Premature Birth Treatment in Mumbai

Our Approach to Preterm Neonatal Care

Every week in the womb matters - when it ends early, we bridge the gap.

A baby born at 28 weeks weighs little more than a bag of sugar. Their skin is translucent, their lungs lack the surfactant needed to breathe independently, their brain is exquisitely vulnerable to pressure changes and low oxygen, and their gut cannot yet coordinate sucking, swallowing, and breathing. Yet with the right environment, the right support, and the right team, babies born even at the edge of viability can and do survive - and go on to live full, healthy, and unremarkable lives.

At Shree Hospitals, our approach to preterm baby NICU care and survival support in Mumbai is built around two equally important goals: keeping the baby alive and stable in the short term, and protecting the developing brain and organ systems to give the best possible long-term developmental outcome. These are not the same goal, and our neonatal team holds both in mind simultaneously throughout every day of a preterm infant's admission.

1. Delivery Room Stabilisation - The First Minutes

• Dedicated neonatal resuscitation team present at every anticipated preterm delivery
• Plastic wrap and radiant warmer use from birth - preventing the hypothermia that can catastrophically worsen outcomes in preterm neonates
• Gentle respiratory support initiated immediately - avoiding aggressive ventilation that can injure the immature lung
• Delayed cord clamping where clinically safe - providing an additional bolus of blood and stem cells that significantly benefits preterm babies
• In-delivery-room surfactant therapy for premature babies for extremely preterm infants where early administration improves outcomes

2. Respiratory Support - The First Priority
    
   Lung immaturity is the most immediately life-threatening consequence of prematurity:

• Non-invasive CPAP as the first-line respiratory support - maintaining lung inflation without the trauma of intubation
• Intubation and mechanical ventilation when CPAP is insufficient - using lung-protective strategies to minimise ventilator-induced lung injury
• Surfactant therapy for premature babies - delivered directly into the airway to replace the natural substance the lungs haven't yet produced
• High-frequency oscillatory ventilation for severe respiratory failure unresponsive to conventional approaches
• Inhaled nitric oxide for pulmonary hypertension complicating prematurity

3. Nutritional Support - Building From Day One
    
   Every calorie matters when a preterm baby needs to grow and develop:

• Total parenteral nutrition started within hours of birth - providing protein, glucose, lipids, vitamins, and minerals intravenously while enteral feeds are established
• Minimal enteral feeding with expressed breast milk from the earliest possible day - tiny volumes protect the gut lining and prime the digestive system
• Gradual feed advancement guided by the baby's clinical tolerance, bowel sounds, and abdominal examination
• Lactation support for mothers of preterm babies - expressed breast milk is the single most protective nutritional intervention available
• Kangaroo mother care - skin-to-skin contact with the mother, proven to improve weight gain, reduce infection, and support breastfeeding

4. Brain Protection - The Long-Term Investment
    
   The preterm brain is exquisitely vulnerable, and protecting it requires constant vigilance:

• Cranial ultrasound from day one - screening for intraventricular haemorrhage, the most common brain injury of prematurity
• Avoiding preventable factors that worsen brain injury - hypoglycaemia, excessive stimulation, rapid fluid shifts, and uncorrected anaemia
• Amplitude-integrated EEG for seizure monitoring in high-risk neonates
• Magnesium sulphate administration before delivery where possible - a neuroprotective strategy significantly reducing cerebral palsy risk
• Early physiotherapy input within the NICU setting, supporting appropriate developmental positioning

5. Infection Prevention & Screening
    
   The preterm immune system is profoundly immature:

• Strict hand hygiene protocols throughout our NICU - the single most effective infection prevention measure
• Blood culture-guided antibiotic therapy for suspected sepsis, with early de-escalation when cultures are negative
• Routine screening for retinopathy of prematurity (ROP) - a vision-threatening complication in very preterm babies
• Newborn hearing screening before NICU discharge - identifying any hearing impairment for early intervention
• Scheduled vaccination catch-up from the appropriate corrected gestational age

6. Family-Centred Care & Developmental Follow-Up
    

• Parents welcomed as active participants in care from day one - kangaroo mother care, feeding participation, and developmental positioning support
• Psychological support for families navigating the emotional weight of a prolonged NICU admission
• Structured developmental follow-up clinic at corrected ages 3, 6, 12, and 24 months
• Early intervention referral for any developmental concerns identified during follow-up
• Discharge planning beginning well before the anticipated discharge date, ensuring families feel prepared and confident.