Premature birth rates are continuing to climb amidst efforts by several organizations and research to find the cause. The average gestation of full term pregnancy of 40 weeks has decreased to the average length of 39 weeks. As research marches on to find a cause and a method to control this phenomenon, we have a situation that can no longer be ignored.
The fact is there are over 9,600 preterm infants born every week in the United States alone. These tiny babies, some less than 16 ounces, struggle every day just to survive. Yet manufacturers of everyday clothing and accessories have refused to acknowledge the special needs these tiny miracles have. It could be a half a million children a year are not worthy of special manufacturing or it may be the consumer value is not high enough. Whatever these manufacturers reasoning’s are, there is only one manufacturer that has put preemies comfort ahead of profit margins.
As any parent of a premature infant will attest, it is next to impossible to find clothing that is sized for babies 3-6 pounds, tiny nipples for bottles in which they can suckle, diapers, pacifiers, on and on. Some manufacturers have labeled their clothing as Preemie yet when they are put on these tiny babies they are still too big. Why? Because the average 3-6 pound baby is 12 ½ inches from wrist to wrist and manufacturers make their clothing 17 inches from wrist to wrist. Parents are destined to roll, tuck, and fold these garments until their baby has grown into typical newborn clothing that can take months.
Alternatively, out of desperation, they resort to doll clothing. Some parents justify putting their babies in these clothes because it is the only clothing they can find that fits the baby. Unfortunately, parents are unaware of the pain they are unknowingly causing their child. Doll clothing is made from stiff cotton so that it retains its shape. Seams are stitched with nylon thread and are large and bulky. Take an outfit and rub it gently on the inside or your arm and you will feel the harshness.
Preemies skin is so rice paper thin you can see the blood veins. This is why their sensitivity is manifested. To understand why preemies are more sensitive to pain you need a little understanding of the makeup of skin. The skin is the largest organ in the body and is made up of three main layers. The Epidermis, the Dermis and the underlying Subcutaneous fatty tissue. Within these layers lie the blood vessels, nerves, sweat/oil glands and hair follicles. The Epidermis, or outer layer, is further divided into the; Stratum Corneum, Stratum Granulosum and Stratum Germinatium. The latter of these are at the junction of the Epidermis and Dermis and are where the renewal of the Basal Cells is carried out. These cells constantly divide and are called Keratinocytes. Simplistically, these can be thought of as analogous to the bricks in a wall, with the mortar between, made up of lipids (fat cells).
It is this barrier, which allows the retention of fluids within the Epidermal cells, which remain plump and prevent the introduction of microorganisms, chemicals and allergens. When intact, this imaginary wall regulates temperature, acts as a barrier to infection, balances water/electrolytes, stores fat and insulates against the cold. The skin is also a large tactile area, for the interpretation of stimuli.
The Stratum Corneum itself is made up of 10-20 microscopic layers in an adult and the full term infant. In premature infants however, this number drops to between 2-3 layers. In extremely premature infants, of less than 23 gestational weeks, this layer may be virtually non-existent. Consequently, the risk to these babies is even higher.
Babies are born with an alkaline skin surface, with an average pH of 6.34. However, within days, the pH falls to about 4.95 (acid). This also occurs in premature infants, although the process may take weeks rather than days to complete. This is known as the ‘Acid Mantle’ and is the skins protector. The development of this ‘Acid Mantle’ takes between 2 and 8 weeks, depending on gestational age, so it is even more important to avoid damage to the premature infant’s skin in their early weeks of life.
Damage to the baby’s skin is inevitable through medical treatments, tape used for keeping the cannula in place, and general care of the infant. Alleviating as much discomfort to these tiny babies is even more important. One way to accomplishes this is to dress the infant in clothing that is comfortable and accommodates their special needs.There is only one manufacturer that has designed a line of clothing specifically for preemies that addresses all their medical needs.
If you have a preemie, know someone who does, or medically assist these babies, consider the baby’s comfort next time you reach for newborn sized or doll clothing to dress them. A baby that is not in continuous pain will respond and thrive much better. If in doubt, wrap yourself in steel wool for a day!