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Ages & Stages

Health Issues of Premature Babies

Because premature babies are born before they are physically ready to leave the womb, they often face some health problems. These newborns have higher rates of disabilities such as cerebral palsy, for example, and face lower rates of survival.

That's why premature babies are given extra medical attention and assistance immediately after delivery. Depending on how premature your baby is, your pediatrician or obstetrician may call in a neonatologist (a pediatrician who specializes in the care of premature or very ill babies). They can help determine what, if any, special treatment your newborn needs to help them thrive.

Here are some of the most common health conditions in premature infants:

Respiratory distress syndrome (RDS)

  • What it is: RDS is a breathing disorder related to the baby's immature lungs. It occurs because the lungs of preterm babies often lack surfactant, a liquid substance that allows the lungs to remain expanded.

  • Treatment: Artificial surfactants can be used to treat these babies. In addition, a ventilator or CPAP machine can help them breathe better and maintain adequate oxygen levels in their blood. Sometimes, extremely preterm babies may need long term oxygen treatment; occasionally, they may go home on supportive oxygen therapy. See When Baby Needs Oxygen At Home for more information.

Bronchopulmonary dysplasia (BPD)

  • What it is: BPD, or chronic lung disease, is a term used to describe babies who require oxygen for several weeks or months. They tend to outgrow this uncommon condition, which varies in severity, as their lungs grow and mature.

Apnea and bradycardia

  • What it is: Apnea is a temporary pause (more than 20 seconds) in breathing that is common in preterm infants. It often is associated with a decline in the heart rate, called bradycardia, and desaturation, which is a decline in the amount of oxygen in the blood. Apnea, bradycardia and desaturations are monitored by pulse oximetry. Most infants outgrow the condition by the time they leave the hospital.

Retinopathy of prematurity (ROP)

  • What it is: ROP is an eye disease in which the retinas are not fully developed.

  • Treatment: Most cases of ROP resolve on their own. However, serious cases may need treatment, which may include laser surgery and/or injections of medication. Your infant may be examined by a pediatric ophthalmologist or retina specialist to diagnose any problems and, if needed, recommend treatment.

Intraventricular hemorrhage (IVH)

  • What it is: IVH is bleeding inside or around the ventricles, the spaces in the brain containing cerebrospinal fluid. IVH is most common in premature babies, especially very-low-birth-weight babies (less than 3 pounds, 5 ounces, or 1,500 grams). Bleeding can happen, since blood vessels in a premature baby's brain are very fragile and immature. They can rupture easily. Nearly all IVH occurs within the first week after birth.

  • Treatment: Grades 1 and 2 IVH are most common, and often there are no further complications. Grades 3 and 4 are more serious and can result in long-term brain injury. Hydrocephalus (too much cerebral spinal fluid in the brain) may develop after severe IVH. There is no specific treatment for IVH, except to treat any other health problems that may worsen the condition.

Necrotizing enterocolitis (NEC)

  • What it is: NEC is the most common and serious intestinal disease among premature babies. It happens when tissue in the small or large intestine is injured or inflamed, which can lead to death of tissue. In rare cases, a hole (perforation) can form in the intestinal wall. Most cases of NEC occur in babies born before 32 weeks gestation. NEC usually develops within the first two to four weeks after birth. Signs include trouble feeding and a swollen belly.

  • Treatment: Treatment for NEC involves stopping feedings for five to seven days and giving antibiotics. If it is severe, surgery may be needed. Breast milk is the single most effect way to prevent NEC in preterm infants.


  • What it is: Jaundice happens when a chemical called bilirubin builds up in the baby's blood. As a result, the skin may develop a yellowish color. Jaundice can occur in babies of any race or color.

  • Treatment: Treating jaundice involves placing the undressed baby under special lights (while their eyes are covered to protect them).

Other health problems in premature babies

Other conditions sometimes seen in preterm babies include anemia of prematurity (a low red blood cell count) and heart murmurs.

Do some premature babies face higher health risks than others?

African Americans and Native Americans have the highest newborn death rate associated with prematurity. Also, in general, male premature infants have poorer health outcomes than female infants.


Talk with your child's doctor if you have any concerns about the health of your premature baby.

More information

Last Updated
Adapted from Caring for Your Baby and Young Child: Birth to Age 5 7th Edition (Copyright © 2019 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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