Nepean Neonatal Intensive Care Unit

Nepean Neonatal Intensive Care Unit Parents Support
(NNICUPS) Reg Charity No CC29534

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Common health problems

Breathing problems

Both full - term and premature babies have breathing ptoblems soon after birth, but these are usually for different reasons.

Full - term babies may have breathing difficulties because of infection, or as a result of inhaling meconium - stained liquor into the lungs.
Premature babies may have immature lungs. This is called Hyaline Membrane Desease (HMD) or Respiratory Distress Syndrome (RDS). Premature babies (like full term babies) may also have infection in their lungs (pneumonia).
All these problems are treated with oxygen and, if necessary, CPAP or ventilation to help the baby with breathing. If infection is suspected, intravenious antibiotics will also be given.
Brief pauses in breathing (apnoea) are common in premature babies, and may be associated with slowing of the heart rate (bradycardia). This can result in a bluish change in the baby's colour, which is rarely a cause for concern. With stimulation, breathing will become regular again.
Apnoea and Bradycardia are usually due to the breathing centre in the brain being immature. Most babies will grow out of this problem by about 37 weeks gestation. In the meantime, they are monitored to detect apnoea / bradycardia, and treated with preventative medicine.

Hypoglycaemia

Hypoglycaemia means that the glucose (sugar) level in the babies blood is too low. This is common in sick, premature babies or small babies, or in a baby born to a mother with diabetes.

It is treated with frequent feeds or by an intravenous glucose infusion

Jaundice

This refers to the yellow colour of the skin which most babies develop by about three to four days of age. It is due to the buildup of a pigment called bilirubin which comes from the normal breakdown of red cells in the blood. Bilirubin is usually removed by the liver, but in new born babies (in particular if they are premature), the liver is not very efficient at doing this.

If the bilirubin level rises too high, it is treated by placing the baby under fluorescent lights or on a special fibreoptic blanket. This is called phototherapy.

Infection

Babies, particularly if they are premature, are more susceptible to infection than adults. Infections mostly occur in the lungs, blood, urine or skin, and this may show in many different ways.

If the staff suspect that your baby is developing an infection, he will have additional test done and be treated with antibiotics if indicated.

Anaemia

Babies who are anaemic have a low level of haemobloblin.

The haemogloblin is the part of the red blood cells carry oxygen to the vital organs.

Sick newborn babies often become anaemic and may require one or more small blood transfusions. These are called "top-up" transfusions

Feed intolerance / enterocolitis

Premature babies often have problems digesting milk feeds when they first start. Consequently they may need to stop and start feeds several times before they can cope with having all milk feeds.

This is called intolerence.

Necrotising enterocolitis (NEC) is an inlamation of the bowel wall. Although it is fairly common on premature babies, we do not know what causes it.
NEC is suspected if a babies abdomen becomes swollen, if there is a green bile (green coloured fluid) in the stomach fluid, or there is blood in the stools.
The treatment is to rest the bowel (this means no milk feeds), and give intravenous fluids and antibiotics for one or two weeks. Some babies may require surgery if the NEC is severe.

Eye problems

Premature babies, particularly those weighing less than 1,000gms at birth, may develop abnormal blood vessels and scarring in the back of their eyes. This is called Retinopathy of Prematurity (ROP). We do not know exactly what causes it..

In approximately 90% of cases, the ROP disappears by itself as the baby gets older. However, in a very small percentage of babies an operation may be needed.

All babies weighing less than 1,200 gms or before 32 weeks gestation will routinely have their eyes checked in the nursery when they are a few weeks old.

Intraventricular haemorrage

IVH is a fairly common problem in very premature babies. This is where there is bleeding into the fluid filled cavities (ventricles) in the brain, and rarely into the brain tissue itself. There are four grades of IVH. The milder forms (grades one and two) resolve spontaneously with no long term consequences. However grades three and four are more serious. Your doctor will discuss IVH with you in more detail if your baby has this problem.

Patent ductus arteriosus

This is common in premature babies. it occurs when the pathway between two major blood vessels just outside the heart (used in foetal blood circulation) stay open after birth. This is treated with medication and occasionally may require an operation.

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Common health problems