Compared with full-term newborns, preterm babies have different care needs and require special nursing approaches. Their organs are not fully developed, and they are less able to adapt to the outside environment, so preterm infant care often demands more careful and continuous attention. This article will highlight the key physiological characteristics of preterm newborns and outline the main nursing considerations, helping readers gain a clear and practical understanding of preterm baby care.
What Is a Preterm Newborn?
Before discussing the key nursing considerations for preterm newborns, it is important to first understand what a preterm baby is and the main physiological characteristics that distinguish them from full-term infants.
Defining a Preterm Newborn:
1. Gestational Age Less Than 37 Weeks
A preterm newborn is generally defined as a baby born before 37 completed weeks of gestation, which is the most widely used and core criterion in clinical and nursing practice.
2. Further Classification by Gestational Age
To better assess care needs, preterm infants are often subdivided based on gestational age:
- Late Preterm: 34–36 weeks
- Moderate Preterm: 32–33 weeks
- Very Preterm: less than 32 weeks
- Extremely Preterm: less than 28 weeks
3. Birth Weight as a Supporting Indicator
While gestational age is the primary criterion for defining preterm newborns, birth weight is also an important reference in nursing assessment. Due to shortened intrauterine development, preterm babies usually have lower birth weights, with some meeting the criteria for low birth weight or extremely low birth weight.
Typical clinical reference ranges include:
- Low Birth Weight (LBW): less than 2,500 g
- Very Low Birth Weight (VLBW): less than 1,500 g
- Extremely Low Birth Weight (ELBW): less than 1,000 g
4. Signs of Immature Organ Systems
Preterm infants often show underdeveloped physiological functions, such as immature respiration, temperature regulation, digestion, and immune response, which are important for nursing assessment.
In practice, no single indicator can fully reflect the care needs of a preterm newborn. Nurses should consider gestational age, birth weight, and the development status of various organ systems together to make informed, targeted care decisions and develop individualized nursing plans.
Key Characteristics of Preterm Newborns
During late gestation (usually after 28 weeks), multiple organ systems undergo critical development and functional maturation, including the lungs, nervous system, digestive system, and immune system. If a baby is born before this stage, these organs may not have fully developed, which not only affects the newborn’s ability to adapt to the external environment but also increases the complexity and challenges of nursing care.
Compared with full-term newborns, preterm infants show clear differences in appearance and physiological functions, which can be summarized as follows:
1. Smaller size and lower birth weight
Due to shortened intrauterine development, preterm newborns are generally smaller and weigh less than full-term infants, with lower subcutaneous fat stores. As a result, they are more prone to unstable body temperature and often require care in an incubator or other controlled environment to maintain warmth and reduce energy loss.
2. Thin and fragile skin
The skin of preterm infants is underdeveloped, thin, and more transparent, with incomplete subcutaneous tissue and stratum corneum. Their delicate skin is easily damaged by friction, adhesive materials, or frequent handling, and they are more susceptible to moisture loss and infection.
3. Low muscle tone and limited activity
Preterm infants often have reduced muscle tone and limited limb activity, with poor posture control. This creates nursing challenges, including unstable positioning, increased risk of pressure on joints or skin, higher sensitivity to handling, and difficulties with coordinated sucking and swallowing during feeding.
4. Unstable respiratory function
Immature lungs and underdeveloped respiratory regulation make preterm infants prone to irregular breathing, apnea, or low oxygen saturation. Nursing staff need to continuously monitor respiratory rate, breathing patterns, and oxygen levels, and provide timely respiratory support or interventions as needed.
5. Feeding difficulties
The coordination of sucking, swallowing, and breathing is often underdeveloped, making feeding challenging. Depending on the infant’s maturity and clinical condition, different feeding methods may be required, such as oral feeding, nasogastric (NG) tube feeding, or other assisted feeding techniques.
6. Immature immune function
Preterm infants have an underdeveloped immune system and are more vulnerable to infections. Extra attention to sterile technique, hygiene, and environmental management is essential during nursing care.
Daily Care Considerations for Preterm Newborns
In daily care, preterm newborns require extra attention due to their fragile physiology. Key points include:
- Cleaning and skin care: Preterm babies have thin, delicate skin. Use gentle, non-irritating cleansers, avoid excessive rubbing, and keep the skin dry. Change diapers or wipes promptly to reduce irritation and the risk of infection.
- Bathing: Keep bath water temperature around 36–37°C and keep baths short to prevent heat loss. Handle the baby gently, supporting the neck and limbs at all times.
- Feeding: Choose feeding methods according to the baby’s sucking and swallowing abilities, such as oral feeding, nasogastric (NG) tube feeding, or feeding with breast milk or formula. Keep the baby’s head slightly elevated, allow proper intervals between feeds, and watch for spit-up or choking.
- Temperature maintenance: If the baby is not in an incubator, keep the room comfortably warm, dress the baby in appropriately snug clothing or wraps, and regularly check hands, feet, and skin color.
- Environment management: Maintain a quiet, warm, and humidified care area. Reduce bright lights and loud noises to help the baby rest peacefully.
- Gentle handling: Daily tasks such as holding, changing clothes, or measuring vital signs should be done with gentle movements to avoid startling the baby, always supporting the neck and spine.
The overall principle is to provide care that is gentle, gradual, and attentive. Safe and comfortable handling helps preterm infants adapt to the outside environment and supports healthy growth and development.
How to Practice Preterm Newborn Care Steps
To help nurses become familiar with the daily care routines of preterm newborns and improve their practical skills, Medarchitect provides professional preterm infant nursing models and training tools. By simulating real-life care scenarios, learners can safely practice various procedures—from cleaning, bathing, and temperature maintenance to feeding and positioning—while mastering gentle handling, environmental management, and individualized care techniques.
1. 24-Week Preterm Newborn Care Model: approximately 25 cm long and weighs around 350 g, closely matching the size and proportions of a real 22 to 24-week preterm infant. It features realistic oral and nasal structures, allowing learners to practice both oral feeding and nasogastric (NG) tube feeding safely and effectively.
2. 30-Week Preterm Newborn Care Model: approximately 38 cm long and weighs around 1.2 kg, closely reflecting the size of a real 28-32 week preterm infant. It is designed for practicing daily care procedures, including cleaning, bathing, temperature maintenance, feeding, and positioning, helping nurses gain hands-on experience and build confidence in preterm newborn care.
▶️Explore More Newborn Nursing Care Models→
Conclusion
Caring for preterm newborns is challenging. For nurses, every gentle touch and patient feeding is an act of care and support for these tiny lives. Although the process is complex and requires close attention, through structured learning, hands-on practice, and the use of professional nursing models, caregivers can gradually build confidence and skill, providing safe, warm, and individualized care for preterm infants. This is not only a development of technical ability but also a careful and heartfelt commitment to protecting life.
