The following words and expressions may appear in some of your readings on babies or on preterm birth. This by no means implies that your child will have all or any of these conditions.

Anemia: Red blood cells are responsible for carrying oxygen through the blood stream to different parts of the body. A person who does not have enough red blood cells or whose red blood cells is said to be anemic. Generally, people who are anemic may feel weak and get tired easily.

Growth and weight gain may be slower in babies that are anemic. Anemia may also worsen existing breathing and heart problems. It is important, therefore, that babies have enough iron at their disposal since iron is required to form red blood cells.

Babies accumulate iron stores mostly in the last trimester of pregnancy. Because preterm babies were born early, they may not have had enough time to do so. Further, some red blood cells are lost each time a blood test is taken. For both of these reasons, preterm babies are given iron supplements from hospital discharge until one year corrected age.

Apnea and bradycardia: Apnea is a long pause in breathing, lasting more than 15 seconds in babies. Apnea is quite common in infants born preterm. In addition, the heart beat sometimes slows down when the baby stops breathing. A slow heart rate is called bradycardia. Preterm babies are generally given caffeine to stimulate both breathing and heart rate. Apnea and bradycardia in preterm babies usually resolve and disappear by 36-40 weeks’ postmenstrual age.

Bradycardia: A heart rate that is too slow. Tachycardia is a heart rate that is too fast.

Bronchopulmonary dysplasia (BPD): BPD is a chronic lung disease mainly of preterm babies. It may occur in very preterm infants or in those who have been on oxygen supplementation for long periods of time. For instance, babies born extremely preterm who need oxygen until 36 weeks’ postmenstrual age and beyond sometimes get BPD. X-rays of babies with BPD show abnormalities in lung structure. Children who’ve had BPD as babies may have long-term breathing difficulties similar to asthma.

Necrotizing enterocolitis (NEC): NEC is an intestinal infection. It occurs mainly in very preterm babies in whom the gut is still very immature. Babies with NEC suffer from a distended abdomen, digestive problems, and possibly blood in the stool.

Treatment involves giving the intestines a chance to rest and recuperate fully. The baby will therefore be fed intravenously and be given antibiotics to fight the infection. Once the gut is healed, regular feedings by mouth can begin gradually.

Parenteral nutrition: Parenteral nutrition is another word for intravenous feeding. It is the delivery of nutrients into a vein instead of by mouth; for instance, for a baby with necrotizing enterocolitis (NEC). Parenteral nutrition consists of proteins, sugars, fatty acids, vitamins, iron, and other necessary nutrients. Parenteral nutrition may be given to an infant, alone or as a supplement to milk feedings, until he is able to breastfeed or bottle-feed adequately on his own.

Jaundice: Jaundice is a yellowish colouring of the skin. Babies may get jaundiced in the first few days after birth, when the liver is not yet able to get rid of excess bilirubin. Bilirubin is a yellowish pigment produced by the breakdown of red blood cells. Treatment consists of putting the baby under special blue lights that break down the bilirubin. This light treatment is known as phototherapy.

Phototherapy: Phototherapy is any form of treatment using lights. Phototherapy is used to treat jaundice in newborns.

Intraventricular hemorrhage (IVH): Intraventricular hemorrhage is bleeding within the brain. The word intraventricular refers to the ventricles of the brain. IVH occurs mostly in infants born before 33 weeks’ gestation or whose birth weight was less than 1500 grams. The amount of bleeding is graded on a 4-point scale. Grades 3 and 4 bleeding are considered very severe and may lead to developmental problems.

Periventricular leukomalacia: Periventricular leukomalacia is brain damage to the white matter of the brain. It may be caused by a lack of oxygen or a lack of blood flow to the brain or by infection and inflammation. White matter consists of nerves and tissue that connect brain areas and where nerves that control the muscle pass through.

Periventricular leukomalacia affects mostly infants who were born before 32 weeks’ gestation and whose weight at birth was less than 1500 grams. Depending on the amount and type of damage, it may result in cerebral palsy or in other intellectual, developmental, or neurological disorders.

Osteopenia of prematurity: Osteopenia is a lower-than-normal bone density. Preterm babies may not have balanced amounts of phosphate, calcium, and vitamin D. Because their bones may be less dense and strong than otherwise, they may be at risk for fractures. Osteopenia is treated with dietary supplements to encourage healthy bone growth.

Patent ductus arteriosus (PDA): In the fetus, there is an artery called the ductus arteriosus that allows the blood circulation to bypass the lungs. A fetus’ lungs are not used for breathing; the fetus obtains its oxygen directly from the placenta. At birth, conditions change; blood has to go to the lungs for the baby to obtain oxygen. The ductus arteriosus, no longer needed, closes fairly quickly.

In preterm infants, the ductus arteriosus may remain open, or “patent”. This may affect normal blood flow and consequently, the baby’s health.

Medications can be given to try to help the ductus arteriosus close by itself. Alternatively, a surgical procedure called PDA ligation may be required.

Retinopathy of prematurity (ROP): ROP is an abnormal growth of the blood vessels in the eye. It affects mainly infants born before 31 weeks’ gestation or with birth weight less than 1250 grams. ROP can cause problems with vision. A few weeks after a preterm baby is born, an ophthalmologist will do a test to screen for the condition. If needed, treatment can halt progression.

Septicemia: Septicemia is any infection that has spread to the blood stream. Septicemia makes a person very sick. The initial infection may have been caused by bacteria, virus, or even a fungus.

Respiratory distress syndrome: Respiratory distress syndrome, also called hyaline membrane disease, occurs mostly in newborns born preterm. It is a breathing disorder caused by a lack of surfactant.

Surfactant is a soapy substance produced in the lungs that keeps the little air sacks open (by preventing the membranes from sticking). Imagine blowing a balloon when the sides stick together…. Surfactant makes it easier to breathe.

Surfactant is produced by the fetus during the last trimester of pregnancy. Babies born before 34 weeks’ gestation may not have enough surfactant in their lungs. Newborns at risk of respiratory distress syndrome will be given surfactant in the delivery room and/or the NICU.

In addition to surfactant, babies with respiratory distress syndrome may need extra oxygen or a ventilator to help them breathe properly.

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