if you are nearly full-term why would you need a NICU?

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A new report in My Health News Daily makes us aware of the risks to infants who are born "almost" full term, or between 34 and 36 weeks.

Many of these infants appear normal,  are treated in a regular nursery, and are often sent home on the second day of life, like  normal  full-term  newborns.

However, in the study referred to in the link above, by Dr. Ramzin Shahid showed that these infants demonstrated an increased risk of requiring subsequent hospital admissions, due to breathing problems or jaundice, than their full-term counter parts. In addition, if a baby born at 36 weeks was cared for in a NICU, he or she was  less likely to have subsequent problems leading to re-hospitalization, than if that infant had been cared for and discharged from a "regular" nursery.

In fact, the risk of subsequent hospitalization is 3-times as great for those treated in a normal newborn nursery, and 2.8 times as great if a late preterm infant discharged prior to the age of 48 hours. Infants that are not quite full term have issues controling their breathing well, they may be poor feeders, and require close observation especially if breast feeding, they have trouble controlling their temperature, and are at higher risk of needing treatment for jaundice if they develop that.

So, there are several take home messages here:

One--if you happen to give birth slightly early( between 34 and 36 weeks gestation), ask your doctor to provide the extra care that might be necessary for your baby, and don't pressure the doctor to let you take the baby home on day 2. Wait until he or she is over 48 hours of life.

Two--don't be surprised OR DISAPPOINTED if your doctor moves the baby to the neonatal intensive care unit (NICU) for closer monitoring. It doesn't mean your baby is critically ill, but might just save you and the baby from having a scary few hours at home, before you have to come back due to an unforseen problem that is part of the infant's immaturity.

The more observation that is accomplished in the first few days, the less the chance that a major problem will be missed requiring emergency treatment later.

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About Dr. Ackerman

Alice Ackerman, MD, MBA, FAAP, FCCM is the Chair of the Department of Pediatrics at Carilion Clinic and Professor and Founding Chair of Pediatrics at the Virginia Tech Carilion School of Medicine. Dr. Ackerman is recognized nationally as an expert in pediatric critical care.

She has been at Carilion Clinic since June of 2007. Her primary goals are to enhance the health care of children in the Roanoke Valley and Southwest Virginia, and is actively working to do this both as physician in chief of the children's hospital, as well as through involvement with many state-wide initiatives.

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