Almost 1 of every 10 infants born in the United States are premature, or preemies. A premature birth is when a baby is born before 37 completed weeks of pregnancy. A full-term pregnancy is 40 weeks.

Important growth and development happen throughout pregnancy - especially in the final months and weeks. Because they are born too early, preemies weigh much less than full-term babies. They may have health problems because their organs did not have enough time to develop. Problems that a baby born too early may have include

• Breathing problems
• Feeding difficulties
• Cerebral palsy
• Developmental delay
• Vision problems
• Hearing problems

Preemies need special medical care in a neonatal intensive care unit, or NICU. They stay there until their organ systems can work on their own.

There are some known risk factors for premature birth. But even if a woman does everything “right” during pregnancy, she can still have a premature baby.

• Carrying more than one baby (twins, triplets, quadruplets or more)
• Having a previous preterm birth
• Problems with the uterus or cervix
• Chronic health problems in the mother, such as high blood pressure, diabetes, and clotting disorders
• Certain infections during pregnancy
• Drinking alcohol
• Using illicit drugs
• Smoking
• Black race

Doctors sometimes decide to deliver a baby early because of concerns for the health of the mother or the baby. Despite the problems associated with a premature birth, this may be the safest option. However, in most cases preterm labor begins unexpectedly.

Preterm labor warning signs include:

• Contractions (your abdomen tightens like a fist) every 10 minutes or more often
• Change in vaginal discharge (leaking fluid or bleeding from your vagina)
• Pelvic pressure — the feeling your baby is pushing down
• Low, dull backache
• Cramps that feel like a menstrual period
• Abdominal cramps with or without diarrhea

Should you experience any of these symptoms during pregnancy call your doctor’s office immediately.

A premature baby, or preemie, is defined as one that is born before the 37th week of pregnancy. A full term pregnancy is 40 weeks. More than a half million babies are born premature each year in the United States or about 1 in every 8 births. Prematurity is the leading cause of death in newborns and preemies are at increased risks for lifelong health problems.

Premature infants may face a number of health challenges, including:

• Low birth weight
• Underdeveloped organs or organ systems
• Breathing and respiratory problems because of underdeveloped lungs
• Learning and developmental disabilities
• Cerebral palsy
• Life-threatening infections
• Serious lung condition, known as respiratory distress syndrome
• Vision and hearing loss
• Feeding and digestive problems
• Jaundice

Some premature babies require special care and spend weeks of months in the hospital, often in a neonatal intensive care unit.

When you're short of breath, it's hard or uncomfortable for you to take in the oxygen your body needs. You may feel as if you're not getting enough air. Sometimes you can have mild breathing problems because of a stuffy nose or intense exercise. But shortness of breath can also be a sign of a serious disease.

Many conditions can make you feel short of breath:

• Lung conditions such as asthma, emphysema, or pneumonia
• Problems with your trachea or bronchi, which are part of your airway system
• Heart disease can make you feel breathless if your heart cannot pump enough blood to supply oxygen to your body
• Anxiety and panic attacks
• Allergies

If you often have trouble breathing, it is important to find out the cause.

What is cerebral palsy (CP)?

Cerebral palsy (CP) is a group of disorders that cause problems with movement, balance, and posture. CP affects the cerebral motor cortex. This is the part of the brain that directs muscle movement. In fact, the first part of the name, cerebral, means having to do with the brain. The second part, palsy, means weakness or problems with using the muscles.

What are the types of cerebral palsy (CP)?

There are different types of CP:

• Spastic cerebral palsy, which is the most common type. It causes increased muscle tone, stiff muscles, and awkward movements. Sometimes it only affects one part of the body. In other cases, it can affect both arms and legs, the trunk, and the face.
• Dyskinetic cerebral palsy, which causes problems controlling the movement of the hands, arms, feet, and legs. This can make it hard to sit and walk.
• Ataxic cerebral palsy, which causes problems with balance and coordination
• Mixed cerebral palsy, which means that you have symptoms of more than one type

What causes cerebral palsy (CP)?

CP is caused by abnormal development or damage to the developing brain. It could happen when

• The cerebral motor cortex doesn't develop normally during fetal growth
• There is an injury to the brain before, during, or after birth

Both the brain damage and the disabilities it causes are permanent.

