Home care for a premature child: bathing, massage, food, vaccinations, how to sleep and walk. How to quickly gain weight to premature children?

Premature children have their physiological and anatomical characteristics. The states of the newborn, its development and the characteristics of the care will tell this article.

Premature children are special creatures. Already outside the mother’s abdomen, but still immature and unsuitable for the usual life of a newborn. Such children need special care and increased attention.

It does not always happen that prematurity for a particular baby is a very serious problem, because even ahead of time, sometimes children are born with a weight within normal limits, suck the chest well and develop adequately.

Probleming premature babies are just born with body weight deficiency.
Caring for such a baby is aimed at preventing hypoglycemia, preserving optimal heat and feeding itself.

How to quickly gain weight to a premature child?

The most optimal option for feeding a premature baby is mom's milk. It is worth noting that the milk of a woman who gave birth on time differs in composition from her mother’s milk, who gave birth to a baby in a timely manner. For premature babies, nature has provided milk with a lower fat content and a high protein content.

If possible, it is necessary to feed the baby with breasts or expressed mom's milk. If this is not possible, they are fed with special mixtures. Before reaching a weight of 1800 g, a starting, saturated mixture is used, upon reaching the weight line in 1800 g, a “transition” mixture is used for feeding
Today, calorie, rather than a voluminous calculation of nutrition of premature children, is used, which is more correct. They begin to feed the baby literally dropped, with 5-15 ml of milk or a mixture, gradually increasing volume
For babies with very low weight, the daily volume of milk is 60 ml, further volume is increased by 20 ml per kg of weight daily until the baby begins to receive 200 ml per 1 kg of weight per day
Kids born with a weight of more than 2500 kg receive feeding at the rate of 150 ml per kg of weight per day, divide the total volume by 8 and give every 3 hours. To control the weight gain, the baby is regularly weighed and controlled feeding is carried out (weight before and after feeding)
If breastfeeding is impossible for any reason, pediatricians recommend that the premature babies recommend special mixtures of Neckal, Enfalak, Pre-Nann, Pre-Tutelli, Similak Heded Car

It is especially important to introduce complementary foods in time.

Juices (vegetable or fruit) are introduced from 1-3 months, from 3-5 drops, gradually bringing to the desired volume (multiply a month of life by 10)
From 2 months they give fruit puree, starting from 0.5 hours.
Egg yolk boiled, injected from 3 months
From this age, cottage cheese is introduced (10 g for a month, then add 10 g, give 20 g another month, for subsequent months +5 g, until the volume is 50 g)
From 4 months, the first complementary foods are injected in the form of porridge cooked on water or a vegetable decoction, after a month add a second complementary foods - mashed potatoes from vegetables. Puree meat (10 g) can be entered from 5 months
A 8-month-old child can already offer bread or unsweetened children's cookies, vegetable soups and meat decoctions are added to the diet. At 8-9 months, 3 complementary foods in the form of a fermented milk or cow's milk are already replacing one method of the main food product of the baby

Anemia in premature children, hemoglobin level

, Premature babies, due to their physiological characteristics, are subject to anemia. This condition develops by the end of the 1st, the beginning of the 2nd month of life. There are 3 degrees of anemia prematurely with hemoglobin:

100-85 g/l
84-70 g/l
Indicators below 70 g/l.

Symptomatically, the phenomenon of anemia is expressed in the strong pallor of the skin, when listening - an increase in heart rate (heart rate), systolic noise, a decrease in tone and activity, the child ceases to add weight.

The first and second degree of anemia does not require special treatment, the baby should be fully fed and saturated with B vitamins, vitamin E, ascorbic acid, folic acid.

With severe degree, hemotransfusion is shown - the transfusion of small volumes of red blood cells until hemoglobin rises to 90 g/l.

Jaundice in premature children, bilirubin in blood

Such a thing as the physiological jaundice of newborn for premature babies exists very conditionally. Jaundice manifests itself as a more or less pronounced yellowness, occurs 2 or 3 after birth
This condition is due to the insufficient functional development of the baby’s liver, as a result of which indirect bilirubin (forms with erythrocyte decay) accumulates in the blood
Indirect bilirubin, which should normally turn through the enzyme of the liver-transferase liver into a direct bilirubin harmless for the body, has toxic properties
The large concentrations of its blood content are dangerous with a very severe damage to the brain - the so -called nuclear jaundice

The jaundice of children born on time is temporarily and non -hazard, this condition continues about a week. In children born ahead of schedule, this condition lasts from 1 month and can last longer than two. The more complicated the general condition of the baby, the longer the jaundice lasts.

