The post The power of a mother’s touch – Kangaroo Mother Care appeared first on All4Baby.
]]>About four million babies die each year in the first week of life, according to The Lancet; replicating the protective and nourishing environment of a Kangaroo pouch, through Kangaroo Mother Care, could help 25% survive, says Dr Nils Bergman, a public health physician specialising in Kangaroo Mother Care (KMC) in South Africa.
“The very best environment for a baby to grow and thrive, is the mother’s body,” says Dr Bergman. “When placed skin-to-skin on her mother’s chest, a baby receives warmth, protection and food, and its brain can develop optimally.”
“Skin-to-skin contact should ideally start at birth, but is helpful at any time. It should be continuous day and night, but must be at least one hour to give benefit,” says Dr Bergman.
The next part of Kangaroo Mother Care is exclusive breastfeeding. That means that for an average mother, direct suckling by the baby from the breasts is all that is needed. For very premature babies, expressing milk and addition of some essential nutrients may be necessary.
Thirdly: support to the mother-child dyad means that whatever is needed for the medical, emotional, psychological and physical wellbeing of mother and baby is provided to them, without separating them. This might mean adding ultramodern equipment if available, or intense psychological support in contexts with no resources. It can even mean going home very early.
In the past, parents of premature babies were excluded from care directly after birth, including the neonatal ICU. Now, it’s known that separation causes harm to all babies – especially preterm infants.
Recent science shows that parents’ presence has a positive influence on brain development, says Jill Bergman, who has promoted Kangaroo Mother Care for 24 years. “We are realising more and more from neuroscience that the parent as central to the healthcare team is not just essential for survival, it ensures a good start to life,” she says.
1. Regulation
The baby at birth is wide-awake for the first 60-90 minutes and experiencing certain sensations. He hears mom’s familiar voice, feels her heartbeat, smells the familiar scent of her and her breast milk. The baby feels safe and comforted by these sensory signs and so his body calms.
Heart rate, breathing and oxygen saturation, blood pressure and temperature all stabilise far faster on mom than when they are separated. Baby has his basic needs for warmth, food and protection met.
2. Bonding and attachment
Baby’s brain also calms, and all of the expected sensations are collected and fire pathways in the brain. The baby will feel safe and open his eyes to make contact with his mother. This is the start of early bonding, and emotional and social intelligence. As continued contact and breastfeeding continues, a secure attachment is formed, which is the basis of all future physical and psychological health.
3. Breastfeeding
“A baby in the right place is very competent!” says Jill Bergman. A proper latch ensures adequate nutrition, and stimulation of all of the essential hormones. The mother’s chest will warm automatically if her baby is cold, and even cool baby if too warm.
4. Sleep
During quiet sleep, all of these sensations collected will fire and wire circuits to the emotional brain (amygdala), be organised and sent back to the cortex when he wakes again, thus completing the brain circuits for healthy development. Sleep should not be disturbed.
If a baby is separated from her mother early on, all those essential processes are disturbed and a stress response is created. When the baby cries, his heart rate and blood pressure goes up, and oxygen levels go down. The baby crying uses up more calories so is more likely to become hypoglycaemic; these calories are better used for growth.
“High levels of stress hormones for long periods of time are toxic to the neurons that make the brain work. The stress hormone cortisol makes more neurons die off at a faster rate. This disrupts and disturbs developing pathways and circuits. With prolonged stress after birth, the brain is measurably smaller one year later. The only difference between toxic and tolerable stress is the absence or presence of mother or father,” says Jill.
Kangaroo Mother Care babies benefit from better brain and emotional development, less stress, less crying, fewer brain bleeds, more settled sleep. They are more alert when awake and feel less pain from injections, the heart rate stabilises, more breast milk is produced and babies gain weight faster.
Ultimately babies can go home earlier when they have done Kangaroo Mother Care and have better brain and emotional development.
Your baby only needs a nappy and cap. Put her on your bare skin – starting at birth – facing you, inside your shirt. Sit in a chair with cushions so you can be at a 30-40 degree angle to help baby’s breathing. Tuck her legs up in the foetal position. Put her hands near her face for self-soothing. Cover her and yourself. Your body will automatically warm up if your baby is cold or will cool down if your baby is hot. Relax, knowing that your body is the best place for her.
To do this for long periods with a small or premature baby, safe technique requires that the airway is secured, and the baby firmly wrapped against parent’s chest. In this way baby and parents can both sleep. When awake and feeding, the wrapper is loosened, allowing eye contact, and access to the breast.
For more details see the book Hold Your Prem by the Bergmans and www.kangaroomothercare.com
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]]>The post Born at 25 weeks, a story of hope appeared first on All4Baby.
]]>“This was our first child and we were very excited from the beginning. We had wanted to have a child for a long time. It felt like a miracle from the start, but I was naïve about what was going to happen later on. In my mind it was all going to work out perfectly, I was going to have a normal birth and breastfeed without any problems.All the signs up to that point showed everything was well,” says Tanya.
“But when the pain didn’t go away and I started bleeding, I knew something was wrong,” she says. Tanya and her husband, Davy, went to the hospital where their gynae did a physical exam and a scan and confirmed everything was in order.
But the pain escalated through that night and her instincts told her all was not well.
“I woke up early the next morning, but I was so weak I could hardly move. The pain was intense and I could feel the baby moving down into the birth canal. I knew I was in labour, I knew the baby was coming,” says Tanya.
“He was crowning in the car and I kept saying to Davy, ‘drive faster, drive faster’. Although we were only 10 minutes away from the hospital, it felt like the longest drive ever. I closed my eyes so I couldn’t see how far we still had to go.”
“We arrived at the hospital and I stood beside a pillar in the entrance and shouted for someone to help me. I had to keep my legs together to keep the baby from coming out.”
It wasn’t until the staff of the maternity unit saw the baby’s head that they realised Tanya was in an advanced stage of labour. The baby was delivered straight away, with one push.
“I looked at the faces around me in the delivery room and I saw expressions of sorrow and regret.” They looked at Davy, who was distraught and very emotional. The looks implied ‘I’m so sorry for your loss’. I picked my head up and I saw a tiny blue baby. We were overcome with sadness and anguish, thinking that he had not survived, and seeing his little body lying still, without any movement.
“Everyone was quiet, and the pause in conversation felt very long. Then, out of the blue, this sound came, like a gasp. Kyle had taken a breath. Our despair turned into hope.”
Tanya had suffered a placental abruption, where the placenta (which is the source of nourishment for the unborn baby) becomes separated from the uterus. The cause of the condition is unknown, but Davy recalls: “It was a very painful and traumatic experience – Tanya had labour pains for more than 24 hours.”
Kyle had arrived 15 weeks early, weighing just 700g. A foetus is deemed clinically viable from 26 weeks’ gestation.
“The gynae wrapped Kyle in a hospital gown, and the nurse took him and ran to neonatal ICU, where they resuscitated him. They worked on him for an hour to stabilise him and he was on life support for a day and a half,” says Tanya.
“The doctors gave him a 10% chance of survival. He’d been starved of oxygen and we were warned of the possible complications that could arise in the days ahead, like heart and lung conditions and brain bleeds. The first 48 hours were crucial.”
‘Don’t get your hopes up, expect the worst,’ they said.
“I cried so much when I saw him, he looked so tiny and underdeveloped. He had a drip in his head, a feeding tube into his stomach and two other cords attached to his tiny little feet.”
Kyle’s birth was a life changing experience and it put things into perspective for us. I held onto my faith – not the stats and science – based on that first breath, which I believe was him saying ‘I’m here for a purpose, I am going to fight to live, I am going to hold onto hope, it’s my time’.
“We were totally unprepared. We hadn’t thought of names, done the shopping, or got his room ready or anything. I was depressed those first few days, I blamed myself, and thought if I had done this or that maybe things would be different. But I also knew I had done everything to keep fit and healthy, I have never drunk alcohol or smoked in my life, and so it felt unfair that my baby was suffering.”
“But I had to put these things behind me. I never looked back, I just thought about what my baby needed from me. He needed to draw strength from us.”
Kyle spent three months in neonatal intensive care and has had two heart surgeries already.
“From the beginning, we knew we needed to prepare for complications. After a few weeks, Kyle became very ill and the cardiologist picked up some problems. The first was the congenital heart disorder PDA (patent ductus arteriosus) where a connecting blood vessel that is open when the baby is in the womb so that blood bypasses the immature, non-functioning lungs, fails to close at birth. In order to get blood oxygenated, Kyle had to have the gap closed surgically when he reached a kilogram in weight. Kyle was one month old and weighed 900g when this procedure was done.”
The second surgery which was done when Kyle was seven months old and weighed three kilograms, was to open a chamber of the heart that was too small.
Kyle has six-monthly check-ups with his cardiologist, and his third operation, to close the hole in his heart due to atrial septal defect (ASD), is planned for when he reaches 15 kilograms.
“The journey was very stressful and a huge emotional roller coaster for us. Good news and happy moments of bonding always preceded bad news from the doctors, nurses and specialists. Fear, nervousness and despair were common emotions that we experienced, together with pride, joy and hope,” say Tanya and Davy.
“The saying: ‘Where there is life, there is hope’ became our mantra. We never stopped believing that everything would turn out perfectly.”
“The day we brought him home for the first time was the best day of our lives. Our house finally became a home,” they say.
Touched by the Moodleys’ story, the Discovery Health Concierge team reacted to their situation and founded the Premmie Concierge Project, which aims to assist and support parents of babies in the neonatal ICU and beyond.
Although he still has heart defects (atrial septal defect and pulmonary valve stenosis) and poor weight gain, Kyle, who is about to celebrate his second birthday, is an energetic and fun-loving little boy. He learns at least two new words a day. He loves playing with his toy cars, trucks and buses but his favourite pastimes are snuggling up to mommy, playing with daddy and chasing after his cat, Bizzy.
For more information on the Premmie Concierge Project, visit www.discovery.co.za. For more Medical Miracle stories, visit DiscoverySA on YouTube.
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]]>The post Premature twin birth – a real life story appeared first on All4Baby.
]]>She held back on heavy lifting, did only low-impact exercise, ate well and generally looked after herself.
“I honestly expected my twin pregnancy to be much harder than it was. It was a textbook pregnancy. Our boys grew well from the beginning and I was convinced the doctors would have to induce me.”
“Of course, my husband Jon was less naïve than I was and he organised for us to attend a workshop for multiple parents, which included a talk on premature birth, by The Multiple Birth Association. The speaker had had triplets that weighed around 500g at birth. The talk was unsettling, but I was still convinced that our boys would be inside until at least 37 weeks.”
“Suddenly at 33 weeks, we found out that my placenta had started to calcify and one of the babies was not getting the nutrients it needed to grow. I was promptly put on bed rest and my doctor started to scan every two days. The nurses kept asking me if I could feel contractions, but I felt nothing.”
The rest seemed to help and the baby started growing again. But the calcification worsened.
“Jon, ever-practical, made sure my bags were packed and ready, in case we delivered earlier than expected. Thanks to our registration with Discovery’s Vitality Baby, the two goodie bags we received meant that we didn’t need to buy many of the items we needed for our hospital stay. During one of the heartbeat scans, he asked the nurse if we could have a tour of the neonatal ICU, which she arranged for us.”
“This was an eye opening experience and I would recommend it for anyone expecting twins. Seeing the NICU helped us understand all the wires, boxes, beeps and lights in an objective way. We saw how small babies can be born and still survive, for example there was a little girl there who weighed just 600g and was doing well.”
“At 35 weeks exactly, at my latest scan, my doctor did not look happy. He announced that one of the babies now had an umbilical cord wrapped around his neck. He immediately scheduled us for an emergency C-section at Sandton Medi Clinic. My boys, Alexander and Dylan, were born on 21 May 2012, weighing 2.1kg and 2.4kg.”
“It was only eight hours later that I got to see my babies’ faces properly for the first time. They were in NICU for 10 days and it was the hardest time of my life. Despite their healthy weights and the fact that they had reached 35 weeks inside, they were considered premature because they didn’t have a sucking reflex yet. They had to learn to suck before they could be sent home. They were also slightly jaundiced and had to spend quite some time under the lamps. It was a very frustrating time. They were tube-fed formula and I couldn’t breastfeed. I believe not being able to breastfeed them there impacted my milk supply, because even though I took something to help boost supply, I never produced enough to even feed one of them.”
“One thing we did not have to worry about was whether their NICU stay would be paid for. As a Comprehensive Plan Discovery member, both my boys were fully covered for their entire stay at the hospital.”
“The time in ICU wasn’t just hard, it was also rewarding. The nurses put them on a schedule and we learned all the things new parents need to know, from bathing, nappies and other things that many women only get three days of nursing help for.”
“My boys will be turning one soon and they have without doubt caught up with their birth ages. They are an absolute blessing and despite the difficult start, I wouldn’t trade it for the world.”
About the Author:
For more Medical Miracle stories, visit DiscoverySA on YouTube. For more information on Discovery, visit their website www.discovery.co.za .
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