BABY COME EARLY !

A MANAGEMENT PLAN FOR DEALING WITH PREMATURE BABIES

A baby is said to be pre-term, premature of a preemie when born three weeks (or more) before the due date. For the new parents, it is a shock to realize that the frail, thin bundle with a lot of body hair (lanugo), who looks more like a foetus, is actually their baby. Preemies have translucent skin, soft ear cartilage, wrinkled features and a weak cry. A few (depending on their gestational age and body weight) may have problems with breathing, feeding and temperature regulation.

Most of their organs are immature. They need to complete that part of their development, which would have otherwise happened in the secure environment of their mother’s womb.

Neonatal intensive care units (NICUs) are designed to provide care to preemies; they receive round-the-clock monitoring by trained doctors and nurses.

IN THE HOSPITAL

In a NICU, the baby is kept under very hygienic conditions in an incubator that is warm and adjusted to provide the body temperature needed. Most of the early feeds are given through a tube as premature babies lack the sucking reflex or are too weak to do so,

Preemies are given a special high-fat, low-birth weight formula that helps them gain weigh faster. If the baby has breathing problems, oxygen therapy is initially used, but if the problem does not settle, a ventilator may be used.

There is also a continuous monitoring of the heart, blood pressure and blood sugar levels according to a famous of India. “Neonatology has witnessed some of the most dramatic improvements in the latest three decades.

Survival is now possible in babies as small as 500 grams and of 23 weeks gestational age in the western countries, and there are instances of survival of babies born as early as 26 weeks and as tiny as 690 grams. “While professional care is essential, the bond developed between the baby and the parents from this stage itself is critical in ensuring the baby’s growth and development. Doctors encourage the parents to be very close to the baby, and take part in most of the daily activities involving their baby in the NICU. This can be a very trying, anxiety-ridden period, especially for the mother. It is important for her to relax, banish any guilt she may have about having ‘caused’ the premature delivery in any way and to think positively. It helps to talk and clarify any doubts; it is best to consult the doctors and staff of the NICU, since nobody understands the situation better than them. It is also essential to get friends and the families to help out with other necessary chores, as trips to the NICU are draining.

AT HOME

Having spent a few days or weeks at the NICU, the baby is ready to go home once it has reached a weight of about 1.8 kilograms and is 36 weeks old (and able to sustain on its own). Usually, the doctors and the NICU staff provide the mother with all the guidelines about caring for the baby at home.

However, it helps to take special advice on issues that may need attention, to take down all the phone numbers (especially of the NICU) and make sure of an alternative contact number in case the baby’s regular pediatrician cannot be contacted.

Once the baby has reached the full-term barrier, she may be shared joyfully with the family and friends. However, all parents should remember that the baby’s age is not to be counted from the date she was born, but from the date she was supposed to have been born. This becomes particularly important because the baby will probably reach some development milestone later than other babies. Mothers should remember to look at the development chart from the actual due date; then they will realize that the baby does not lag.

It takes two years for a premature baby to catch up with the other children of her age. And once she does, there will be no stopping her!

CAUSES FOR PREMATURE BABIES

Most women go into pre-term labour each year. While the exact causes are not clearly understood, risk factors in the expectant mother include:

• Pre-eclampsia, a condition associated with the second trimester and characterized by high blood pressure, fluid retention and protein in urine.
  
• Diabetes, kidney problems or heart ailments.
  
• Multiple pregnancies, earlier abortions and a history of pre-term deliveries
  
• Problems of the uterus or cervix
  
• Persistent / untreated infection, especially of the urinary tract
  
• Being under 18 or older than 35 years
  
• Lack of adequate prenatal care

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Nursing a Baby in Public:

What a mother has got to do?

It happened when I was a young, fairly sheltered teenager- at least I was as sheltered as a public school student could be in those days. One evening I was shocked to see when a mother across from me, with complete disregard for the sensibilities of any of us, unbuttoned her entire blouse in a most revealing way and began nursing her baby.

A few years later, I was in a situation where a young mother needed to nurse her baby and had no choice but to do it in a group setting that included a few young men. She was obviously uncomfortable and embarrassed as she draped herself and the baby with a large blanket.

