Premature Babies and Kids

If you've never been inside a NICU, it can be hard to imagine how tiny
preemies really are. Because there's so much equipment and because
they're so small, it's sometimes scary to see a baby in the NICU. For parents,
it can be just as hard to try to picture your newborn preemie as a toddler or a
young child. So many loving families have sent in stories and pictures of their
babies that I felt like it was time to organize them into a photo gallery to help
my readers see what preemies really look like, at birth and as they grow.
Happy viewing!

Preemies Born at 23 Weeks

Babies born at 23 weeks are at the very limits of survivability, but many
babies born so early survive with few long-term complications from their
early birth. Now 2 years old, the baby boy pictured above weighed only 1 lb
6 oz at birth.
Most pregnancies last approximately 40 weeks. Babies born between 37 and
42 weeks of gestation are considered full term. Babies that are born before
37 weeks gestation are defined as premature.

Currently, medically speaking the definition of viability is set at 23 weeks

gestation. In many hospitals this is the cutoff point of medical intervention in
the attempt to save the life a baby born prematurely.

However, this is a loose definition based on a generalization and keeping in

mind the dates may be off by a few weeks in either direction. A baby born at
or before 23 weeks gestation typically will require extensive medical
intervention including, respiratory support, invasive treatments, and a long
and sometimes tough stay in the Neonatal Intensive Care Unit.?

Premature Birth Statistics

As many as 11.4 percent of all pregnancies end in early deliveries.
About 450,000 babies in the United States alone are born too soon and
15 million babies are born preterm around the world - that's 1 in 10!
80 plus percent of preterm births are unanticipated.
Approximately 45-50% of preterm births are idiopathic. (unknown)
30% are related to preterm rupture of membranes. (PROM)
15-20% are attributed to medically indicated (example: preeclampsia,
abruption, IUGR) or elective preterm deliveries.

"Events leading to preterm birth are still not completely understood,

although the etiology is thought to be multifactorial.

It is, however, unclear whether preterm birth results from the interaction of
several pathways or the independent effect of each pathway. Causal factors
linked to preterm birth include medical conditions of the mother or fetus,
genetic influences, environmental exposure, infertility treatments, behavioral
and socioeconomic factors, and iatrogenic (related to medical examination or
treatment) prematurity." (WHO)
Did You Know?
The premature birth rate in the United States has dropped for the
seventh consecutive year, to 11.4 percent of all births in 2013.
This is the lowest rate in 17 years! The federal government's goal had
been to reduce preterm births from a baseline of 12.7 percent in 2007
to 11.4 percent by 2020. The new figures mean the country hit the
target seven years early.
The U.S. still has one of the highest rates of preterm birth of any high-
resource country
Medical expenses for a baby born prematurely average about $54,000,
compared with $4,000 for a healthy, full-term newborn.
Preterm birth rates remain stubbornly higher among certain racial and
ethnic groups in the U.S., including black, Native American and
Hispanic women. The rate of preterm birth among uninsured women
also is far higher than the national average (19.8 percent in 2013.)

Percentage Based on Gestational Age (approximate)

More than 70 percent of premature babies are born between 34 and 36

weeks gestation.
12 percent of premature babies are born between 32 and 33 weeks
gestation.
10 percent of premature babies are born between 28 and 32 weeks
gestation.
6 percent of premature babies are born before 28 weeks gestation.

Survival Rates (approximately based on multiple factors)

Babies born 23 weeks have a 17 percent chance of survival.

Babies born at 24 weeks have a 39 percent chance of survival.
Babies born at 25 weeks have a 50 percent chance of survival.
Babies born at 26 weeks have an 80 percent chance of survival.
Babies born at 27 weeks have a 90 percent chance of survival.
Babies born between 28-31 weeks gestation have at 90-95 percent
chance of survival.
 Babies born between 32-33 weeks have a 95 percent chance of
survival.
Most babies born 34 weeks or greater have the same likelihood of
survival as a full term infant.

