A baby born before 37 weeks of
pregnancy is considered premature or born too early. Other terms used for prematurity
are preterm and the nicknames "preemie" or "premie". About 1 in every 10 infants are
born prematurely. Twins and other multiples are more likely to be premature than single
Many premature babies weigh less
than 5 pounds, 8 ounces (2,500 grams). This is considered low birth weight. Risks
prematurity are higher for younger, lighter babies. But even older, heavier preemies
still at risk.
Premature birth may have a number
of causes. About 2 out of 3 premature births are because of issues that directly cause
early labor and birth, such as those listed below. Other problems can make the mother
baby sick and need early delivery. Sometimes the exact cause for a premature birth
unknown. This can be true even though the mother may have "done everything right"
Four things that may cause premature labor are:
- Being pregnant with more than 1
- Bleeding or other problems with the uterus
- Infection in the uterus or elsewhere in the body
Many women have no known risk factors for premature birth. But several things can
make premature birth more likely.
Women with these risk factors are more likely to deliver early:
- Having had a past preterm labor or
- Getting pregnant within a short time (less than a year) after having had a baby
- Being pregnant with more than 1
- Having an abnormal cervix or uterus
- Being young, such as a teenager, or
older than 35
- Being African American
- Having health problems, such as high
blood pressure, diabetes, heart disease, or kidney disease, or high levels of social
and psychological stress
- Using illegal drugs, such as
In addition, women who develop any of the following problems during pregnancy are
more likely to deliver early:
- High blood pressure
- Blood-clotting problems
- Problems with the placenta
- Vaginal bleeding
Certain developmental problems in
unborn babies can also lead to premature birth.
How a premature baby looks and acts
depends on how prematurely they are born. The following are the most common symptoms of
a premature baby:
- Small size. Premature babies often
weigh less than 5 pounds, 8 ounces.
- Thin, shiny, pink, or red skin
depending on how early the baby was born. You may be able to see veins through the
- Little body fat
- Little scalp hair. Babies may have
lots of soft body hair (lanugo) depending on how early they were born
- Weak cry and trouble breathing due to
underdeveloped lungs and weak muscles
- Low muscle tone
- Male and female genitals are not yet
The symptoms of prematurity may
seem like other health conditions. Make sure your child sees their healthcare provider
for a diagnosis.
A baby born before 37 weeks of
pregnancy is considered premature or born too early. More specific definitions
Early term infants. Babies born between 37 weeks and 38
weeks, 6 days. These babies are early, but not premature.
Late preterm infants. Babies born between 34 weeks and 36
weeks, 6 days.
Moderate preterm infants.
Babies born between 32 weeks and 33 weeks, 6 days.
Very preterm infants. Babies born below 32 weeks.
Extremely preterm infants. Babies born below 28
Treatment will depend on your
child’s symptoms, age, and general health. It will also depend on how severe the
condition is. General treatment for prematurity involves supporting babies with
intensive care until they have developed enough to breathe, eat, and stay warm by
themselves. Usually this happens around the time of their due date.
Treatment may include:
- Corticosteroid medicine given to the
mother before a premature birth to help the baby’s lungs and other organs grow and
- Watching the baby’s temperature, blood
pressure, heart and breathing rates, and oxygen levels
- Temperature-controlled bed or
- Oxygen or pressure support given by
mask, with prongs in the nose, or with a breathing machine called a ventilator
- IV (intravenous) fluids, feedings, or medicines
- Special feedings with a feeding tube
in the nose or mouth that delivers breastmilk or formula to the stomach
- X-rays or other imaging tests
- Skin-to-skin contact with the parents (kangaroo care)
Premature babies are cared for by a
neonatologist. This is a pediatrician with extra training to care for critically ill
newborns. Other specialists may also care for babies, depending on their health
Premature babies are born before
their bodies and organ systems have fully matured. These babies are smaller than they
would have been if they were born at full term. They may need help breathing, eating,
fighting infection, and staying warm. Extremely premature babies, those born before
weeks, are at the greatest risk for problems. Their organs and body systems are not
ready for life on their own outside the mother’s uterus. And they may be too immature
function well even with intensive care support.
