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What are the major complications for premature babies?

Premature baby in hospitalPremature births can lead to complications and in such a tiny, fragile person, it’s extremely important that every precaution is taken.

If you have a baby in the Neonatal Intensive Care Unit (NICU) or Special Care Nursery (SCN), these are some of the potential medical complications for premature babies that their medical team will be looking out for.

What are some of the major complications for premature babies?


A premature baby’s immune system is very compromised which puts them at a higher risk of getting an infection. The most effective way of preventing infection is hand washing. This means that anyone visiting preterm babies will need to wash their hands or use hand sanitiser when they enter the NICU or SCN and whenever they touch the baby.


Many premature babies suffer from jaundice. Treatment involves babies put under a special blue light called phototherapy.

Breathing Problems

Respiratory Distress Syndrome (RDS): This is when babies have difficulty breathing due to a lack of an agent in the lungs called surfactant.  Treatment may include the use of a  respirator (ventilator) and continuous positive airway pressure (CPAP)

Chronic Lung Disease: This occurs when a baby’s lungs start to deteriorate. This is most common in babies who have had prolonged use of a ventilator as their lungs are still immature and sometimes the constant pressure of the ventilator can cause damage to their lungs.


Due to complications arising out of respiratory issues, pneumonia can occur. Pneumonia can result in not enough oxygen reaching the body. Treatments includes antibiotics as well as supplemental oxygen and intubation. If this is left untreated, it can evolve into a deadly infection or lead to sepsis or meningitis.

Apnoea and Bradycardia

Apnoea is when the baby stops breathing temporarily. Bradycardia is the sudden drop of heart rate to an abnormally low level of less than 100 beats a minute. Normal foetal heart rate is 120-160.

An alarm will normally sound if a baby is experiencing either an apnoea or bradycardia. Some babies will start breathing or bring their heart rate back up on their own however other may need a light tap or rub on the back to remind the baby to start breathing or bring the heart rate up.

Intraventricular haemorrhage (IVH)

Babies born at less than 34 weeks have an increased risk of bleeding in their brain. This happens because immature blood vessels may not tolerate the changes in circulation that take place during labour or in the first few days of life. This can lead to complications like cerebral palsy, intellectual disabilities and learning difficulties.

Inability to maintain body heat

Premature babies have very little body fat and immature skin which makes it difficult for them to maintain their body heat. Consequently, they are placed in an incubator/humidicrib until they are able to regulate their body temperature themselves.

Immature gastrointestinal and digestive system

A premature baby’s gastrointestinal systems is too immature to digest nutrients safely.  Initially, they may be fed through an intravenous (IV) drip. They will also be fed through a tube that goes into their stomach until they are ready to suck and swallow.


This is caused by abnormally low concentration of red blood cells. Premature babies are at a high risk of having low levels and are therefore more susceptible to anemia than babies born at term. If the anemia is severe, treatment involves blood transfusion.

Patent Ductus Arteriosus (PDA)

This is a congenital heart defect whereby the baby’s ductus arteriosus (open blood vessel) fails to close after birth. Treatment involves a medication that stops or slows the production of prostaglandin E (a chemical compound that helps keep the ductus arteriosus open). In serious cases surgery may be required.

Retinopathy of Prematurity (ROP)

This is a disease that can cause blindness in premature babies. There are many different stages and treatments dependent on how severe it is.

Necrotizing Enterocolitis (NEC)

This happens when a part of the baby’s intestine develops poor blood flow which can lead to infections in the bowel. Treatment includes IV feeding and antibiotics, and in serious cases, sometimes surgery.


This is a medical condition in which bacteria enters the blood stream. Sepsis often brings infection to the lungs and therefore can lead to pneumonia. Treatment involves antibiotics.

Visit our Premmie Baby Information Hub for more article, support and resources for parents of premature babies.

-written with information from representatives of the National Premmie Foundation

SUPPORT: Get support from others in our online Premmie Baby Support section in our forum.

 The content in this article should be used as a guide only. If you experience any health-related concerns you should contact your local healthcare provider or nearest emergency department.

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