3 Essential Steps to Ensure Preterm Infant Survival Without Complications
Preterm infants, born before 37 weeks of gestation, are at a higher risk for complications such as respiratory distress, infections, and feeding difficulties. However, with timely and appropriate care, many preterm can survive without significant issues. Thus, three important steps that can drastically improve outcomes for premature babies are as follows:
1. Provide Early Respiratory Support with Surfactant and Oxygen Management
· Administer Surfactant via INSURE: Surfactant therapy is crucial for preterm infants with respiratory distress syndrome (RDS). The INSURE method—INtubation, SURfactant administration, and Extubation—helps improve lung function and stabilize the baby.
· Use Low Oxygen Concentration (<30% FiO2): It is critical to keep the oxygen concentrations below 30%, given the risk of oxygen toxicity and possibly irreversible lung damage. Reduced FiO2 also encourages superior development of the lung.
· Wean to Room Air with Less Invasive Support: As the infant stabilizes, transition from high oxygen levels to room air as soon as possible. Use tools like High-Flow Nasal Cannula (HFNC) or Bubble CPAP to provide gentle respiratory support while reducing reliance on supplemental oxygen.
2. Early Introduction of Mother’s Milk to Reduce Infections and NEC
· Feed Early with Mother’s Milk: Early enteral feeding with mother breast milk is one of the most successful measures to reduce infections (including sepsis) and severe gastrointestinal diseases such as Necrotizing Enterocolitis (NEC).
· Human Milk is Protective: Breast milk is rich in antibodies and bioactive substances that boost immunity and maturation of the gut in preterm infants leading to reduction of infections and supporting growth.
3. Strict Hand Hygiene to Prevent Infections
· Follow WHO Handwashing Guidelines: Hand hygiene is the easiest way to prevent nosocomial infections (Hospital Acquired Infections) yet it has done wonders. According to the World Health Organization (WHO), all caregivers, family members and healthcare staff must wash their hands before holding the baby using the 6 steps of WHO handwashing technique.
· Prevent Cross-Infections: In the NICU (Neonatal Intensive Care Unit), where preterm babies are highly vulnerable, strict infection control measures—like disinfecting surfaces and equipment—are crucial for protecting infants from cross-contamination.
By following these three essential steps—providing early respiratory support with surfactant, introducing mother’s milk, and ensuring strict hand hygiene—most preterm infants can survive and thrive without complications. These simple, evidence-based measures can dramatically improve outcomes and give preterm infants the best chance at a healthy future.
This article is authored by Dr. B Uday Kiran, Consultant Pediatrician, Manipal hospital, Vijayawada