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.

When we say a baby is premature we mean that he has not yet matured to the point where he can cope easily outside the security of his mother’s uterus. Although the chances today that a premature or low birth-weight baby will survive and thrive are vastly improved in comparison to our mother’s generation, it’s still a difficult experience to see your baby being taken away to a special-care or intensive-care unit immediately after the delivery. Understanding why a baby needs special treatment for a few days or weeks will help lessen your anxiety. Premature babies have very weak muscle tone and don’t move much. They often have calcium and iron deficiencies, as well as low blood-sugar levels. If they are very premature their eyes may still be sealed. They have very red and wrinkled skin. Their heads are disproportionately large in comparison to the rest of the body, and the bones in their skull are soft. They are more than usually prone to jaundice.