A premature baby is a baby born before 37 weeks of pregnancy. But above all, it is a tiny human being who had to become a fighter before his or her body was ready for it. In the world of neonatology and physiotherapy, we often talk about the „race against time”, but what is really the biggest challenge in this race?

It is not only a struggle for food intake, independent breathing or functioning eyesight, but also for the proper functioning of the brain, which is developing every day. As paediatric physiotherapist With many years of experience working with premature babies, I know that the road ahead for such a baby and its parents is rarely straight.

Find out why early intervention in children born prematurely is not a choice, but a necessity that goes far beyond mere fitness. The road to the goal is not easy but it is certainly worth fighting for a good future for the little warriors.

The premature baby - who it is and what it comes into the world with

As paediatric physiotherapist in Warsaw I have had the opportunity to observe the development of many premature babies. I have spent hundreds of hours examining them, planning therapies, selecting orthopaedic equipment and mentally supporting the parents.

These seemingly small creatures are huge heroes. Their inner strength and determination is something that consistently fascinates and motivates me.

As a mum of two children, I know that every parent dreams of peaceful parenthood and wants to give their little one the best start. About the first months without fear, without hospital corridors, without endless visits. In the case of a premature baby, I have to verify this dream sometimes brutally, although with full empathy. The first months of life of a premature baby is often a time of constant checks, tests and therapy. It has little to do with peace of mind, but you know what? IT'S WORTH IT. It is worth it, because everyone Efforts made for the proper development of premature babies will pay off a thousandfold.

The biggest challenge in treating preterm infants is not a specific motor deficit. It is the complexity and multidimensionality of their needs. When the child is born prematurely, his nervous, respiratory, circulatory and every other system is violently torn from the safe, quiet and confined environment of the womb. He is suddenly greeted by a world full of blinding lights, the noise of hospital equipment and the pain of medical procedures. This builds the foundation we have to work on - a foundation that is very fragile at the start.

Why does therapy for a premature baby need to start as soon as possible?

The answer lies in the neuroplasticity of the brain. The brain of a premature baby is like freshly ground clay - incredibly susceptible to modelling, but also rapidly hardening. In the first months of life, neuronal connections form at the speed of light.

The problem is that lying in one position for a long time under a ventilator, accompanied by tubes and wires, severely restricts the child's free spontaneous activity. With every week that the child perpetuates incorrect positioning and movement patterns, the brain starts to recognise them as the „norm”.

Our task (therapists and parents together) is to use this golden window of plasticity before bad habits in the brain are permanently stored. There is no room for a „let's wait and see” strategy. - in a premature baby, every week of delay can turn out to be months of catching up. The earlier we introduce therapy, the less effort a child will have to make to learn proper movement in the future.

Therefore, in Kids Medic in Warsaw, therapy for premature babies is recommended immediately after receiving the green light from the neonatologist. This is not a recommendation out of caution, but a decision based on how the baby's developing brain works.

What a premature baby needs - a comprehensive approach to therapy

Parents very often ask me: „Mrs Anna, when will our little one start crawling?”. And I, when carrying out the examination, look not only at the deficits in physical development child But I look at the whole functioning of it.

As a sensory integration diagnostician, I can pick up on sensory disorders already at the infant stage. Therefore, the therapies that work for premature babies are not only neurodevelopmental Ndt Bobath or Vojta, but also elements of sensory integration and respiratory therapy. Premature babies need support on many levels, which complement and permeate each other.

Sensory development

This is one of the latest perceived, and greatest challenges. The toddler in the incubator has experienced sensory deprivation (lack of soothing mother's touch) while being over-stimulated (noise, insertions, intense light). This leads to sensory integration disorders. Such the child may be afraid of touch, noise, have difficulty calming down, sleeping soundly or react with anxiety to new stimuli.

Cognitive and social development

Problems concentrating or making eye contact often have their origin in the immaturity of the nervous system. Therapy must support the building of a relationship with the carer, which is the basis for the child's future emotional development.

Respiratory physiotherapy for the preterm infant - the foundation of everything

A challenge that is all too rarely talked about, but which is the foundation of everything - is breathing. Premature babies often struggle with bronchopulmonary dysplasia (BPD) or simply immaturity of the lung tissue. A child who struggles for every breath will not have the resources to learn to turn or sit up. This is a simple but often underestimated link.

Respiratory physiotherapy - proper positioning, supporting the diaphragm - this is often the first and most important stage of our work. Without a strong, efficient respiratory system, there can be no postural stabilisation. They are interconnected vessels. If the chest is stiff and breathing is shallow, the whole the child's body will be under constant tension, preventing proper motor development.

Feeding and speech of prematurity - the role of the neurologist

For a premature baby, „suck-swallow-breathe” coordination is a real Mount Everest of skills. Many babies born prematurely have traumas in the mouth area due to intubation or probing. This leaves a mark.

This is where neurological therapy, which is an absolute pillar of early intervention. It is not „learning to speak”. It is working on mouth sensation, correct tongue and lip positioning, correct tension of the circular muscles of the mouth, safe swallowing.

If we do not help the child at this stage, in the future he or she may face food selectivity, speech defects and even tension problems throughout the trunk. Neurologist and physiotherapist in a premature baby are a tandem, which must work closely together. W Kids Medic We work just like that - together, not side by side.

The parent as therapist - the most difficult and important role

When working with premature babies, a huge challenge is also... the support of the parents. As a mum, I know how easy it is to drown in anxiety about your child. As a therapist, I see that parent of a premature baby is often in a state of permanent stress and exhaustion, which does not go away when leaving hospital.

Therapy for a premature baby is not just 45 minutes in the office. It is the way of carrying, bathing, feeding, talking to the child, playing and all care activities 24 hours a day. Our task is to teach parents how to become their child's therapist in their everyday life. And most importantly, so that the sheer joy of being a mum or dad is not lost in the process.

Intensive treatment of preterm infants should not destroy proximity. It should build on it and strengthen it. This is possible, and this is what we are fighting for together with the parents of our little patients.

Is every day worth fighting for?

The biggest challenge in treating preterm infants is understanding that we don't have time to wait. Their development is a complex jigsaw puzzle in which movement, breathing, muscle tension, eating and emotions form one integral whole.

Intensive early intervention is not about „tormenting the child”, but giving him or her a chance to make up for a start that has been brutally rushed. Although the brain of a premature baby is very fragile and sensitive and has an incredible power to regenerate and grow - if only we give it a helping hand in the right way and at the right time.

If your baby is born prematurely, don't wait until there is a ‘problem’ or a moment when you are concerned that your baby should already be doing something and you can't see it yet. Every week is important for his future fitness and comfort.