Baby Piper shortly after she was born at 33 weeks.
This article contains stories and pictures of babies born prematurely. Links are provided at the bottom of the page for services and support.
When expecting a new baby, most people mark their calendars for bub to arrive sometime around their due date. A healthy pregnancy is expected to last around 40 weeks, with pregnancy considered full term any time between 37 and 42 weeks.
But some people go into labour earlier than expected or have medical conditions that mean they need to birth their baby before 37 weeks. This is called premature birth and their baby is a premature baby.
Having a premature baby can be a stressful experience, often meaning extended stays in hospital for the baby and more intensive medical care than most parents expect for their newborn. Knowing some of the ins and outs of premature birth, how premature babies are cared for, and hearing stories from others who have had similar experiences can make the journey easier.
Read on to find out more about premature birth and hear from Queensland families with premature birth experiences.
What is premature or pre-term birth?
Premature birth is when a baby is born before 37 completed weeks of pregnancy. Nearly 92% of babies in Australia are born at term, which means between 37 and 42 weeks' gestation. Around 8.2% are born pre-term, or prematurely, between 23 and 36 weeks.
If a baby is at risk of being born between 22 and 23 weeks there are greater potential long-term problems; all parents whose babies are at risk of extremely premature birth should have a discussion with the specialist neonatal intensive care unit (NICU) team to understand the risks. Sadly, babies born at less than 22 to 23 weeks are too immature to be able to survive at this stage, so every effort is made to continue the pregnancy as long as possible and for their birthing parent to be transferred to a hospital with a NICU, to give baby the best chance.
A premature baby might be birthed vaginally or by caesarean section. When it becomes clear that premature labour is underway or early birth is required, the medical care team will work with the baby’s family to decide what kind of birth is the right option.
What are premature babies like?
Every week in utero, babies undergo a lot of development. This means that a premature baby born at 24 weeks will be significantly different and have different care needs than a baby born later in pregnancy.
Some babies born around 35 or 36 weeks, or ‘near term’, won’t need medical intervention after birth, though they will be monitored closely by hospital staff in the hours after being born. In some cases, these babies can remain with their parents in a maternity ward and do not need admission to a neonatal unit. Others will need neonatal unit support. It is hard to predict what a baby at this near-term gestation will need, so the best approach is to see how they go and make sure they are cared for as an individual.
Babies born very early in pregnancy will often need help to breathe, feed and regulate their body temperature and heart rate. They may need different medical procedures to help them thrive and develop and require support from medical staff and devices.
Tayla and Koa’s story: surgery after birth
Koa was born at 32 weeks and required surgery for a tumour on his tailbone.
When Tayla had her baby Koa at Toowoomba Base Hospital at 32 weeks, he seemed to be very healthy despite his early arrival. However, when he was one week old, a lump was discovered at the base of his tailbone that after investigation turned out to be a benign tumour which would require surgery, and could have possibly triggered his early arrival.
‘The doctors originally thought it was a cyst or ingrown hair,’ says Tayla. ‘He was transported to the Mater Mothers Hospital in Brisbane for further testing. It was found that Koa had a completely internal sacrococcygeal teratoma that had attached to his tailbone and was taking up 90% of his stomach and pelvis area.’
Koa’s surgery was successful, but complicated, and he required hospital care in Brisbane for three months afterwards. Tayla says that while he needs ongoing care and check-ups, he is now thriving at eight months old.
‘Koa needs one catheter at night, originally it was four, he is on permanent medications and will have check-ups at Queensland Children’s Hospital for the next five years. However, he is a thriving and happy boy.’
Koa is now thriving at eight months old.
Why are some babies born prematurely?
When premature labour starts ‘spontaneously’ this means it begins by itself. There is often no identifiable reason for premature labour to happen.
Some medical conditions can mean it is safer to birth a baby prematurely than waiting for labour to start or scheduling birth closer to 40 weeks of pregnancy.
Reasons that a baby might be born prematurely include:
- the cervix is unable to hold the weight of the baby and uterus or begins to open, sometimes called ‘cervical incompetence’ or ‘cervical insufficiency’.
- the birth parent has a medical condition that puts them or the baby at risk and means they need to birth early , like preeclampsia, diabetes or an infection
- placenta problems: placental insufficiency, placenta praevia, placenta accreta and placental abruption can all be reasons a baby is born early
- waters breaking (preterm rupture of the membranes)
- the birth parent has a history of premature labour.
Kaytee and Braedan's story: Preterm pre-labour rupture of the membranes
Kaytee’s baby boy Braedan was born at 27 weeks and 6 days due to a condition called preterm pre-labour rupture of the membranes, or PPROM, which means her waters broke very early. She had already had early bleeding in her pregnancy, but being told her waters had broken was a surprise.
