A premature baby (or 'preemies' as such babies are called) is usually born before the 37th week of pregnancy. A normal pregnancy that lasts for about 40 weeks is always best for baby. But a pregnancy that ends between 20 weeks and 37 weeks is considered pre-term, and all pre-term babies weigh less and are at significant risk for health problems - as their organs did not have enough time to develop.

Earlier the birth, the greater the risk
Premature babies who are born really early and do very well often make headlines. But it's important to know that those babies are the exceptions. Babies who are born very pre-term are at a very high risk for brain problems, breathing problems, digestive problems, and death in the first few days of life.

Unfortunately, they also are at risk for problems later in their lives in the form of delayed development and learning problems in school. The effects of premature birth can be devastating throughout the child's life. The earlier in pregnancy a baby is born, the more health problems it is likely to have.

How early is too early?
Today, with advancements in neonatal care, babies born after the 25th week of pregnancy are considered mature enough to survive, though they may need a prolonged period of intensive care. However, besides the age, other genetic factors and weight can also increase the chances of survival of a premature baby.

Gestational Age	Chances of Survival
Less than 23 weeks	Not mature enough to survive
24 to 25 weeks	Have chances of survival - but need prolonged neonatal care
26 to 29 weeks	Have better chance of surviving and growing up normal with or without mild or moderate problems
30 to 33 weeks	Higher rate of survival
34 to 37 weeks	Only mildly immature, therefore will survive

Caring for a Premature Baby
Most premature babies (especially those born before 30-33 weeks) need to be on a ventilator to help them breath normally. In addition, a premature baby may also have Respiratory Distress Syndrome (RDS) during the first few days of life, because of his immature lungs. Babies with RDS are usually on a ventilator and will probably also receive a medication called surfactant to help their lungs.

Many premature babies are also put on antibiotics, as infections are a common reason for premature births. Feeding is through intravenous fluids, either through an IV or umbilical central line. A special bed with a radiant warmer could be used to help maintain baby's body temperature and this may include a cellophane wrapping to minimize the loss of heat and fluids through their thin skin. Some babies will probably also be on a cardio-respiratory monitor with a pulse oximeter to measure the oxygen in their blood, or may have a feeding tube if they are old enough to eat.

Preemies require special care even after they are discharged from the hospital - which could be around the original due date. They usually require periodic evaluations to identify and treat any problems that may crop up.

When it's too early...
When a premature baby is born too early, Doctors usually involve the parents in deciding the next line of action. However, one cannot generalize on the survival rate and outcome of premature babies as all preemies are individuals. Besides the obvious parameters like gestational age and size, many other factors such as the maturity of the baby's organs and other medical problems such as infections, birth defects etc. also determine the baby's future.

Though medical advancements have increased the chances of survival of premature babies, most babies are also severely handicapped. And when faced with a tiny, sick, premature baby, Doctors are often faced with the dilemma of whether to do their utmost to ensure the baby's survival or let nature take its course. The baby's future quality of life and pros and cons of survival should be discussed with the parents and thus, Doctors can help make an informed decision about baby's life.

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