By The Great Courses Staff

A record-breaking baby boy, born 16 weeks prematurely, has been discharged from Keio University Hospital in Tokyo. After five months of treatment, he’s going home with his parents, according to CBS News. How do neonatal doctors treat such tiny, fragile patients?

The baby boy, whose name was not released to the public, was delivered by emergency C-section and weighed as much as a large onion, reports CBS. Although, he could once fit into an adult’s cupped hands, he now weighs more than seven pounds and eats regularly. This medical miracle invites us to look at neonatal care and how such life-saving treatments are possible.

Identifying Health Problems in the NICU

Newborns, premature or not, are frequently treated in the Neonatal Intensive Care Unit, or NICU for short. A NICU is an extension of a maternity ward and has special equipment for—and doctors who specialize in—sick newborns. “Such a place didn’t exist in the early 1960s, but it’s now an essential part of any hospital with an obstetrics unit,” said Dr. Roy Benaroch, Adjunct Assistant Professor of Pediatrics at the Emory University School of Medicine.

Medical advancements help identify illnesses in infants and newborns better than ever before. For example, when a newborn grunts, he or she only shows difficulty breathing. However, heart disease, infection, low blood sugar, or other troubles may cause grunting. So what do doctors do? “We ask the staff to check the pulse ox (blood oxygen), draw blood for a complete blood count and blood culture, check the blood sugar, and get a chest x-ray,” Dr. Benaroch said.

Dr. Benaroch explained that each test rules out many different health problems. For example, low blood sugar may stem from maternal diabetes. Strong heartbeats indicate good cardiovascular health. A fuzzy-looking lung in the chest x-ray suggests neonatal pneumonia. In the latter case, doctors can administer intravenous antibiotics to newborns to help counteract pneumonia.

Causes and Complications of Early Delivery

Surprisingly, the medical industry has made little progress in preventing premature labor. Doctors now know many risk factors, however. Twins, in vitro conception, chronic health problems in the mother, and anomalies of the uterus all matter. “Moms who take illicit drugs, smoke, or drink alcohol are also at risk of premature birth, as are moms who don’t get good prenatal care,” Dr. Benaroch said. “But most of the time, a premature birth has no specific cause that we can identify.”

In addition, premature birth raises the risks of health complications for the baby. Fortunately, neonatal care has grown by leaps and bounds to treat premature birth problems. Premature babies, also referred to as preemies, typically have underdeveloped lungs that need help functioning. A device that gives continuous positive airway pressure is called CPAP for short and provides gentle pressure to keep the baby’s lungs inflated. This device helps support lung function as the preemie’s lungs continue to develop in the weeks and months following its birth.

Developments in IV administration have reached the point where doctors can give premature babies IV fluids and even feedings directly to the stomach through the umbilical stump. Premature babies have trouble maintaining their body temperatures. Doctors can use incubators to keep babies warm; although, they also recommend skin-to-skin contact with the baby’s parents.

The thought of infant mortality is terrifying for anyone with a preemie baby joining their family—whether they’re a parent, grandparent, uncle or aunt, or other relative. Although little can be done to prevent premature births, modern advances in medicine do save lives and do give early babies the opportunity for living long, healthy lives.

Dr. Roy Benaroch contributed to this article. Dr. Benaroch is Adjunct Assistant Professor of Pediatrics at the Emory University School of Medicine. He earned his B.S. in Engineering at Tulane University, followed by his M.D. at Emory University.