When the premature infants can suck their own milk and ensure the daily intake, they can maintain their normal body temperature under the indoor temperature of 21-24 ℃; their body weight increases by 10-30g every day, reaching 2300 grams or more; there are no complications; there is no need to take oxygen; there is no anemia and other nutritional deficiency symptoms. But after the child is discharged from hospital, the body is still very weak, parents should take care of it very carefully.
Prevention of infection
In addition to those who take care of the children (mother or grandmother), it is better not to let others into the room of premature infants, let alone carry the children to relatives and neighbors. People who take care of children should wash their hands carefully before feeding and changing diapers. Bottles and utensils should be disinfected every day. Bedding should be washed and dried frequently. The room should be ventilated. The baby should be bathed and changed every day to keep the skin clean. Mother should wear a mask when she has a cold.
Because of the difficulty in regulating the temperature of premature infants, the requirements of temperature and humidity in nursing are very important. The clothing for premature birth should be soft and warm, simple and easy to wear. Diapers should also be soft and easy to absorb water. All clothes should be tied with belts instead of pins and buttons. Heat preservation is not the same as covering children strictly. In home care, the indoor temperature should be kept at 24-28 ℃, and the indoor relative humidity should be between 55% and 65%. If the indoor temperature can not reach the standard, it can be considered to use warm water bags to keep children warm, but pay attention to safety. The infant’s body temperature should be kept at 36-37 ℃, and the temperature should be measured once in the morning and afternoon. If the difference between the maximum temperature and the minimum temperature is 1 ℃, corresponding measures should be taken to ensure the stability of the temperature. When the baby’s weight is less than 2.5 kg, do not take a bath. You can wipe the baby’s neck, armpit, thigh root and other wrinkles every 2-3 days. If the body weight of more than 3 kg, each time milk up to 100 ml, you can take a bath like a healthy newborn. But in the cold season, pay attention to the indoor temperature and water temperature when bathing.
At present, people from all walks of life pay more attention to it. Generally speaking, early feeding can shorten the time of physiological weight loss, or reduce the degree of hypoglycemia, and reduce the concentration of serum bilirubin. Generally, sugar water should be fed 6-12 hours after birth, and milk should be fed 24 hours after birth. If cyanosis, dyspnea or surgical delivery have occurred in patients with low weight or poor general condition, the feeding can be postponed and intravenous rehydration can be conducted.
Feeding method: according to the different maturity of premature infants, for those with heavy birth weight and good sucking reflex, they can directly breastfeed, otherwise, they can be fed by dropper or gastric tube.
The intake depends on the birth weight and maturity of preterm infants. The formula for calculating the intake of preterm infants can be referred to.
The maximum intake of premature infants within 10 days after birth (ML) = (actual days of birth + 10) × body weight (g / 100). After 10 days, the maximum amount of lactation (ML) = 1 / 5-1 / 4 body weight (g) or more is the maximum intake. If the preterm infants can’t finish eating, the remaining part can be replenished by vein to ensure the supply of protein, heat and water.
Feeding interval: according to the milk formula and weight arrangement, the general weight of less than 1000 grams, once per hour; 1001-1500 grams, every 1.5 hours; 1501-2000 grams, every 2 hours; 2001-2500 grams, every 3 hours, or the specific situation of treatment.
The nutritional requirement of preterm infants is a problem that has been continuously discussed and studied
It is generally believed that the requirement of heat for premature infants is higher than that for mature infants, and 110-150 kcal per kilogram of body weight per day is required. Because the resting metabolic rate of premature infants means that the work of lung respiration is greater than that of mature infants, but the absorptive capacity of premature infants is lower than that of mature infants, so it is better to start with a slightly lower heat supply. Increase gradually according to the situation.
Protein: the protein intake of mature infants from breast milk accounts for 6-7% of the total calories, and the protein intake of premature infants accounts for 10.2% of the total calories, which is higher than that of normal infants.
Amino acids: there are 9 kinds of essential amino acids in normal infants and 11 kinds in preterm infants. Due to the lack of relevant invertase enzymes, preterm infants cannot convert methionine into cystine and phenylalanine into tyrosine. Therefore, cystine and tyrosine become essential amino acids and must be taken from food.
Inorganic salt: preterm infants need more than mature infants, because the last stage of the fetus is the stage of increasing inorganic salts, such as calcium, phosphorus and iron. If less than months, premature infants will lack inorganic salts.
Vitamin: premature infants lack vitamin E and are prone to hemolytic anemia. The absorption rate of fat in preterm infants is not as good as that of mature infants, and may lack fat soluble vitamins and other nutrients. It remains to be studied whether formula food or breast-feeding is better for preterm infants. In short, the nutrition of preterm infants should vary from person to person. Due to different situations and individual differences, nutrition should be carefully considered in combination with individual conditions.
The tactile stimulation brought by touching will form a kind of reflection in the child’s brain. At this time, the children’s eyes, hands and feet move with each other. When there are more connections and activities between these brain cells, the development of children’s intelligence is promoted. Another benefit is that children can cry less and sleep better. But the abdomen massage, may cause the child’s digestion absorption function enhancement.
In case of the following conditions, contact the doctor in time:
(1) the body temperature drops below 35 ℃ or rises to above 38 ℃, but still has no effect after taking corresponding warming or cooling measures; 2) coughing, foaming, shortness of breath; 3) sudden decrease of milk intake, sallow complexion and weak crying; 4) sudden abdominal distension; 5) spasm and convulsion.
In the care of premature infants, do not be impatient, to be careful, more observation of changes in children, but not too nervous, to scientific conditioning, to have confidence, the child will grow up healthily. Practice has proved that before the age of 2 is a valuable time to make up for the congenital deficiency. As long as scientific feeding is carried out, it is possible for premature infants to catch up with normal infants before the age of two. Such premature infants, physical strength, intelligence will not be worse than normal people. (guidance expert: Luo Ping, deputy chief physician of Pediatrics, General Hospital of military region)
Related links: what is the content of neonatal care? 7 aspects of neonatal special care: careful nursing of 4 sensitive parts of newborn