It is believed that a mother understands what a child does not say. This aptly explains this year’s World Premature Day theme; ‘A Parent's embrace: A powerful therapy. Enable skin-to-skin contact from the moment of birth,’ whose aim is to shine a light on the risks and impacts faced by preterm infants and their families as well as raise awareness on preterm birth challenges.
Dr Sabrina Kitaka, a paediatrician, says a parent’s embrace, commonly known as Kangaroo Mother Care allows for the baby to stay warm. The embrace improves warmth through skin-to-skin contact, and has other benefits such as maintaining good digestion, emotional stability and reduction in the number of days to be spent in the special care baby unit.
According to the Uganda National Institute of Public Health, Uganda has a high preterm birth rate of 14 per 1,000 live births. These preterm births are directly responsible for eight out of 27 neonatal deaths per 1,000 live births in Uganda and remain among the top three causes of death during the neonatal period in Uganda.
According to the United Nations Children's Fund (Unicef), preterm birth is the leading cause of death among children under the age of five. Every year, an estimated 15 million babies, which accounts for about one in 10 children are born prematurely worldwide.
Public health and lactation consultant, Zabina Nabirye of The Diet Clinic, says prematurity comes with various challenges to the parents but the most visible are usually the challenges of feeding and warmth.
“All babies, whether preterm or full term, should be placed in skin-to-skin contact with their mothers immediately after birth. This promotes bonding as well as initiating breastfeeding within the first hour of life. Skin-to-skin contact, particularly kangaroo mother care is critical to keep the preterm baby warm and healthy,” Nabirye explains.
Kangaroo mother care
The World Health Organisation (WHO) defines kangaroo mother care as a method of care for preterm infants. The method involves infants being carried, usually by the mother, with skin-to-skin contact.
The Malaria Consortium, a leading non-profit organisations specialising in the prevention, control and treatment of malaria and other communicable diseases among vulnerable populations, promotes kangaroo mother care initiative in Uganda.
“Sometimes we get premature babies that cannot breastfeed. We keep them in a warmer place and instruct the mother or attendant to monitor them. If we get more than one, we use an incubator and monitor them using a thermometer. After two to three days, the babies will improve and begin breastfeeding and we then encourage mothers to practice kangaroo mother care,” explains Magret Bingi, a midwife at Mtwetwe Health Centre IV, which is under the consortium support.
Nabirye adds that this year’s theme is, therefore, critical to advocate and sensitise the public to always practice rooming-in or keeping the baby and mother together throughout the day and night.
Dr Kitaka observes that since preterm babies are usually small and weak to attach to breastfeed, breast expression is, therefore, the most recommended feeding approach.
Nabirye further explains that the mother should express breast milk for about three to four weeks, after which they should gradually start breastfeeding. Breast expression allows the mother to get both the fore and hind breastmilk and as Nabirye adds, the hind milk is fatty, and allows the baby to gain weight more quickly.
“This period allows the baby’s stomach capacity to develop fully. Mothers must, therefore, be supported to express breast milk and feed the babies using a cup, or spoon but not a bottle,” she adds.
Health for sick babies
According to sanfordhealth.org, if your baby is ill or suffering from acute respiratory distress syndrome, then immediate medical care prevents skin-to-skin time.
Neonatal intensive care unit (NICU) staff, who often include skin-to-skin care in their developmental care practices, will work with you to make skin-to-skin contact possible.
In NICU, a baby has more stress and emotional needs. Ongoing tests, noises and procedures are different from the quiet, warm womb the baby has known. Being able to hold these babies skin-to-skin, even with monitors attached and/or equipment attached to them, still has been shown to help them relax and be more contented.
One study even found that premature newborns who had prolonged skin-to-skin contact with their mothers while hospitalised actually had better survival odds.
Once you are home with your baby, it is still beneficial to make this practice a part of your day. While only in a diaper, snuggle your baby upright on your chest. Revel in the closeness and tactile comfort you both are enjoying. If the air is a bit chilly, place a blanket loosely over both of you. Make these sessions as comforting as you can. Avoid diaper changing or other tasks that might make baby unhappy before you start.
Good times to work it into your home routine include during breast or bottle-feeding, first thing in the morning or right after baths. Try to keep the baby in position for an hour because this allows them to go through a full sleep and wake cycle. Being on their mother’s chest helps your baby settle in better to that rhythm.
Babies can benefit from skin-to-skin for months. Some experts recommend it for at least three months for full-term babies and six months for premature babies. So snuggle up with your baby and enjoy the experience of being a parent.
When a mother and baby are together, hormones that regulate lactation balance out, helping the mother to produce more milk and breastfeed more successfully. Newborns’ heightened sense of smell helps them seek out the nipple and begin breastfeeding more quickly when placed skin-to-skin. One study showed that mothers who practiced kangaroo care were more likely to breastfeed exclusively and for longer periods.
What about fathers?
If you are the father, hold your baby on your bare chest. You will enjoy the emotional benefits and the intimacy it creates between you and your newborn child. Knowing you are improving your baby’s health is also a plus.
Additional information from sanfordhealth.org