Premature Babies

Every baby is an individual, so there's no single answer that fits them all. Babies born earliest or smallest are most likely to have health problems. 

We have a lot of evidence now from two large studies of the very earliest premature babies. 

In the EPICure study, researchers followed the progress of extremely premature babies who were born in 1995. 

Hospital care for premature babies has improved tremendously since then, so the researchers are also studying another group of babies born in 2006. This is the EPICure 2 study. 

These studies included babies who had no more than 26 weeks in the uterus (womb). The usual time for a baby to stay in the uterus (womb) is 40 weeks. Babies born at around 40 weeks are described as being born at term. Some of the oldest children have now been followed up until the age of 11. 

A premature baby's chance of surviving has improved dramatically over the years. But it does appear that extremely premature babies still face greater health and developmentchallenges. 

Cerebral palsy, learning difficulties, behaviour problems and respiratory conditions are more common than in children who were born at term. 

However, bear in mind that these studies involved the earliest, tiniest babies. Few babies are extremely premature. Most premature babies, 80 per cent, arrive between 32 weeks and 36 weeks, and they are often called late preterms. 

In general, the longer babies can stay in the uterus, or the closer they are to term, the better building blocks they have for good health in the future.

What are the common health problems for premature newborns?

Many premature babies have breathing problems at birth. This is because their lungs did not have enough time to mature before they were born. For a while, your baby might need to be on a ventilator or a gentler type of breathing machine called a continuous positive airway pressure (CPAP). 

A very small number of babies will still need oxygen when they go home from hospital. Most of these babies will eventually come off oxygen. 

Some premature babies are born with heart problems and may need surgery. In the early days, premature babies are also vulnerable to bleeding on the brain, serious infections and bowel problems. Specialist doctors and nurses will monitor your baby closely for signs of any illness.

Will my baby have long-term health problems?

Your doctor may already have told you about a health problem that your baby faces. Usually, though, it's a case of watch and wait. 

The uncertainty can make this a stressful time for families. Parents who've been through it advise taking one day at a time. The risks are highest for babies born the earliest and smallest. Remember, each baby is different and children beat the odds every day.

Will my baby grow up to be smaller than other children of her age?

It really depends on how early your baby was born. Care for premature babies gets better all the time. This means there's been an improvement in how well premature babies grow and gain weight. For at least the first two years, your baby's healthcare team will probably take her prematurity into account when they weigh and measure her.

Will my baby walk, crawl and talk at the same time as other babies?

Always keep in mind your baby's corrected age. This is the number of weeks or months since her due date, not the actual date she was born. For example, if she was born two months early, you could expect her to reach these milestones two months later than a full-term baby who was born on the same date.

Will my baby go on to have problems when she is school age?

Some children who were born prematurely need extra support at school, but by no means all. Again, much depends on how early your baby was born. 

The media tend to report stories about children's abilities based on the EPICure findings. But media storiesmay not give an accurate picture. That's because the EPICure studies focused on the smallest and earliest babies, which make up a minority of premature babies. Also, these are the babies who have the most health challenges to overcome. 

The EPICure studies have followed children who were born extremely prematurely up to the age of 11. The studies found that these children were more likely to have learning and behaviour problems than children who were born at term. 

This group of children especially had problems with memory, language and problem- solving. They were more likely to struggle with school subjects. About half of children who were born extremely prematurely have below average performance at school, compared with five per cent of their classmates. 

Babies born later, between 32 weeks and 36 weeks (late preterms) have less difficulty at school, but may still struggle more than their full-term peers. In a large study, 71 per cent of late preterm children were successful in key stage one assessments, compared to 79 per cent of children born at term. 

However early your child was born, it is worth making sure that her health visitor and teachers keep a close eye on her early development. Then you can be sure she gets the extra help she may need, from preschoolonwards. 

Bear in mind that your child's performance at school could be affected by the time of year she was born too. So babies born in the summer, just before the academic year starts, tend to do less well than autumn or winter-born babies. 

Not surprisingly, the same effect is true for babies born prematurely. If your baby was born prematurely in July or August, she will be even younger than the youngest term-born babies, developmentally. 

This could help you keep things in perspective when the time comes for parents' evenings at school. 

Be assured that most premature babies thrive as they grow. See our photo gallery of prem babies then and now, to see how well the featured children are doing.

What help can I get with caring for my baby at home?

You can call the neonatal unit about any problems or worries, even after your baby has come home. Your baby is also likely to have follow-up appointments. 

If your baby needs extra care, you might have home visits from specialist nurses. You can also get help, advice and care for your baby from yourhealth visitor and your family doctor.