Caring for the smallest of the small is how neonatal pharmacist Oh Ching Ching (left), 27, describes her job.

A premature baby "can be the size of an adult's palm and weigh just over 1kg," she said. But they are not tiny adults.

"Premature babies are a unique population with their own special needs. A lot of their organs are not fully mature. This means their bodies may not be able to handle medications the way ours do," she explained.

The liver and kidneys of premature babies, defined as those born before the 37th week, are not fully functional and this hinders the body from clearing the drugs given to them.

"This means the lowest level of certain antibiotics in the blood has to be closely monitored to see if it is accumulating in the tiny body or effectively cleared," Ms Oh explained.

"Also, these patients cannot communicate like you and I do, making it difficult to assess pain. So I need to be extra careful and alert," she said.

Aside from the challenge of what to give them, how to give it to them is another problem. They cannot swallow and their veins are too tiny and fragile to infuse.

Premature babies are mostly given their medicines and nutritional feeds through a central line or an umbilical catheter. It is a tiny plastic tube inserted into the blood vessel of a baby's umbilical cord through which fluids are given and blood samples withdrawn.

Before she began specialising in the tiniest people, Ms Oh worked in the general pharmacy of the KK Women's and Children's Hospital (KKH).

"But I was interested in learning more about pharmaceutical care of the paediatrics and neonatal population. When I was given the opportunity at KKH, I jumped at it," she said.

Neonatal practice is a rapidly developing area.

The popularity of in vitro fertilisation, and its accompanying multiple births, results in more premature babies being born.

And with advancements in medical care, babies born weighing less than 1kg have a better chance of surviving than ever before - about 80 per cent now, compared with 20 per cent 20 years ago.

Ms Oh's work involves more than drug therapy. She also works with the Neonatal ICU nurses to monitor their nutrition, which, like the medicines, must be given intravenously.

"This is closely related to providing a holistic pharmaceutical care to the neonates," she said.

"We have to monitor the baby's electrolyte levels, and whether he can tolerate the rich nutrients."

Ms Oh goes on rounds with the doctors every morning to understand her charges' conditions, so that she can intervene in their medication if necessary, counsel parents and teach them how to care for their tiny babies.

Ms Oh said her happiest moments are to see her charges 'graduating' from NICU and going home with their parents.

"We miss them when they go home, but we are glad they are able to go home," she said.

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