What happens just after your premature baby is born

Whatever your premature baby's birth was like, it will have taken a lot out of you, so try to rest and gather your strength for the days ahead. The medical team will assess your baby's health and start treating them if necessary.

Coping after the birth: one day at a time

If your baby is very small or unwell, you may be feeling exhausted, emotional and shaken. You may also be frightened about what the future holds for them, and for your family. The best thing you can do for your baby is to look after yourself and ask for help and support.

Stabilising your baby

If your baby is premature, the time for cuddles will come, but first of all they will need to see the medical team. As soon as your baby's are born, they will stabilise them which may mean they need to:

  • resuscitate them if necessary, including clearing their airways to allow your baby to breathe, proper head positioning, provision of warmth, drying them, appropriate stimulation, and assessment of breathing, heart rate, and colour.
  • for warmth they may place your baby on a heated trolley and put a little hat and warm blankets on them. If they're very tiny, they may zip them up in a plastic bag up to their neck.
  • help them to breathe if they are having trouble: they may put an oxygen mask on them, or may blow oxygen into their lungs using the mask. They may need to have a breathing tube inserted into their windpipe to help them breathe. This tube can also be used to take any fluids out of the lungs, and to blow medication called surfactant into the lungs.

Helping your premature baby's heart beat

If your baby's heart rate is less than 100 beats per minute, they will be given additional oxygen, or fluids through a drip (a needle inserted into a vein).

If their heart rate drops below 60 beats per minute, the team will need to carry out cardiopulmonary resuscitation (CPR) - pumping the chest to push blood from the heart to the rest of the body. They may also need to give them fluids and medication through a drip.

Your premature baby's Apgar score

Once your baby is stabilised, the healthcare team will give them a thorough physical examination to confirm their gestational age and identify of any potential problems.

Your newborn will get an Apgar score between zero and ten to assess their health. The system gives your baby a score of zero, one or two in five areas:

  • heart rate
  • breathing
  • muscle tone
  • reflex (crying or moving away in response to stimulation)
  • skin colour.

The total figure is added up to provide a maximum score of ten, although babies seldom get the top score.

Premature babies often have lower scores because three key factors - muscle tone, colour and reflex - depend on the baby's gestational age.

What happens next

If your baby was born in a hospital that has the facilities for all their needs, they will be moved to the baby unit. If they need specialist care that is not available in your hospital, they will be transferred to another hospital that has the facilities they need.Read about transferring your premature baby here, and in utero transfer.

The baby unit

Caring for your baby

  • Mother holding baby to her chest.

    Kangaroo care

    Skin-to-skin contact with your premature baby is a wonderful way for you both to bond. It also provides health benefits.

  • Mother holding premature baby.

    Caring for your baby: your role

    The healthcare team will cater for your baby's medical needs, but they need you too. As you get to know your premature baby, you will begin to work out what they need.

  • Premature baby using feeding equipment.

    Feeding your premature baby

    Your premature baby's diet will be carefully balanced to suit their tiny digestive system while meeting the needs of their growing body.

  • Premature baby in incubator.

    Positioning your premature baby

    Positioning your premature baby correctly can make them feel secure, improve their breathing ability, strengthen their muscles and reduce the risk of cot death.

Treatment and medical support your baby may have

Sources

BMJ Best Practice (2011) Premature newborn care, treatment, step-by-step, http://bestpractice.bmj.com/best-practice/monograph/671/treatment/step-b...

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Last reviewed on July 1st, 2014. Next review date July 1st, 2017.

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