Babies born at 37 weeks of gestation sometimes require specialized medical attention in a Neonatal Intensive Care Unit (NICU). This article explains why a baby might need NICU care at this gestational age and what families can expect during their stay.
Understanding 37 Weeks Gestation
A full-term pregnancy is considered between 39 weeks and 40 weeks, 6 days. Babies born at 37 weeks are classified as “early term” infants. They are not preterm (born before 37 weeks), but also not yet full-term. While outwardly they may appear developed, their internal systems are still maturing.
The final weeks of pregnancy are crucial for the development of organs like the brain, lungs, and liver. Babies born at 37 weeks may have less developed organ systems compared to those born a few weeks later.
Why Some 37-Week Babies Need NICU Care
Respiratory issues are common, with transient tachypnea of the newborn (TTN) being a frequent reason. TTN occurs when excess fluid remains in the lungs after birth, causing rapid breathing. It often resolves within 24 to 48 hours but may require oxygen support.
Feeding difficulties are another significant concern for early-term babies. Their suck-swallow-breathe coordination might not be fully synchronized, leading to inefficient feeding, poor latch, or excessive sleepiness during feeds. This can lead to insufficient calorie intake and inadequate weight gain.
Temperature instability is also observed. Less body fat makes it harder for them to maintain a stable body temperature. Hypoglycemia, or low blood sugar, can occur due to limited energy reserves and feeding difficulties.
Jaundice, characterized by yellowing of the skin and eyes, is more prevalent in babies born at 37 weeks. This occurs when the baby’s immature liver is less effective at processing bilirubin, a yellow pigment from red blood cell breakdown. While often mild, elevated bilirubin levels may require phototherapy to prevent complications. Early-term babies also have an increased susceptibility to infections due to their developing immune systems. Factors like prolonged rupture of membranes or maternal infection can elevate this risk.
What Happens During a NICU Stay
Babies requiring NICU care are placed in an environment designed to support their maturation. They are often housed in incubators, which provide a controlled, warm, and sterile space. Incubators help maintain a stable body temperature, compensating for the baby’s limited ability to regulate their own warmth.
Constant monitoring is standard practice. Wires attached to the baby track vital signs like heart rate, breathing, blood pressure, and oxygen levels. This continuous oversight allows the medical team to detect and respond quickly to any changes.
Supportive care for feeding difficulties often involves gavage feeding, where a thin tube delivers milk directly to the baby’s stomach. This ensures adequate nutrition while the baby develops oral feeding coordination. Phototherapy, using specialized lights, is administered for jaundice to help break down excess bilirubin. Medical staff, including neonatologists and specialized nurses, provide continuous observation and tailored interventions.
Journey Towards Discharge
The goal of a NICU stay is to ensure the baby is medically stable and can thrive at home. Several milestones must be met before discharge. The baby must maintain a stable body temperature independently in an open crib, without an incubator. Consistent weight gain is another criterion, showing sufficient nutrition and appropriate growth.
Successful oral feeding, by breast or bottle, is essential. The baby must consistently take enough milk to support growth and maintain blood sugar levels without tube feedings. Respiratory stability is also crucial, meaning the baby can breathe effectively without significant pauses or heart rate drops.
Before discharge, parents receive education on infant care, including safe sleep practices and any specific medical needs. Follow-up appointments with pediatricians are scheduled to monitor continued development and address lingering concerns.