he youngest premature baby in Sri Lanka was born on June 19 of this year, at the Sri Jayewardenepura Hospital. The baby girl is in good health.
To find out more about the baby, we interviewed her parents and the NICU (Neo-Natal Intensive Care Unit) Staff of the Sri Jayawardenepura Hospital.
The tiny baby girl looked healthy and was being showered with love and care by the NICU staff. She is just 75 days old. Her mother Anandaraja was holding the baby in her arms. With still unopened eyes, she smiled whenever she heard her mother’s voice.
Anthonymuththu David Egwin and Anandaraja Victo Amalini married nine years ago. They had to wait nine years for their dream of a baby to materialize. Now they are 37 and 35-years-old respectively. The doctors who assisted at this time were Professor Neil Senevirathna and later Dr. Milhan Batcha of Vindana Reproductive Health Centre at Barnes place, Colombo. They were expecting to have an IVF baby (In Vitro Fertilization). Their first effort was unsuccessful and the first pregnancy failed on June 17.
Later Anandaraja became pregnant again, this time with twins.
“We live in Vavuniya. We were warned about premature births by several people and we were sent to the Sri Jayawardenepura Hospital, as it was well-facilitated to deal with this type of delivery. Although we lost one of our twins due to heart failure, we are happy that we have our little princess. The doctors and nurses cared for our baby very well.”
We interviewed the Neonatalogist Consultant at Sri Jayawardenepura Hospital, Dr. Medha Weerasekara.
“She was sent to us from the Vavuniya Hospital. They sent her on time, because they knew the risk she was facing. I must add that this was one of the main factors that helped us save the baby’s life. In Sri Lanka, most hospitals have the necessary facilities for premature births. High-risk mothers in labour should enter well-facilitated hospitals for the safety of both the baby and mother. I advice mothers to choose such hospitals for their delivery, if they are warned of any risk beforehand.
It is generally believed that in developing countries, premature babies cannot survive because of the lack of necessary facilities. However, we have proven that premature babies can survive with the existing facilities and expertise we have in most of our hospitals. We refused to give up a life and we decided that we should accept the challenge of saving the baby. We tried and succeeded. We have shown that we can save a baby’s life even if its chances for survival were low.” Regarding the rare incident of the surviving baby, Dr. Medha explained their experiences.
“The twins were on the weight scale that required a caesarean operation. While we were waiting for the operation, one of the twins died due to a heart problem. The surviving baby’s birth weight was 700 grams (generally 400 grams). This baby was expected to be born on October 14.
Usually the gestation period is about 40 weeks. Less than 25 weeks is considered premature. This baby was just 23-weeks-old when she was born. To my knowledge, babies in this category haven’t survived in Sri Lanka before.
This is the first such instance. The maturity of the baby becomes the crucial point for its survival.’’
Premature births in Sri Lanka
In Sri Lanka, Neonatal Mortality Rates (NNMR) have decreased by 52.2% according to the Annual Health Bulletin published in 2012 by the Medical Statistics Unit of the Health Ministry. Neonatal mortality is defined as the number of neonates (an infant who is 28 days old) dying before reaching 28 weeks of age, per 1000 live births in a given year.
Premature babies have extremely low birth weight and require treatment with oxygen, surfactant and mechanical assistance to help them breathe. They are too weak to suck, swallow or breathe. They are fed through a vein. Premature babies are unable to cry and sleep a great deal. The World Health Organization has defined premature birth as a baby born before completing 37 weeks of the gestation period. Premature births are increasing and have become a widespread global problem. In low-income countries, an average of 12% premature babies are born, compared with 9% in high-income countries. Within low-income countries, poorer families are at a higher risk of premature births. In developed countries, 22 to 24-week-old babies can survive, while in developing countries it is assumed that babies less than 25 weeks are unable to survive. Therefore, doctors do not try to save these babies; they offer comfort and care to the parents, while hoping the baby survives.
"In Sri Lanka, most hospitals have the necessary facilities for premature births. High-risk mothers in labour should enter well-facilitated hospitals for the safety of both the baby and mother"
The reasons that contribute to premature births are complex and multiple factors are involved. After being born, premature babies are kept in a silent and dark environment as they are very sensitive to light and sound. Even the slightest noise can affect them. Their organs (heart, lungs, gut) are not mature enough to function in the natural environment and therefore in the Neonatal Intensive Care Unit, they are kept in a specially arranged atmosphere, similar to the mother’s womb.
Risks involved in premature births
Vision-related problems, hearing problems; lung-related breathing problems, sensory motor problems and bleeding in the brain are a few risks premature babies develop. As their organs are not fully mature, even the oxygen level of the environment can harm them. Until they grow accustomed to the natural environment, they are given special care by doctors and their parents.
The mother of the baby, Mrs. Anandaraja is a Teacher while her husband Anthonymuththu is employed in the RDA. They are staying in Colombo for three months as the baby girl needs constant checkups from the hospital. They are grateful to the ever-dedicated NICU staff of the Sri Jayawardenepura Hospital, the doctors and everyone else who worked hard to save their baby.
Dr. Medha Weerasekara added that it was important for mothers to choose a well-facilitated hospital for childbirth and pointed out that although we belong to the developing country category, we can save premature babies as we have the expertise of well-trained doctors and nurses and the necessary facilities in most hospitals in Sri Lanka. She said premature babies could survive if they were given the necessary care.
pix by damith wickramasinghe