Methods for the prevention of nuclear jaundice:

irradiation of daylight lamps to enhance the breakdown of bilirubin
the introduction of hemodesis and solution of albumin intravenously
luminin therapy for binding bilirubin for 5 -10 days

Colic in premature children

With this unpleasant phenomenon - intestinal colic - every mommy came across. Particularly prone to premature babies are especially prone to.

Bouts of abdominal pain can be more often and more intense than that of ordinary children. The leading role in such intensive suffering of the baby is played by the insufficient development of the enzymatic intestinal system and the nervous system, due to which gases are formed in too large quantities. The pressure of the gases on the intestinal walls causes severe muscle spasm and pain.

The cause of colic may be improper feeding or intestinal allergies.

How can you help the baby:

dry warm diaper on the tummy
setting a gas -air tube
abdomen massage
enema for intestinal cleansing
special wind -bearing teas for newborns (caraway seeds, dill, chamomile, mint)
Espumisan in drops, sub-symplex

If these methods are not effective, the baby must be examined in order to exclude surgical pathology.

Growth and weight of premature children by months

The kid, born ahead of time, more intensively adds in weight and growth in the first year of life compared to ordinary peers. The exception is only the first month, during which the mass increases slightly.

By the third month, the weight doubles, to the sixth - it triples. Up to 6 months, growth is added by 2.5-5.5 cm, 7-8 months-growth adds 2 cm, from 9 to 12 months-1.5 cm each month.

Normally, such children increase weight compared to the mass at birth by 4-6 times, children with a high degree of prematurity-6-8 times. The average growth of 12-month premature babies is 70-77 cm, that is, it increases by 27-38 cm from the moment of birth.

First month

Swallowing and sucking reflexes are poorly developed. In their absence, the child is fed through the probe. There is practically no weight gain, very low activity. The main task is to protect the baby from cold and infections.

Second month

It is still difficult to suck, the baby is easily tired. Body weight is systematically increasing. The child can be laid out on the stomach.

The third month

The main thing is sleep and food. Body weight doubles. Learns to fix the eye, mimic reactions, and a grasping reflex are developing. Trys to raise the head.

Fourth month

The kid begins to confidently hold his head, begins to smile, fix his gaze, holds the toy, makes sounds. The increase in muscle tone is characteristic.

Fifth month

The baby shows interest in the world around him, smiles, improves sound and visual attention. The baby exactly determines which side comes on the auditory stimulus, is able to hold the object in the hand.

Sixth month

The weight of the child is tripled. The active development of the baby finally expands the opportunities to communicate with him. He recognizes his native faces well, ruling, babbling. Actively clutching with legs and handles and slightly squats, starting from the surface, if you take it under the mice.

Seventh month

The kid is already able to turn over on the tummy, begins to crawl, confidently holds toys. Psycho -emotional development is activated. The first teeth can be cut out.

Eighth month

Motor activity is characteristic. The baby crawls well, tries to sit, stands on all fours. It shows an active interest in communication. He understands that if he is asked to find an object, he carefully listens to his mother’s fairy tales, nursery rhymes, rulings and babble in response.

Ninth month

He sits confidently, sits down, holding on to the support, crawls on all fours. "Communicates", tries to pronounce the first syllables.

Tenth month

It is good and can cross, holding on to the support. He knows his name, reacts to all sounds, pronounces separate syllables well. He learns to play with familiar objects, follows their movement with interest.

The eleventh month

Can take his first steps without support. Emotional activity is at the level of an ordinary child. Playing with cubes, pyramids. It is perfectly in contact with relatives.

Devveny month

It can already move independently. Actively communicates with others as far as possible, says the first words. Normally, by this time, in physical development, a premature child is catching up with his full -term peers. Nervous and psychic processes are somewhat lagging behind. In general, by this time, the baby gains weight 5 -7 times from birth weight.

The circumference of the head of a premature baby

The pediatricians are observed with special attentiveness to increase the circumference of the head of a premature baby. This is due to the risk of the development of pathologies of the central nervous system. Normally, children add 4-5 cm in the head of the head in the first month, during the second-2-3 cm, the next month is 2.5 cm, up to six months-another 1.5 cm, and after the sixth month-0.5- 1 cm every month.