The odds of survival increase as the pregnancy progresses. With every week
a baby remains in the womb the chance for thriving and surviving increases.
However, gestational age isnt the only determining factor for survival for
babies born too early. Multiple factors play an important role in how well a
baby will do including birth weight, complications of pregnancy such as
placental abruption, infection, and immature lung development to name just
a few. Fortunately, medical research and advances have increased the
chances of survival in even the tiniest of babies.

Outcome Statistics (approximate)

Percentage statistics based on babies born before 26 weeks gestation:

Those who may develop a severe disability secondary to early birth-

22%
Those who may develop a moderate disability or special needs from
premature birth- 24%
Those who may develop a mild disability- 34%
20% of all those born at 26 weeks gestation or earlier will have no long
term effects from their prematurity.

Based on gestational age and birth weight, premature babies are placed
loosely into defined categories of mild, moderate, and extreme prematurity:

Mild: Babies born between 33 and 36 weeks gestation and/or have a birth
weight between 1500g-2000g (3lbs 5oz and 5lbs 8oz)?

Moderate: Babies born between 28 and 32 weeks gestation with a birth

weight between 1000g-1500g (2lbs 3oz and 3lbs 5oz)?

Extreme: Babies born before 28 weeks gestation or who have a birth weight
of less than 1000g (2lbs 3oz)

Late preterm baby, born between 34 and 37 weeks of pregnancy

Preemie, born at less than 32 weeks of pregnancy
Micro-preemie, born at less than 25 weeks of pregnancy
Redefining Prematurity

The American Congress of Obstetricians and Gynecologists (ACOG) and the

Society for Maternal-Fetal Medicine (SMFM) recently announced that they are
recommending the use of the label "term" in pregnancy be replaced by new
gestational age designations.

According to the new designations, full term will refer to 39 weeks through
40 weeks and 6 days of pregnancy. In the past, a pregnancy between 37 and
42 weeks was considered full term.

This change reflects findings from the National Institute of Child Health and
Development NICHD, research about poorer health outcomes of babies born
at 37 and 38 weeks of pregnancy, (previously considered full-term)
compared to those born after 39 weeks.?

For example, research shows that compared to babies born at or after 39

weeks of pregnancy, babies born before 39 weeks are:

At greater risk of being admitted to the Neonatal Intensive Care Unit

(NICU)
At a 20% greater risk of complications, including breathing, feeding,
and temperature problems; sepsis (severe blood infection); and
cerebral palsy?
5% more likely to have an intellectual or developmental disability
At a 50% greater risk for death within the first year of life

Mothers who deliver at or after 39 weeks of pregnancy typically have better

outcomes than do mothers who deliver before 39 weeks.

New categories as defined by NICHD:

Early term: 37 weeks through 38 weeks and 6 days

Full term: 39 weeks through 40 weeks and 6 days
Late term: 41 weeks through 41 weeks and 6 days
Post-term: 42 weeks and beyond
Famous Preemies of Yesterday and Today

Napoleon Bonaparte: born in 1769 was one of the greatest military

leaders in history. His small statue is noted to be the result of his
premature birth.
Victor Hugo: a great French novelist, most famous for creating Les
Miserable, was a preemie born in 1802
Mark Twain: An accomplished American writer born in 1835, born 2
months premature.
Sidney Poitier: Award winning actor, film director, and activist.
Winston Churchill: A British politician and statesman, born 2 months
premature in 1874.
Albert Einstein: Born premature in Germany in March of 1879. Einstein
experienced small beginnings in a time where neonatology was
virtually nonexistent and went on to make outstanding achievements
in math and science.
Anna Pavlova: Born 2 months premature in 1881 and grew up to
become one of the worlds most famous ballerinas.
Patrick Bouvier Kennedy: The 3rd child of Jacqueline and John F.
Kennedy was born at 34 weeks and died at 2 days of age due to
Hyaline Membrane Disease, also known as Respiratory Distress
Syndrome or RDS. RDS is one of the most common complications of
prematurity. The loss of the first familys baby deeply moved the nation
and led to an outpouring of public and private resources for medical
research leading to use of surfactant therapy in babies born with
immature lungs.
Stevie Wonder: Famous American singer born in 1950 and was one of
many premature infants born in the 40s and 50s affected by a
condition called Retinopathy of Prematurity (ROP) that caused him to
lose his eyesight as a baby. Medically advances today have
dramatically reduced the risk of ROP in babies born too soon.?
Isaac Newton: Scientist and inventor who described the laws of gravity.
Born in 1643, small enough to fit into a quart mug, according to his
mother.
Charles Darwin: An English naturalist and scientist- the originator of
the biological theory of evolution.
Pablo Picasso: Artist and Spanish painter- famous sculptor, printmaker,
ceramicist.
Michael J. Fox: Canadian-born actor, author, producer, and activist.
 Wayne Brady: American actor, singer, comedian and television
personality; born 3 months premature.
Phillip Phillips: Musician and winner of American Idol 2012. Born
premature in 1990 and almost didnt make it. He has struggled with
digestive issues and is said to be a NEC survivor.