Who is at risk for cerebral palsy (CP)?

CP is more common among boys than girls. It affects black children more often than white children.

Certain medical conditions or events that can happen during pregnancy and delivery that may increase a baby's risk of being born with cerebral palsy, including

• Being born too small
• Being born too early
• Being born a twin or other multiple birth
• Being conceived by in vitro fertilization (IVF) or other assisted reproductive technology (ART)
• Having a mother who had an infection during pregnancy
• Having a mother with certain health problems in pregnancy, such as thyroid problems
• Severe jaundice
• Having complications during birth
• Rh incompatibility
• Seizures
• Exposure to toxins

What are the signs of cerebral palsy (CP)?

There are many different types and levels of disability with CP. So the signs can be different in each child.

The signs usually appear in the early months of life. But sometimes there is a delay in getting a diagnosis until after age two. Infants with CP often have developmental delays. They are slow to reach developmental milestones such as learning to roll over, sit, crawl, or walk. They may also have abnormal muscle tone. They may seem floppy, or they may be stiff or rigid.

It's important to know that children without CP can also have these signs. Contact your child's health care provider know if your child has any of these signs, so you can get a correct diagnosis.

How is cerebral palsy (CP) diagnosed?

Diagnosing CP involves several steps:

• Developmental monitoring (or surveillance) means tracking a child's growth and development over time. If there are any concerns about your child's development, then he or she should have a developmental screening test as soon as possible.
• Developmental screening involves a giving your child a short test to check for motor, movement, or other developmental delays. If the screenings are not normal, the provider will recommend some evaluations.
• Developmental and medical evaluations are done to diagnose which disorder your child has. The provider many use many tools to make the diagnosis:
  • A check of your child's motor skills, muscle tone, reflexes, and posture
  • A medical history
  • Lab tests, genetic tests, and/or imaging tests

What are the treatments for cerebral palsy (CP)?

There is no cure for CP, but treatment can improve the lives of those who have it. It is important to begin a treatment program as early as possible.

A team of health professionals will work with you and your child to develop a treatment plan. Common treatments include

• Medicines
• Surgery
• Assistive devices
• Physical, occupational, recreational, and speech therapy

Can cerebral palsy (CP) be prevented?

You cannot prevent the genetic problems that can cause CP. But it may be possible to manage or avoid some of the risk factors for CP. For example, making sure that pregnant women have been vaccinated could prevent certain infections that can cause CP in unborn babies. Using cars seats for infants and toddlers could prevent head injuries, which can be a cause of CP.

As children grow older, they develop in several different ways. Child development includes physical, intellectual, social, and emotional changes.

Children grow and mature at very different rates. It's hard to say what "normal" is. There can be big differences in height, weight, and build among healthy children. Diet, exercise and genes are all factors. Some children begin puberty or are close to it before they are teenagers.

Children start to become more independent from their parents. They may rebel. They also look outward - to their friends, who are usually of the same sex. Peer approval becomes very important. Your child may try new behaviors to be part of "the group." This can also be the time that parents or teachers recognize learning disabilities or behavioral problems in children. These problems can get worse as time goes on, so it is important to get help early.

If you have low vision, eyeglasses, contact lenses, medicine, or surgery may not help. Activities like reading, shopping, cooking, writing, and watching TV may be hard to do. The leading causes of low vision and blindness in the United States are age-related eye diseases: macular degeneration, cataract and glaucoma. Other eye disorders, eye injuries, and birth defects can also cause vision loss.

Whatever the cause, lost vision cannot be restored. It can, however, be managed. A loss of vision means that you may have to reorganize your life and learn new ways of doing things. If you have some vision, visual aids such as special glasses and large print books can make life easier. There are also devices to help those with no vision, like text-reading software and braille books.

The sooner vision loss or eye disease is found and treated, the greater your chances of keeping your remaining vision. You should have regular comprehensive eye exams by an eye care professional.

Most children hear and listen from the moment they are born. They learn to talk by imitating the sounds around them and the voices of their parents and caregivers. But about 2 or 3 out of every 1,000 children in the United States are born deaf or hard-of-hearing. More lose their hearing later during childhood.

Babies should have a hearing screening before they are a month old. If your child has a hearing loss, it is important to consider the use of hearing devices and other communication options by age 6 months. That's because children start learning speech and language long before they talk.

