MANILA -- Micro preemies are babies born before 26 weeks gestation period. They usually weigh around 800 grams. They look sticky or gelatinous as their skin is white and their veins are very visible. Since their immune, respiratory and other bodily systems are still weak, they are required to stay in the neonatal intensive care units (NICU) of hospitals.
In Faith Catherine’s case, she needs to stay at the Philippine Children’s Medical Center’s NICU in Quezon City for 120 days. There, she is placed inside an incubator for warmth and to keep infections at bay. Her every breath is assisted by a ventilator.
“Faith was born exactly 500 grams and 24 weeks, the minimum requirement for doctors’ protocol to be aggressive in treatment (for premature babies). My wife’s water bag ruptured at 23 weeks and five days and we were advised to have the baby removed to save her from getting an infection,” Faith’s father, Noriel told Philippine News Agency (PNA).
The couple decided to keep Faith as they already lost their first child two years ago due to miscarriage caused by incompetent cervix. Consequently, Roan, Faith’s mom, stayed two days in the labor room to be administered with four steroids shots that helped develop unborn Faith's lungs.
While Noriel felt proud about their daughter surviving the delivery, Roan hated herself for not delivering their child in full term.
“The first time I saw Faith, I felt angry with myself. I felt like I failed her as a mother, but as I see her day by day my admiration for my daughter's strength grows,” she said.
According to the World Health Organization (WHO), around 15 million babies are born preterm or before 37 completed weeks of gestation, and this number is rising. This means one in 10 babies around the world is born premature.
Kristine Arranz, pediatric consultant at The Medical City, told PNA that prematurity among unborn babies result from various maternal and neonatal causes.
“Like mothers who are smokers and alcoholics are at risk of delivering premature babies. Mothers with co-morbid conditions like hypertension, diabetes, and infections can also give birth to premature babies. Twin pregnancies are also at risk to deliver preterm babies,” she said.
WHO reported that prematurity is one of the leading causes of death among children under five years old. Their latest data in 2015 showed that approximately 1 million children died due to prematurity and preterm birth complications.
WHO's data show that 60 percent of the preemies born worldwide are from Asia and South Africa. India, China, Nigeria, Pakistan, Indonesia, America, Bangladesh, Philippines, Democratic Republic of Congo and Brazil are the top ten countries with the greatest numbers of preterm births. Around 348,900 preemies are born in the country yearly.
While there are chances for preemies to survive, WHO said there are inequalities in survival around the world, adding that half of those who were born in low-income families die due to lack of feasible and cost-effective care.
“Chances of survival may vary, depending on several factors like how premature was the baby born, the clinical condition of the baby at birth, the economic status of the family, the facility where the mother gave birth and the skills of those who delivered the babies, too,” Arranz said.
Noriel said Faith had acquired an infection because her immune system is not yet fully developed. To survive the infection, Faith was given antibiotics for 45 days and other medicines. She also received a series of blood transfusions.
“She was in a mechanical ventilator for about 50 days which causes her to have pneumonia. It was a very slow process and when the doctors were able to eliminate the infection, Faith’s condition becomes better,” he added.
To date, Faith is already on her 69-day stay at PCMC’s NICU. Her doctors say she is a "grower" as she continues to gain weight each day and is free from infections and illnesses.
“Currently, the only contraption is her orogastric tube where they feed her. The doctors just need to monitor her and for Faith to gain more weight before they transfer her to a regular ward,” Noriel said.
WHO said there are many procedures and treatments which can be done to improve preemies’ survival rate after delivery. These include basic care for infections and breathing difficulties, breastfeeding support and provision of warmth.
Arranz said most of the leading tertiary hospitals in the country are well-equipped with the technology and skilled professionals capable of delivering and caring for preemies.
“Filipino pediatricians, especially our pediatric neonatologists, are globally competitive and well-trained to handle such babies already,” she added.
To boost Faith’s chances of survival, Noriel and Roan were advised by the doctors at the NICU to do Kangaroo Mother Care (KMC) for a minimum of 90 minutes daily.
“Skin to skin contact of the baby and mother, during the first week, I had to do it since Roan was sick,” Noriel said.
He added KMC helps normalize oxygen saturation, body temperature, weight gain and bond between baby and parents.
According to WHO, prevention of deaths and complications among preemies starts with a healthy pregnancy.
WHO’s antenatal care guidelines include key interventions to help prevent preterm birth, such as counselling on healthy diet and optimal nutrition and use of tobacco and other substances.
WHO emphasizes the importance of fetal measurements through ultrasound to help determine gestational age and detect possibility multiple pregnancies. It strongly suggests monthly checkups during pregnancy to identify and manage other risk factors, such as infections, which may affect unborn babies.
Apart from praying for Faith, Noriel and Roan whisper words of encouragement and love to her as they visit her daily at the hospital.
"We tell her to keep strong, to hold on and to keep on fighting. Every day I would tell her that Jesus loves her more than we love her. We would sing a lullaby to keep her relax and at peace," Noriel said.
Instead of focusing on the amount of money they need to raise for their daughter's treatment, Roan said they celebrate Faith's daily progress and achievements.
"We would celebrate every kick, every arm lift, every smile, every news from the doctor of increased feeding and completed medication. It was a huge milestone for us when she was extubated and now, she is already breathing on her own, and now weighs 690 grams," she added.
The couple created a personal online blog which they update daily with their experiences, thoughts and simple joys as they visit Faith. The couple also documents Faith's daily milestones through the blog.
Stressing that prematurity among unborn babies is preventable, Arranz said proper planning and care is important before and during pregnancy.
"To all expectant mothers, and even newly-married couples who are planning to get pregnant already, take good care of yourselves during and even prior to pregnancy. Regular prenatal check-ups with your OB-gyne are very important in making sure that we deliver your babies healthy and term," she added.
To boost people's awareness about prematurity or preterm births, WHO declared November 17 as the World Prematurity Day. Through this event, WHO aims to promote guidelines, tools and evidence-based recommendations that would help prevent and promote proper care for preterm babies.
This year's theme is "Working together: Partnering with families in the care of small and sick newborns” which acknowledges the journeys of preemies and their families. (PNA)