24 weeker - how bad is it?

Specialties NICU

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a friend of mine has just had her baby at 24 weeks 4 days. as a theatre nurse, all I know of preemies is their tendency to develop NEC, so can someone please give me the lowdown - obviously this is not good, but how bad is it? what can she expect?

Specializes in CDI Supervisor; Formerly NICU.

Thought of your friend last night when we were dealing with a circling 23.5 weeker. Pray everything is better for you all. Very exhausting and emotional night. *sigh*

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Sadly I saw an ex 24 weeker, then 43 weeks, 2 days from discharge, get NEC, perf and die all before lunch (his last PO feeding being at 6am). You never ever know with these kiddos.

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well, little lady is still hanging in there. a few days ago dad got to touch her for the first time, then the next day mum got to change her nappy, and yesterday mum got to have her first 'cuddle'.

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Goats'r'us - Australia and the US have different categories how we divide our baby nurseries. In Australia a level III nursery is the highest level offering most advanced care to the youngest and sickest babies. Your friends baby will be in a level III nursery where she receives the best possible medical and nursing care. Australia is one of the most advanced countries when it comes to neonatal medicine.(I reckon she's not in Alice) If your friends child has a chance on live - than that is where she is right now. Nobody will be able to predict outcomes - most infants who are majorly affected will show so by missing big milestones and are usually diagnosed by age two with cerebral palsy. Mild learning disabilities can still show during the first few years at school and if they actually go to uni they are probably among the little miracle group.

Hang on in there mate...

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My twin and I were born at 23 weeks gestation in 1984. We both survived and are completely healthy. My twin unfortunately developed ROP and now is completely blind. She has had her right eye removed due to severe glaucoma and can't see anything out of her left eye. She was in the NICU for the 4 months after birth and sent home with o2, I was in for 3 months after birth. Other than her having the ROP, we are both completely healthy..it's weird actually, I can see scars on both of our wrists from all the ABGs they did in the first few months of life. So think positively...things always turn out okay:)

No, things do not always turn out right! Yes, there are a few miracles here and there.The ones the media focuses on. But there is the vast majority that ends up not just fine with varying degrees of intellectual and physical disabilities. Go and ask those moms and dads who suffered through month and years of ICU and have a quadriplegic, trachy, peg, child with seizures at home who can neither sit,talk, walk, nor eat,play or relate to anyone. Who burnt through all the families and extended relatives funds for all the medical bills. Ask if they agree with your statement. We don't know what psychological damage we do to the microprems neither. They suffer through NICU. There is so much pain and so much stress which we can't address.

A 24 weeker can turn out okay and those are the ones everyone hopes for- but some times it is in the best interest of the patient to cease treatment.

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again, thanks for the information, and the mixture of cold realism and promising anecdotes. together they give me a nicely rounded picture of how things are.

baby is now onto day 4 on the outside, and so far things are going as well as can be expected.

can someone please tell me, is there a point where the risk of things going wrong decreases, or is it a case of 'i'll believe she's ok when she leaves NICU/turns 5/starts university'?

While I understand your need to reach a "comfortable" stage where risks of bad outcomes goes down, there honestly isn't a pat answer for this type of question. As another poster stated, in report these babes are referred to as "a former 24 weeker" because problems in which you'd think you'd be out of the woods by now may pop up later than expected.

Some problems are there from the outset, others may develop later on, and some even later. My daughter was born early, and she has some language delays. Fortunately, I have a degree in speech-language pathology and I'm able to work with her in this area. However, I ask her pedi when we may be out of the woods with EVERYTHING, and she says that some problems don't become apparent until school age.

It's a long journey with all the expected ups and downs. I suggest to your friend to find out various resources available to her. In the US, there are programs available for the 0-3 population. A child-life specialist may visit the house, twice or more to check the baby's progress and can make referrals on what she sees. This program is the tip of the iceberg as there are also resources available through the school district. However, as I said, I'm familiar with programs in the US and I readily admit that I don't know what's available in Australia.

My heart is with your friend, and I she can find and utilize all the options that are available to her. Best of luck to your friend and babe!

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Esme> Please understand the spirit of my question with absolutely no negativity intended. :)

What life choices are you referring to? I read the article a few times and I'm wondering which life choices you are referring to.

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update, since i've just returned to look at this thread..

she's now closing in on 2kg, weaning off CPAP really well and in an open cot!

mum and dad get to see her whole face!!

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Specializes in being a Credible Source.
I can now add that she tips the scales at a mighty 680g (1 1/2 pounds to you imperials) and I've decided this is pretty good for a girl of her development. well, it's better than 400g...[/quote']

The most important thing I've seen so far is that she is a SHE. Preemie girls do much better, on average, than do preemie boys.

24 weekers have significant risks for various physical and cognitive problems though some end up within normal limits across the board. The odds of WNL are fairly low but with all such issues, the severity run a broad spectrum.

The reason for the preterm birth can affect the prognosis.

Parenting a preemie is a roller coaster of emotions and energy and it continues long after discharge.

I'd like to recommend a book that was given us when our microkid joined the world unexpectedly:

Preemies: The Essential Guide for Parents of Premature Babies

It was written by a writer who had preemie twins and her sister who's a neonatologist.

It's a great book.

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Specializes in being a Credible Source.
as another poster stated, in report these babes are referred to as "a former 24 weeker" because problems in which you'd think you'd be out of the woods by now may pop up later than expected.

yep. my daughter was off the vent, on the vent, off the vent, on the vent... turn the corner then go around the block and get another transfusion... two steps forward, one step back... and sometimes two or three steps back... and we ended up with major issues at age 2-1/2 and age 4, requiring hospitalization and urgent surgery.

you just don't know... these kids are at higher risk for everything.

some problems are there from the outset, others may develop later on, and some even later. my daughter was born early, and she has some language delays. fortunately, i have a degree in speech-language pathology and i'm able to work with her in this area. however, i ask her pedi when we may be out of the woods with everything, and she says that some problems don't become apparent until school age.

well put. my 27 weeker is now 10 and doing fabulously but i still see some residual deficits and some cognitive processing issues. nothing severe but they're there... though most would never realize it.

well-written post
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Specializes in NICU, ED, Forensic Nursing.

I am a "24 weeker" born at 1lb 8 oz. I now weigh alot more than that, about to celebrate my 22 birthday in 8 days. I am currently in my sophomore year of nursing school, I have no issues that I know of. Positive thinking can help to turn things around and boost morale. Everyone needs a morale boost to face the hardest things in life. I hope that everything turns out okay. Please give yourself and your friend and the baby my best! I hope that everything works out.

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