‘When I was 22 weeks, the staff at Gold Coast University Hospital told me my waters had broken early and labour could come within 48 hours,’ says Kaytee. 'My whole world came crashing down, but when there’s a heartbeat, there’s hope.’
Kaytee didn’t go into labour and would spend the next five weeks as an in-patient under the care of the maternity unit. She was given a tour of the Neonatal Intensive Care Unit (NICU) before Braedan’s arrival, knowing that’s where he would spend his first weeks.
Braedan was born at 27 weeks and 6 days gestation and is now thriving at home.
Baby Braedan spent his first weeks being cared for in the NICU.
'We had amazing care and he’s doing amazing now, at 15 months but 12 months adjusted,' says Kaytee.
Care for premature babies
Premature babies who need a high-level of medical care will be looked after in a neonatal unit, sometimes this can be called a neonatal intensive care unit (NICU). If born in a hospital that doesn’t have a NICU, they will be transferred to a hospital that does. A NICU is staffed by specialist nurses, doctors and allied health professionals who provide round-the-clock care using special equipment made for small and unwell babies.
As they progress to needing less intensive medical care – or for babies who were born later and do not develop breathing issues – they can be transferred to Special Care Units, which sometimes means they can receive care at or closer to their home hospital.
Craig and Adam’s story: NeoRESQ transfer to the Neonatal Intensive Care Unit
Craig’s son Adam was born at 32 weeks, after his wife Shalisa’s waters broke at 30 weeks.
'At 32 weeks, my wife started going into labour. We headed to Buderim Private Hospital, and after a fairly short time Adam was born,' says Craig. 'Adam was stabilised, but having apnea moments, so he was transported by NeoRESQ to Sunshine Coast University Hospital.'
Adam’s lungs and nervous system were not yet fully developed. In a premature baby, this can cause apnea, which means the baby’s breathing slows down or stops. Adam required specialist care in a NICU.
Neonatal Retrieval Service, or NeoRESQ, is a specialised service that transports premature and critically ill infants and their families between hospitals for treatment. For Adam, this service meant he could be transferred to the NICU at the Sunshine Coast University Hospital.
Adam required breathing assistance after he was born.
‘Adam remained at SCUH for a week until he was off oxygen, breathing himself, had been treated for jaundice and just had his feeding tube. Then he was able to be transferred back to the Special Care Nursey at Buderim Hospital, where he stayed for six weeks.’
Another common condition in preterm babies is jaundice which causes the skin and whites of the eyes to become yellow. It is caused by their immature liver and their higher number of red blood cells. The natural breakdown of red blood cells results in high levels of a product called bilirubin, which builds up in the blood. The levels are monitored to make sure they stay below a safe level. Mild jaundice is harmless and will often go away untreated. Babies with higher bilirubin levels can be treated with phototherapy, which is a special kind of blue light given through phototherapy blankets or lights above their cot.
A feeding tube can be used to feed babies like Adam who have difficulty sucking or swallowing after birth. This prevents them from safely breast or bottle feeding. A baby’s sucking reflex begins to develop at around 32 weeks of pregnancy, with further time required to learn how to combine the suck with swallowing and breathing. Depending on what gestation they were born and any other health issues, a premature baby’s sucking reflex may be weak or immature. Breastmilk or formula can be delivered through a feeding tube, which is put into the baby’s nose or mouth, then passes directly down into their stomach. Medicines can also be given through the feeding tube.
After he was born, Adam was flagged with a high risk of developing cerebral palsy. Craig says that while it’s yet unknown what led to this, a future MRI will be able to show which region of Adam’s brain is affected, and Adam’s prematurity, early breathing difficulties or birth process are all factors in the diagnosis.
Adam has since been formally diagnosed with Cerebral Palsy, Spastic Quadriplegia by the rehabilitation team at Queensland Childrens Hospital, a diagnosis that will be confirmed by MRI when he is two years old.
Craig says that with ongoing support and therapy, Adam is now thriving.
‘12 months on, Adam is going well. We have been able to access NDIS funding which has enabled him to have regular therapy with physios and occupational therapists. The care we received at both hospitals was incredible and has given Adam the best start to life possible.’
Adam is doing well with ongoing therapy and support.
Outcomes for premature babies
Specialist care for premature babies can minimise the risk of ongoing health and development issues. Some premature babies may experience short or long-term health impacts and some very small or unwell babies may not survive.
A premature baby’s health and outcomes can be impacted by how many weeks gestation they have reached before they are born, the reason that they are born prematurely, or any complications experienced during the pregnancy.
Once born, babies continue to develop in the same order as they would in the womb.
