Special Problems for Premature Infants

All newborn infants experience some stress when they go from their weightless, comfortable, quiet, dark, warm, nutritional and undemanding intrauterine environment into the loud, bright, sterile, gravitational extrauterine environment after their birth. Premature infants have an especially hard time dealing with the transition from their intrauterine environment into the world because they many times aren't yet adapted or able to live outside of the womb. Many preterm infants cannot yet breathe on their own, feed on their own, regulate their body temperature, their movements, or their autonomic responses to stimuli. Neonatal Intensive Care Units (NICUs) are designed to meet the medical needs of these infants by providing oxygen (either through nasal tubes or ventilator), gastric tubes, incubators, and restraints to keep infants from pulling out their necessary equipment. Premature infants also have many other potential medical problems associated with being immature (such as apnea and bradycardia), and thus may require other treatments or medicines. Apnea can cause a decrease in blood flow, a decrease oxygen concentration, and central nervous system depression (Parentsoup). All of the medical interventions required for keeping premature infants alive can cause a very stressful environment for the infants (Goldson 1999). NICUs tend to have high noise levels comparable to that produced by traffic when standing on a street corner (book 7). The constant noise exposure can lead to sensory hearing loss and abnormal hearing development (Goldson 1999). Premature infants are also exposed to very high levels of light, especially those who receive light treatment for disorders such as jaundice (Goldson 1999). Most of the interactions NICU infants have with people involve medical procedures, which are often painful, and there is little cuddling or social interaction. The typical NICU environment leads to high stress levels in premature infants (Goldson 1999). Also, the stressful NICU environment has been shown to influence arterial oxygen saturation and contribute to the development of chronic lung disease (Als et al. 1994). Also, researchers are concerned how premature infants vision and hearing sensory systems are immature and the bombardment of light and noise may inhibit developing pathways and interfere with full differentiation (Als et al. 1994).