Caring for premature babies
20 July 2020
THE growth and development of a baby is important from the moment the child is formed in the womb, but what follows after the mother gives birth also plays a huge role in the baby's physical and mental health.
As all babies go through different stages of growth, there are instances where babies are born before term, which will then require special medical care due to prematurity, low birth weight, and other high-risk situations.
This may even lead them to be admitted to the neonatal intensive care unit (NICU) for treatment.
Sunway Medical Centre Velocity (SMCV), senior consultant neonatologist, Dr Hasmawati Hassan says that a family-centred approach is crucial to support the development of the child.
"We strongly believe that a family's involvement in the healthcare of a child is important. Our social workers provide supportive counselling to assist families in coping with the unpredictability of a potentially life-threatening condition. They also link families with community resources for emotional, as well as financial support," she says.
KEEPING THEM SAFE
The care for the newborn in the NICU can also be carried out before the birth of the baby.
Upon recommendation by the obstetrician, a neonatologist or paediatrician working in the NICU will be asked to see high-risk mothers in the instance that the unborn baby may be jeopardised due to the condition of the mother. This may be due to chronic diseases in pregnant mothers that can affect the growth of the baby, such as chronic renal failure, chronic heart diseases and autoimmune diseases.
In some cases, the baby may be revealed to have certain abnormalities, which can be detected through an antenatal ultrasound. The consultant in charge will then discuss the risk and prognosis of the baby with the high-risk mother so the obstetrician can perform an intervention before term to safeguard the baby's health and prevent further complications to both mother and child.
In the unfortunate event that the baby is shown to be in a grave condition during the antenatal ultrasound, the obstetrician, neonatologist or paediatrician will carry out counselling.
These mothers are counselled so they are prepared psychologically to accept the grave condition of the baby upon birth and that the baby might not survive.
In the case of a premature birth or ill newborns, these babies will require critical management and the length of stay depends on the prognosis and disease process, if any.
Some of the conditions for a baby to be admitted to the NICU include problems related to premature birth, respiratory distress requiring ventilatory support and congenital abnormalities requiring monitoring and intervention.
Infection or sepsis in babies related to maternal chorioamnionitis also calls for NICU admission as does perinatal depression caused by traumatic delivery that can lead to decreased blood flow or oxygen to the baby.
Electrolyte abnormalities like hypoglycaemia or low blood sugar also call for the NICU admission.
Newborn babies who are well will usually stay with their mothers for breastfeeding in the postnatal wards, and the neonatologist or paediatrician will be tasked with screening the babies for any diseases such as congenital abnormalities (such as cataract, cleft palate, heart lesion, congenital hip dislocation and spine abnormalities).
All other relevant tests will also be conducted.
After the birth of the baby, there will be several follow-up consultations – beginning with a first-week follow up to determine the well-being of the baby.
Later on, they will be given dates for immunisation and developmental follow-ups in line with the National Immunisation Schedule.
FAMILY TIES
Dr Hasmawati further adds that parental involvement in the wellbeing of the child is key so that parents can manage the baby's growth better and have a deeper understanding of their condition.
"When caring for a premature baby, try not to be in too much distress about being separated from them when they are in the NICU. The babies will be in good hands, and you can spend as much time with them there if your condition and theirs permits. Be mindful of the policies set by the NICU to avoid infections, and ask NICU doctors about the diagnosis, what to expect in the short and long term and what your options are."
