The birth of baby is always a great emotion and fills the hearts of parents and friends with joy, however when a baby arrives early matters can be very different. In the last 2-3 months of pregnancy the mother begins to prepare physically and psychologically for the birth, so when prematurity interrupts the natural order of a pregnancy with little or no warning, parents are often in shock and confused. Furthermore in some cases parents have to learn to cope with intensive care (NICU- Neonatal Intensive Care Unit), and this is not always an easy task.
In this website parents will find useful information that we hope will help them to deal with this sometimes traumatic experience. As we believe that it might be easier if they can better understand what is happening to the very small baby that has just entered their life In particular parents will find some simple details regarding Respiratory Distress Syndrome, Surfactant Replacement Therapy, and other complications regarding prematurity.
Premature babies in the 21st centuries are much more fortunate than those babies born even just a generation earlier and if we go back to the 1950s virtually no survivors were reported under 1000g birth weight. Today a baby weighing approximately 1000g at birth has an over 90% chance of complete recovery and even the tiniest babies (500-700g birth weight) have a relatively good chance of survival, even though they may develop more complications.
One of the most common respiratory diseases of the premature babies, for which they often require oxygen administration and mechanical ventilation, is Respiratory Distress Syndrome, also known as RDS. The main cause of RDS is lung immaturity, as neonatal lungs are not simply small versions of adult lungs, they are developing lungs and in fact lung development finishes when the child is 8 years old!
The introduction of Surfactant Replacement Therapy has dramatically reduced the incidence and severity of RDS… but what is surfactant? Why do some premature babies require exogenous surfactant? Here below you will find a very simple description, however should you wish to know more about RDS and the other complications of prematurity please read our dedicated pages and don't forget to talk to your physician.
The Simple Surfactant Story:
While the baby is in the uterus the baby does not breath through his lungs, as gaseous exchange takes place at the placenta and oxygenated blood returns to the heart through the umbilical vein. In the meantime the baby's lungs develop so that at birth the baby will be able to take his first breath, air will substitute the lung fluids and the oxygen level will rise in the alveoli (tiny terminal sacs in the lungs), but when a baby is born preterm, the lungs may not yet have started to produce sufficient surfactant (surfactant production occurs during 24-28 weeks), making breathing difficult.
Surfactant is a liquid produced by the lungs to help keep the alveoli open during expiration ie. when the baby breaths out, in fact if the alveoli were to collapse every time the baby expires it would take a great effort for the baby to re-inflate them with air each time he breaths in… just imagine how hard it is to inflate a balloon when it is completely deflated!
Therefore an adequate level of surfactant in the baby's lungs will:
reduce the effort needed to expand the lungs
reduce tendency for alveoli to collapse
An inadequate level of surfactant in some cases leads to RDS and therefore exogenous surfactant is administered to the baby to prevent or decrease the severity of RDS.
If you are concerned about the present and future health of a premature baby we first of all invite you to talk to the healthcare professionals that are looking after the baby, the neonatologists, the nurses and other staff will be able to give you support and specific information regarding the conditions of the baby and possible future developments.
The premature baby...
Pregnancy lasts approximately 9 months, however nature is not exact and all babies born between 37 and 41 weeks are considered to have been born at the correct time, i.e. to be a normal term delivery.
Approximately 10% of babies are born early and whilst for some babies we can find a reason (multiple births, infections, maternal stress), about a third of premature births have no apparent explanation. When delivery occurs before the 37th week, the baby is called "premature", if delivery occurs in the expected time but the baby is particularly small, that is under 2500g, it is called "Low Birth Weight". Below you will find the most common terms used in the neonatal units to describe the newborn babies
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