Jacinta and Piper’s story: Intrauterine growth restriction
Baby Piper was born at 33 weeks, but intrauterine growth restriction – which means the baby has slow growth or has stopped growing inside the uterus – meant that she was only the size of a 27-week-old baby, weighing in at 1.2 kilograms.
‘At 20 weeks we discovered Piper was not growing, she was below the 1 percentile for her gestation,’ says Piper’s mum, Jacinta. ‘We were rushed to the Royal Brisbane and Women’s Hospital (RBWH) at 24 weeks due to the placenta not delivering enough oxygen.’
Jacinta and Piper’s care was transferred to RBWH where they received highly specialised care. After initially considering an emergency caesarean section, doctors decided to monitor Piper’s condition in the womb after giving Jacinta steroid shots that would help Piper’s lungs develop. Jacinta was allowed to return home for a couple of months, with multiple hospital visits each week to check on Piper’s growth.
‘At 33 weeks, Piper completely stopped growing and the placenta no longer provided any oxygen to her, and we had to have an emergency caesarean section,’ says Jacinta.
Despite her small size and early delivery, Piper had minimal complications after birth, surprising everyone.
‘Piper came out breathing and completely shocked all the doctors. She was on Continuous Positive Airway Pressure (CPAP) for eight hours and she had no complications apart from recurring jaundice, feeding and being super small. We stayed in hospital for almost 50 days and then we were able to come home.’
There are several different ways that premature babies might be given breathing support. Premature babies’ lungs and brain are not fully developed, which can put them at higher risk of breathing complications. Oxygen can be delivered through a mask or little prongs that sit in baby’s nostrils. CPAP, which Piper received, is delivered through a snug fitting mask that covers the nose or prongs that sit just inside the nostrils. CPAP gives pressure, and additional oxygen if required, to support the baby’s airways and lungs. High flow oxygen is similar to CPAP. Higher intensity treatment may require a ventilator which either supports or does all the breathing for a baby, normally via a tube placed down into the baby’s main airway.
Now two, Piper has thrived, catching up on the expected weight for her age.
'She’s a beautiful little girl,’ says Jacinta. “It was such a journey, but a journey with a beautiful outcome.’
Piper was very small when born, but has caught up with the expected weight for her age.
Care for families of premature babies
It’s not only the newborn who needs care and support when a premature baby is born. It is normal for parents and carers of premature babies to feel:
- scared or worried about their baby’s health and future.
- stressed if they have to be away from their home, other children and support systems.
- stressed if they have to return to work or are missing work to care for their child
- worried that something they did caused their baby to be born prematurely
Birthing parents also need to recover from the birth, and those who can breastfeed or pump breastmilk for their babies are also adjusting to this new role.
Kayla’s story: Mental wellbeing after a premature birth experience
Kayla, a nurse, felt something was not right when she experienced an increase in vaginal discharge while at work when she was 24 weeks pregnant with her son, Henry. An assessment showed she might give birth that day. She didn't go into labour, and the next day was transported from the Sunshine Coast University Hospital by ambulance to RBWH, where she stayed on bed rest until Henry was born two weeks later.
‘I really struggled, especially while in RBWH on bed rest,’ says Kayla. ‘I remember being in a very dark mental place while waiting for Henry to be born and only coped when in a single room away from other mums and babies.’
After he was born, Henry was admitted to the NICU, where he stayed for 64 days, before being transferred to Sunshine Coast University Hospital for another few weeks.
‘During Henry’s NICU stay, I received counselling from a psychologist at RBWH, which was helpful,’ says Kayla. ‘Unfortunately, Henry was never able to breastfeed, which I really struggled with, though I did manage to pump for six months and provide him with breastmilk.’
Kayla found the stress of an early birth and Henry’s need for intensive care, as well as the difficulty of not being able to breastfeed when she really wanted to, impacted her mental health. Receiving counselling and starting on medication when she returned home helped her to start feeling more like herself.
‘My advice would be to get help early if you think you need it and don’t be afraid to start medications if needed. When you are in it, it’s so hard, nearly impossible to see the light. But it will come.’
Kayla says she also found support from loved ones had a huge impact on her experience.
‘Family support is so, so helpful and is also what got me through! My mum was at the hospital every day while on I was on bed rest, and my in-laws looked after our dogs which took a burden off.’
Despite his early challenges, Henry is now doing well.
‘I now look at the experience and am so proud that Henry was born a prem. I tell everyone that asks how old he is that he was a 27-weeker, because I am so proud of how well he’s doing!’
Henry has come a long way since his birth at 27 weeks' gestation.
Craig story: Seeking support for dads and non-birthing parents and carers
For Craig, whose son Adam was born at 32 weeks, the suddenness of his son’s birth and the following days when he needed a high level of care meant he didn’t have a lot of time to think about his own experience as he became a new parent.
