.
7. Hearing tests
Congenital hearing impairment often affects language development, so early detection, early diagnosis and early intervention are required. Generally, premature infants should improve hearing screening before discharge from hospital, but regular follow-up is required at otolaryngology department if they fail.
8. Craniocerebral examination
Some premature infants have complications of intracranial hemorrhage or leukoencephalomalacia. Neurological follow-up is still needed to evaluate the severity of brain injury after discharge. If the development is obviously backward, rehabilitation training can be carried out as soon as possible.
9. Child health
Premature babies should undergo regular physical examination in the Children’s Health Department after discharge from hospital to monitor their growth and development. Calcium and vitamins should be supplemented reasonably under the guidance of doctors. Premature babies are prone to anemia. Iron should be supplemented appropriately under the guidance of doctors and hemoglobin changes should be monitored regularly.
10. Other
In addition, there are also some premature babies who are prone to cholestasis syndrome due to long intravenous nutrition time. Pay attention to stool color and follow up regularly in digestive department. The incidence rate of inguinal hernia and cryptorchidism in premature babies is very high, and regular follow-up to general surgery and urology is also required.
Premature babies need more care from their parents! Nursing after the baby is discharged from hospital requires more responsibility and patience. The baby is the happy fruit in the family. Parents should not forget to irrigate while enjoying the fruit, hoping that every premature baby will grow up healthily.