Current Records

Some famous preemies are only known to the world due to their early
birth:

Rumaisa Rahman, born at 25 weeks gestation in September of 2004 in

a Chicago area hospital is thought to hold the current record as the
Worlds smallest surviving baby, weighing 244 grams or 8.6 ounces.
James Elgin Gill, born in May 1987 in Ottawa Canada was the earliest
premature baby in the world. He was 128 days premature at 21 weeks
and 5 days gestation. James weighed 644g or 1lb 6oz. He survived and
is reported to be healthy in his mid-20s.
?Amillia Taylor has also been cited as the most premature baby. Born in
October 2006 in Miami Florida at 21 weeks and 6 days gestation. At
birth, she was 9 inches long and weighed 233g or 10 ounces.?
Babies Born at 24 Weeks

Premature babies born at 24 weeks of pregnancy are born 16 weeks early -

that's 4 months early! Eloise, pictured above, was born at 24 weeks after her
mom had severe preeclampsia.
Premature Babies Born at 25 Weeks

Babies born 15 weeks early are at risk for many complications of

prematurity, and Sofia, pictured above, went through most of them. She's
home from the NICU now with her adoring family.
Premature Infants Born at 26 Weeks

By 26 weeks, babies are fully formed and look like perfect, miniature babies.
They are very early, but most babies born at this gestational age survive to
NICU discharge. Pictured above, April Jevette is a miracle baby born after her
mom had 4 miscarriages.
Preemies Born at 27 Weeks

Babies born in the 7th month of pregnancy are very small when they're born,
and it can be scary to see them with all of the NICU equipment. As the baby
pictured above shows, they grow up to be just as chubby and adorable as
babies born at term.
Premature Babies Born at 28 Weeks

Having a troubled pregnancy is scary, especially when it ends with rupture of

membranes (PPROM) at 25 weeks and an emergency c-section 3 months
early. Chloe, above, worried her family in the beginning but is doing well now
and should come home from the NICU soon.
Preemies Born at 30 Weeks

The care of premature babies has changed remarkably over the last half
century, including the discovery that giving a pregnant mom steroids could
help her premature baby's lungs to develop faster. Although he was born
more than 10 years ago, Sebastian, pictured above, received steroids before
birth and was breathing on his own within just a few hours.
Infants Born at 31 Weeks

Most pregnancies go smoothly, but some moms experience serious health

problems during their pregnancies. Ethan, pictured above, was born 9 weeks
early due to a dangerous condition called HELLP syndrome.
Premature Babies Born at 32 Weeks

Finding out you're pregnant with twins or other multiples is an overwhelming

experience. Preparing for two or more babies takes a lot of planning and
equipment - more clothing, more car seats, more high chairs - more of
everything! Having multiples also takes more prenatal care since the risk of
premature birth for twins and multiples is higher than for singleton
pregnancies. Kaitlyn and Leanne, pictured above, were born early due to
complications from their multiple birth.
Preemies Born at 33 Weeks

There are many different causes of premature birth, or reasons why a baby
might be born early. In some cases, premature labor and birth are abrupt and
scary. Aelis Rhayne's birth was scary and dangerous for both mom and baby,
but this little miracle is home now with her family.
Preemie Babies Born at 34 Weeks