Then, for good measure, perhaps wishing she could disappear entirely, she even covered her head with another blanket! Needless to say, this is what really attracted attention. The young men probably wouldn’t have noticed that she was nursing, but now they were asking, “What on earth is she doing under those blankets?” when I became a mother, I decided there had to be some sort of middle ground.

There are a number of interesting reactions to public nursing within any community. Some feel that nursing is appropriate in any setting. On the other extreme are those who feel that a woman should never nurse her baby in any setting except for her home- and that, even there, she must never nurse in front of anyone but her own husband and perhaps other mothers.

Modestly is an important consideration, of course. Some nursing mother are, in general, less modest that other and consequently are not as sensitive towards onlookers. Others labor (or should I say, nurse) under the delusion that the “baby’s head hides everything”. Still others drape themselves and their babies under a variety of blankets and covers, or wear clothing especially suitable for discreet nursing.

What I find especially interesting is the often vocal condemnation of public nursing. Often these outspoken critics have been exposed- literally- to rather indiscreet and revealing displays.

They do not realize that public nursing can be done in such a discreet and chaste manner that only another nursing mother (or sometime her husband) is aware of what is going on. There are other critics, however, who seem less disturbed about the possibility of immodesty; rather, they seem to find nursing-no matter how it is done- to be offensive in some way an activity best carried out in private. For example, I have been in groups where one mother began covering herself with a blanket, only to have someone exclaim, “You’re not going to nurse that baby here, are you?!” Modesty was certainly not an issue in this case: the mother would be covered by more layers of material while nursing her baby than she would while not nursing. In addition, some men who denounce public nursing have no qualms about visiting public beaches or watching broadcast TV, with its plethora of scantily clad women and ubiquitous lingerie commercials.

One such man even told me, on more than one occasion, that he frequently watches fashion shows of beach attire in order to see “just how bad the bathing suits are getting each year”.

Yet, heaven help the poor mother who nurse any where dares near him, no matter how many blankets might cover her! Many mothers who have nursed discreetly in public have experienced the situation of having someone want to admire the “sleeping baby”.

When the potential admirer is told that the baby is nursing, he or she may react in any number of ways: “Oh, how wonderful! I left my little baby at home and can’t wait to get back to her! I should have known you were nursing.” “I’m go glad that more young women are nursing their babies these days.” “Can I get you something to drink?” “Oh.” “Ugh.” “Oh, I’m so sorry – I didn’t realize” – while blushing and beating a hasty retreat. “You’re nursing? And beating a hasty retreat. “You’re nursing? Now? Here?!” “I can’t believe you would do that in public.” “The bathroom is right over there.” “I think you had better leave.”

It seems than, that as nursing mothers, we have a number of choices:

1.       Never nurse in public

2.       Nurse only in front of other women

3.       Nurse only in your own home

4.       Nurse only in front of your immediate family

5.       Nurse only in front of your husband (and maybe your mother)

6.       Nurse only in those setting where you, your husband, and others are comfortable

7.       Nurse anywhere, but make sure you are doing it under several blankets

8.       Nurse anywhere, as long as you are wearing clothing that enables you to nurse discreetly

9.       Figure that it’s just a cultural hang-up, that everybody else needs to grow up, and nurse wherever you please, whenever you please, however you please.

 

 

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Breast feeding myths

Many women do not have enough breast milk

This is not true. The vast majority of women do so because they are not getting the milk that the mother has. And this happens mostly because the baby is not properly latched on to the breast. Which is why, it is very important for the mother to learn how to latch on the baby properly from someone who knows how to do it.

You should wash your nipples each time before you breastfeed

Not necessarily. Breast milk protects the baby against infection. Washing nipples before each feeding makes breastfeeding unnecessarily complicated and washes away essential oils from the nipple.

If you have an infection you should stop breastfeeding

This is not required. With very few exceptions, the baby will be protected by the continuation of breastfeeding. Even if you have a breast infection, it will heal faster if you continue to breastfeed.

If you baby has diarrhea or vomiting, you should stop breastfeeding

 The best medicine for a baby’s gut infection is breast milk. You may stop other foods for some time, but must continue breastfeeding. Breast milk is the only fluid your baby needs when she has diarrhea and or vomiting except under exceptional circumstances.

 

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