Physiologic Differences Between Pre-Term Newborns and Full-Term Newborns
Several physiologic variations differentiate the typical pre-term newborn from the typical full-term newborn. Three such differences are described in this section (Todres & Fugate, 1996).
Poor infant weight gain is one physiologic difference between the typical pre-term newborn from the typical full-term newborn. A normal full-term newborn may lose up to 10 percent of body weight in the first few days of life, but should regain to birthweight by 10 days and follow a growth curve thereafter (Todres & Fugate, 1996). Frequently, a pre-term infant will be found to not be gaining weight adequately when checked at 10 to 14 days of age. At this time, the cause of inadequate intake should be evaluated.
Infant jaundice is a second physiologic difference between the typical pre-term newborn from the typical full-term newborn. There is clearly an association between breast-feeding and high levels of serum bilirubin in the first few days of life. In full-term newborns in the absence of hemolytic disease, however, hyperbiliru-binemia has little clinical significance (Newman & Maisels, 1992). There is no evidence that breast milk itself causes early jaundice; rather, caloric deprivation and delayed stooling have been implicated.
The syndrome of "breast milk jaundice" has its onset after the third day of life, peaks at five-to-15 days, and appears to be caused by substances in the milk itself. Typically, serum bilirubin drops quickly when breast-feeding is interrupted for 18-to-24 hours and does not return to previous levels when breast-feeding is resumed, though some jaundice may persist for weeks. There is considerable overlap between early- and late-onset jaundice syndromes.
Cardiopulmonary arrest is a third physiologic difference that may distinguish between the typical pre-term newborn from the typical full-term newborn (Todres & Fugate, 1996). ...