Some premature babies need more care than others. If your baby needs special treatment, your doctor should explain why it is required and what will happen. It can be hard to prepare parents for any treatment completely, especially if a baby is extremely premature or ill. Seeing your tiny baby with an endotracheal tube and UAC line in place, under a phototherapy light, with an eye shield, and more, would shake anyone, including a parent who is a doctor, and everyone on the staff will be sympathetic. We hope the following information will make you feel more calm and confident about asking them questions.

Medication

Your baby will be medicated as the doctor thinks they need to be. Examples of drugs they may be given include antibiotics, painkillers of varying strengths, from morphine to paracetemol, medicine to raise their blood pressure, diuretics to make them pee more, steroids to support their growth, and a wide range of nutritional supplements. If your baby needs to keep taking medication after you go home, the nurses will explain everything to you.

Treating jaundice

Many of us will recognise jaundice, a condition in which a baby’s skin looks yellow. This happens when their immature liver can’t excrete bilirubin, a byproduct of the breakdown of red blood cells. The good news is that doctors rarely worry when they see it, as it can be treated so effectively with phototherapy. If your baby has jaundice, the first thing the staff will do is arrange for this very safe exposure to a light that is similar to ultraviolet light. Your baby’s eyes will be covered with pages, or a tinted perspex box will go over their head. There are special phototherapy mattresses and blankets, and your baby will be laid on them in their nappy and made very comfortable in order to maximise their exposure. From then on, the team will try to balance your baby’s feeding and care needs (babies undergoing phototherapy can get diarrhoea and be very drowsy) while allowing them as much light as possible. They’ll also give him or her lots of water to help flush the bilirubin out.

Exchange transfusions

If phototherapy isn’t working, your baby may need to have all their blood—yes, all of it—replaced bit by bit. This is called an exchange transfusion and can be done through your baby’s umbilical lines. These are two arteries and a vein, allowing the old blood to be taken out of the artery and the new blood into the vein. Umbilical catheters can only be put in during the first day of life, but once there, they can stay in place for as long as they are needed.

Cooling treatments

A baby can benefit from a cooling treatment if they were born after 36 weeks and had a very difficult time in the process, with the brain being deprived of oxygen. Studies show that cooling will slow their metabolic rate and may prevent or reduce brain damage, as oxygen-starved brain cells won’t die immediately if kept cool. Cooling treatments are only performed at specialist centres. The baby is placed on a special cooling mattress. The cooling happens for 72 hours, and the baby is then gradually rewarmed.

Treatment requiring transfers

Sometimes the neonatal unit cannot treat a baby’s very serious issues, and they need to be transferred to another hospital temporarily. Examples of treatment requiring transfers include those for a major heart or bowel problem. After treatment or surgery, such a baby will return to the unit and have its skin swabbed for bacteria. The doctors and nurses will then wear gloves to handle your baby until the swab comes back clean.

If your baby goes home and develops any of the issues mentioned above (apart from the very serious ones), and needs to return to the hospital, they’ll be put in the children’s ward or children’s intensive care unit. This will be the case even if they have just been discharged. We recognise that, whether you’re going to a new hospital or ward, meeting a whole new team and worrying whether your baby will receive the same level of care seems exhausting at what is already a draining time. We can’t help but crave the familiar when so much seems uncertain. However, you can be confident that any staff you deal with will be trained to support you, as well as well-briefed on your baby’s specific needs.

Which treatments will my premature baby receive?

Which treatment might a premature baby receive after birth?