A Week by Week Premature Baby Guide - 32 Weeks through 36 Weeks Gestation

A quick peek at 32 Weeks through 36 Weeks Gestation

Briella- born at 36 weeks gestation.

Thirty Two Weeks (32)

Thanks to their recently maturing lungs and a strengthening immune system, over 90% of babies born in their 32nd week survive! Babies born at 32 weeks gestation typically weigh about 1.8 kg. Babies born at this gestation are considered moderately premature. Babies born at 32 will have some layers of subcutaneous brown fat, and their wrinkly skin looks more like that of a term baby.

They are mature enough to begin to maintain their own body temperature but may still need a little help as they continue to grow. Babies born at 32 weeks use all five of their senses to learn about their environments. Their eyesight is still developing, and they can form images; Faces are their favorite form of stimulation. 32 weekers will have more spontaneous movements but will still continue to be uncoordinated and not purposeful. At this stage, the preemie will be awake more, with alert periods lasting longer. Premature babies born at 32 weeks will still need a lot of sleep and continue to thrive and grow in a quiet environment. The 32 week preemie is beginning to develop their suck, but will not be ready to feed from a bottle or breast yet, because they have not developed the coordination to suck, swallow, and breathe all at the same time. This milestone will come very soon and with practice such as pacifier use and kangaroo care while being fed, they will help develop the patterns necessary for future feedings.

All babies born at 32 weeks will require a NICU stay but may quickly catch up to their full term peers and may have few or little long term effects of prematurity.

Thirty Three Weeks (33)

Babies born at 33 weeks gestation have a 95 percent chance of survival. Babies born at this gestation typically weigh about 1.9 kg.

Babies born at 33 weeks are considered moderately premature. The baby born at 33 weeks is getting close to the size of a baby born at term and may be mature enough to begin to hold their own body temperature, but may still need a little help as they continue to grow. Although the 33 weeker looks like a smaller term baby, they’re systems are still immature and they will need time and your patience as they grow and learn. The 33 weeker’s bones are fully formed; their fingernails come to the end of their fingertips, and their footprints may be fully formed. However, the respiratory system has not finished fully developing until the last weeks of pregnancy, and antibodies have only started to pass from mother to baby, so their immune systems are compromised. The premature baby born at 33 weeks may be able to nipple feed, but they may need practice and patience as they remember to coordinate sucking swallowing and breathing. The 33 weeker can still get overwhelmed by too much activity and may show outwards signs of stress by hiccupping, sneezing, arching away, and crying.

It’s important to pay attention to these signs as they are signs of overstimulation. Premature babies born at 33 weeks will still need a lot of sleep and continue to thrive and grow in a quiet environment. They are developing sleep- wake cycles and their circadian rhythm which are so important for brain development. Learning to eat, maintaining body temperature, and gaining weight are all milestones that can take the longest to master in the NICU. 33-week preemies will all require some sort of NICU stay although their course may not be complicated with a lot of medical intervention.

Thirty Four Weeks (34)

Babies born at 34 weeks gestation have a 90-95 percent chance of survival. Babies born at this gestation will typically weigh about 2.1 kg. Babies born at 34 weeks are often called late preterm babies. They are mature enough to begin to maintain their own body temperature, and may be able to be in an open crib environment instead of an incubator, but keep in mind that these babies still need plenty of rest and sleep time to grow. Babies born at 34 weeks use all five of their senses to learn about their environments.Their eyesight is still developing, and they can form images. Faces are their favorite form of stimulation.They will begin to wake more often and thrive from touch and familiar sounds. Antibodies have only started to pass from mother to baby by 34 weeks, so their immune systems are compromised. The premature baby born at 34 weeks will be learning how to nipple feed, but they may need lots of practice and patience because their suck, swallow, breathe, reflex is not well coordinated yet. Although these babies look very similar to full term babies, they are different in many ways. They may need help breathing for a short period of time, but learning how to eat will take the longest. All babies born at 34 weeks will require some sort of NICU stay, but may quickly catch up to their full term peers and may have few or little long term effects of prematurity.

Thirty Five Weeks (35)

Babies born at 35 weeks gestation statistically have about the same likelihood of survival of that of a full term infant. Babies born at this gestation will typically weight about 2.4kg. Infants born at 35 weeks are often called late preterm babies. Although these babies look very similar to full term babies, they are still premature and are different in many ways. The immune system of a 35 weeker may be compromised because antibodies do not pass from mother to baby until the very last weeks of pregnancy. The 35 weeker’s bones are fully formed; their fingernails come to the end of their fingertips, and their footprints are fully formed. However, their lungs may not be completely developed for another couple of weeks. The baby born at 35 weeks will still need time to learn and grow. They may not have enough fat or energy stores to stay warm, or enough strength to breast or bottle feed effectively. Therefore, a lot of babies born at 35 weeks gestation will have to spend some time in the Neonatal Intensive Care learning these things before they can go home.

Thirty Six Weeks (36)

Babies born at 36 weeks gestation statistically have about the same likelihood of survival of that of a full term infant. Babies born at this gestation will typically weight about 2.6kg Infants born at 36 weeks are often called late preterm babies. Although these babies look very similar to full-term babies and are "structurally" ready for the real world, they are still premature and different in so many ways. The immune system of a 36 week preemie may be compromised because antibodies do not pass from mother to baby until the very last weeks of pregnancy. The 36 weeker’s bones are fully formed and now completely hardened, and their muscle tone is improving, however, their lungs may not be completely developed for another couple of weeks. The baby born at 36 weeks gestation will still need time to learn and grow, and may not have enough strength to breast or bottle feed effectively. Therefore some 36 weekers may have to spend time in the NICU learning these things before they can go home.

**The information provided in this series is not intended as a substitute for medical advice. Keep in mind that this information is a general guideline. No two babies are alike, and no two NICU journeys are the same, and, for this reason, there may be variations in the timing, progression, and statistical information of each individual baby**

Sources:

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Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice - Coughlin - 2009 - Journal of Advanced Nursing - Wiley Online Library. (n.d.). Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2009.05052.x/full

Growing Home- Preemie Developmental Care in the NICU. (n.d.). Retrieved from http://www.peekabooicu.net/2011/09/growing-home-preemie-developmental-care-in-the-nicu/

The Importance of Sleep and the Premature Baby. (n.d.). Retrieved from http://www.peekabooicu.net/2012/11/the-importance-of-sleep-and-the-premature-baby/

Level of NICU Quality of Developmental Care and Neurobehavioral Performance in Very Preterm Infants. (n.d.). Retrieved from http://pediatrics.aappublications.org/content/129/5/e1129.full

The Profile of a Preemie: The Senses and Your Premature Baby. (n.d.). Retrieved from http://www.peekabooicu.net/2013/02/the-profile-of-a-preemie/

Premature Birth Statistics | Statistic Brain. (n.d.). Retrieved from http://www.statisticbrain.com/premature-birth-statistics/

Understanding Preemie Development: Meriter Health Services. (n.d.). Retrieved from http://www.meriter.com/services/newborn-intensive-care-unit/understanding-and-parenting-your-preemie/understanding-preemie-development

What can I do for my baby while in the NICU? (n.d.). Retrieved from http://preemies.about.com/od/Preemie-Parents/ss/Parenting-your-Preemie-in-the-Neonatal-Intensive-Care.htm

Your Preemie’s Special Language. (n.d.). Retrieved from http://www.peekabooicu.net/2014/05/your-preemies-special-language/

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