Rickets in premature children

All diseases in children who were born ahead of schedule are peculiar and have difficulties in diagnosis. Therefore, prevention is more effective than treating pathology
A special metabolism of premature babies can create conditions for the development of rickets even with proper feeding and good environmental conditions
In case of violations of the correct diet, the risk of rickets increases. Visible manifestations of rickets can be detected by 2 months, earlier signs of the disease are visible only in an X -ray picture

Signs of the disease:

deformation of some bones
the skull is slightly flattened on the sides
the fontanel is large
fragile rib bones
X -ray shows skeletal osteoporosis

Pediatricians are prescribed for the prevention of rickets in prematurely:

UFO from 5-6 weeks
reception of vitamin D (300 thousand units with a course of 2 weeks), with the disease, the dosage doubles
fish oil in the same amount, which, with signs of rickets, replace vitamin D
CA twice a day with a course of 1 month

In addition to specific prevention, non -specific measures are carried out:

walks in the open air,
bathing with a gradual decrease in temperature from 39 to 37 degrees
vitamin C
rosehip extract or juices from the second month of life

Rodniki in premature babies

The baby born ahead of time, the seams between the cranial bones and the rear fontanel are open. Rodniki-small and large in size is larger than usual, although it can be large small due to displaced bones.

The closure of the fontances occurs somewhat later than in full -term children (a small fontanel in the newborn full -term is closed). If there are no complications and the child develops normally, then a large fontanel should overgrow by 16-24 months.

Hearing for premature children

Premature children are very vulnerable and they are in their hearing problems much more often than in children born on time. The immaturity of the nervous system, complicated by additional factors, determines the high risk of disorders of the hearing apparatus.

Risk factors:

infections
high bilirubin
fruit hypoxia
birth injuries
brain hemorrhages
hypothermia
long Ivl

On the 3-5th day of the life of the unforgettable life, an otolaryngologist necessarily examines and hardware audio screaming is carried out in order to identify hearing disorders.

Congenital hearing problems are in total 3%.

5% of children have a risk of problems with the hearing aid in 5 years of life. At home, the child must be observed very carefully on the 3, 6, 9 months corrected: what is the reaction to loud sounds, the sound in general, whether the baby distinguishes, reacts to his name, call, is listening to speech.

The child should be observed from the risk group before the appearance of his own speech.

The skin of a premature baby

In premature babies, the skin is very thin and vulnerable. The epidermal layer is poorly developed, which makes the skin weakly disabled from microorganisms. After removing the original lubrication, the skin of the baby becomes brightly hyperemic, this redness can last up to 2 weeks. After the skin becomes ordinary, it begins to actively peel off
The jaundice gives the skin a yellow, and pallor and a bluish tint speaks of internal pathology. Children with a high degree of prematureness can have cyanic limbs and the region of the nasolabial triangle
The baby’s body is covered with soft hairs - lanugo. Subcutaneous fat is not developed, the elasticity of the skin is significantly reduced, it is easy to collect it in folds, this sign is especially pronounced in children very prematurely

The excretory skin function is difficult due to the fact that the sweat glands begin to work only by three months of age, this can contribute to overheating of the child.

Nervous system

The brain of the baby is immature, the reflexes are weakly exposed, a decreased muscle tone is observed. The sucking reflex at birth is weakened or not developed, its development is stimulated by special acupressure
A disturbed thermoregulation mechanism requires constant maintenance of optimal temperature for a premature baby. Self -senses are quite developed and function well immediately after birth
Such children often have convulsive syndrome. They have a high risk of cerebral palsy, the signs of which are visible from birth, and the final diagnosis is made after 12 months
Due to the high risks of developing pathologies of the central nervous system, premature babies are observed by children's neuropathologists, they are prescribed massage courses for the treatment and prevention of diseases

How much do you need to walk with a premature child?

A premature baby should be protected from sharp temperature fluctuations. Children, whose body weight at birth was more than 1.5 kg, can be carried out for fresh air from two -week age, but only in the summer
In the offseason at an outdoor temperature of 10 degrees, you can go out with the baby for a walk only from a month, preferably from one and a half (if weight is more than 2.5 kg). If the temperature is lower, then you can start walking with a two -month age, when the weight is 2.8 - 3 kg
The walking time was initially 10 -15 minutes, adding daily for 5-10 minutes, the total time of stay in the fresh air is brought to 1.5 hours

Bathing a premature child

If the body of the child’s body is less than 1.5 kg at birth, then swimming is not carried out in the first 3 weeks of home stay. Children with a large weight can start bathing in a week. For swimming, the water is necessarily boiled until the baby reaches 3 months of age. The temperature regime of water is 38 degrees, the air in the room is 25.

