By Faith lawino and Beryl Alaka.
Of the most thrilling and exciting moments on earth, is the joy of giving birth to a newborn. The happiness and fulfillment that comes with being a mother is unexplainable, however, such joy is cut short by the baby being delivered before its due time.
The act of delivering a baby before its due time that is before 37 completed weeks is termed as Pre-term birth. It is commonly known as Premature birth.
Every year, 15 million babies are born pre-term all over the world. This counts for more than one baby out of 10 globally who are born prematurely.
Pre-term births often occur simultaneously and there is need to create awareness and public education on the matter.
Mama Dorothy Nyongo’ Kisumu’s first lady joined pre term moms and their care givers at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) to create awareness on premature births.
They marched along the streets of Kisumu to mark the world prematurity day whose theme was ‘zero separation, keeping parents and babies born too soon together.’
In every 100 births at JOOTRH, 10 are premature. The mothers of pre term babies were acknowledged as heroes and gifted during the celebrations.
Mama Nyong’o acknowledged that premature births often come with a lot of anxiety and burden to parents and even to family members. “There is dire need to create awareness on pre-term births to remove the psychosocial burden in parents who often blame themselves for giving birth to premature babies.” She said
To families, the mother’s absence in the family usually brings loneliness and sadness in the family but especially among the children. This is a big challenge since the mother is the backbone of the family, an issue which extends to the community since children need parents care to grow and function well.
Annually, the world celebrates World Prematurity Day usually on 17th November. World Pre-term Day is a key moment to focus global attention on the burden of pre-term birth, leading to long term morbidity and infant mortality.
It is an opportunity to call attention to the heavy burden that pre-term birth cause on parents, families, friends and on former pre-term born children and also a chance to talk about solutions. According to The World Health Organization Global Report 2019, the theme for World Prematurity Day was, “Survive and thrive: Transforming care for every small and sick newborn.” Currently, the theme for World Pre-term Day due to be celebrated today is, Zero Separation Act Now! Keep Parents and babies born too soon together.
Dr. Josephine Ojigo, is a consultant Pediatrician and head of Pediatric department at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH), explained facts about pre-term babies, the care process and importantly, the need to provide community education and create awareness on pre-term births.
JOOTRH Newborn unit, is a department within the Division of Pediatrics. It’s a 50 bed capacity segment ,providing immediate and standard neonatal care. It has around 900 admissions yearly with a daily bed occupancy of about 20-50 babies.
4 out of 10 babies admitted to the JOOTRH newborn unit are premature. Some premature infants also often have other conditions that warrant their admission at the newborn unit. Such include; infections or even surgical intervention.
Dr Ojigo said that most of the babies administered at the newborn unit are mostly from the maternity unit, specifically the labour unit.
Upgrading to a level 6 facility, JOOTRH has continued to receive babies referred from peripheral public hospitals within Kisumu and neighboring counties such as Vihiga, Siaya, Nyamira, Kisii and even as far as Migori. It also hosts babies from private hospitals such as Agha Khan and Avenue hospital in Kisumu County.
The basic needs for a premature baby are; warmth, feeding and management of infections and any other complication. “In pre-term babies, normal transition does not occur and adaption has to occur very fast for them to adapt. Some therefore, develop complications such as breathing problems since the lungs are not mature and risk of infections are very high.” Dr Ojigo adds.
Others take time to develop suckling process and therefore have to be fed milk.
Joyce Oketch who is the nurse in charge of the new born unit at JOOTRH added that the department is equipped with a recitation room where babies are received and further admitted at the nursery for monitoring band stabilization.
The unit admits babies as tiny as 900 grams. There is a Nursery II room where babies above 1000grams are admitted. Babies here are put under incubator care and feeding is done through the mouth or nose of the baby using nasogastric tubes.
This is done to babies who have not developed the sulking process also called the reflex process. Mothers have to first express their breast milk which is then fed to their babies.
The Nursery III room are for babies’ of 1600 grams and above. Preterm babies are usually released to be taken home after they attain a weight of 1800 grams.
Apart from baby feeding using nasogastric tubes, babies who are able to suck are breast fed by their mothers.
“This aids in bonding the mother and the child and helps in brain development and growth, babies tend to grow faster when they are close to their mothers.” Dr Ojigo added.
The young infant feeding program, advocates for mother’s milk to the baby since it is the best, as it contains nutrients that aid in healthy growth of the baby.
Infants are usually fed in a three hourly basis or even after two hours in extreme cases. The third approach that the pediatric department employs is the family centered approach. This is where mothers of babies are involved.
The department has a Kangaroo mother care room where mothers stay skin to skin contact with their pre-term babies. This enables the infant to get warmth from the mother, a condition that is close to what the baby would have gotten in the womb.
Kangaroo room comes from the term where kangaroo animals carry their young ones in their pouch. The importance of family center approach is that it helps build confidence in mothers, when premature birth occurs, some mothers blame themselves and some even feel unworthy.
There are specific machines in the facility that aid in the development and survival of premature babies. They include; Breathing machines or incubators which sip up positive pressure to the baby. It helps their lungs to remain open throughout, since they cannot breathe on their own.
Phototherapy machine, that is used to prevent jaundice in babies. Jaundice is the yellow coloration in babies due to increased breakdown in the red blood cells. The yellow pigmentation in babies if not prevented can lead to permanent brain damage to the baby.
There are many mothers to premature babies and Rebecca Achieng’ from Muhoroni, is a victim of self-blame and feelings of being unworthy and burdened.
Rebecca is a mother of 5, three children at home and twin baby girls born prematurely. She is also asthmatic and recalls of the numerous nights that she spent in tears with the fear of losing her two lovely twins.
Amazingly, she gave birth on a Mashujaa Day, a day she was a heroine but still had to spend several days and nights at the Newborn Care Unit, nursing her babies.
The babies were born underweight before their due time. Through the Nursing care at JOOTRH new born unit, she is a mother of all smiles as she and her babies will be going home.
The babies now weigh 1860 grams and 1810 grams respectively. The hours of pain however, are not forgotten as she questioned why she gave birth to premature babies.
Rebecca’s previous deliveries had been successful and giving birth before due date in a way interfered with her self-confidence and esteem.
JOOTRH, is in partnership with Newborn Essential Solution and Technologies, (NEST) which is supported by Kenya Medical Research Institute (KEMRI) and The Ministry of Health. (MOH)
Dr Ojigo underscored the need to invest in quality newborn care. Joyce Oketch the nursing officer in charge, also adds that sometimes there is insufficient drugs such as caffeine in the facility. She pleads to the Ministry of Health to act as fast as possible to ensure effective service to the Newborns.
The aim is the pre maturity day was to eradicate stigmatization and enlighten mothers and even fathers on premature births.
It is an important day to take care of those born prematurely and give them space and a voice, love, care and attention. Pre-term birth is not a crime but in can be prevented and reduced.