Approximately 84,000 preterm babies are born in South Africa every year. To mitigate the many risks that accompany these kinds of births, it may be necessary for these babies and their mothers to be referred to a Neonatal Intensive Care Unit (NICU). Administering the proper treatments and having access to expert information on how to cope with preterm birth and other complications, is a crucial part of raising a healthy infant.
Aliné Hall, Clinical Quality Specialist at Mediclinic Southern Africa explains that the NICU provides critical support for mothers and babies. At Mediclinic the NICU admits predominantly preterm babies, but also admits newborn babies who are born with a viral or bacterial infection, have congenital abnormalities or who need additional help transitioning from being in-utero to the post-delivery period.
Supporting brain development
Touching on some of the most common issues that medical professionals in the NICU deal with, Hall says that preterm babies are fully formed but their organs need to mature enough for them to manage without support.
“For example, the brain of a preterm baby, being not fully matured, may not be able to co-ordinate sucking, swallowing and breathing. In these cases, the baby may require nasogastric tube feeds, which involves feeding the baby their mother’s breastmilk through a tube that goes through the nose or mouth and into the stomach,” she explains. As the baby matures this feeding reflex develops and the baby is able to take their full feed from breastfeeding.
Furthermore, because the involuntary act of breathing involves a central drive in the brain, preterm babies with underdeveloped neurological systems may forget to breathe. As the baby matures and reaches term gestation, this issue normally resolves – but until then, they are closely monitored so the nursing staff can intervene quickly, and they are given medication to stimulate their breathing.
Helping preterm babies breathe more easily
The bulk of admissions to the NICU relates to preterm babies who are born with lungs that are not yet ready to support their bodily functions. In this case, they will be administered a special drug called surfactant to help the lungs mature.
Following this, they may need additional respiratory support, which ranges from extra oxygen to non-invasive ventilation (where pressure is given to the airway via a mask or prongs on the nose) or invasive ventilation (where an endotracheal tube is passed through the nose into the lungs and the baby breathes with the assistance of the ventilator).
Addressing feeding issues
In cases where a preterm baby is born with underdeveloped gut, the baby may need to receive intravenous feeds via a special catheter which is inserted into a vein. Preterm babies are also more predisposed to neonatal jaundice. Resolving this may require phototherapy, which is light therapy that helps to break down the jaundice in the skin and allow it to pass out of the body .
Ultimately, as Hall asserts, “The basic aim of NICU is to get the baby strong enough to be feeding on their own, growing well and able to maintain their temperature in the normal environment and not an incubator and get them home as soon as possible.”
Understanding the risks for baby
A preterm or sick newborn baby has an underdeveloped immune system which makes them more susceptible to infections. In addition, the more preterm the baby is – the higher the risk of long-term neurological difficulties, sight and hearing challenges as well as learning difficulties. Although the NICU can never mimic the safety of the maternal womb, modern NICU’s attempt to create a safe environment for them to grow and develop as healthily as possible.
Helping moms to recover
Health implications for the mother will depend on why the baby was born premature or sick. If she suffered pre-eclampsia, for example, she may have ongoing blood pressure challenges. In addition, if she has a placenta problem and experiences prolonged bleeding, she may require a blood transfusion.
“Apart from the neurological, respiratory and physical effects that come with having a preterm baby or experiencing other birthing complications, there are also emotional factors to consider, which are often overlooked. Moms whose babies are born early or who have congenital conditions often experience extreme levels of stress and concern.
It is also not uncommon for these mothers to grieve the loss of a normal pregnancy and being able to hold and feed their baby immediately after birth. For this reason, at Mediclinic’s NICU we place an equal emphasis on the wellbeing of the mother and giving her the tools and support she needs to take care of her baby’s special needs,” says Hall.
Post-NICU care
Mediclinic’s NICU treats thousands of these cases every year and through intervention and treatment, is able to successfully send preterm babies home with their families. The weeks and months that follow their stay in the NICU are however, just as critical.
“Parents need to remember that their baby was still premature even though they may take home a big baby. It is therefore advisable in the winter months to avoid crowds and normal winter viruses, and to limit visitors to only those who are well. There is always some anxiety when taking the baby home, but the best place for baby is skin to skin with mom or dad, and being safe in their love,” says Hall.
Help on-demand.
To assist parents with preterm babies and those born under normal conditions, Mediclinic has developed its own Baby App, which provides an exclusive programme to support parents through pre- and post-natal pregnancy care.
“We know how important expert information is to expectant parents at every stage of pregnancy. This is where the Mediclinic Baby programme can make the world of difference. Through the app, parents can access tailor-made antenatal courses, presented by childbirth professionals. We are confident that equipped with the right information, parents can make the informed decisions that will set their family and their baby up for a long, happy and prosperous life,” concludes Hall.
