Premature Babies’ Comfort - Siew’s Priority

After nearly two decades of caring for newborns, including premature babies, the cries of these little ones no longer faze Siew Jeang Hong, 39.

Instead,the Head Nurse of the Neonatal Intensive Care Unit (NICU) at Sunway Medical Centre Velocity (SMCV) says the cries and wails have become a motivating melody, driving her to go the extra mile in ensuring the comfort of these babies.

Caring for premature babies, in particular, comes with its own set of challenges that demand not only knowledge and skills but also immense patience and mental strength to ensure they are returned to their parents in the best possible condition.

"In my 18 years of service, I have cared for many premature babies, including those as small as the size of a hand, weighing between 600 to 800 grams. Typically, babies of this size are born around 26 weeks of gestation.

"Some experience complications due to underdeveloped organs, so caring for them is truly challenging," she told Bernama recently.

Siew also shared that she must continually prepare herself mentally to cope with emotionally difficult situations, such as when premature babies cannot be saved.

MINDFUL OF BABY’S NEEDS

A baby is classified as premature if born before 37 weeks of gestation. The normal pregnancy duration for a full-term birth ranges from 37 to 42 weeks.

Siew Jeang Hong, Head Nurse of the Neonatal Intensive Care Unit (NICU) at Sunway Medical Centre Velocity (SMCV).

Elaborating further, Siew said premature babies require various forms of care to support their growth, with an incubator being one of the essential tools.

An incubator serves several essential functions to meet the needs of premature babies, including regulating the baby's body temperature, protecting them from infections, and monitoring heart rate.

In addition, premature babies require high attention from their caregivers, including understanding the baby's body language.

"For example, unlike full-term babies, premature babies are fed using the orogastric method, where a tube is inserted directly into the stomach through the nose, as they are not yet able to suck, swallow, or breathe naturally.

“This feeding method does not fully satisfy the baby. So, when the baby starts to whimper, squirm, or open their mouth, it’s their body language indicating hunger and a desire to nurse," she explained.

KANGAROO CARE

Also sharing her experience, Senior Nurse of the NICU, Melanie Anne Rowe, 38, said a premature baby admitted to the unit must be separated from the mother from the first day of birth and will only be discharged once the necessary developmental milestones are met.

A premature baby admitted to the Neonatal Intensive Care Unit (NICU) must be separated from the mother from the first day of birth.

"The duration of care for a premature baby in the NICU depends on the baby's health status and gestational age at birth. Generally, premature babies stay in the NICU until they reach an appropriate developmental stage, which can range from a few weeks to several months," she said.

“Premature babies are typically discharged when their weight stabilises (around two kilograms or more), they can breathe on their own without the assistance of a machine, they are able to nurse well, and there are no critical health issues," she explained.

She added that during this time, the baby still requires the presence and nurturing touch of the mother to support growth and emotional development.

"To meet these needs, we use the ‘kangaroo mother care' method, which involves skin-to-skin contact. The baby is placed on the mother's chest to foster bonding, and we also encourage mothers to provide breast milk. This method helps the baby feel comforted and supports growth," she added.

30,000 PREMATURE BIRTHS

Meanwhile, citing data from the Malaysian National Neonatal Registry (MNNR) 2020, Consultant Paediatrian and Neonatologist at SMCV, Dr Lee Mei Ling, said Malaysia records about 300,000 births each year, with about 10 per cent, or 30,000, being premature births.

Dr Lee Mei Ling, Consultant Paediatrian and Neonatologist at SMCV.

“The survival rate for babies born between 28 to 32 weeks (of gestation) and receiving treatment in the NICU now stands at 80 to 90 per cent,” she told Bernama.

Dr Lee expects the number of premature births to continue rising in the coming years, with most being born at 23 to 25 weeks of gestation, which is earlier than before.

The main contributing factors include the lifestyle choices of pregnant women, such as stress, smoking, vaping, alcohol consumption, and drug use.

“Additionally, health issues in the mother, such as hypertension, diabetes, or infections, also contribute to premature births," she said, adding that pregnancies with multiple foetuses also increase the risk of premature birth.

According to Dr Lee, socioeconomic factors also contribute to the issue, especially in rural areas, where mothers may not pay adequate attention to antenatal care or balanced nutrition due to financial constraints.

“Regular antenatal check-ups for expectant mothers, adopting healthy lifestyle practices, maintaining a balanced diet, and ensuring sufficient rest are crucial in preventing premature births,” she emphasised.

RECOVERY OF PREMATURE BABIES

Dr Lee said early intervention programmes are crucial for the recovery of premature babies to ensure their growth process is perfect, which includes physiotherapy (head and body movements, posture control), occupational therapy (stimulating gross motor skills), and speech therapy.

Premature babies require various forms of care to support their growth, with an incubator being one of the essential tools.

“Usually, I will conduct follow-up treatments for at least two years to ensure optimal development with no other issues. We also ensure that the baby’s muscles are in good condition and monitor developmental milestones such as walking, crawling, or sitting,” she said.

Commenting on neonatal medical technology in Malaysia, she said the country has medical facilities that are on par with several developed countries in Asia.

“In terms of the quality of care for premature babies, Malaysia has the expertise and technology; however, in terms of access to the latest technologies, including those that utilise artificial intelligence, improvements are needed,” she added.

(This article is in conjunction with World Prematurity Day, celebrated on Nov 17 each year)