Premature birth leading cause of deaths
Botswana joined the rest of the world to commemorate the World Prematurity Day ( WPD) on November 18th in Francistown under the theme, ‘ A parent’s embrace, a powerful therapy. Enable skin- to- skin contact from the moment of birth’.
Giving an outlook during the World Prematurity Day ( WPD), Dr. Tshireletso Ramaphane- Makwape, a Paediatrician who works at the Special Care Baby Unit, explained that a premature baby is a baby born before 37 completed weeks of pregnancy.
According to Dr. RamaphaneMakwape, these babies are born with weight that ranges from 500g to1.5kg. When they are born, they are not yet ready to sustain themselves outside the womb.
“Their organs are not mature, and they might need machines to breath. Some of the health issues that they might face include bleeding in the brain, and others might live with disability,” she explained, adding that they are also prone to infections, which is why they don’t allow a lot of people to go into their rooms.
She also highlights that as medical practitioners, they educate and talk to the parents, explaining to them what their new life will entail, as well as the challenges that might possibly arise.
She said they update the parents about the progress of the baby, as well as do tests to see if there are any changes. As is the case with cases, like this, parents are bound to have anxiety, with some being afraid to hold the baby.
But with the help of a psychologist, they are able to work through these issues. In some cases, the baby can be hospitalised for three to four months depending on case- to- case basis.
But even with all the problems that they face, there are success stories for preterm babies. One that she recalls is that of a baby girl who was born at 500g. Today, she is leading a healthy life, and is now aged two years.
Causes that might lead to a preterm birth vary, and they include hypertension, low blood/ anaemia, under nutrition, mothers who are either below the ages of 21, or even mothers who are between 35- 40 years as well as obesity and diabetes.
Other medical factors include problems with the uterus, cervix, placenta - such as placenta previa, where the placenta attaches low in the uterus.
The placenta might partially or completely cover the opening of the uterus called the cervix. Placenta Previa can cause severe bleeding in the mother before or after delivery, pregnancy with twins or triplets.
WPD is one of the most important days in the year, as it raises awareness of the challenges and burden of preterm birth globally. This year’s theme is in line with the 2021 theme of Zero Separation.
Skin- to- skin contact has proven to be an extremely beneficial and effective practices with many benefits to the preterm baby like initiation and sustaining breastfeeding, stabilisation of vital signs, weight gain and promotes bonding.
“Let me highlight that a parent’s embrace not just a mother’s embrace, so even fathers should do skin- to- skin. Unfortunately, in our hospital settings, due to lack of space, fathers are unable to do this but they can do this once the babies are discharged from the hospital.”
The World Health Organisation ( WHO) recently published new guidelines. WHO recommends that Skin to Kangaroo mother care or skin to skin contact should begin immediately after the babies take their first breath, without any initial period in an incubator.
In the guidelines, WHO also shares that these tiny game changers can survive, thrive and chance the world but that this can only happen if each baby is given that chance.
“These guidelines show that improving outcomes for these tiny babies is not always about providing the most high- tech solutions, but rather ensuring access to essential healthcare that is centered around the needs of families,” said Tedros Adhanom Ghebreyesus, the WHO Director- General.
According to the guidelines, numbers are rising, which makes prematurity the leading cause of death of
children under five, and an urgent public health issue. The guidelines further point out that when it comes to survival, significant disparities exist depending on where premature babies are born.
“Whereas most born at or after 28 weeks in richer countries go on to survive, the rate in poorer countries can be as low as 10 per cent,” says the guidelines.
The guidelines also highlight that preterm babies lack body fat, so many have problems regulating their own temperature when they are born, and they often require medical assistance with breathing.
“Previous recommendations called for these babies to first be stabilized in an incubator or warmer, for around three to seven days on average, representing an initial separation from their primary caregiver,” states the guidelines. However, WHO said research now shows that starting kangaroo mother care immediately after birth saves many more lives, reduces infections and hypothermia, and improves feeding.
For premature and small babies, the first embrace with a parent is not only emotionally important, but also absolutely critical for their survival and health said Dr. Karen Edmond, Medical Officer for New- born Health at WHO.