“Prematurely born babies face many potential complications after birth. With modern technology and significant advances in the approach to their care, however, we are today increasingly able to support many of these tiny infants and enable them to develop into healthy children.”
This was the message conveyed by Professor André van Niekerk, a paediatrician and paediatric pulmonologist practising at Netcare Alberlito Hospital on the KwaZulu-Natal North Coast, during an event held at Netcare Alberlito Hospital to mark World Prematurity Day on Friday, 16 November.
“Supported by the remarkable life-support system of the womb, which includes the placenta and umbilical cord, babies in the womb are able to grow and to develop and mature their organ systems until birth. The process of labour itself finally ‘enlivens’ the baby by activating the physiological processes required for a seamless transition from life in the womb to life outside of the womb,” explains Professor Van Niekerk.
Womb-time essential for development
“Prematurely born babies, however, do not get the necessary womb-time for their organs to develop properly and are physiologically unprepared for birth. This leaves many of these babies vulnerable to a large spectrum of possible health challenges,” he adds.
“They may, for example, be more prone to neurologic problems due to the underdeveloped brain, develop jaundice due to immaturity of the liver, breathing difficulties due to underdeveloped lungs, feeding problems due to an immature digestive system, and may have an increased susceptibility to blood circulation problems and infections.”
“The developing brain forms as many as 40 000 new nerve connections per minute during the final weeks of pregnancy, so early birth can also impact this critical organ in later life. A recent landmark study involving more than 400 000 children showed an increase in the need for educational assistance, such as speech and occupational therapy, for every week that a baby is born before reaching full term,” he observes.
“The more prematurely a baby is born, the greater their risk of organ immaturity and potential health problems. Even children who are born as little as one week prematurely can be impacted by their early birth.”
“Fortunately, modern technology and methods of care for these babies have advanced in recent years, so that dedicated neonatal intensive care units, such as the one at Netcare Alberlito Hospital, are able to give pre-term babies the chance to survive and to thrive.”
Professor Van Niekerk explains that in uncomplicated pregnancies the transition from placenta-dependent living to an independent life occurs somewhere between 37 and 42 weeks. Infants born before 37 weeks of pregnancy are considered premature. Those born before 32 weeks are referred to as ‘early-preterm babies’, while those born between 32 and 37 completed weeks of pregnancy are classified as ‘late preterm’. Babies born between 37 and before 39 completed weeks of pregnancy are known as ‘early term babies’.
The live-giving properties of donor breast milk
Breastmilk helps premature infants to develop and greatly assists in preventing many of the complications that may occur with prematurity but mothers of premature babies are usually not physiologically able to supply enough life-giving breastmilk for their babies.
“One critical but often overlooked development in the care of these babies has been the introduction of donor breastmilk. The introduction of human milk banks, however, is providing an alternative means to support these vulnerable babies and has considerably improved outcomes for them,” notes Professor Van Niekerk.
"In uncomplicated pregnancies, the spontaneous onset of labour indicates the infant’s readiness to transition to placenta-independent living. The process of labour itself, or those hours of discomfort for the mom, releases a cascade of hormones in the mother and baby, which also serves to ‘invigorate’ the baby and prepare them for life outside of the womb.
“These hormones activate many of those functions that had previously been supported by the placenta. They prepare babies to commence regulating their own body temperature, metabolise glucose, regulate oxygen supply to the body and to feed from the breast, among other things. They also prepare the mother to bond with and nurse her baby.
“The transitioning also requires the passing on, or inoculation, of a set of genes – called a microbiome – from a mother to her baby. These genes come from the beneficial microorganisms, called probiotics, which live in and on the surface of the mother’s body. There are more than 1 000 species of beneficial microorganisms for which we as humans provide a ‘home’ in and on our bodies. Recent research has highlighted the importance of this process and the important role these beneficial microorganisms play.”
The baby’s microbiome starts developing prior to birth, but the most important contributor comes from the mother’s vagina during birth. This diverse microbiome is also passed on through breastmilk and through contact with the mother’s skin after birth. Breastmilk alone contributes some one hundred million of these microorganisms per day to the baby.
“Premature babies are usually born by caesarean section and the mother is often unable to successfully breastfeed her baby during the critical early days, and were given formula milk before donor milk became available. In addition, the infant is usually admitted to the neonatal ICU and is consequently not able to spend time on the mother’s skin. They may also require antibiotics to ward off infections, all of which may serve to inhibit the development of a healthy microbiome.”
“Breastmilk is a more finite resource than blood but is just as important to saving lives. We therefore appeal to lactating mothers to please donate milk to a human milk bank, such as the Ncelisa human milk bank at Netcare Alberlito Hospital, so that prematurely born babies can benefit from its life-giving properties,” concluded Professor Van Niekerk.
To find out more about the services offered through Netcare hospitals and other of the Group’s facilities, please contact Netcare’s customer service centre: email: [email protected] or phone 0860 NETCARE (0860 638 2273). Note that the centre operates Mondays to Fridays from 08:00 to 16:30.
For more information on this media release, contact MNA at the contact details listed below.
Issued by: MNA on behalf of Netcare Alberlito Hospital
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster
Telephone: (011) 469 3016
Email: [email protected], [email protected], [email protected] or [email protected]