What happens if a child has been born earlier than expected, accidentally several weeks before the due date? In addition to the immediate care adequate for premature babies (see footnote no.1.) (in the perinatal intensive centrum – PIC), their condition and progression, affected by the underdevelopment of their organs, must be followed up. A specialist called neonatologist participates in this course. Dr. Hajnalka Szabó, our clinic’s neonatologist and intensive therapist, in addition to taking care of premature babies is also practicing as a pediatric pulmonologist.
Owing to preterm birth, the discontinued intrauterine lung development may have consequences like impaired respiratory function, asthma and adults’ COPD (chronic obstructive pulmonary disease). That is why the prematures’ pediatric pulmonological follow-up is very important, no matter if artificial respiration was given to the infant or not.
Prematures are disposed to more diseases in childhood, too
Nowadays a number of adult age chronic pulmonary diseases are being related to the newborns’ respiratory disorders, like certain types of asthma or certain forms of COPD. Some clinical examinations, executed on large number of patients, have proved that school age respiratory function rates of premature children are lower even if they did not have any respiratory disease at their newborn age. So, even in case of late preterm birth, the child’s pulmonological follow-up has great importance.
What can we do to minimize the chance of chronic pulmonary diseases’ development owing to preterm birth?
1./ Aftercare is very important when the baby is discharged from the hospital’s premature maternity ward. Generally, this service is provided by a group of specialists, in which in addition to the contribution of a neonatologist, neurologist, ophthalmologist, physical therapist, the significant participation of a pediatric pulmonologist also has great importance. Regular measurement and registration of the baby’s respiratory function’s parameters could be of great importance.
2./ Again, the significance of prevention, early recognition and treatment of respiratory infections is very high.
3./ Parents, raising premature children, must be supported with information, advice, empathy given not only by the doctor and other supporting persons (for example health visitor, specialist for mental hygiene) but other parents or parental organizations facing similar problems.
4./ By following the steps mentioned above quality of life of the premature could be improved substantially. If efforts of the involved medical team and careful parents are united, the chances for the premature babies’ full and happy life are going to be better and better.
Respiratory symptoms of premature babies:
- rapid respiratory rate (tachypnea)
- difficult breathing (deep retractions in the neck or in the interspace of ribs, nasal flaring)
- stridor, wheezing when breathing
- if the premature baby was discharged from the intensive ward with the condition of oxygen intake treatment or pulse oxymeter monitoring
- pauses in breathing (apnea)
- coughing (dry or catarrhal)
General symptoms of prematures:
- inexplicable restlessness
- frequent bringing up of milk (especially when it comes together with coughing)
- inferior weight gain
- recurring respiratory infections
- feeding problems
- anything else which may trouble the parents
Mature newborns’ respiratory and general symptoms:
- coughing, stridor, wheezing when breathing, rapid respiratory rate or difficult breathing
- prevailing running nose since the baby was born
- if the baby was born with respiratory, pulmonological and/or chest development disorder and has undergone an operation (for example diaphragmatic hernia, gullet obstruction etc.)
- if the newborn baby was in a ventilator
- any other symptom which may trouble the parents
Acute and chronic symptoms in childhood, irrespectively of age:
- coughing with our without fever (originating from e.g. pneumonia, bronchitis)
- acute or recurring hoarseness, barking cough (for example Croup disease), loud inspiration (stidor)
- infants’ ’staccato’ like coughing and difficult breathing
- recurring pneumonia
- frequent respiratory infections
- children suffering from known muscle weakness disorders
- sleep apnea
- stridor and gasping during physical stress and sporting activities
- respiratory infection with stridor, gasping and symptoms of allergic rhinitis (e.g. snuffles, itchy nose)
Premature babies are more likely to have pulmonary diseases and other later complications than babies who are born closer to their due dates.
Long term consequences – like cerebral palsy, visual and auditory disturbances and other neurological disorders (delayed motor development, mental problems, recurring infections) – are also more frequent. If the newborn’s or infant’s condition and recovery require the cooperation of more physicians, at Svábhegyi Children’s Clinic we could provide the completion of collaboration with specialists of developmental neurology, otorhinolaryngology, special needs education or other specialties.
We are looking forward to seeing you to discuss cases when you are uncertain about the care of your premature or mature baby and you need advice and recommendations.