Some of the problems premature babies may have include:
- Keeping their body temperature steady
or staying warm
- Breathing problems, including serious
short- and long-term problems
- Blood pressure problems due to immaturity of various organ
systems (especially low blood pressure in early hours and days)
- Blood problems. These include low red
blood cell counts (anemia), yellow color to the skin from breaking down red blood
- Kidney problems due to immaturity
- Digestive problems, including immature
absorption and digestion. Most premature babies need intravenous (IV) nutrition for
some time at birth. In some cases, there may be inflammation and death of parts of
the intestine (necrotizing enterocolitis). Babies are often not able to feed by mouth
until closer to their due date and will need tube feedings. The best feeding is mom's
own milk. If this isn't possible, donor human milk from a milk bank is the safest
- Nervous system problems, including
bleeding in the brain or seizures
- Infections due to immature immune
system and therefore not being able to fight off bacteria and viruses in the
Premature babies can have long-term health problems as well. Generally, the more premature
the baby, the more serious and long-lasting the health problems may be.
More babies are surviving even
though they are born early and are very small. But it is best to prevent preterm
and other health issues if possible.
It's important to get good prenatal care while you are pregnant. Your healthcare provider
can help find problems and suggest lifestyle changes to lower the risk for preterm
labor and birth. Some ways to help prevent prematurity include:
- Stopping smoking if you smoke. Stop
smoking before you are pregnant.
- Avoid alcohol and drugs
- Finding out if you are at risk for
- Learning the symptoms of preterm
- Getting treated for preterm labor
- Wait at least 18 months between pregnancies
Your healthcare provider may give
you the hormone progesterone if you are at high risk for preterm birth. Progesterone
help if you have had a past preterm birth.
Premature babies often need time to
catch up in both development and growth. In the hospital, this catch-up time may mean
learning to eat and sleep, as well as steadily gaining weight. Babies may stay in
hospital until around the time they reach the pregnancy due date. They may be cared
in a neonatal intensive care unit (NICU).
Talk with your baby's healthcare provider about when your baby will be able to go
home. In general, babies can go home when they:
- Have no serious health conditions
- Can stay warm in an open crib without
- Take all feedings by mouth,
maintaining their expected growth rate
- Have no recent pauses in breathing
(apnea) or low heart rate
Before discharge, premature babies
need an eye exam and hearing test to check for problems linked to prematurity. You
be able to give care, including medicines and feedings, before your baby can go home.
You will also need information about follow-up visits with the baby's healthcare
provider and vaccines. Many hospitals have special follow-up healthcare programs for
premature and low-birth-weight babies.
Even though they are otherwise
ready to go home, some babies still have special needs. This includes things such
extra oxygen or tube feedings. You will learn how to take care of your baby if they
these things. Hospital staff can help set up special home care.
Ask your baby’s healthcare
provider about staying overnight with your baby at the hospital before your baby goes
home. This can help you adjust to caring for your baby while providers are nearby
help and reassurance. You may also feel more confident taking your baby home when
know infant CPR and safety.
Premature babies are at increased
risk for SIDS (sudden infant death syndrome). You should always put your baby down
sleep on their back.
- Babies born before 37 weeks of
pregnancy are considered premature or born too early.
- Many premature babies also weigh less
than 5 pounds, 8 ounces (2,500 grams). They may be called low birth weight.
- Premature babies can have long-term
health problems. In general, the more premature the baby, the more serious and
long-lasting the health problems may be.
- Prenatal care is a key factor in
preventing preterm births and low-birth-weight babies.
- Premature babies are at increased risk
for SIDS (sudden infant death syndrome).
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a
new diagnosis, and any new medicines, treatments, or tests. Also write down any new
instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.