The Burden of Prematurity (1)

Apr 19

The Burden of Prematurity (1)

By Petra Akinti Onyegbule

Caring for a preemie is a FULL TIME JOB. No kidding. In neonatal intensive care and special care baby units of hospitals where preemies are kept, treated and cared for, doctors and nurses are assisted by various equipment and machines for all round monitoring every second of the day, and for as long as they need constant monitoring.

The moment they are discharged however, it becomes a different ball game entirely. The preemie mom is gradually introduced to and taught how to care for her baby whilst still in the hospital. The process was simply called ‘PARTICIPATING’ at the NICU of the National Hospital, Abuja. The next paragraph describes what this entailed as I learnt to practice it.

At 4:30 am, I would resume at NICU. The drill: go straight to the MOTHER’s CHANGING ROOM, wash hands thoroughly, locate a sterilized gown with my name taped to it from the previous night, remove my blouse and wear the gown, clean breasts with clean, wet hand towel with special concentration on the nipples, wash hands thoroughly again, pick a sterilized cup and express fresh breast milk into it. I have to state at this point that the NHA didn’t allow the use of breast pumps. Expressing was done manually because, keeping the simple rules of hygiene was a lot more straightforward than trusting some of us to keep our breast pumps very clean at all times. No need stating how extremely painful the process of manually expressing breast milk at least, 4 times daily can be. All what I’ve explained would take about 20-25 minutes as we were taught to be quick. From that room to the incubator room. There, I would locate her bucket containing 2 measuring cups and a 20-ml syringe all soaked in Milton and water. The bucket cover served as feeding tray which is placed on a seat in front of another chair on which I would sit. After measuring out approved quantity of breast milk into one of two cups using a syringe and prescribed dosage of her medications in the other cup, I would open the incubator door, greet Miss R, smile at and sometimes with her, pick her up and out of the incubator, take my seat beside the incubator and proceed to clean her up very thoroughly with olive oil and cotton wool, change her diaper, using some cotton wool, I’d make a bib for her, then feed her with both breast milk and drugs. Next step is to burp. A little bit of Kangaroo Mother Care and it would be time to place her back in the incubator, wash up utensils and keep in the bucket of fresh water and Milton, keep surroundings clean, then leave.

Feeding and changing of diaper was done every two hours. Until the last round at 11 pm after which mothers could rest till the next morning while nurses fed babies during the night. At home, there was no relieve until I figured it was okay to increase time between meals to 3-hourly so she could sleep longer as well.

Following the strictest rule of hygiene of course. This is important because apart from Temperature Control, the NEXT CARDINAL RULE in caring for a preemie is to ensure INFECTION PREVENTION. A preemie’s immunity is only some way developed before they are born. Therefore, their bodies do not have the capacity to fight off infections as those with fully developed immunity would. It is therefore important that preemies are kept in very clean environment and the primary care giver at home (usually the mother) does not engage in any activity that could pose threat of infection.

Until your baby attains the required weight of 2.5 kg (may vary, but this is what I am sure of), it will not be given BCG immunization which boosts immunity against Tuberculosis. Until this vaccine is given, DO NOT EXPOSE YOUR BABY. Miss R was born on August 21, 2009. She did not take the BCG vaccine until January 7, 2010 when she weighed 2.6 kg during our post discharge check-up on January 5. It was only after January 7 that even her grandmas could carry her. Her dad must have carried her less than 3 times prior. I simply could not take chances. And we were good.

You can not be too careful with a preemie; negligence even for a little while is criminal as anything can happen.

Do your UTMOST and watch your little one blossom one day at a time.

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