Baby born 25 weeks

Table of Contents

What To Expect

If your baby was born between 25 and 28 weeks’ gestation, you’re probably thinking “how can my baby possibly be okay when s/he was born 4 months early?” While, obviously, this is not an ideal situation, the truth is that many babies born at this degree of extreme prematurity do survive and can have very good outcomes. You may have been threatening preterm delivery for several weeks, and the benefit to your baby of delivering after 25 weeks compared with before cannot be overstated! A recent study of outcomes in Canadian NICUs cites a survival rate of 82% for infants born at 26 weeks, compared with 54% if born at 24 weeks. The sacrifices you made to make it past 25 weeks were well worth it and you deserve to be commended!! Somehow, though, you don’t feel lucky. Your baby is hooked up to all these machines, and you can’t hold him/her, and your doctors are being noncommital. They tell you to expect a 3-4 month NICU stay with lots of ups and downs. What is going to happen?

The first few hours after birth

A lot of people were in the delivery room, and there was a lot of activity by your baby’s bedside. Your baby may be showing some spontaneous breathing, but is too small to breathe independently, so s/he most likely has a breathing tube either in his/her throat or in his/her nose. To minimize heat loss, s/he may have been placed inside a plastic bag. You only briefly got to see him/her – and couldn’t touch your baby – before taking your new son or daughter to the NICU. Your birthing support person went with your baby – and now it seems like a very long time since s/he’s come back. The medical team is very busy getting your baby stabilized and starting life-saving treatments. S/he is being placed on the breathing machine, and most likely receiving surfactant into his/her lungs if not given in the delivery room. Catheters may be inserted into the blood vessels in the umbilical cord, to allow for blood drawing, monitoring, and giving medications and nutrition. Your baby may be active and moving, and may not be requiring lots of support. This is called the “honeymoon,” which typically ends 12 – 48 hours after birth (see FAQs for further discussion). Your baby may need medication to keep his/her blood pressure up, may need a blood transfusion already, and may be receiving antibiotics to treat a possible infection, if your labor was spontaneous.

The neonatologists are watching your baby very closely, taking things hour-by-hour. This will change as your baby gets older.

The end of the first week

Your neonatologists are now looking at things day-by-day rather than hour-by-hour as before. Your baby may no longer be on the breathing machine, but rather may have a device on his/her nose/face that is blowing air into tiny lungs. Those catheters in the belly button may have been removed and replaced with a different kind of catheter called a PICC line or a PCVC (see FAQ’s for further information). This is where intravenous nutrition and medications are being delivered. You were probably asked about breastfeeding and, if you said yes, you have been pumping regularly. Finally you’re starting to get enough milk that you can collect it. Your baby may already be receiving tiny amounts of your breastmilk – or another specialized feeding substance – through a tube into his/her tummy. Your baby is losing weight, but your doctors say that’s a good thing. Things seem to be pretty good, and you start to relax a bit.

Second week of life (DOL 8 – 14)

When your baby is around one week old, or maybe a little sooner, s/he may have a head ultrasound performed. This ultrasound, not unlike the ultrasounds you may have had while you were pregnant, is a way of examining the basic structure of your baby’s brain without entering his/her body. Your doctors primarily are looking for signs of bleeding in the brain, called an intraventricular hemorrhage (IVH). (See Intraventricular hemorrhage in Diagnoses/Conditions for more information.) Extremely premature babies have very fragile blood vessels that can easily break and bleed, especially with rapid changes in blood pressure. When this happens to the blood vessels that line the ventricles of the brain, we may be able to see the blood clot on the ultrasound. If your baby has suffered an IVH, your doctors will talk to you about its significance and what to expect in the weeks to come. Many babies with IVH go on to develop without abnormalities and, conversely, some babies who never had IVH end up with brain abnormalities. In the second week of life – or later – your baby may also have an ultrasound of his/her heart to look for a patent ductus arteriosus (PDA). (See PDA in Diagnoses/Conditions for more information.) The ductus arteriosus is a blood vessel found in the fetus that is programmed to self-destruct within minutes to hours after birth at term. In babies born prematurely, that programmed destruction may not occur and – while essential for a fetus – may cause problems for a baby. Your doctors may decide it needs to be closed, or may decide to watch-and-wait. If you have questions about these decisions, be sure to ask your neonatologist.

Feeds should be increasing in volume into your baby’s tummy and less into his/her veins. It is more likely than last week that the breathing tube in his/her windpipe will have been removed and replaced with some sort of nasal device that is blowing air into his/her lungs. S/he should have stopped losing weight, and may actually be back to birthweight by now.

End of the first month

If things have gone well, your baby is now feeding entirely into his/her tummy, the breathing tube has been out of the windpipe for some time, and problems with IVH and/or PDA are either eliminated, or stable right now. You may be kangarooing regularly, and weight gain is steady. (Don’t forget to chronicle your baby’s journey, and chart his/her growth, in My NICU.) You may also be changing diapers, taking temperatures, and performing other baby-care tasks. If you’re having some trouble keeping your supply of breastmilk up, see “Breastfeeding” for helpful tips.

Second month of life

You’ve settled into a routine, and can really see how your baby has grown. Over the past few weeks, you may have had some scares, with your baby’s feeds being interrupted for a few days, and maybe hearing that s/he was “being evaluated for sepsis.” Your baby’s blood was drawn, maybe urine and spinal fluid too, and antibiotics (see “NICU Medications”) may have been given. It is not uncommon for babies in the NICU to acquire infection during their hospital stays, resulting from inability to fight infection as well as the invasive procedures and devices necessary to care for him/her. (Prevention of these infections is why your NICU has rules and procedures for handwashing and such.) Feeding on breastmilk decreases the likelihood of these infections. Your baby may have had quite a problem with his/her feeds, perhaps leading to the diagnosis of necrotizing enterocolitis (NEC). This condition occurs in babies most often around 30 – 32 weeks PMA who are receiving all their feeds into their tummies – more often with formula than breastmilk. (See NEC in Diagnoses/conditions for further information.) Babies with medical NEC may receive antibiotics for a week or two, and have a period of bowel rest; in more severe cases, the intestine can develop a hole, causing serious infection and requiring surgery (known as surgical NEC). Some cases of surgical NEC can result in long-term complications and, in the most severe cases, can be life-threatening. No one knows for sure what causes NEC; breastmilk has been shown to decrease (but not eliminate) the risk of developing it. If your baby has surgical NEC, have frequent conversations with your baby’s neonatologist and surgeon about the short and long term plans.

When your baby is two months old (DOL #60), it’s time for his/her first set of baby shots. Immunizations are the only milestone that uses chronologic age for scheduling (see “How Old is My Baby?). The American Academy of Pediatrics (AAP) recommends a comprehensive schedule of immunizations in the first 12 -15 months of life to adequately protect infants and children from life-threatening infections.

