Tommy's PregnancyHub

My premature baby’s development in the womb – week 26

If you have been told you are at risk of a premature birth, you may be feeling anxious. Here’s some information about your baby’s development this week.

This information is for women who have been told that they are at risk of a premature birth

If you are not at risk of having a premature baby, we have information for you in our pregnancy calendar - our week-by-week guide to the stages of pregnancy.

Your pregnancy symptoms

Getting a whooping cough vaccine

Whooping cough (pertussis) is a respiratory infection that develops into severe coughing fits. This illness can be very severe, especially in very young babies. 

You can protect your baby by getting vaccinated. The immunity you get from the vaccine will pass to your baby through the placenta and protect them until they are old enough to be routinely vaccinated against whooping cough at 8 weeks old. 

You will be offered the whooping cough vaccine by your GP or midwife between 16 and 32 weeks of pregnancy (although it can be given right up until you go into labour). Talk to your midwife or GP if you haven’t been offered your vaccine yet. 

It's understandable to be anxious about having a vaccine during pregnancy. However, the evidence tells us that the whooping cough vaccine is safe for you and your unborn baby. 

Find out more about the whooping cough vaccine.

Eating well

Eating a healthy, balanced diet and staying active during pregnancy has many benefits. For example, it can help you maintain a healthy weight may also reduce your risk of gestational diabetes (and therefore reduce your risk of premature birth).  

Staying active

As you are at risk of a premature birth, talk to your midwife or doctor about how much activity is safe for you and your baby. Find out more about safe exercising in pregnancy.

Other symptoms

If you are at risk of giving birth early, it’s important to take care of yourself. There are also some things you can do to try and reduce the risk of giving birth early.

Tell your midwife or doctor if you have any symptoms that you are worried about. Do not worry if you've talked about it before and don't be concerned about whether you're wasting anyone's time. This is your pregnancy and it's important to trust your own instincts if you feel something isn't right.

You can also call the Tommy’s midwives on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected]

Symptoms of early labour

Call your midwife or hospital maternity unit straight away if you think you are in early labour. It may be a false alarm, but it’s best to get checked out. Find out more about the symptoms of early labour

Your mental health

If you have been told that you are at increased risk of giving birth early, it’s important to try and reduce stress and take care of your emotional health. Find out more about coping with the idea of a premature birth.

Your baby's development this week

At this point, your baby’s lungs are getting stronger every day.  The baby's eyelids open for the first time around now and they will soon start blinking. 

What may happen if your baby is born this week

Some of this information may be difficult to read. If you have any questions about your pregnancy or risk of premature birth please talk to your doctor or midwife.

You can also call the Tommy’s midwives on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected]

Babies born before 28 weeks are described as being extremely preterm. Approximately 8 in 10 babies will survive if they are born now.

1 in 10 babies born at this time will have a severe disability. Up to 1 in 4 of children without a severe disability may have a milder disability, such as learning difficulties, behavioural problems or mild cerebral palsy. 

Babies born before 28 weeks will need help with their breathing. The healthcare team may put a breathing tube passed through their mouth or nose and into their lungs (known as ‘intubation’), which is connected to a machine called a ventilator. This machine does most or all of the breathing for the baby. 

Some babies may not need a ventilator and instead they will have small prongs into their nostrils or a mask over their nose connected to a machine (called ‘CPAP’) that provides air or oxygen with pressure to make the effort of breathing easier for them.  Your baby will be given some medicine into their lungs, called surfactant, to help with their breathing. 

The healthcare team will recommend caffeine treatment to help reduce or treat apnoea.   Apnoea is a common condition where a baby may pause their breathing for a variable amount of time.  

Babies born at this stage are at risk of hypothermia (an abnormally low body temperature). When they are born, they will be placed into a clear plastic bag up to their neck to help keep them warm and protect their fragile skin. On the neonatal unit, they will be placed in an incubator that is humidified to keep them warm.    

They will need a thin tube passed through their nose or mouth into their tummy that milk can be given through. They will also need fluids or nutrition (a ‘drip’) through a thin tube into a vein (intravenous or IV line). This will often be into one of the veins in their umbilical cord.

Babies born now may have low blood pressure so the healthcare team may also need to raise your baby’s blood pressure with extra fluids or medicines. 

Babies born now are also at risk of infection and will be given antibiotics until blood tests confirm they do not have an infection. 

Your healthcare team will monitor your premature baby closely to make sure they receive the best possible care. 

Regan, Lesley (2019) Your pregnancy week by week, Penguin Random House, London

NHS. You and your baby at 26 weeks pregnant. https://www.nhs.uk/pregnancy/week-by-week/13-to-27/26-weeks/ (Page last reviewed: 17 July 2018 Next review due: 17 July 2021) 

NHS. You and your baby at 22 weeks pregnant. https://www.nhs.uk/pregnancy/keeping-well/whooping-cough-vaccination/ (Page last reviewed: 17 October 2019 Next review due: 17 October 2022)

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. What can help prevent gestational diabetes? 2017 Jun 29. https://www.ncbi.nlm.nih.gov/books/NBK441575

British Association of Perinatal Medicine. (2019) Perinatal Management of Extreme Preterm Birth before 27 weeks of gestation. British Association of Perinatal Medicine https://hubble-live-assets.s3.amazonaws.com/bapm/attachment/file/182/Extreme_Preterm_28-11-19_FINAL.pdf
  
Bamat N et al. (2019) Positive end‐expiratory pressure for preterm infants requiring conventional mechanical ventilation for respiratory distress syndrome or bronchopulmonary dysplasia. Cochrane Database of Systematic Reviews 2019; Issue 2. Art. No.: CD004500. DOI: 10.1002/14651858.CD004500.pub3.
  
NICE (2019) Specialist neonatal respiratory care for babies born preterm. NICE guideline 124. National Institute for Health and Care Excellence https://www.nice.org.uk/guidance/ng124

Moschino L et al. (2020) Caffeine in preterm infants: where are we in 2020? ERJ Open Res. 2020; 6(1): 00330-2019.

Ballout RA et al. (2017) Body positioning for spontaneously breathing preterm infants with apnoea. Cochrane Database of Systematic Reviews 2017; Issue 1. Art. No.: CD004951. DOI: 10.1002/14651858.CD004951.pub3.

Wyllie J, Ainsworth S, Tinnion R (2015) Resuscitation Council Guideline: Resuscitation and support of transition of babies at birth. www.resus.org.uk/resuscitation-guidelines/resuscitation-and-support-of-transition-of-babies-at-birth/ 

McCall EM et al. (2018) Interventions to prevent hypothermia at birth in preterm and/or low birth weight infants. Cochrane Database of Systematic Reviews 2018; Issue 2. Art. No.: CD004210. DOI: 10.1002/14651858.CD004210.pub5.

NICE (2021) Neonatal infection: antibiotics for prevention and treatment.NICE guideline NG 195. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ng195