Premature Infant and Newborn

Question 1

What are the Respiratory changes after birth?

Answer 1

Foetal fluid removed
Lungs filled with air
Surfactant released
Gas exchange

Question 2

What are the other main changes?

Answer 2

Control of own movements
Independent hormonal responses
Thermoregulation
Feeding
Immunocompetence
Conversion to adult Hb

Question 3

What are the Cardiovascular changes after birth?

Answer 3

Closure of foetal circulation
Blood flow resistance of BV increases
Increased O2 in lungs causes decreased bloodflow resistance to lungs, Perfusion of the lungs, Fall in pulmonary artery pressure, Increase in systemic blood pressure, Increase in cardiac output, Foetal lung fluid removed

Question 4

What are the maternal benefits of breast feeding?

Answer 4

1) Reduce cancer risk
2) Improved health with less problems
Delays fertility, more ecological, less food/medical expense

Question 5

What are the foetal benefits of breast feeding?

Answer 5

1) Less infection: diarhooea, aom etc
2) Less immune driven/allergenic disease
3) Reduces risk of NEC
4) Reduces risk of SIDS
5) Reduced GORD
6) Higher IV
7) Better cognitive development
8) Lowrisk of childhood inguinal hernia

Question 6

What are the respiratory problems in premature?

Answer 6

Little/no:
1) Surfactant: Retained in T2 pneumocytes
2) Alveoli: Absent at 24 weeks then exponential increase towards term (Very common way of death)
- Lung damage worse by o2, sepsis and ventilation