A baby with respiratory distress syndrome (RDS) may stop breathing for a short time. This is called apnea. Although it sounds very frightening, apnea is not uncommon, and most babies start breathing again after gentle stimulation such as a top or a stroke. Other respiratory problems can arise from fluid inhaled into the lungs or a lack of surfactant – a substance produced in the lungs that keeps them from collapsing. If a baby’s do not have enough surfactant coating, they don’t expand as well as they should. This can cause the smaller air sacs to collapse, leading to hyaline membrane disease, a condition common in babies born before 31 weeks.
Babies suffering from any of these complications can be given oxygen either by way of a face mask or by a small tube inserted directly into the windpipe and attached to a ventilator.
A premature or low birth-weight baby needs to be fed more frequently than a full-term baby because he burns calories more quickly. You can understand why he needs to be fed so often if you think on a tiny hummingbird; it never stops feeding since its weight is so low compared to its volume that it needs constant food to stoke up the metabolic burners and keep the temperature normal. The smaller the baby, therefore, the more often he needs to feed and the less time he spends asleep. For premature babies the challenge of living outside the uterus is clearly an exhausting one. The lack of stimulation from being in an incubator and the inability to move very much means that, apart from frequent feeding, these premature babies spend most of their time sleeping.
About 7 percent of all babies born in the U.S. weigh less than 5½ pounds (2.5 kilograms), either because they are premature or for other reasons. All low birth-weight babies need special care.
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