Babies born at 34 weeks or later are called late preterm babies. They may
look like full term babies and be almost as big, but they often still have some
health problems related to prematurity. Learning to eat is sometimes their
biggest challenge, and parents need a lot of patience as they wait for their
baby to get strong enough to breastfeed or bottle feed well. Natalie Renee,
pictured above, was in the NICU for almost 2 weeks before she came home.
Premature Infants Born at 35 Weeks

Many premature babies aren't able to eat right away, and need to be fed
with IV fluids before they can begin milk feedings. Because they can't nurse
right away, breastfeeding a premature baby can be challenging. The mom of
the baby born at 35 weeks pictured above knew that it was important for her
to breastfeed, and started pumping for her baby right away.
Babies Born at 36 Weeks

If you've had a premature baby, you may be worried about your chances of
having another preemie if you get pregnant again. Nolan Michael, pictured
above, was born 2 weeks later than his 34-week big sister thanks to bedrest
and careful prenatal care.

What is a Late Preterm Infant?

Late preterm infants -- babies born between 34 and 37 weeks gestation --

look like smaller versions of full term babies. For a long time, late preterm
babies were treated like full term babies. However, research has increasingly
shown that these babies are not the same as full term infants, and that they
have a unique set of needs and challenges. Babies born close to term are, in
fact, preemies.
Even after 37 weeks gestation, full term infants may have some of the same
problems as late preterm babies. The risk of health problems due to
prematurity starts to decline around 37 weeks, but doesn't level off
completely until 39 weeks gestation.

Immediate Health Concerns

In the hours after birth, babies face several challenges as they adjust to life
outside the uterus. Breathing air, staying warm, and getting used to the
world are all hard work! Although many late preterm babies adjust just fine,
some have trouble. Even late preterm babies born to healthy moms with no
complications may face:

Respiratory problems: Respiratory problems occur in 4.2% of late

preterm births, but only 0.1% of full term births. Respiratory problems
may be mild or severe, and may include respiratory distress syndrome,
transient tachypnea of the newborn, pulmonary hypertension, and the
need for respiratory support.

Hypoglycemia: While only 0.4% of term babies suffer from low blood
sugar in the hours after birth, 6.8% of late preterm babies are
hypoglycemic after delivery. Babies who are born early have not stored
as much sugar as full term babies, and become hypoglycemic easily
when they are cold or stressed.

Poor thermoregulation: Preterm babies don't have as much stored fat

as term babies have, and they get cold easily. Cold babies burn more
calories to try to stay warm, making hypoglycemia worse and slowing
weight gain.

Concerns in the First Weeks

Even after late preterm babies make the initial adjustment to life outside the
womb, they still face challenges. These challenges lead to a high rate of
hospital readmission in late preterm babies who are discharged within 48
hours of birth. Parents and pediatricians caring for late preterm babies need
to be careful to make sure that these fragile babies stay healthy after they
go home.

Jaundice: Although only 2.5% of full term babies have jaundice serious
enough to need phototherapy, 18% of late preterm babies have
jaundice bad enough that it must be treated.
Feeding challenges: Late preterm babies get tired easily and may not
be strong enough feeders to drink enough breastmilk or formula to
gain weight. This can cause dehydration or failure to thrive.
Breastfeeding failure is another risk: moms whose babies do not
breastfeed effectively may not produce enough milk to feed their
babies.
Sepsis: Because their immune systems are not fully developed, late
preterm infants have a greater risk of infection than term babies. They
are more likely to have bloodwork drawn to test for infection and are
more likely to require antibiotic therapy.

Further Concerns

Many of the problems that late preterm babies face are known to impact
brain development. Unfortunately, most studies of long-term
neurodevelopmental outcomes in premature babies have focused on babies
born before 34 weeks. We do know that late preterm babies are at risk for
developmental delay, and more research is being done to see how late
preterm babies do in school as they grow older. Nonetheless, with good care,
the majority of these infants are likely to do just fine.