PMA 34 wks and beyond

By now, hopefully, your baby is “feeding and growing.” S/he may have moved to another spot in the NICU, sometimes called the “convalescent” nursery or “special care” nursery. Weight gain is steady, most of the tubes and lines have been removed, and your baby may now be in an open crib rather than in an incubator. S/he may be wearing “baby clothes” and starting to feed from a bottle. S/he may still require a little bit of oxygen delivered through a nasal cannula, and may still be having apnea/bradycardia/desaturation spells. (See “Apnea of Prematurity” in Diagnoses/Conditions.) Now is when it gets really hard. Why can’t you take your baby home? All s/he really needs to do is eat better, and, if only the nurses would try more often, your baby would get it. Your NICU team understands you are impatient. Everyone wants your baby to get home the moment s/he is ready – not one moment later, but not one moment sooner, either. (See “When Can I Take My Baby Home?) A baby without complications will be ready for discharge home when s/he can do all the things a term baby can do. These skills come through brain development, not by practice. Nature says it takes 266 days from conception for a baby to fully develop – that’s how your due date was determined. For babies born prematurely, our hope is that development occurs at the same rate as if the pregnancy had continued. We can slow it down, but we can’t do too much to speed it up. Some babies are ready for discharge as early as 36 – 37 weeks PMA, but we can’t predict which ones. Keep your due date in mind as your target for discharge, and keep an open dialogue with your neonatologists about discharge plans.

A preterm birth is one that happens before 37 completed weeks of pregnancy.

The World Health Organisation gives the following definitions for the different stages of preterm birth:

  • Extremely preterm: before 28 weeks
  • Very preterm: from 28 to 32 weeks
  • Moderate to late preterm: from 32 to 37 weeks.

General UK premature birth statistics

  • Around 7% of births in the UK are preterm. That is 60,000 babies each year
  • This is higher than many countries in Europe and higher than Cuba, Ecuador and Iraq

Of the births that were preterm in the UK:

  • 5% were extremely preterm (before 28 weeks)
  • 11% were very preterm (between 28 and 32 weeks)
  • 85% were moderately preterm (between 32 and 37 weeks).

Chances of survival following preterm birth

Medical advances mean that we are getting better at treating preterm babies but the chances of survival still depend on gestational age (week of pregnancy) at time of birth.

  • Less than 22 weeks is close to zero chance of survival
  • 22 weeks is around 10%
  • 24 weeks is around 60%
  • 27 weeks is around 89%
  • 31 weeks is around 95%
  • 34 weeks is equivalent to a baby born at full term.

Preterm birth and neonatal death

Complications arising from premature birth is the leading cause of neonatal death (death in the first few weeks after birth) in the UK.

Preterm birth and multiple pregnancies

Having more than one baby is a risk factor for preterm birth. On average, most singleton pregnancies last 39 weeks, twin pregnancies 37 weeks and triplets 33 weeks.

  • Risk of prematurity with singleton pregnancy: 7%
  • Risk of prematurity with multiple pregnancy: 57%

Risk of disability in preterm children

Generally, the earlier the birth, the higher the risk of problems. However these are only statistics and cannot predict how an individual child will do; some extremely premature babies do very well and develop into healthy children.

  • 1 in 10 of all premature babies will have a permanent disability such as lung disease, cerebral palsy, blindness or deafness.
  • 1 in 2 of premature babies born before 26 weeks of gestation will have some sort of disability (this includes mild disability such as requiring glasses).

In one study of 241 children born before 26 weeks’ gestation the following was found:

  • 22% severe disability (eg cerebral palsy + not walking, low cognitive scores, blindness, profound deafness)
  • 24% moderate disability (eg cerebral palsy + walking, IQ/cognitive scores in the special needs range, lesser degree of visual or hearing impairment)
  • 34% mild disability (defined as low IQ/cognitive score, squint, requiring glasses)
  • 20% no problems.

Preterm birth by ethnicity

The risk of preterm birth is highest for Black Caribbean women and lowest for White British and White Other.

  • Bangladeshi: 8%
  • Indian: 7%
  • Pakistani:7%
  • Black African: 8%
  • Black Caribbean: 10%
  • White British: 7%
  • White Other: 6%

Causes of preterm birth

In some cases a cause of preterm birth can be shown but more often it is unknown or unclear.

In 1 in 4 preterm births, the birth is planned (induced labour or c-section) to save the life of mother or baby from pregnancy complications such as pre-eclampsia, fetal growth restriction, waters breaking early (PPROM) or infection

Preventing premature birth

Too often health professionals are not able to tell women why they have had a premature birth. This area of research is underfunded, with many taking an unhelpful (and unique to pregnancy) approach of ‘It was not meant to be’.

Research into why premature birth happens is the only way we can save lives and prevent future loss. Tommy’s funds more than £400k of research into premature birth every year. We are focused on predicting early which women will have a premature birth and treating them to prevent it happening.

Read about our research into prematurity here.

Viability of extremely premature babies

‘As a society we need to ensure we have the frameworks in place to provide the long-term care and support these children may need,’ Clare Murphy, director of external affairs at British Pregnancy Advisory Service, told the Telegraph. ‘It’s disappointing that those who are so keen to use the survival of these very premature infants to call for reform of abortion, often seem reluctant to expend the same energy on improving the lives of these babies as they grow up.’

8) What are the implications of improvements in the survival of extremely premature babies for the law on abortion?
Many countries, Britain included, impose legal ‘time limits’ on the gestation at which a fetus can be legally aborted. In Britain, this limit is 24 weeks: unless a serious fetal anomaly has been detected, or unless there is a risk of ‘grave permanent injury’ to the physical or mental health of the pregnant woman, or to her life, in which case it is available up to term.

The argument that is often used to justify the 24-week limit is that this is the point at which a fetus becomes ‘viable’; therefore, it is treated by law more as a baby than a fetus. Ninety-nine per cent of all abortions in England and Wales take place at under 20 weeks’ gestation.

There are a number of problems with using ideas about viability as an argument against abortion.
First, as noted above, the situation of a woman going into premature labour with a wanted pregnancy, and that of a woman needing an abortion in the second trimester, are very different. By the same token, the status of a baby spontaneously arriving too early, and the status of a pregnancy that a woman is still carrying, are very different: legally, morally, and emotionally.

The reasons why women need late abortions, and the other arguments marshalled against late abortion, is discussed in a separate briefing. With regard to often-made media claims that the improved survival of extremely pre-term infants raises questions about the legal time limit for abortion, we should be clear that this is a politically-motivated argument that exploits our very human desire that very premature babies survive and thrive to make us equate abortion with ‘killing’ born babies.

