Having a baby between 34 and 37 weeks in pregnancy is referred to as late preterm. While a baby born at this time is not as likely to have problems as the earlier preterm babies, they have not reached full maturity, which happens between 37 and 40 weeks. Around 7% of babies are born late preterm. These babies may also be called “near term” and they account for 71% of all premature births (premature births are those occurring before 37 weeks in pregnancy).

Sometimes it is unavoidable that a baby needs to be born early due to a pregnancy complication. Parents can be reassured that their baby will receive excellent care and that most of these babies will be fine. It can be very helpful to know what to expect and what questions to ask if you are faced with this situation.

Babies born between 34 and 37 weeks may look healthy and can usually breathe on their own, giving the impression that they are full term. However they are still developing many of their systems that help them to adjust to life outside the uterus. They are more likely to spend extra time in the nursery or newborn intensive care unit (NICU) because they may have problems from being born early. Even if they do not require NICU care, they do need special considerations.

• Late preterm babies may have feeding problems. They often eat less at a feeding, and may have more trouble coordinating sucking and swallowing. They have more reflux (a painful condition where stomach contents go back up into the esophagus). They may be sleepier and are often difficult to wake for feedings.
• Late preterm babies are also more likely to have breathing problems following birth and later are more likely to catch RSV, a virus that can lead to pneumonia and other respiratory difficulties.
• They may have a more difficult time keeping their body temperature up because they have less body fat. They may also have more immature immune systems and should be watched more closely for infections.
• Late preterm babies develop jaundice more often than full term babies do. In jaundice, the skin turns yellow from the bilirubin count in the blood. It is a serious condition which must be watched closely and sometimes treated if the bilirubin count in the blood gets too high. This is determined by a blood test. Jaundice may lead to an extra day or two in the hospital to treat, or the need to treat at home.
• These babies have blood sugar problems (hypoglycemia) more often than full-term babies.

Parents should be aware of these concerns and talk to their baby’s doctor or nurse practitioner about how to care for their child. It may be recommended that the baby be seen within a few days after going home.

Feeding Concerns

Breastfeeding is especially important because it protects against infection and breastmilk is more easily digested. Since a late preterm baby may not nurse often or vigorously, the mother may want to also use a breast pump to stimulate the breast to increase milk production until the baby is nursing more vigorously. Breastfeeding support from experts is very helpful. The baby may also need to be awakened to eat in the early days or weeks.

Some things parents can do to protect their late preterm infant

Each child is unique and may have special needs. Discuss these with your baby’s doctor or nurse practitioner.

• If sleepy, wake the baby for feedings, feed the baby frequently, burping often during the feeding.
• Avoid smokers and anyone who is sick who may spread germs to your baby.
• Keep your baby warm.
• Use skin-to-skin contact (kangaroo care).
• Speak with lactation specialists to help with breastfeeding success.
• As with all newborn babies, place your baby on his or her back for sleep.

Sources:

ACOG Today, September, 2008

BBC News, “Warning of near-term birth risk”, 2004. Accessed at http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/3528056.stm.

Berman, Jenn. “Near Term babies Need More Care. What parents need to know about their near term infants.” Accessed at www.familymagazinegroup.com.

March of Dimes, “Late Preterm Birth: Every Week Matters” Medical Perspectives on Prematurity. March 2006.

Wang, et al. “Clinical Outcomes of Near-Term Infants”. Pediatrics Vol. 114 No. 2 August 2004.