The beating heart of Kalafong’s baby ward
There is a quiet serenity in Ward 4 at the Kalafong Hospital in Atteridgeville, Pretoria, even though it houses 20 newborns and their mums. Kalafong’s kangaroo babies are sound asleep in their pouches. All of the babies were either born below average birth weight – less than 2.5kg – or prematurely, and would usually be confined to incubators away from their mothers.
But Dr Elise van Rooyen, the head of the hospital’s Kangaroo Mother Care Unit, is working hard to change this way of doing things.
She is championing her cause through her research at the University of Pretoria, training other state hospitals to also become kangaroo-care friendly.
“Listen,” she says. “Our babies almost never cry. They are at peace.”
Van Rooyen and her team have been operating the kangaroo care unit since 1999 at Kalafong. In that time, 5 600 vulnerable newborns have gone through the ward, and only 44 have died.
Van Rooyen says 44% of those 5 600 were high-risk babies who weighed less than 1.5kg.
Cornelia Ngomane said both she and her son Banele love kangaroo care. Leandi van der Linde’s second son, Janko, is much more relaxed than her eldest, despite his lower birth weight.
“This has been a much more tranquil experience for us both,” said Van der Linde. “As long as my kangaroo baby is lying on my breast, he is happy.” Mothers have their own eating hall and lounge, and don’t leave the ward until their baby is discharged.
Annah Bonokwane and Angel have been residents of Ward 4 for 99 days.
Angel weighed just 700g at birth when Bonokwane gave birth at 27 weeks on May 6.
“I was angry and scared at first when she was born,” Bonokwane said, swaddling Angel in her special Thari wrap.
Angel is almost chubby now, weighing in at 2.8kg. “This has helped me with bonding with my baby. I have this wonderful feeling. I was taught all these great things and my baby is strong.”
Van Rooyen designed the low-cost Thari wrap in 2003 for South Africa’s kangaroo mums. The baby is positioned between the mother’s breasts and tied directly to her – skin on skin. The mother’s skin, unlike the rough linen of an incubator, serves as a biological membrane.
“The mother’s skin moisturises the baby’s skin, preventing it from drying out, and decreases the chances of bacteria entering the skin,” says Van Rooyen. “There are bacteria that live in symbiosis on the mother’s skin. These bacteria colonise the baby’s skin and protect it from pathological and harmful bacteria.”
Premature babies are normally removed from their mothers as soon as they’re born and their tiny bodies are exposed to all kinds of invasive procedures, including a painful drip.
Every four hours, a nurse comes to check the babies’ blood-glucose levels with a heel prick.
“This is all very traumatic for a newborn, snugly cuddled in its mother’s womb up to now,” said Van Rooyen.
“These babies can experience severe pain, for instance from soft stroking on the skin. The high stress levels that continue without a pause have a very harmful effect on the babies’ development.”
By contrast, the kangaroo care babies are fed breast milk either directly, or through a cup. Breast-feeding is central to the health of kangaroo care babies, Van Rooyen explains.
The babies hear their mothers’ heartbeat, as it sounded while in the womb.
Van Rooyen says infection rates go down with the method as well, with babies less exposed to the nasty bugs that often roam in hospitals.
Babies are also discharged earlier if they are healthy, even if they still have a low weight.
Even though Kangaroo Mother Care works best with mums, fathers can also participate to give mothers a break.
MOTHER’S TOUCH Annah Bonokwane and her baby, who was born prematurely and is being treated at Kalafong Hospital’s Kangaroo Mother Care Unit
SAVING LIVES Dr Elise van Rooyen, the head of the hospital’s Kangaroo Mother Care Unit