Near Term Babies Need More Care

What parents need to know about their near term infants

by Jenn Berman

Prior to giving birth to my twin girls, I had heard of premature babies or preemies but never near-term infants. I thought that if my girls made it to 35 or 36 weeks, looked healthy and were able to stay out of the Neonatal Intensive Care Unit (NICU) that we were in the clear. I was wrong.

What is a "Near Term" Baby? The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) defines the near-term infant as any baby born between 34 and 37 weeks of gestation. One study published in the journal Pediatrics found that as many as 7% of babies born during the study qualified as near-term. Because these babies often have normal Apgar scores (the test doctors give newborns shortly after birth to evaluate heart rate, breathing, muscle tone, "reflex irritability, and skin coloration), healthy birth weights and can breathe on their own, they are often treated like full term babies which they are not.

Medical Issues There are five common health issues that parents need to be aware of with near-term infants. They are: Feeding problems can arise because near-term babies tend to eat less food at a feeding and as a result need to eat more frequently. They often have difficulty coordinating sucking and swallowing which can make it difficult for them to eat. In addition, Gastroesophageal Reflux is a common problem in near-term babies, which can make it difficult to keep food down. Near-term infants may sleep for longer intervals and have difficulty waking up to feed or sometimes have trouble falling to sleep due to gastrointestinal discomfort.

Breathing issues can come up since near-term infants are more susceptible to respiratory distress.

Near-term babies have a more difficult time regulating their body temperatures largely as a result of the fact that they tend to have less body fat at birth than full term babies. Preemies will frequently have immature immune systems and are more susceptible to infection, jaundice, or illnesses. They are at a higher risk for Respiratory Syncytial Virus or RSV, a dangerous virus that can lead to pneumonia among other respiratory difficulties.

What Parents Need to Know Given inaccurate conception dates, the lack of information about near-term babies and a near term baby's misleading healthy appearance, parents need to be aware of the possibility that their babies are not full term in order to make sure they get the best possible medical care. If you have or suspect that you have a near-term infant it is crucial to get accurate information about caring for your child. When my husband and I were in the hospital we were given a lot of information that was detrimental to our near-term babies. For example when we were taught to bottle feed (we supplemented with formula) we were told to hold the babies close to our bodies. We found that our babies would fall asleep during the feed and not get enough nutrition. When we consulted with a nurse who knew about near-term babies she taught us to hold our babies away from our bodies when we feed so that our body heat did not make them fall asleep. There are many other tips like that which parents of near-tem babies need to know but are often not educated about due to lack of information available. Parents who don't get this information may find themselves frustrated and feeling alone which can be harmful to the bonding process between the parent and child. If you have a near-tem baby or think you may be at a high risk of having one I recommend finding professionals that you can count on for good information.

______________________________________________________________ Tips

Always check with your pediatrician before trying any recommendations. The following are common tips that are given to parents of near term-babies.

Feed the baby holding him away from your body.

Feed frequently.

Burp frequently during each feed.

Try not to allow feeding session to last more than 30-40 minutes.

Wash and disinfect your hands frequently.

Don't allow smokers, toddlers, or anyone who is sick near your baby.

Make sure to keep your baby warm.

Spend time doing "kangaroo care" or skin to skin contact with your infant.

Work with a lactation consultant to assure optimum breastfeeding.

If your child has Reflux ask your doctor if she should be side sleeping.