Yet as the Guardian’s Polly Toynbee wrote on 1 September 2014, ‘The date at which a fetus might be viable has nothing to do with a woman’s right to choose. Some day an embryo might be reared in a test tube to full term, but that changes nothing for a woman’s right not to be a mother.’ She continues:
‘One in three women will have an abortion by the age of 45. Accidental pregnancy or change in circumstance once pregnant crosses all classes. Abortion is very, very ordinary and a mark of civilisation – liberty for women and every child wanted. YouGov finds only 7% want abortion banned: these calls for pushing back the date are just a way for pro-lifers to inch towards abolition week by week. In the process, they would deny abortion to the most desperate cases who leave it the latest – the very young or the middle aged who thought they had gone through the menopause.’

The callous politicisation of improvements in the survival of extremely premature babies is damaging to women who need abortions in the second trimester of pregnancy. It is also damaging to the discussion about how we, as a society, best care for very premature infants. By talking up the extent to which survival of very premature babies has improved, and glossing over the actual statistics and the problems that these babies are likely to face, parents of extremely premature babies can be provided with false hope. Other factors that can affect the survival of very pre-term infants are often ignored.
‘It is really because of the abortion debate that we have got so fixated by weeks when it comes to premature babies, and the shame about this study is that it didn’t move beyond that,’ said John Wyatt, professor of Ethics & Perinatology at University College London, commenting on the study by Swamy et al. in 2010:

‘What we really need to start looking at is weight, sex, whether it is singleton pregnancy and whether steroids have been given. A girl is much more likely to survive than a boy, for instance, and the heavier the better. If we can give parents an individualised chance of survival, we really would be getting somewhere.’

John Wyatt is well known for his opposition to abortion – yet he recognises that collapsing together the issues of premature babies and abortion time limits profoundly distorts the terms of the discussions that we need to be having. Meanwhile, those who wish to restrict women’s access to abortion in the second trimester of pregnancy need to ask themselves one simple question. Why would a woman have an abortion at 22 or 23 weeks, if she didn’t really need one?

Once Alba was stabilised they rushed her off to the neonatal unit.

Rebecca said: “As they were leaving, one of the doctors said to me, ‘Do you want to look at her?’

14 When they were born, Alba was incubated as she was struggling to breathe Hugo had a nose tube to help him breathe

I turned my head to look at her and I think I expected to see a little alien. She was a baby, but she was so teeny tiny. All I could see was her head. Her body was in a clear plastic bag to keep her warm and she had a little knitted hat on. She had a perfect face.

“I was told they were going to try and find beds at Leeds General Infirmary for all of us.

“Alba went over first. They came back for Hugo but as they got him into the ambulance his heart rate dropped and the oxygen levels in his blood were dangerously low. They had to ask Alex to leave the ambulance while they got him breathing again.

“They took him back to the neonatal ward at St James’ where he was given a blood transfusion. He was incubated at that point as he was struggling to breathe.

“I was able to go and see Hugo on the neonatal ward before they moved him. It was a strange feeling. I didn’t look at him and think he was mine. I felt so detached from them both.”

14 Alba, pictured, was popped in a sandwich bag post-birth – this replicates the heat of a womb

Hugo was then successfully transferred to Leeds General Infirmary, and Rebecca was moved four hours later.

Rebecca said: “In the intensive care unit they were both so still and tiny. You can put your hand into the incubator. The nurses encourage you to change their nappies and touch them.

“The doctor who spoke to us was very realistic about their chances. He said every hour counts and that the first 12 hours were crucial. If they survived that they had a better chance of surviving 24 hours, 48 hours and so on.

“Alba was doing well. Within 24 hours she was off the ventilator, Hugo was the weaker of the two. I spent five days in the hospital then I went home. But I went back to visit every day. The early days were so hard. I didn’t have any hope. I was constantly preparing for the worst.”

14 Pictured while pregnant, Rebecca was excited about giving Bella a sister

She continued: “At five weeks old, Hugo had a heart operation to repair a duct in the heart. It was a few weeks before he was taken off a ventilator and about 10 days after that happened he deteriorated; he got an infection, so he was put back on the ventilator again.

“He had to go into isolation as he picked up a bug similar to MRSA. At one point we thought he might need a hernia operation, but fortunately he didn’t.”

But as days passed, the babies, now almost five months, grew stronger and healthier.

Incredibly Alba returned home in April at three months’ old and Hugo followed four weeks later.
Rebecca said: From the minute we brought Alba home she was a different baby. She was awake and alert. Hospitals are very sterile and there is little to stimulate them. All they did was sleep. Now Alba is smiling and laughing.

14 Rebecca, Alex and the twins nowCredit: Peter Powell

“Both came home on oxygen. Alba came off quickly but Hugo still has his. We have to carry the tanks around in the bottom of the pram. Hugo’s journey has been particularly tough, but he’s come out the other side as such a happy, healthy little boy. He is such a little fighter.

“Both babies still have regular appointments and we don’t know what health problems they will face as they grow older as a result of being born so early.

“But right now, we are just enjoying having them home. Big sister Bella is absolutely brilliant with the babies. She’s like a little mummy to them.

“It’s been an emotional roller coaster and there were times we thought we’d have to say goodbye to the twins. But now we are happy as can be.”

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A mum told how she saved her premature baby by drinking 15 pints of water a day, to replace fluids she had lost.

What causes premature births? How many weeks early can a baby be born and survive and what are the risks?

David Silva pays emotional tribute to Yaya Toure in video message while cradling son Mateo who was born prematurely

Born at barely 25 weeks, twins beat odds to survive

PUNE: For the parents of these “extremely premature” twins born at a city hospital on March 31, their journey from birth to home has been nothing short of a miracle.
The twins delivered through a C-section were born at 25 weeks, four months before the expected delivery date, and weighed only 600g and 620g at birth. They were severely underdeveloped with their eyes fused. Their skin was so fragile that it would tear on being touched.
However, advanced technology, trained and caring medical staff ensured that the twins survived the 90-day ordeal and returned home healthy.
“It was a huge challenge for the medical team. The babies weighed 1,810g and 1,786g at the time of discharge. This is the first case of extremely premature twins surviving and going home in Maharashtra,” said neonatologist Sachin Shah of Surya Mother and Child Care Superspeciality Hospital, Wakad.
The relieved parents recall the ordeal they had to go through even before the twins were conceived. After two failed pregnancies over the last seven years, the woman conceived the twins through in-vitro fertilisation (IVF). She was enrolled for antenatal care and was aware about twin fetuses. She was also aware about the possibility of delivering them prematurely.
However, after five-and-a-half months of pregnancy, she developed pregnancy-induced hypertension, medically termed as pre-eclampsia. The hypertension caused decreased flow of blood to the fetus. This complication forced doctors to deliver the babies prematurely at 25 weeks. “Handling 25 weeks’ singleton is simple, but twinning complicates the care and survival,” Shah said.
Immediately after birth, the twins were put on life support. Special catheters were attached through the umbilicus for 24×7 monitoring of blood pressure and administration of nutrition.
The journey ahead was full of highs and lows. There were victories like the babies going off the ventilator in 10 days. The small feeds and the ability to digest mother’s milk was next. And the twins seemed to be gaining weight to everyone’s relief. But there were also worrisome days when infections, feeding intolerance, jaundice, chronic lung disease or retinopathy of prematurity pushed one or the other twin back into intensive monitoring and respiratory support.
However, the medical staff and the parents worked relentlessly to nurture the twins to health. After 90 days of intensive care, the twins went home. The mother and grandmother were trained to handle preterm babies.
“Both boys are doing well at home. Amitaksh now weighs 3,000g while Ayaansh weighs 2,970g. They make eye contact, smile, respond and recognise people around,” said the mother, who holds a top government job.
When contacted, senior neonatologist L S Deshmukh, president of National Neonatology Forum (NNF), Maharashtra chapter, said, “This is perhaps the first case of preterm twins in Maharashtra that survived despite weighing so little at birth.” NNF is a pan-India body of neonatologists.

