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In general, the medical team makes sure to adapt to the rhythm of the child, avoiding disturbing him at all times and intervening to provide care when he is awake. The light is dimmed as much as possible and the noise is limited. The baby is comfortably installed in his incubator: cocoons can be used to restore the fetal position.
The incubator, a necessary step for premature babies
All premature babies under 35 weeks pass at least a few days in an incubator (incubator). In large and very premature babies, the skin does not yet have an epidermis, which prevents the newborn from being able to maintain its body temperature. The incubator is therefore used to maintain a temperature between 36,7 ° C and 37,5 ° C. She also creates a humid environment in order to avoid losses by evaporation which would lead to weight loss of the newborn. Sometimes a plastic blanket is added to the child’s skin to limit other types of heat loss. There are no specific recommendations as to when the baby can come out of the incubator. It is estimated thatit must weigh at least 2 kg and be able to withstand temperature transitions.
The breathing of the premature infant: from assistance to neonatal resuscitation
The premature newborn can breathe very well independently. In this case, no assistance is set up. If this is not the case, several solutions exist: we can use medicines to stimulate respiratory control (caffeine, doxapram…). If the respiratory immaturity is greater or if the newborn presents a respiratory pathology due to prematurity, respiratory assistance will be set up. Either a ventilation mask or a tube passing through the trachea will be used.
Feeding the premature baby: little by little
The premature newborn has a immature digestive tract. We must therefore start to feed it gradually. He is given small amounts of breast milk through a tube directly into his stomach and in addition, he receives nutrients by blood infusion. As the child’s digestive tolerance improves, the gastric feeding is increased until the blood supply is suppressed. The ideal food for premature babies is breast milk. As much as possible, we privilege the direct donation: the mother draws her milk at the maternity hospital and it is given to the child. Otherwise, female milk stored in whey is used. When the infant is past 32 weeks or weighs more than 1,5 kg, it is possible to wean it from female milk and feed it with special milk for premature babies.
The immune system of premature babies is fragile
The immune system of premature babies is immature. In addition, before 34 weeks, the skin is not fully formed and cannot play its role as an immune barrier. So the baby is particularly susceptible to infections, especially those transmitted by the hands.
The hygiene rules for staff and parents in a neonatal unit are strict: do not wear jewelry, watches or bracelets and wash your hands systematically before and after touching a baby.