Premature Babies and Edema

Edema is bodily swelling caused by fluid leaving the bloodstream and traveling into the tissues. It is common in premature babies, whose urinary and circulatory systems are not fully developed. Severe forms of edema are usually caused by health conditions such as problems with the heart or lungs.

If your child is premature, they will generally need help expelling fluids. Depending on the severity of the edema, treatment may include fluid restriction, corticosteroids to help decrease inflammation, and diuretics to increase urine output.

This article covers types of edema, symptoms, and how it's treated, plus infant care after you're home.

Nurse and premature baby
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Types and Symptoms of Edema

Preemies have a higher water content than full-term babies and the regular routine of administering fluids in the NICU may contribute to edema. Infants also have a slower red blood cell production, so the breakdown of red cells may be faster than their ability to produce new red blood cells. This is even more of a problem for preemies. Poor circulation can also make it difficult for your preemie’s body to remove excess fluid.

Edema may be mild, causing swelling in the feet or legs, or severe, causing such widespread swelling that the body’s organs are overwhelmed.

Hydrops fetalis is a severe form of edema that can affect a newborn or unborn fetus. This type can be immune (rare) or nonimmune (more common). Nonimmune hydrops fetalis is caused by a medical condition such as anemia, a problem with the heart or lungs, or a genetic condition.

The symptoms of edema may include:

  • Swelling of the whole body or parts of the body
  • Pale skin color
  • Problems breathing
  • Bruise-like spots on the skin
  • Jaundice (yellowing of the skin or eyes)

Because infants are often lying flat, edema may settle in dependent areas or is more diffused. It can also settle in the genitalia.

Treating Edema

If your child was born premature, the NICU will manage the amount of fluids they're given to help prevent or reduce edema. Other treatment options for premature babies with edema may include the following:

  • Diuretics may be given to help them release fluid. Furosemide is a common treatment for swelling in preemies. These treatments are generally administered to help your baby along as the underlying cause of their edema will improve as they grow stronger and more self-sufficient.
  • Blood transfusions may also be given to help improve your child’s blood flow.
  • Corticosteroids may be given in severe cases to help reduce inflammation caused by capillary leaks.

If diuretics are used, the dosage and amount of time your baby’s edema treatment will take depends heavily on their age, organ function, ability to breathe on their own, and blood circulation. The age and size of your baby will also be accounted for in their treatment plan.

Treatment lasts as long as is required for your child’s bodily functions. As your child becomes more physiologically mature, treatment will no longer be necessary. 

Once You're Home

While some conditions that cause edema can have lasting effects, minor cases of edema usually resolve without causing any long-term problems.

Once your baby has been discharged from the NICU, it's important to follow your pediatrician's guidelines for follow-up care, nutrition, and what to watch out for in the weeks after you return home. Very preterm infants are at risk for health problems, including respiratory issues and growth concerns, so it's important to monitor their development and make sure they have consistent ongoing care.

6 Sources
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