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Twin pregnancies are automatically higher risk than normal pregnancies. To put it simply, having twins increases the odds that something will go wrong during the pregnancy. But that doesn’t mean that moms with twins are doomed to have problems or need to suffer extreme stress worrying about how early can twins be born. Many twins are delivered without any major problems.

How Early Can Twins Be Born?

How early can you have twins? Twins can be born much earlier than a normal, singleton baby. It’s possible to deliver twins after less than 25 weeks of pregnancy. The earlier twins are born, the higher their risk of developing multiple health problems.

The best answer to the question “How early can twins be born?” is “extremely early.”

How early can twins be born and survive? Twins born at 25 weeks have a survival rate of at least 50%. This improves with each additional week of the twin pregnancy.

What’s a Typical Delivery Time for Twins?

When are twins born? The average twin is delivered after 36 weeks of gestation. Contrast that with the average for non-twins: 40 weeks. In other words, twins tend to be delivered a full month earlier than non-twins.

When are fraternal twins usually born? When are identical twins usually born? The average week twins are born is 36 regardless of whether they are identical or fraternal.

Our twin girls were delivered at 36 weeks but remember that your twin delivery will likely be different.

Your OB/GYN might tell you that the ideal time to deliver twins is a little earlier than the due date. This might come as a surprise, but keeping your twins until the actual due date could result in much larger babies and a lot more complications. You will be more at risk to have placental, labor-related, and delivery complications.

In addition, if your twins go full term, there will be no room left inside Mom. She will be miserable!

Are Twins Always Premature?

A premature birth is typically less than 37 weeks. Reports show that more than 60 percent of all twins are delivered prematurely, mostly after about 34 weeks.

(NOTE: Still expecting? Get weekly updates on your twin pregnancy here.)

If you give birth to twins before 32 weeks, your babies are more likely to have a low body weight and the potential for permanent disabilities. Here’s a great week-by-week summary of what to expect with premature babies.

Why Are Twins Born Early?

Twins are delivered earlier than non-twins largely because of decreased space in the womb. There simply isn’t enough room in most wombs for twins to grow to the size of normal babies before birth.

A lot depends on whether the twins are sharing the same placenta or each twin has its own placenta. Twins that share the same placenta are called monochorionic twins. Twins that do not share placentas are called dichorionic twins.

All monochorionic twins are identical twins and most dichorionic twins are fraternal twins. (A small fraction of dichorionic twins are also identical twins.)

Monochorionic twins have a much higher risk of having problems during pregnancy than dichorionic twins. They typically have shorter gestation times than dichorionic twins.

Monochorionic twins do not always share the placenta equally. Sometimes, like in the case of Twin-to-Twin Transfusion Syndrome one twin receives a lot more blood and oxygen than the other. Because babies that are dichorionic twins have their own placentas, they do not have any placenta-related blood flow problems.

Survival Rates

Survival rates for twins depend on how long their gestation period was and their birth weight. The longer the gestation period, the better the survival rates. The lower the birth weight, the worse the survival rates.

Roughly half of all twins can be classified as low birth weight, 5 lbs 7 oz (2,500 grams) or less. Survival rates for twins between 3 lbs 5 oz and 4 lbs 7 oz (1,500 to 2,000 grams) are quite good. They can be as high as 95%, surprising as this might seem.

(RELATED: Expecting twins? Avoid these 4 critical mistakes expectant twin parents make.)

On the other hand, survival rates for twins less than 2 lbs 3 oz (1,000 grams) are only 70%. That can be frightening to a lot of prospective parents.

Fortunately, the vast majority of twins have a birth weight greater than 2 lbs 3 oz when they are delivered. Most pregnant women do not need to worry about their twins being born with birth weights this low.

Maximizing Twins’ Chances

Women pregnant with twins that do their best to remain in excellent health during pregnancy are less likely to deliver early than pregnant women with poor health during pregnancy. In other words, the mother’s lifestyle can make a real difference.

Pregnant women can help their babies by avoiding smoking and alcohol. Smoking in particular greatly increases the risk of babies being born prematurely.

A healthy diet rich in fruits and vegetables also helps diminish the risk of complications with pregnancy. Pregnant women that follow a healthy lifestyle do not need to worry as much about how early can twins be born.

Be sure to consult with your physician for specific advice on your twin pregnancy.

Discuss Options

Since many twins are born prematurely, you should start discussing the birth options with your midwife or doctor during the early stages of pregnancy. Due to the riskier nature of your twin pregnancy and upcoming delivery, you’ll be having frequent visits to the obstetrician. During these visits, all the aspects related to your twin pregnancy, labor, and delivery will be monitored carefully.

Ask your doctor when is it safe to deliver twins based on your situation and health of both Mom and babies.

(NOTE: Still expecting? Get weekly updates on your twin pregnancy here.)

In many cases, twins have to spend time in the NICU. This is particularly true if your twins arrive very early. Even if the twins are delivered near full term, your babies might have to stay in the hospital a little longer than normal.

The bottom line is that it is impossible to predict if your twins will be born early. You need to prepare for that possibility and discuss your options with your medical provider.

While you can do the best you can during the pregnancy, don’t blame yourself if your twins are born early. It is normal for twins to arrive early and they may just do that regardless of mom’s health or best efforts.

Still wondering how to prepare for your twins? I cover specific things you should know and prepare for in my Dad’s Guide to Twins book. Learn more about the book here.

Picture by Jeremy Miles

Further Reading

Don’t forget to pick up a copy of the definitive guide to raising twins. “Dad’s Guide to Raising Twins” was written for fathers of twins to help guide you through the first several years with twins. .

25 Weeks Pregnant

You’re 25 weeks pregnant and it’s probably dawned on you that soon you’ll actually have to deliver this baby. That might be little scary, but it’s also exciting! What’s cool is that most hospitals will let you pre-register for delivery, which means you can fill out your admissions paperwork early so you don’t have to stand around filling out a bunch of forms while in the throes of labor.

How Big Is Baby at 25 Weeks?

Baby at 25 weeks is as big as a head of cauliflower, measuring 13.6 inches in length and weighing nearly 1.5 pounds.

