A late preterm infant is a baby born between 34 weeks 0 days and 36 weeks 6 days of gestation. While closer to their due date than other preterm infants, they are still considered premature. Understanding their unique aspects is important for their development and care, as their physiology and needs differ from full-term newborns. This classification helps healthcare providers and parents recognize that these infants require specialized attention.
Defining Late Preterm
This classification highlights that despite their near-term appearance, these infants often have different physiological maturity levels. The term “late preterm” replaced older terminology like “near term,” which incorrectly suggested routine care. This distinct category emphasizes that these babies are still immature and may face specific challenges not typically seen in infants born at 37 weeks gestation or later. Late preterm infants constitute a significant portion of all preterm births, accounting for approximately 70-75% of them.
Distinct Developmental Characteristics
Late preterm infants exhibit several developmental differences compared to full-term babies due to their abbreviated gestation. They often struggle with temperature regulation, possessing less body fat and immature physiological systems for maintaining warmth. Their bodies may lose heat more easily, requiring careful attention.
Feeding coordination can also be problematic, as they may struggle with the suck-swallow-breathe reflex. This immaturity can lead to poor milk intake, inadequate weight gain, or dehydration. Their stamina for feeding may be limited, causing them to fall asleep during feeds or show little interest.
Respiratory stability is another concern, as their lungs are still maturing and may have insufficient surfactant, a substance that helps keep air sacs open. This can result in conditions like respiratory distress syndrome or transient tachypnea of the newborn. Additionally, late preterm infants are at an increased risk for hypoglycemia (low blood sugar) due to lower glycogen stores. Jaundice, a yellowing of the skin caused by elevated bilirubin levels, is also more prevalent and prolonged because their livers are less mature in processing bilirubin.
Hospital Care and Monitoring
Upon birth, late preterm infants receive close medical observation in the hospital. Healthcare providers monitor them for several potential issues, including respiratory distress, feeding difficulties, jaundice, and temperature instability. This monitoring may occur in various settings, such as the mother’s room, a newborn nursery, a special care nursery, or even the neonatal intensive care unit, depending on the infant’s needs.
Specialized support is provided to address these vulnerabilities. Nurses and lactation consultants assist with feeding strategies, helping infants develop efficient suckling and ensuring adequate milk transfer. Vital signs are regularly checked. If an infant struggles with maintaining body temperature, warming lights or incubators may be used. Before discharge, healthcare teams ensure the infant has stable vital signs and is feeding successfully, typically requiring at least 48 hours of observation.
Supporting the Late Preterm Infant at Home
Once a late preterm infant is discharged, care strategies are important for their well-being at home. Parents receive guidance on feeding, often involving more frequent feeds (at least 8 times in 24 hours) and gently waking the baby if they sleep through a feeding. Observing for signs of effective feeding, such as audible swallowing and adequate wet and soiled diapers, is crucial.
Monitoring for signs of illness is also a key aspect of home care. Parents are educated to watch for symptoms like fever, poor feeding, lethargy, or changes in breathing patterns, and to contact their healthcare provider if concerns arise. Safe sleep practices are emphasized, including placing the infant on their back for all sleep times in a crib or bassinet without soft bedding. Room sharing, where the baby sleeps in the same room as the parents but in a separate safe sleep space, is recommended for the first six months.
Scheduled follow-up medical appointments are important, often within 24 to 48 hours of discharge, to assess weight gain, check for jaundice, and address any feeding challenges. Healthcare providers also stress protecting the infant from germs by encouraging handwashing and limiting exposure to sick individuals. These measures help support the late preterm infant’s continued development and reduce the risk of rehospitalization.