Prematurity

Prematurity is defined as the birth of a baby before 37 weeks of gestation. With the increase in fertility treatments and the increase in the age of pregnant women, preterm births are more and more frequent, with an average of approximately 9% worldwide.

The advances in modern medicine and the differentiation of health professionals in this area today allow the survival of babies from 24 weeks and 500g of weight, but the risk of problems in development and behaviour is significantly higher in premature infants. This has shown to be more incidental when the gestational age at birth is lower.

When babies are born before 35 weeks, they need special care in a Neonatal Intensive Care Unit (NICU). Premature babies are more sensitive, fragile and have difficulty when it comes to feeding or calming.

During his/her stay in the Unit, it is necessary to place the baby in an incubator, monitor their vital parameters continuously and often help them to breathe and eat through medical devices, making the environment a little intimidating for the parents and aggressive from the sensory point of view for the baby.

The NIDCAP – Newborn Individualized Developmental Care and Assessment Program - is a program of individualised care and assessment of the development of premature infants, created in 1984 by Heidelise Als, PhD, being the only program that comprehensively focuses on the family and is based on evidence, promoting care for the development of premature babies.

The objective of NIDCAP is to adapt the environment of the neonatal unit to the unique neurodevelopment potential of each baby and to the medical challenges that you will have to face during your stay at the NICU.

This neuroprotection care for the premature baby, centred on the family, aims to protect the premature baby from excessive light, sound and other excessive stimuli from the NICU environment. Individualised care is given to each baby in terms of hygiene and comfort, support for the Kangaroo method, skin to skin, breastfeeding and sleep promotion.

Weekly meetings are held with the medical and nursing staff in order to complement information for parents and promote their calm and well-being. Joint accommodation between the parents and the baby is promoted prior to discharge with a view to greater confidence on the part of the parents.

In our NICU, since its inauguration in July 2014, all babies are cared for according to the NIDCAP program, with the utmost respect for the individual care of each premature baby, with a view to the best care.

“When I take care of a baby my mind is in my hands” John Chappel

Hospital discharge for a premature baby
Text by Nurse Ana Freitas

Premature birth is something unexpected and a delicate situation that triggers concerns, anxiety, insecurities and a feeling of frustration at the separation of your child from parents. The family experiences opposite feelings, based at the same time on hope, when witnessing the premature struggle for life, but also the anxiety for constant clinical instability.

The need for a prolonged hospital stay, with consequent indefinite absence of the baby's parents, the constant stressful contact with a hospital environment, the appearance and health conditions of the premature baby, the high resource of technologies and the interaction with different healthcare professionals, are all factors that can hamper the development of the parenting role and affect the bond between preterm infants and their parents.

The arrival of hospital discharge is a moment that is long awaited moment by parents, but also at the same time frightening. It is full of challenges and fears, being characterised by expectations and uncertainties, as it is a turning point in which parents face the moment when they take care of the baby truly and autonomously. That is why it is important for parents to be involved at every step, with all care, as early as possible.

During hospitalisation in our Unit, the nursing intervention is not only based on day-to-day care, such as hygiene, food / breastfeeding and comfort care, but also in holistic care, considering multiple perspectives, such as psychosocial and cultural aspects of the family unit.

The follow-up of the premature newborn and his/her family after hospital discharge is part of our health policies and essential for the promotion of health and prevention of baby's illness.