Hearing problems can be temporary or permanent. Sometimes, ear infections, injuries or diseases affect hearing. If your child does not hear well, get help.

Apnea in infants is the term used to describe episodes of cessation of breathing and may be due to many physiological and pathophysiological processes. Brief periods of apnea that occur in short cycles of 5 seconds to 10 seconds is not pathologic and is referred to as periodic breathing. Periodic breathing is seen predominantly during the age of two to four weeks and resolves by age six months.

Apnea is frequently seen in preterm infants but can occur at any age.

Apnea of prematurity is defined as a sudden cessation of breathing that lasts for at least 20 seconds or is accompanied by bradycardia or oxygen desaturation (cyanosis) in an infant younger than 37 weeks’ gestational age.

Apnea of infancy is defined as “an unexplained episode of cessation of breathing for 20 seconds or longer, or a shorter respiratory pause associated with bradycardia, cyanosis, pallor, and/or marked hypotonia.”

Apnea may be central, obstructive, or mixed.

Central apnea is due to the depressed respiratory center where there is a cessation of output from the central respiratory centers, and there is no respiratory effort.

Obstructive apnea occurs when there is an obstruction to the airway, and respiratory efforts are inadequate to maintain ventilation.

Mixed apnea (a period of central apnea, typically followed by airway obstruction) is the most frequent type among preterm infants.

At a glance: Retinopathy of Prematurity

• Early Symptoms: None

• Late Symptoms: Unusual eye movements, white pupils, vision loss

• Diagnosis: Eye exam or photographs of the retinas

• Treatment: None (for mild cases), laser treatment, freeze treatment, eye injections (for severe cases)

Abnormal increase in RESPIRATORY RATE in the newborn. It is self-limiting and attributed to the delayed fetal lung fluid clearance often in CAESAREAN SECTION delivery.

The CDC has determined that in the majority of infants born prematurely, regardless of birth weight, should be vaccinated with the same dose(s), at the same chronological age and according to the same schedule and precautions as full-term infants and children.

Children should receive their first immunizations two months after birth. The one immunization that a premature infant may not receive on schedule is the hepatitis B vaccine, which is usually given at birth. This vaccine is not effective in very small infants and is not given until an infant is at least 2,000 grams.

Babies born earlier than 37 weeks of gestational age are at elevated risk for RSV. Those less than 32 weeks at birth are at even greater risk for severe RSV disease due to the lack of full development of their lungs and immune responses. Small preemies are more likely to develop subsequent issues associated with chronic or recurring lung disease.

Family members can help prevent babies from contracting RSV by understanding how it's acquired and taking these steps:

1. The best way to protect against RSV is to make sure other children and adults with cold symptoms stay away from the baby.
2. . This virus can survive on surfaces for several hours. It thrives on countertops and tissues. Family members should avoid touching these surfaces, then handling the baby or objects, such as toys or bottles used for the child. Otherwise, the virus can infect the baby through his or her eyes and nose. It is important to keep toys and personal items as clean as possible. Anyone who comes in regular contact with the child should take the time to wash his or her hands or use antibacterial gels often.
3. If the baby was premature, it is important to check with his or her pediatrician to see if the child is at higher risk than normal for RSV. The doctor also should go through all the options to helping to protect the baby from the virus.
4. Family members should be on the lookout for any persistent coughing, wheezing or difficulty breathing and contact a pediatrician if observed.
5. Parents or other family members who are the primary caretakers almost always know their baby better than anyone else. If the baby looks somehow "off" to you - appears lethargic, acts different or has trouble feeding - don't hesitate to dial the pediatrician's number.

Premature birth (also called preterm birth) is when a baby is born before 37 weeks. Premature babies often have a low birth weight (less than 5½ pounds). Both of these can make it challenging to breastfeed, especially if the baby has to stay in the hospital for extra care. But breastmilk helps premature babies grow and stay healthy.

Some babies can breastfeed right away. This may be true if your baby was born at a low birth weight but after 37 weeks. These babies will need more skin-to-skin contact to help keep warm. These smaller babies may also need to be fed more often because their stomachs are smaller, and they may get sleepier during those feedings.

