By the time of hospital discharge, most premature infants do not require specialized medical care. Regular medical care and evaluation are necessary though, as 50 to 70 percent of former preterm infants can have minor developmental issues that affect long-term development.

By the time of hospital discharge, most premature infants do not require specialized medical care. Regular medical care and evaluation are necessary though, as 50 to 70 percent of former preterm infants can have minor developmental issues that affect long-term development.

In addition to regular immunizations, premature infants should receive periodic hearing and eye examinations. Doctors will examine nervous system development such as muscle tone and positioning, and development of motor skills like smiling, sitting and walking. Doctors also measure speech and behavioral development during followup, as some infants may require speech, occupational or physical therapy as they grow up.

The Neonatal Developmental Clinic at Nationwide Children's Hospital provides developmental screenings for infants up to 2 years of age following their hospital stay. Within the hospital's followup clinic is a Neonatal Neurology Clinic staffed by two neurologists and two developmental/behavioral pediatricians who visit the clinic once a week.

After leaving the hospital, many premature infants continue to experience episodes of apnea. During an apnea spell, a baby stops breathing for 15 to 20 seconds, the heart rate may decrease and the skin may turn pale, purplish, or blue. Doctors usually diagnose this condition before the baby is discharged, and it generally goes away as the infant matures.

Some preemies may develop a respiratory condition called bronchopulmonary dysplasia (BPD), which involves scarring and inflammation in the lungs. Infants with BPD may need supplemental oxygen and medications after discharge.

Because their immune systems are weaker than those of older kids, premature infants have a higher risk of infection after discharge. They are particularly vulnerable to respiratory syncytial virus (RSV), a common infection in young kids that is often mistaken for a cold or the flu. Although RSV causes few problems in adults and older kids, it is a common cause for rehospitalization of preemies. An immunization is available to help protect infants from RSV. Infants born at less than 32 weeks and any born from 32 to 35 weeks that attend day care, have contact with multiple children or are exposed to second-hand smoke may be able to receive the vaccine pending approval by their insurance company.

Developmental followup is critical for premature babies. Many continue to see specialists for several years to measure their vision, hearing, speech and motor skills.

Mary Ann Nelin, MD, works in the Division of Neonat-ology's Neonatal Developmental Clinic at Nationwide Children's Hospital. She attended the University of Texas Health Sciences Center at San Antonio and has been with the hospital since 2003.

Mary Ann

Nelin