Premature birth data

[cdubz]

Discussed in https://github.com/babybuddy/babybuddy/discussions/318

^{Originally posted by rbeumer September 24, 2021} Our son was born early (<37 weeks) so he is still in the hospital. We care for him as much as possible but there are some things that are done differently because of his age:

• feeding via a tube because he is unable to swallow until he is old enough. This should be an option for feeding type.
• Age: when baby's are premature you basically track two ages: days past since birth and how much weeks the baby would have been if it was still in the womb. My proposal would be to be able to track this separately if you mark the baby as premature.

I hope this can help other parents 🙂

[jcgoette]

Possible model update

Add non-required GA (gestational age). From this and the existing birthdate, we can calculate and could display elsewhere:

• Postmenstrual age (PMA)
  • GA plus chronological age
• Corrected age
  • Chronological age minus the number of weeks born before 40 weeks of gestation

[cdubz]

Thanks, @jcgoette. That’s pretty much what I was thinking but you’ve already got the technical terms ⭐

[cdubz]

Reading up some more on the terminology in GA, PMA, PCA, Chronological Age, Corrected Age – Using the Correct Terminology in the NICU and fiddling with this Gestational age calculator for preterm infants I'm thinking the easier non-required field to add would be due date. The calculations seems like they'd be simpler (between that and birth date).

@jcgoette any reason you can think GA (I'm assuming this would be just a number field for weeks) would be more appropriate?

[jcgoette]

I don't feel strongly and I'm not an expert in this field:

I think for parents who have a premature baby, the GA will be readily available/known to them.

The EDD could be used to calculate the GA, but only if you knew which method was used to determine EDD (LMP vs. US).

Since the other metrics are calculated directly from GA and not EDD, I think it's best to use GA if possible.

[cdubz]

@TaddyJ @rbeumer any opinion on the discussion here re: adding GA or EDD as the primary field to track and calculate age data for preemies (since y'all have experience)? @jcgoette has me thinking GA makes sense but having never heard of the term before looking in to this I'm curious if its really something that is readily available to parents of preemies or if EDD is easier.

[rbeumer]

English is not my first language and I live in Europe so the norms may be different for us compared to the USA.

I'm not sure what the difference would be between using GA and expected due date. During pregnancy they calculated the expected due date based on size as seen on the ultrasound pictures in the first 12(?) weeks when all babies are the same size at the same age. In the hospital they used the number of weeks of pregnancy (which is GA?) as a reference for his development. For example: at 34-35 weeks a baby would be expected to develop x and y skills (e.g. drinking from a bottle).

I would say that two fields would be useful: expected due date (when the baby would be 40 weeks of age) and an optional field to enter the number of weeks and days when the baby was actually born. So, let's say a baby is born at 30 weeks of pregnancy and it has been 2 weeks you could show the age as 32 weeks.

Until 40 weeks of age you could show the number of weeks based on the actual date of birth. I'm not sure if that should be a manual switch for interested parents or you could add some kind of logic that if the actual date of birth is before 37 weeks you would show this “special” age (which is the cutoff date at which a birth is considered normal over here). After 40 weeks of age you could start showing the age as 0 weeks/days and so on.

[joostvannus]

We just started using Baby buddy and like it very much.

Our baby girl was also born prematurely, and we would like to track how much of her feeding is done by tube. Therefore we would also like to see the feeding type "Tube", or "Sonde" in Dutch, added to the selectable feeding types.

Is it possible to make this change separate of the proposed age chance so the change can be implemented quicker? (Assuming that adding a feeding type is an easy change)

Please let me know if I can do anything to help.

[TaddyJ]

@TaddyJ @rbeumer any opinion on the discussion here re: adding GA or EDD as the primary field to track and calculate age data for preemies (since y'all have experience)? @jcgoette has me thinking GA makes sense but having never heard of the term before looking in to this I'm curious if its really something that is readily available to parents of preemies or if EDD is easier.

Sorry I didn't see this earlier. Gestational age or Expected Due Date are especially the same thing. It's fancy talk for if your baby was born when it was supposed to it would be this old. Makes it easier for working out milestones pre 2 yrs of age. Our son has just turned 2 and is just shy of his GA now and you wouldn't know.

This could be easily done by having a checkbox in the child setup. "Show Gestational Age First". And at the top it would show their GA and followed by their Birth Age in the dashboard. And at the age of 2 it could go back to hidden. Should be pretty easy to add it to the database/dashboard. If GA = yes display date, if null = hidden??

On the tube feeding. Maybe an easy way to add tube feeding/alternative methods would be to add tags in the same way you have done for nappy changes.??

I.e Formula -Tube Not a perfect solution but definitely one that will make the feeds searchable and visible through colours much easier.

On a side note we are expecting our 2nd in 6 months time. So hopefully we won't need to worry about this feature but definitely handy for some other parents who will unfortunately have to experience a pre term baby. 🥰