If your baby is born prematurely and you are not able to breastfeed at first, you can:

• Hand express or pump colostrum in the hospital as soon as you are able
• Talk to the hospital staff about renting an electric pump. Call your insurance company or the local Women, Infants and Children (WIC) office to find out whether insurance will pay for rental of this type of pump. Most insurance plans must cover the cost of a breast pump, but different insurance plans will cover different types of pumps.
• Pump milk as often as you would normally breastfeed — about eight times in a 24-hour period (every 3 hours).
• Give your baby skin-to-skin contact once your baby is ready to breastfeed directly. This can be very calming and a great start to your first feeding. Be sure to work with a lactation consultant on proper latch and positioning. It may take some time for you and your baby to get into a good routine.

Expecting or caring for a baby? Take these steps to help baby sleep safely and reduce the risk of sleep-related infant deaths, including sudden infant death syndrome (SIDS).

There are about 3,400 sleep-related deaths among US babies each year. CDC supports the recommendations issued by the American Academy of Pediatrics (AAP) to reduce the risk of all sleep-related infant deaths, including SIDS.

Parents and caregivers can help create a safe sleep area for babies by taking the following steps:

• Place your baby on his or her back for all sleep times—naps and at night. Even if a baby spits up during sleep, babies’ anatomy and gag reflex help prevent them from choking while sleeping on their backs. Babies who sleep on their backs are much less likely to die of SIDS than babies who sleep on their sides or stomachs.
• Use a firm, flat (not at an angle or inclined) sleep surface, such as a mattress in a safety-approved crib covered only by a fitted sheet. Some parents and caretakers might feel they should place their baby on a soft surface to help the be more comfortable while sleeping. However, soft surfaces can increase the risk of sleep-related death. A firm sleep surface helps reduce the risk of SIDS and suffocation.
• Keep your baby’s sleep area (for example, a crib or bassinet) in the same room where you sleep, ideally until your baby is at least 6 months old. Accidental suffocation or strangulation can happen when a baby is sleeping in an adult bed or other unsafe sleep surfaces. Sharing a room with your baby is much safer than bed sharing and may decrease the risk of SIDS by as much as 50%. Also, placing the crib close to your bed so that the baby is within view and reach can also help make it easier to feed, comfort, and monitor your baby.
• Keep soft bedding such as blankets, pillows, bumper pads, and soft toys out of your baby’s sleep area. Additionally, do not cover your baby’s head or allow your baby to get too hot. Some parents may feel they should add sheets or blankets to their baby’s crib to help keep their baby warm and comfortable while sleeping. However, sheets, comforters, and blankets can increase the risk of suffocation or overheat your baby. If you’re worried about your baby getting cold during sleep, you can dress them in sleep clothing, like a wearable blanket. In a Pediatrics report, CDC scientists and colleagues found that infant suffocation deaths during sleep were most frequently due to soft bedding, such as blankets and pillows.

What is SIDS?

• "SIDS" stands for Sudden Infant Death Syndrome.
• Sudden, unexplained death of an infant less than 1 year old.

What should I know about SIDS?

• Babies sleep safer on their backs.
• Babies should be placed on a firm sleep surface.

What can I do to lower my baby's risk of SIDS?

• Babies should be put on their backs to sleep for nap and at night.
• Keep toys, objects, and loose bedding out of your baby's sleep area.
• Do not allow smoking around your baby.
• Do not allow your baby to overheat during sleeping.

What about "tummy time"?

• Daily tummy time is necessary for normal development.
• Make sure your baby spends several hours on their tummy when they are awake and someone is watching.

Preterm birth can happen to anyone and many women who have a premature birth have no known risk factors. There are things, however, a woman can do to help your own health and lower the risk of having a premature baby.

• Quit smoking and avoid substances, such as alcohol or drugs.
• See your health care provider for a medical checkup before pregnancy.
• Work with your health care provider to control diseases, such as high blood pressure or diabetes.
• Get prenatal care early, as soon as you think you may be pregnant, and throughout the pregnancy.
• Discuss concerns during pregnancy with your health care provider, and seek medical attention for any warning signs or symptoms of preterm labor.

Birth is a complex but, fortunately, the outcome for most women is a full-term, healthy baby. More research still is needed to understand the risk factors for premature birth, such as how family history, genetics, lifestyle and environment may interact to put some women at greater risk for a premature delivery.