Monday, May 16, 2011

Late Pre-Term info

I’ve received a few comments and emails regarding “late pre-term infants”, so I thought I’d share the limited information I have. Personally I’d never heard the term. I was under the impression that there were preemies and full-term infants, which I thought was 37 weeks.

While taking a breastfeeding class, the director of lactation services informed us that there is a relatively new category called “late pre-term”, babies born between 36-38 weeks. I wrote it down in my notes, but didn’t think about it again, since Kate was supposed to be born at 39 weeks.

Shortly after she was born, the staff brought in the following form (I hope it’s big enough to read)

Kate born in the 37th week, and did have several of the issues listed on the paper. Would she have had them if she were born at 39 weeks? It’s hard to say, maybe, maybe not.

The first, most noticeable issue was temperature regulation. A nurse was just about to take her away to the special care nursery to go under the heating lights when a wonderful lactation consultant/ RN suggested Kangaroo Care. A few hours and lots of cuddle time later, we narrowly missed special care by .1 degree.

She also lacked the suck, swallow, breathe coordination. To keep herself alive, breathing was of course most important, and fortunately not an issue. We had to work on getting her to suck and swallow. For the first day, aside from practicing breastfeeding, she was fed pumped milk by syringe, then graduated to little bottles. They did test her blood sugar before she ate every time. Poor girl.

At some point they tested her bilirubin level which was high, so she was diagnosed with jaundice. As for weight loss, she lost a total of 11 1/2 oz, but weight loss is common in all/ most newborns, so I wasn’t concerned.

Throughout this time I spoke with a few pediatricians and found out that “late pre-term” is a well-known term in their field. One friend, a practicing pediatrician said, Technically, a term baby is 38 weeks (some would even say 39). There has been a reclassification of the 36-38 weekers as "late preterm" since they tend to not act like term babies (keeping temps up, eating well, sleeping easily, etc). We don't worry about 36-38 weekers as much as say... a 30 weeker, but we do realize that there are still some adjustments that baby needs to make."(Hope you don’t mind being quoted, S)

A few other people told me that you would never hear a neonatologist refer to 37 weeks as full-term, as they see too many of them in the NICU. Apparently 37 weekers have a 50% higher mortality rate than 40 weekers.

Here are a few articles I found, and that is the extent of my knowledge on the subject. I’m just beyond grateful for a healthy, thriving little girl. I’ve always been a fan of letting babies stay inside and grow as long as possible, this information definitely confirms that opinion.

From the CDC: “Term” births (37-41weeks) have traditionally been viewed as one homogenous group [8]. There is, however, growing evidence of increased neonatal morbidity among early term (37- 38 weeks) infants, compared with those born full term (39-41 weeks) [37-39]. In response, organizations such as the March of Dimes are recommending that researchers differentiate between early and full term births [40]

New Research Shows Why Every Week of Pregnancy Counts

Rethinking the Definition of "Term Pregnancy"

A Push for More Pregnancies to Last 39 Weeks

The Late PreTerm Infant and Breastfeeding

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