Verified and reviewed by: Midwife Maria Midstam

In this five-part series, you will be able to read about premature babies and the neonatal unit.

Brain development

The brain of the extremely premature baby is very immature.
Most neurons have already formed, but the structure of the brain still needs to develop and organize itself.

• Most of the child's energy goes into brain development.
• The structure of the brain becomes progressively more organized, especially between weeks 25-27.
• The increased structure allows the brain to start working more efficiently - an important foundation for future learning and intelligence.

During this period, the child may also start react to voices and movements in their environment.

Sensory input and movements

Despite the immaturity, several senses have already started to develop:

• Hearing: Is already developed, but the child is very sensitive to loud noises.
• The vision: The eyelids are thin and the eyes are sensitive. Under the right conditions, the child can open their eyes for short periods.
• Smell and taste: The sense of smell is active and the child can sense flavors.
• Hud: Thin, reddish and fragile with superficial nerve fibers that make the skin very sensitive.
• Movement patterns: Immature and often jerky. The child stretches and moves reflexively.

The child switches between shallow sleep and easier wakefulness, making it difficult to determine when it is asleep or awake.

Care and support in the neonatal unit

In the beginning, the extremely premature baby needs intensive care.
The environment is carefully adapted to mimic that in the womb: dark, quiet and calm.

• Incubator: A warm and moist incubator helps keep the baby warm and protects against external stimuli.
• Bed nest: Supports the body and helps the child feel safe.
• Respiratory support: Many children need help from respirator due to an irregular breathing pattern.
• Light treatment: Given when needed, as the liver is immature.
• Nutrition: The child is given small amounts of food via a stomach tube, often combined with nutrition via a drip.
• susceptibility to infection: The child is highly susceptible to infections and needs careful hygiene and monitoring.

Rapid responses

The brain:

Develops rapidly and starts to organize itself for more efficient functioning between weeks 25-27.

Sensory input:

The child can taste, smell and hear voices - but is sensitive to light and sound.

Hud:

Thin, reddish and fragile, with superficial nerve fibers that make the skin sensitive to touch.

Care:

Incubators, breathing support and a calm environment are crucial for the baby's safety and development.

Reactions:

The child may move in response to voices or touch.