What parents of preemies need to know
Posted on 17 November 2016
Once a mother gives birth to a premature baby, the ensuing weeks or months can be incredibly draining. We speak to the multidisciplinary team at Mediclinic Medforum about how they support parents and optimise the in-hospital care their preemies receive.
The length of incubation differs according to a baby’s gestational age and weight, explains Dr Katya De Campos, a paediatrician at Mediclinic Medforum. ‘Ensuring a good outcome can be trying, as the staff knows what this entails but are dealing with anxious parents who generally weren’t prepared for a preterm baby,’ says Sister Prudence Bvuma, a senior professional nurse in the fully equipped neonatal ICU at Mediclinic Medforum.
‘Preemies go through a lot while developing their immune systems. We ensure that they get the best care possible by working within a multidisciplinary team, while also ensuring that parents are getting the maximum amount of emotional support,’ she adds.
Many parents feel helpless but the hospital practises Neurodevelopmental Supportive Care (NDSC) to ensure that the baby grows well neurologically and physically. ‘NDSC entails dimming of lights, minimised noise and minimal handling in the beginning,’ explains Sister Bvuma. ‘But Kangaroo care is introduced quite soon. This involves lots of skin-to-skin contact and, ideally, frequent breastfeeding which is great for both parents and babies.’
Parents and preemies are fully supported at Mediclinic Medforum. ‘We have a highly specialised neonatal ICU with a multidisciplinary team of doctors, nursing staff, dieticians, physiotherapists, audiologists and psychologists to assist parents of preemies,’ says Dr De Campos.
Helena du Preez, a physiotherapist at Mediclinic Medforum, helps parents of preemies with handling their babies and carrying and positioning them correctly. She also does assessments of the baby’s movement and sensory-motor development. ‘I mainly work with preemies who have already been discharged and have developmental delays or cerebral palsy. I also work with children of school-going age – around six years old – who are clumsy, a large percentage of whom were born premature,’ she explains.
‘Preemies are born when the brain is still immature, so there’s a lot of development that must still take place outside of the womb. Their development is therefore slightly different from full-term babies – they are more “open” and not as flexed and therefore efficient as a full-term baby. That’s where the physio comes in, to help with this development.’ While preterm babies generally reach their milestones later, depending on how early they were born, Helena says that if they’re really lagging behind, their parents should bring them in for treatment.
Preemies may also face auditory difficulties. ‘Between 4 and 6% of all premature babies might have hearing loss,’ says Carina Avenant, an audiologist at Mediclinic Medforum. Despite increased risks in preemies, Carina advocates hearing screenings for all babies in keeping with international law, although this isn’t mandated in South Africa yet. ‘Because we can’t expect the baby to press a button or tell us what they can hear, we use objective testing measures through an otoacoustic emission machine, through which sound is sent into the ear. There are structures in the inner ear that move like trees in the wind if everything is working fine, and some of the sounds sent in will echo back,’ she explains.
‘The other testing measure is an automated auditory brainstem response (AABR) test. We put small electrodes with inserted headphones on the baby’s head and measure the brain’s response to sound. If we don’t get good results we do a follow-up test six weeks later. If results still haven’t improved we start with diagnostic testing to determine the degree of the problem, and if necessary decide on a hearing aid,’ says Carina.
‘Later issues can also arise, such as auditory processing problems or just general delayed development, speech and communication. We need to catch and treat this early, because the critical period for language development is birth to the age of three. Parents should check whether their baby responds to their voices and follows them when they speak, and whether the baby is vocalising. If parents notice problems or are concerned, they should consult their paediatrician immediately and get a referral to an ear, nose and throat (ENT) specialist or audiologist,’ Carina advises.
Dr De Campos says once a premature baby is discharged from hospital, parents can provide the best possible care through:
- Ensuring all immunisations are received timeously
- Administering supplements that ensure optimal growth
- Providing lots of love
- Breastfeeding as long as possible
Watch three-time preemie mom, Celeste telling her story about finding the right support: