Micro Preemie – Survival, Care & More

A baby born before completing 27 weeks of gestation or one with an extremely low birth weight due to preterm birth is considered a micro premature baby, often referred to as a micro preemie. These infants face significant health challenges due to their underdeveloped organs and systems. For an expectant mother aware of the risks associated with preterm labor, consulting a fetal medicine specialist is crucial. The specialist can recommend strategies to delay delivery and prolong the pregnancy, improving the baby’s chances of survival and reducing complications. Medications can help delay labor, giving the baby more time to develop. The goal is to ensure the best possible outcome for both the mother and the micro preemie, emphasizing the importance of early intervention and specialized medical care.

What Is a Micro Preemie?

A premature baby born before completing 26 weeks gestation period or weighs under 1.12 lb is called a micro preemie (1). For the micro preemie to thrive, you must know in advance that these babies are very different from full-term babies and their emotional and physical needs have to be catered to with great care and caution.

What Are the Causes of Giving Birth to a Micro Preemie Baby?

When a pregnancy ends early, it is difficult to assess the reasons, but one can say for sure that many factors combine to cause preterm birth. There are two categories of preterm labour – spontaneous preterm birth and medically compelled delivery. Some of the causes are given below (2):

• Any systemic inflammation or infection in the kidney, vagina, uterus, or mouth can cause spontaneous preterm delivery.
• Nicotine or any kind of tobacco prevents nutrients and oxygen from reaching the baby, thereby forcing preterm delivery.
• If the pregnancies are less than six months apart, it presents a high risk of delivering a preterm baby.
• It can also happen due to a genetic history in the family.
• If the cervix is insufficient or there are any other cervical problems, this can be the reason too.

Survival Rates of Micro Preemies

Micro preemies are very weak and fragile and so need a lot of monitoring and care. Utmost care is required to help the baby survive. The table given below indicates the survival rate depending on the week the baby was born:

How Does a Micro Preemie Look?

A micro preemie baby looks very tiny and weak. Their veins may be visible on their body, and their skin looks very thin and appears sticky or gelatinous.

In the NICU, they are also connected to various pieces of equipment, tubes and wires to help them sustain. You’ll see wired stickers on the baby’s legs, arms, feet, wrist or chest. There will also be a monitor attached to the umbilical artery IV line to measure blood pressure. Some may also have tubes in their mouth connected to a ventilator to help them breathe or are put on the continuous positive airway pressure (CPAP). OG/NG tubes will be attached to the baby’s mouth (OG) and nose (NG) to help with the feed.

Short–term Health Concerns for Micro Preemies

Micro preemies are treated in the NICU as they need a lot of external support. Some of the immediate and short-term concerns are given below:

1. Infections

Premature babies have an immature immune system. Infants get infections from the intravenous lines that are inserted in their weak bodies. Sometimes, they catch a cold from a person who is suffering from cold. Good hygiene should be ensured to avoid it (3).

2. Support for Breathing

Premature babies do not have strong lungs to breathe on their own. They either help them breathe by intubating them or use a CPAP device which is non- invasive and less injurious to the lungs (4).

3. Issues with Feeding

The baby’s feeding and growth are one of the most important things to be monitored in the NICU. They are prone to vomiting, and so they are fed a very small amount of food to help the gut mature. After their gut attains maturity, they are introduced to formula feed (5).

4. Injury in the Brain

Micro preemies are always at high risk of brain bleeding. Brain ultrasounds are done to check whether the bleeding is mild or severe. The risk of severe brain bleeding can be neurodevelopmental disorders or cerebral palsy. (6).

5. Problems in the Eye

When babies are born before the gestation period is complete, they may develop a condition that affects the retina’s blood vessels. As they are put on the high amount of oxygen for a prolonged period of time, their eyesight gets affected, and some require glasses as an aid to see clearly.

6. Patent Ductus Arteriosus (PDA)

A patent ductus arteriosus (PDA) is a condition where a blood vessel near the heart, which is normal in a fetus, fails to close after birth. This can cause complications in micro preemies, as it disrupts normal blood flow. PDA is often treated with medication, but surgery may be required if the condition persists.