25 Weeks Pregnant Is How Many Months?

25 weeks pregnant is five months and about two weeks pregnant.

25 Weeks Pregnant Symptoms

While you’re still feeling pretty energetic, you’re probably also starting to feel weighed down by your bigger-by-the-day baby. Your 25 weeks pregnant symptoms may include:

  • Trouble sleeping. Maybe you can’t sleep because you’re getting nervous about delivery, or maybe it’s your haywire hormones—or just your big belly getting in the way. Experiment with different strategies for getting some sleep. One idea is to drink extra water early in the day, so you can start tapering off your intake as you get closer to bedtime. That way, you might need fewer bathroom breaks during the night.
  • Frequent urination. Now that baby’s crowding your bladder, you’ve got to pee. A lot.
  • Constipation. Exercising (it’s as simple as taking regular walks), drinking lots of water, and eating plenty of fiber-rich foods can help you stay, well… regular.
  • Hemorrhoids. We can’t sympathize enough about these swollen varicose anal veins. Hemorrhoids are common in the second half of pregnancy because baby is putting a ton of pressure on your digestive tract. And the constipation certainly isn’t helping. Getting the constipation under control will help prevent straining while you go to the bathroom and hopefully will prevent future swelling and discomfort.
  • Gas and bloating. Your hormones are slowing down digestion, creating excess gas.
  • Heartburn. Add this to your list of tummy troubles. Baby is pushing on your digestive tract, which can, in turn, push stomach acid up your esophagus and cause painful burning. Most antacids should be safe during pregnancy (but always check with your doctor!) and also contain lots of calcium as an added bonus. Avoiding greasy and spicy foods can also help with heartburn, especially before bedtime.
  • Braxton Hicks contractions. Usually these little “practice contractions” show up around 28 weeks, but some moms-to-be notice them earlier than that. If you get them, you’ll notice your uterus get super hard and tight and then go back to normal. Luckily, Braxton Hicks contractions aren’t frequent and they don’t happen regularly. They’ll also go away if you switch positions. Real contractions, on the other hand, will happen repeatedly and will continue to get stronger and more frequent. If you’re worried your contractions are the real deal and not just practice, call the doctor right away. You could be going into preterm labor—some moms-to-be are more at risk for going into labor early, including those who are 25 weeks pregnant with twins—and sometimes preterm labor can be stopped if it’s caught early enough.

25 Weeks Pregnant Belly

You’ve probably gained about 15 to 18 pounds total so far. Are you 25 weeks pregnant with twins? For you it’s probably more like 25 to 40 pounds.

When you’re 25 weeks pregnant, weight gain can be a source of anxiety. We know, we know, we’ve been telling you to gain slowly and steadily, but it’s also really common for the number on your scale to jump around during this time in the second trimester. Part of that may be due to the amount of water weight pregnant women put on in mid-pregnancy. And realistically, gaining the exact same amount of weight each week just isn’t going to happen—there are naturally going to be some fluctuations—your doctor just wants you to make healthy weight gain a goal so you and baby stay as healthy as possible. (And also so your third trimester isn’t miserable because you’re carrying around a lot of extra weight!)

So don’t sweat a few extra pounds, and keep up with your healthy eating and exercise. If your weight gain really is a problem, your doctor will let you know. Instead of stressing too much about your weight, focus on what’s going on inside that 25 weeks pregnant belly.

Fetal movement at 25 weeks has become more noticeable—and you’re probably noticing some patterns. When you’re feeling lots of kicks, baby’s awake, and when you’re not, he or she is likely snoozing. Regular movement is a sign of a healthy, active baby. If you haven’t felt baby move in a while and you want some reassurance that everything’s okay, drink some ice water, play some music, or have your partner give you a light massage, and your little one might just wake up and give you a few jabs.

25 Weeks Pregnant Ultrasound

Baby’s enjoying his or her new sense of equilibrium—yep, your 25-week fetus is now learning which way is up and which is down. In the arena of 25 weeks fetal development, baby’s growing more fat and more hair too!

It’s not likely you’ll get an ultrasound at 25 weeks pregnant, unless your doctor has ordered extra monitoring for baby. You’ll see the OB once this month if you haven’t already. Starting at week 28, your visits will get bumped up to every two weeks.

ICYMI, the glucose challenge screening test will happen between weeks 24 and 28, so if you haven’t gone yet, make sure you have an appointment set. Your doctor may ask you to not eat for several hours beforehand (not so fun when you’re 25 weeks pregnant) and then drink a sugary solution. Your blood will be drawn to see how your body’s processing sugar. This test can rule out gestational diabetes or raise a red flag, in which case your doctor would order further testing.

Pregnancy Checklist at 25 Weeks Pregnant

Reminders for the week:

  • Rent on-trend maternity clothes
  • Jet off for a final trip!
  • Help your baby shower host

25 weeks pregnant: advice, symptoms and what to expect

At twenty-five weeks pregnant, some sleepless nights are in store and your baby’s fingerprints have appeared. Find out more about what your baby and body are doing and the common symptoms to look out for at 25 weeks pregnant.

How big is my baby at 25 weeks?

We’ve gone through a whole fridge of the foods your baby has resembled in size, but this week, she’s about the size of a swede. At about 13 and a half inches long and one and a half pounds heavy, she’s growing steadily.

What’s my baby doing at 25 weeks?

Your baby’s becoming prettier than ever: as the weeks go on, baby fat is developing, meaning the wrinkled skin she’s currently used to is smoothing out and she’s looking more like a newborn than ever. She’s even starting to grow some hair, too.

Your baby’s skin is also getting pinker as her capillaries form under the skin and fill with blood. Blood vessels will also develop this week in your baby’s lungs, bringing her ever closer to that first gulp of fresh air she’ll take after being born.

This week also marks the start of your baby’s nose and nostrils beginning to work, which allows your baby to begin taking practice breaths, breathing in amniotic fluid. She may even be able to smell things by this week too, although many babies can only experience this sense by the third trimester.

Your baby’s hands will develop creases in the palms this week (cute!), and soon sweat glands will form in her skin.

She’ll also have her own unique fingerprints: they’ll have started forming as early as eight weeks. Your baby will also be improving the dexterity in her hands and fingers, which means she’ll be able to grasp things in her fist and even play with her umbilical cord. She may also suck her thumb and play with her hands and feet. Just think, not long until she’s gripping your finger in that little fist!

11 common symptoms to look out for at 25 weeks pregnant:

1) Finding it hard to move around

Now that you’re getting bigger, it’s understandable that it’s more of an effort to move around. Chat with your doctor about which types of exercise are safe, but make sure you’re following a few rules: don’t work out when you’re tired, and stop immediately if you feel pain, shortness of breath or dizziness. Don’t lie flat on your back and try to avoid contact sports.

2) Heartburn

You know the deal by now, your baby is pushing against your digestive tract which can cause stomach acid to come up in your throat. Avoid any foods that trigger it and check with your doctor about using antacids.