‘One minute we were at home, the next we were off to the hospital, next again we’re told the baby is coming that night. I was in ‘business mode’, focused on Shalisa and just getting through it.’
Craig found while the healthcare focus was on his wife and baby, he wasn’t aware of many support services for himself.
‘As a father/non-birthing parent, I felt there wasn’t too much support that I knew about at the time. There was a lot of focus on the mother, which took some adjusting.’
It was when Adam was released from hospital that Craig found a support group that he still uses to this day.
‘I discovered the Life’s Little Treasures Foundation. They have a NICU Connections for Dads group which meets on Facebook once a week. We can jump on, share our stories and what’s been happening, and the volunteers help and support dads in these situations.
‘I’ve been contributing for 12 months now, and I look forward to every Wednesday evening chat.’
Resources for parents and family of premature babies
Parents and other family members and friends can find resources and support at these organisations:
- Miracle Babies: Support - Miracle Babies
- Preterm Infants Parents Association: Home | Preterm Infants Parents Association (pipa.org.au)
- Life’s Little Treasures Foundation: Home - Life's Little Treasures (lifeslittletreasures.org.au)
Non-birthing parents can also talk to hospital staff about what kind of services, like counselling, they can receive from trained staff.
Can premature birth be prevented?
Many causes of premature birth cannot be prevented. Ways to lower the risk of premature labour include:
- not smoking cigarettes or using drugs during pregnancy
- gaining a healthy amount of weight – speak to your pregnancy care team if you are worried you are not gaining enough weight during your pregnancy
- going to all of your antenatal pregnancy appointments, even if you’re feeling well
- attending your mid-pregnancy ultrasound scan.
Jessie and Luxmore’s story: Try not to worry about the ‘what ifs’
When Jessie went for her 20-week scan, she wasn’t anticipating any problems with her pregnancy. She was twenty-one years old, excited to be pregnant and feeling well.
The scan showed a cyst on her baby’s brain, and she was referred from Rockhampton Hospital to the Maternal Fetal Medicine team at RBWH for further assessment. At her appointment three weeks later, the cyst was no longer showing on scans. Jessie’s baby, however, had dropped from measuring in the 26th percentile in size for their age, to the third.
After many tests and conversations about whether Jessie had used alcohol or drugs during her pregnancy, there was no reason doctors could give Jessie for her baby’s restricted growth.
‘The doctor essentially told me it was just “bad luck”,’ says Jessie. ‘There shouldn’t have been an issue, but I experienced intra-uterine growth restriction from poor placental function. I stayed in Brisbane until I had my baby. I was admitted to the ward twice and then stayed at Ronald McDonald House until my baby was born.’
When she was 33 weeks pregnant, Jessie had a planned caesarean section and birthed her baby boy Luxmore Que. While weighing only 1.6 kilograms, Luxmore did well with the aid of steroids delivered while Jessie was pregnant and spent only four days in the NICU before being transferred to the Special Care Unit. After five days, Luxmore and Jessie were transferred back to Rockhampton, where he would spend another four weeks in Special Care.
Jessie couldn't be given a reason for Luxmore's restricted growth.
‘Hindsight is a wonderful thing,’ says Jessie. ‘This was one of the scariest things I’ll ever go through. At the time it felt so hard, because we can’t really tell what happens in utero. I definitely felt a lot of hurt, disappointment and grief for my pregnancy journey, because this isn’t the dream you’re sold as a young woman who dreams of a baby.’
‘But now reflecting, nothing lasted too long even though it felt forever. Now I feel such gratitude for my baby and the care I received at RBWH and Rockhampton.’
Luxmore is now a thriving one-year-old, who loves laughing, crawling and food.
‘My advice to other parents is, don’t worry about things that aren’t even happening yet,’ says Jessie. ‘I wasted so much time worrying about the “what ifs” that I missed a lot of present moments. Enjoy the here and now.’
Luxmore is thriving a year on from his birth.
What to do if you think are you are in premature labour
If you think you are in labour before 37 weeks, you should immediately contact your pregnancy care team or the closest birthing hospital.
Sometimes, medication or rest can be used to stop or slow down labour. Sometimes you might think you’re in labour, but when your midwife or doctor checks, it’s a false alarm. That is okay – it's always better to check for sure.
Signs you might be in labour include:
- contractions – the muscles in your uterus tightening
- your waters breaking
- a show of mucous from your vagina – a change in vaginal mucous, blood or fluid coming from the vagina
- a sudden decrease in your baby’s movements – any time you notice your baby not moving as much as normal, you should contact your pregnancy care team, even if you don’t think you are in labour
- pressure in your pelvis
- cramping in your lower belly
- diarrhoea, nausea or vomiting
- constant lower back pain.
More information and resources
Pregnancy, birth and baby: Premature baby