Caring for a premature child at home

After returning home with the newborn, the mother should provide the child with the most comfortable temperature regime (23-25 \u200b\u200bdegrees). Housing is ventilated every 3-3.5 hours. To support the required level of humidity in the room regularly (3-4 times a day), wet cleaning is carried out
If the baby needs additional heating, use heating pads with water of 60 degrees, which are wrapped in diapers and put on the legs (under the blanket) and on the sides (on the blanket) at a distance of 10 cm. The heat source should be constantly
The baby should be left open. After a month, the child has its own heat transfer and the need for artificial heating disappears. In the baby, body temperature is regularly measured
A newborn weight of up to 2 kg needs a two -layer set of things and additionally it is wrapped in a bike blanket, a woolen envelope, covered with a flannel on top. They are not swaddling tightly, so as not to shy breathing. Clothing for him should be absolutely clean and ironed on both sides

Massage for premature children

Massage is shown to premature babies at home.

What will be massage depends on body weight at birth. You can start the first massage sessions no earlier than one month. If the baby was born with a weight of up to 2 kg, then it can only be careful stroking, if the weight during childbirth was higher, then you can use light pats, tapping, kneading. It is worth starting from 5 minutes.

Rules:

spend not earlier than an hour after eating and no later than 30 minutes before meals
the child should not be sleepy
the total duration is about 10 minutes
the room should be warm and well ventilated
if the child reacts well, then you can hold sessions 2-3 times a day
begin with light strokes, then attach light rubbing and kneading, vibration
first massage the head, fingers, brushes, feet, then pens and legs and the body itself
movements should be rhythmic and non -working
patting and kneading alternate with stroking

Special therapeutic massage is carried out at the appointment of a pediatrician or neuropathologist and is carried out by a specialist.

Why is a premature child groaning?

A premature child is born weak and therefore often cannot even “fully” cry when something bothers him, so he can make a squeak or grunt. The baby can grunt in a dream and during wakefulness. The baby can make such unusual sounds if he is bothering his tummy (constipation), he is uncomfortable or cold, he is hungry
At an older age, he can be disturbed by colic and the child groanes and pushes at the same time. After all the events aimed at facilitating the condition of the baby, the grunts cease to
In a dream, a crumb can grate for the same reasons (discomfort or pain) or due to neurological disorders, so this phenomenon must be told a pediatrician and a neuropathologist

Why does a premature child lose weight?

For children born ahead of schedule, pediatricians divide the period of newborn into three stages, which are different in lecture.

The first stage is characterized by weight loss. Physiologically, ordinary children also lose weight after birth, but prematurely in a percentage ratio lose much more-from 10 to 15%, while the full-term-5-6%.

This period continues the first week after birth and does not depend on the quality of feeding. In the subsequent stages of the newborn, a systematic set of body weight occurs.

The temperature of a premature child

The thermoregulatory system in a premature baby is extremely poorly developed, so the temperature of his body directly depends on the ambient temperature
Increased heat transfer and reduced thermal products easily leads to rapid hypothermia, especially in deeply premature children. Hypothermia can lead to the rapid development of pneumonia
The baby is as easy to overheat as hypothermia. Skin vessels do not know how to respond correctly to thermal stimuli, the sweat glands are underdeveloped, the thermoregulation center is imperfect-these factors lead to the fact that the first 4-5 months of premature crumbs are easy to overheat to very high rates-39.5-40 degrees
This condition is dangerous for violations of the central nervous system, convulsive or hemorrhagic syndromes
It is important to know that premature children may not give an increase in temperature in response to infection, even the most severe pathologies - pneumonia, peritonitis, osteomyelitis can show a small subfebrile increase of 37.1 - 37.3 degrees
Such features can lead to difficulties in making a diagnosis, therefore it is extremely important to create an individual optimal microclimate for the baby

How much should a premature child sleep?

Kids born ahead of schedule are weak and immature and can sleep initially until 20-22 hours a day. In a dream, the child is growing, an immature nervous system entrusts the missed.

The crumbs of the crumbs are short, it weary and quickly falls asleep during feeding. As weight gain and restoration of forces, the periods of wakefulness become longer.

Vaccinations to premature children

Vaccinations of premature babies have some restrictions on the degree of prematurity and the weight of the newborn. In general, premature babies are vaccinated according to the schedule approved by the Ministry of Health. If the baby has certain health problems and he has honey detergents according to indications, the baby makes an individual vaccination schedule immunologist.

Vaccination against tuberculosis (BCG) premature children weighing below 2000 g are made before the discharge, and not immediately after birth
Against hepatitis they instill all prematurely in the first 12 hours of life. Subsequently, a child is carried out three -end vaccination against hepatitis without taking into account the vaccination made in the hospital
The first DTP vaccination (against diphtheria, pertussis, tetanus) plus against hemophilic infection and polio is made on time, at 3 months, then according to schedule