3) Bloating and gas

Your hormones are still slowing down your digestion and causing this pesky symptom. This is coupled with the fact you really are puffing up and bloating as you and your baby grow.

4) Insomnia

Some women find it difficult to sleep once they’ve entered by the second trimester. This can be down to hormones, your uncomfortable growing body or your general nerves about the pregnancy. Turn off your devices by 8pm to prevent the bluelight keeping you wide awake and ensure your bedroom is properly dark. If you’re struggling, getting up and having a walk around the house is better than lying in the same spot getting more and more frustrated.

5) Restless legs

15% of women experience the peculiar effects of RLS, which include a tingling feeling in your feet and legs, along with an urge to move them. Experts aren’t sure what causes it, but many women are helped by different methods, such as acupuncture, a warm bath or eating iron-rich foods.

6) Constipation

This is something that women struggle with the whole way through pregnancy. Exercise lightly to get things moving, eat healthy fibrous foods and keep drinking water!

7) Haemorrhoids/piles

These have been a common symptom over the last few weeks. We really understand that these can be one of the worst, most annoying and embarrassing symptoms. The oh-so-unwelcome haemorrhoids you may be noticing in the rectal area, caused by increased blood flow to the area as well as your enlarged uterus. Avoiding constipation is a good idea as this will only make the piles worse, so make sure you’re stocking up on fibre-rich foods and drinking plenty of water.

8) Frequent urination

Have you noticed how many of the symptoms now revolve around the toilet? The growth of your baby is crowding the bladder and increasing the urge to go to the loo. Don’t stop drinking though as it is super important to stay hydrated!

9) Gorgeous hair

We’ve already warned you about this TERRIBLE symptom – we jest! Finally, a pregnancy symptom you wish would stick around! Your hair may be fuller and glossier than ever thanks to pregnancy hormones keeping a hold of hair you’d normally shed. Enjoy it while it lasts!

10) Bleeding gums

A common but unpleasant side-effect of pregnancy, bleeding gums may affect you this week. Make sure you’re brushing your teeth at least twice a day and flossing regularly, and if you’re concerned, see a dentist to talk through your worries.

11) Braxton Hicks

These uncomfortable pains probably aren’t going anywhere. Braxton hicks practice contractions often begin at around 28 weeks but some mums suffer earlier. Luckily, they shouldn’t be frequent and should go away when you swap positions.

What is my body doing at 25 weeks?

Feeling exhausted? Your expanding bump may start making it harder to get to sleep. Now that you’re in the second trimester, it’s important that you sleep on your side (ideally your left) rather than your back, because lying on your back presses down on the vein that returns blood from your lower body back up to your heart, and also to the placenta.

If you tend to thrash around when you sleep and wake up on your back, just make sure you roll onto your side before dropping back off to sleep. Using cushions to support yourself, including a pillow between your legs, may help make you more comfortable.

What to do this week

  • The birth plan: Now’s a good time to start thinking about where you’d like to give birth. There are generally three choices although they vary depending on where you live (and nope, a luxury five-star hotel is not one of the options!). The first is a regular maternity ward, where you’ll be looked after by midwives, but there’ll also be obstetricians on the wards if needed. The second is a birth centre. These can be attached to hospitals or standalone, have a more ‘homely’ feel and are run by midwives, but there’s no immediate access to things like epidurals or C-sections. Finally, you can give birth at home. This is available if you’re having a low-risk pregnancy. Picking your birth centre does require a lot of thought and you really need to research what’s available to you before making any definite decisions.

Take me back to week 24

Take me to week 26

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Week 25 Ultrasound: What It Would Look Like

American Institute of Ultrasound in Medicine –

While your baby-to-be still has several weeks to go before she’s ready to meet you, she’s begun to explore her home inside the womb. All of her senses are beginning to function. Taste buds develop more on her tongue; her ears, now in their final position, can hear more noises; and her eyes may even be open now, perhaps even blinking and closing when she sleeps. She’s still much skinnier than she’ll be at birth, but she continues to fill out. By the end of this week she’ll probably weigh about 1 1/2 pounds.

For the most part you will be unaware of these explorations, but some you might notice — especially your baby’s responses to certain noises. For example, you might feel your baby jump in reaction to a loud sound, such as a car horn or your ringing alarm clock. She might wiggle and kick to music (although you won’t have any idea whether she’s a fan of what she hears or not!). Her movements might also increase when she hears your voice. Most likely, her movements will happen at regular intervals each day. In other words, she might have a schedule, spending time awake and time asleep, just like you do. Hopefully her awake time doesn’t fall during your time in bed!

Her sensory experiences and newfound nerve connections also extend to her fingers and toes. She might spend her time wiggling her toes or putting her fingers into her mouth. You might be able to see some of these movements on a sonogram image.

While the nerves around her mouth are becoming sensitive as she prepares to be able to suckle and nourish her own body after birth, you’re still nourishing your unborn child via the umbilical cord. (Your blood carries nutrients to your baby through the cord, which consists of a single vein and two arteries.) The umbilical cord is protected against your baby’s gymnastics by Wharton’s jelly — a gelatinous goo that keeps the umbilical cord from twisting and knotting as your baby continues to test her muscles and find things to occupy her waking time.

As your baby grows, so does her brain. Deeper grooves and furrows are developing in her cerebral cortex, which is going to be Command Central for many important functions including her ability to see, hear, smell, speak, and walk. Already her brain controls her rhythmic breathing, digestion, and body temperature; these three activities are essential in order for your baby to be able to live outside your body.

Terms to Know

Blink-startle response: In fetal development, when the unborn baby responds to loud noises with movement.

  • Add to your pregnancy vocabulary.

Important Information About Your Pregnancy

  • Learn more about your baby in the second trimester.
  • Discover more about your 25th week of pregnancy.
  • Sign up for your personal pregnancy calendar!
  • Read about your previous week of pregnancy.
  • Learn what to expect during your next week of pregnancy.

Images courtesy of the American Institute of Ultrasound in Medicine (

  • By Kristen J. Gough and Dr. Laura Riley

Very Low Birth Weight

What is very low birth weight?

Very low birth weight (VLBW) is a term used to describe babies who are born weighing less than 3 pounds, 4 ounces. It is very rare that babies are born this tiny. Only about 1% of babies born in the U.S. are very low birth weight.

What causes very low birth weight?

The main cause of a baby having VLBW is being born too early. This is called preterm or premature birth. Premature means a baby is born before 37 weeks of pregnancy. Very-low-birth-weight babies are often born before 30 weeks of pregnancy. A premature baby has less time in the mother’s uterus to grow and gain weight. Much of a baby’s weight is gained during the later part of pregnancy.

Another cause of very low birth weight is when a baby does not grow well during pregnancy. This is called intrauterine growth restriction (IUGR). It may happen because of problems with the placenta, the mother’s health, or birth defects. Most very low birth weight babies who have IUGR are also born early. They are usually very small and physically immature.