7. Necrotizing Enterocolitis (NEC)

Micro preemies have immature digestive systems, making their intestines highly susceptible to infections. Necrotizing enterocolitis (NEC) is a serious condition where the lining of the bowels becomes infected and begins to deteriorate (7). Treatment typically involves IV fluids and antibiotics, but surgery may be necessary in severe cases.

How Long Are Micro Preemies Kept in the NICU?

Babies who are born before 27 weeks are made to stay in NICU until they complete the full tenure of development or sometimes even more. They often require respiratory support with a ventilator, a CPAP or a nasal cannula. They also try to keep the baby nourished to gain weight and growth of the organs. This support is impossible to provide at home, and so their stay in the NICU is a must during this time.

Long-term Health Issues in Micro Preemie

Micro preemies may develop some long-term health issues which are given below (8):

1. Learning Disabilities

Babies tend to develop physical, mental and emotional handicaps. They end up with cognitive problems, learning or behavioural problems.

2. Problems in Digestion

Some babies end up with food refusal, poor feeding, and many other digestive problems.

3. Hearing or Vision Problems

As complications of premature birth can be severe at times, they may ultimately have permanent hearing or vision loss, or related problems.

4. Lung Disease

Preemies require artificial respiratory support which sometimes leads to asthma or bronchopulmonary dysplasia, a chronic lung disease.

5. Cerebral Palsy

Some preemies may severe or moderate cerebral palsy.

How Parents Can Help in Improving Their Baby’s Outcome

Parents can play a positive and significant role in their micro preemie’s development and to give their babies the best possible start.

1. Early Intervention

Parents should try to minimize the cognitive impact of prematurity by seeking early intervention.

2. Know the Signs of Preterm Labour

Expectant mothers should seek medical care the minute they get an inkling that they might have a preterm delivery.

3. Deliver in a Hospital With NICU

You must identify a good hospital with a level 3 NICU along with 24×7 neonatology coverage, so that the child can avail of the best postnatal care.

4. Early Prenatal Care

You must try to minimize the risk of premature birth by taking prenatal care. Micro preemies are babies born long before the due date and hence, need neonatal intensive care.

FAQs

1. What are the long-term developmental milestones for micro preemie babies?

Micro preemies may experience delays in reaching developmental milestones such as crawling, walking, or talking due to their premature birth. However, with early intervention programs, physical therapy, and regular monitoring, many micro preemies catch up to their peers over time. Each child’s progress is unique and depends on their individual health and care.

2. How does Kangaroo Care benefit micro preemie babies?

Kangaroo care, where the baby is held skin-to-skin against the parent’s chest, has been shown to significantly benefit micro preemies. It helps regulate their body temperature, improves heart and lung function, promotes bonding, and can even enhance weight gain and overall development. This practice is encouraged in NICUs as a supportive care measure.

Caring for a micro preemie is a journey filled with challenges but also incredible strength and hope. Every small milestone is a big victory, and with the right medical care, love, and patience, these tiny fighters can grow and thrive. If you’re going through this experience, remember—you’re not alone. Support from doctors, family, and other parents can make all the difference. Stay hopeful, take it one day at a time, and celebrate every little step forward.

References/Resources:

1. University of Washington – Extremely Low Birth Weight NICU Graduate Supplement to the Critical Elements of Care for the Low Birth Weight Neonatal Intensive Care Graduate (CEC-LBW)

2. Nemours Kids Health – When Your Baby’s Born Premature

3. National Library of Medicine – Infection in the preterm infant

4. Cedars Sinai – Respiratory Distress Syndrome (RDS)

5. Science Direct – Nutrition for the micro preemie: Beyond milk

6. Stanford Medicine – Intraventricular Hemorrhage in Babies

7. Nemours Kids Health – Necrotizing Enterocolitis

8. Cleveland Clinic – Long-term consequences of prematurity

Also Read: 

Infection in Premature Baby
Premature Babies Development Concerns
How to Make Your Premature Baby Gain Weight?

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