Who is at risk for very low birth weight?

A baby is more likely to be very low birth weight if he or she is premature or has intrauterine growth restriction. Other things linked to the mother can increase the risk for VLBW, growth restriction, and prematurity. They include:

  • Having an infection during pregnancy
  • Not gaining enough weight during pregnancy
  • Having a previous pregnancy with a low-birth-weight baby
  • Smoking
  • Using alcohol or drugs
  • Being younger than age 17 or older than age 35
  • Being African American

What are the symptoms of very low birth weight?

Babies with very low birth weight look much smaller than other babies of normal birth weight. A very-low-birth-weight baby’s head may look big compared to the rest of his or her body. A baby with VLBW often looks very thin with little body fat. Blood vessels can be easily seen through the skin.

How is very low birth weight diagnosed?

One of the main reasons for regular prenatal exams is to make sure your unborn baby is growing well. During pregnancy, the size of your baby is estimated in different ways. Your steady weight gain is one way of checking on the baby’s growth.

Another way is to measure the top of your uterus from the pubic bone (fundal height). The number of centimeters measured is usually the same or close to the number of weeks of pregnancy. If the fundal height measurement is low for the number of weeks you are pregnant, it may mean that your baby is not growing well.

Other ways to check the baby’s growth are:

  • Using ultrasound to estimate the baby’s growth and development. Your healthcare provider can use measurements of your baby’s head, belly, and upper leg bone, to estimate his or her weight
  • Comparing your baby’s estimated birth weight with his or her gestational age. The provider may use a formula to figure out your baby’s body mass.

A birth weight of less than 5 pounds, 8 ounces is diagnosed as low birth weight. Babies weighing less than 3 pounds, 4 ounces at birth are considered very low birth weight.

How is very low birth weight treated?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Babies with VLBW may need:

  • Care in the neonatal intensive care unit (NICU)
  • Temperature-controlled beds
  • Special feedings, sometimes with a tube into the stomach if the baby can’t suck
  • Other treatments for complications

The outcome for a baby with VLBW depends mainly on how much the baby weighs and how many weeks of gestation the baby is at birth. The smallest and earliest babies have the most problems. They are less likely to survive.

Babies with VLBW may have a harder time catching up in physical growth because they often have other problems. Many very-low-birth-weight babies are referred to special follow-up healthcare programs.

What are the complications of very low birth weight?

Babies with a very low birth weight have a greater risk of developing problems. Their tiny bodies are not as strong as babies of normal weight. They may have a harder time eating, gaining weight, and fighting infection. They have very little body fat. So they often have trouble staying warm in normal temperatures.

Most babies with a very low birth weight are also premature. This can make it hard to separate the problems caused by the prematurity from the problems of just being so tiny. In general, the lower the baby’s birth weight, the greater the risks for complications. Here are some of the most common problems of babies with VLBW:

  • Low oxygen levels at birth
  • Trouble staying warm
  • Trouble feeding and gaining weight
  • Infection
  • Breathing problems because of immature lungs (respiratory distress syndrome)
  • Nervous system problems, such as bleeding inside the brain or damage to the brain’s white matter
  • Serious digestive problems, such as necrotizing enterocolitis
  • Sudden infant death syndrome (SIDS)

Almost all very-low-birth-weight babies need special care in the NICU until they can gain weight and are well enough to go home.

Risks for long-term problems and disability are increased for babies with VLBW. Long-term complications may include:

  • Cerebral palsy
  • Blindness
  • Deafness
  • Developmental delay

Talk with your baby’s healthcare provider about your baby’s risks for complications.

Can very low birth weight be prevented?

There have been advances in the care of sick and premature babies. More babies today survive even though they are born early and very small. But preventing preterm births is one of the best ways to prevent very low birth weight.

Regular prenatal care is the best way to prevent preterm births and very-low-birth-weight babies. At prenatal visits, your health and the health of your unborn baby are checked. It is important to:

  • Follow a healthy diet during pregnancy. This will help you gain enough weight to help your baby grow and help you stay healthy.
  • Not use alcohol, cigarettes, or drugs. All of these can cause low birth weight and other problems for your baby.

Key points about very low birth weight

  • Very low birth weight is a term used to describe babies who are born weighing less than 3 pounds, 4 ounces.
  • The main cause of very low birth weight is being born too early, called premature birth.
  • Treatment for very low birth weight babies includes care in the NICU, temperature-controlled beds, and special feedings.
  • In general, the lower the baby’s birth weight, the greater the risks for complications.
  • Prenatal care is a key factor in preventing preterm births and very low birth weight.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

The world’s tiniest baby is finally back home following five months at a Tokyo hospital after he was born weighing just half of a pound.

© Xinhua via ZUMA Wire World’s Smallest Baby Who Weighed Half a Pound at Birth Goes Home After 5 Months in Hospital

The baby boy, whose name has not been made public, went home on Feb. 20, much to the delight of his parents who feared for the baby’s life, according to Reuters. He was delivered last August via C-section and weighed 268 grams (9.45 oz) after he failed to gain weight in the womb.

He went home from the hospital weighing 7 lbs.

“I am grateful that he has grown this big because, honestly, I wasn’t sure he could survive,” the boy’s mother told Reuters.

The baby was born at 24 weeks gestation at Tokyo’s Keio University Hospital and could fit in the palm of a person’s hands, CNN reported. Dr. Takeshi Arimitsu, who treated the baby, told CNN that the baby needed a ventilator and an umbilical catheter for infusion therapy when he was born.

A baby boy weighing just 268 grams (9.45 oz) at birth was sent home after months in a Tokyo hospital, the smallest surviving male baby in the world, Keio University hospital said.

— World Health News (@WorldHealthNews) February 28, 2019

Arimitsu notes that premature births aren’t that common in Japan, adding that the rate of infants’ low birthweight “is almost 10 percent in Japan.”

RELATED STORY: Identical Micro-Preemie Twin Girls Among Youngest Babies to Be Born at Iowa Hospital

Before the baby born in Tokyo, the record for the world’s smallest baby went to a baby boy born in 2009 in Germany at just over 9 ounces, according to the University of Iowa’s Tiniest Babies registry.

The news comes just weeks after a pair of micro-preemie twin girls were born at University of Iowa Hospitals and Clinics, according to the Associated Press.

A #baby weighing just 268 grams at #birth has been released from #KeioUniversity hospital in #Tokyo, after growing to a weight of 3,238 grams, and is believed to be the #smallestboy in the #world to be sent home healthy.

Photo: Keio University

— IANS Tweets (@ians_india) February 27, 2019

Sisters Keeley James and Kambry Lee Ewoldt were born 18 weeks early, at just 22 weeks and one day gestation on Nov. 24, placing them among the youngest surviving premature babies born at the hospital.

“I’d never heard of babies being born this early,” the girls’ father Wesley Ewoldt said, according to the AP. “We didn’t have a lot of positive thoughts. They told us from the get-go this is going to be a roller-coaster ride.”

Both babies were about the length of a dollar bill at birth, with Keeley weighing 1 pound and Kambry born at just 13.4 ounces, the AP reported. Dr. Jonathan Klein, medical director of the NICU at University of Iowa Stead Family Children’s Hospital, told the Waterloo-Cedar Falls Courierthis link opens in a new tab that Keeley and Kambry are “clearly” among the top four or five youngest babies ever delivered at the hospital.

A baby born at 29 weeks has reached the preliminary portion of the third trimester and will have a good chance of survival if delivered this early. The 29-week preemie survival rate is between 90 and 95 percent and the baby’s prognosis is excellent.

Development of a Baby Born at 29 Weeks

A pregnancy calendar that tracks the development of a fetus is a good place to start if you are curious as to the survival chances of a baby born at 29 weeks. This information can be obtained from who has been a longstanding trusted resource for expectant women regarding pregnancy and infant development information. The site offers a detailed calendar for each week of fetal development. Some things to know include:

  • According to BabyCenter’s growth estimations for an infant in its 29th week of gestation, the baby’s weight is about 2.5 pounds and is really enduring the rest of this gestational period for the purposes of gaining weight and allowing his organs to develop further.
  • By the end of the second trimester, a fetus has all of its organs and bodily systems intact and can, with the aid of modern neonatal technology, survive birth as early as 23 or 24 weeks.
  • Unfortunately, this does not mean that all infants born this early will survive.
  • Statistically, only one in ten infants born at about 23 weeks will live.
  • Babies at this stage of development are simply too delicate, so delicate that their blood vessels can burst when they aim to exist outside the womb.

What Will a 29 Week Preemie Look Like?

While it is safe to give birth to a preemie born at 29 weeks, they will still require a good amount of care and a long stay in the NICU. The earliest the baby can expect to go home is a couple weeks prior to their original due date. The good news with a 29-week preemie is that their organs are well-developed at this stage and their bodies are quite mature. If you deliver a preemie at 29 weeks, they will:

  • Weigh about 2.5 pounds and be nearly 16 inches in length
  • Have more fat stored under their skin but they are still very small
  • Look more like ‘real’ babies
  • Start to shed their lanugo (the downy hair that covers the baby’s body)
  • Have the ability to blink but they will still be very sensitive to bright lights and loud noises

The majority of twins born at 29 weeks gestation also have an excellent chance of survival with the proper medical care. They will require weeks to months in the NICU as well.

Possible Complications Associated With a Baby Born at 29 Weeks

By the time a fetus has reached 29 weeks, its body is far stronger. However, complications can still arise which include:

Breathing Problems

Over the next few weeks leading up to a full term delivery, a baby will have a chance for its lungs to develop and become stronger so that it can breathe independently after birth. Babies born several weeks prematurely will often need the aid of a ventilator to promote breathing. Many mothers who are expecting to deliver preterm, mainly due to certain medical disorders, will receive steroid injections to speed up the development of their baby’s lungs. Babies born this early will often be whisked off to the neonatal ward for feeding and breathing aids.

Heart Problems

The most common heart problems are patent ductus arteriosus (PDA) which is a hole between the aorta and pulmonary artery which usually closes on its own. If it doesn’t, it can lead to other problems such as a heart murmur and heart failure. The other heart problem associated with a preemie is low blood pressure (hypotension) which may require adjustments in medications, i.v. fluids or possible blood transfusions.

Inability to Maintain Body Heat

Preemies do not have the stored body fat yet to hold in body heat. They can quickly lose their body heat and if the baby’s body temperature dips too low, hypothermia (low core body temperature) can occur. If hypothermia does occur, it can lead to breathing problems and low blood sugar. A premature baby could use up all the energy gained from feedings just to stay warm. This is the reason a smaller premature baby may require additional heat from a warmer or an incubator until they are able to maintain their body temperature on their own.

Blood Problems

Anemia and newborn jaundice are commonly associated with premature babies. Anemia is a condition that occurs when the baby’s body doesn’t have enough red blood cells. Newborn jaundice is when the baby’s blood contains too much bilirubin and causes a yellow discoloration in a baby’s skin and eyes.

Brain Problems

The earlier a preemie is born, the greater the risk that bleeding on the brain can occur. This is known as an intraventricular hemorrhage. Most hemorrhages are mild and resolve on their own. However, some babies may have a larger bleed on the brain that could potentially cause permanent brain injury.

Gastrointestinal Problems

It is not unusual for premature babies to have an immature gastrointestinal system. After a baby starts feeding, a serious condition can occur in which the cells lining the bowel are injured. This is called necrotizing enterocolitis (NEC). There is a much lower chance of premature babies developing NEC if they receive only breast milk.

Infections and Issues With the Immune System

Immunodeficiency is a common problem in premature infants as their bodies are not yet strong enough to take on the natural elements. Oral thrush and frequent infections may plague the first couple years of a child’s life if she has been born significantly premature. As the child ages, her system may strengthen to overcome such problems, but parents of a premature infant should take great pains to ensure that their child’s diet and lifestyle are conducive to vibrant health in order to ward off such difficulties.

Importance of Breast Milk for Preemies has published an article detailing the complications that can occur in prematurely born infants. This article also stresses the importance of breast milk for nourishing preemies and fortifying their immune systems. Preemies are very susceptible to intestinal infections, and breast milk is a natural source of probiotics bacteria in addition to numerous antibodies that can fight off certain pathogens. Babies born at about 29 weeks can often be too weak to nurse, hence many mothers will have to pump their milk to give to their infant through a feeding tube. This process, of course, will not last forever, and as the infant strengthens, it is possible to achieve a normal breastfeeding routine once the baby has left the hospital. Don’t be surprised however if your 29-week preemie needs his breast milk fortified with some kind of nutritional aid. Infants born this early typically suffer from nutritional deficiencies, so an iron-fortified formula may be necessary to bring your baby to health.

Reassurance for Mom

Many expectant mothers agonize over each week of pregnancy, exhaling a breath of reassurance once their baby has passed just one more week of gestation. It is true that premature births are quite common in the United States, but contemporary medicine and technology have made it such that most infants born prematurely at about 29 weeks will do well, and only a small percentage of these infants will endure lifelong health problems due to inadequate development.

Additional Survival Factors

The gestational age at which your baby is born is very telling as to her chances of survival and overall health. However, another important factor in determining the health of your infant at the time of her delivery is the actual reason why this baby was delivered early. A baby born at 30 weeks due to a mother’s uncontrolled gestational diabetes may present an entirely different health situation than that of an infant delivered at 30 weeks due to unexplained preterm labor. It is important for expectant mothers to have their health closely monitored by a physician or midwife during their pregnancies so that underlying health conditions leading to preterm labor can be identified and treated as early as possible.