World prematurity day?? Giving birth to preemie in 30 weeks of gestation

Premature birth at 30 weeks: A journey of strength and resilience - Motherhood Hospital India

Giving birth to a baby is a miracle on its own. However, giving birth to a premature baby and nurturing it to good health, with utmost care, patience and love, is a whole different league. One such story is that of Neha who gave birth to her little one at 30 weeks of gestation. Needless to say, Neha and her partner were on the verge of breaking down when they learnt that they were going to give birth to a premature baby.

NICU procedures and equipment

In todayŸ??s day and age of technological growth, there are a plethora of procedures and top-notch equipment available to help nurture a premature bay into the pink of health. MotherhoodŸ??s Neonatal Intensive Care Unit (NICU) provides exactly that to the concerned parents of a preterm baby. Along with world-class respiratory equipment, monitoring equipment, feeding tubes, incubators and phototherapy, MotherhoodŸ??s NICU also offers the love and care every premature baby needs to grow and develop into a healthy and fit little one.

Furthermore, Motherhood has a level 3 NICU which is equipped to take care and nurture even the smallest and sickest of babies. Apart from premature babies, the level 3 NICU also focuses on taking care of newborns with dangerous illnesses. The staff which works around the clock to ensure the babies get nothing but the best include renowned neonatologists, experienced neonatal nurses and certified respiratory therapists.

Care and treatment for preterm babies

MotherhoodŸ??s NICU is one of the most-preferred hospitals to take care of preterm babies. In NehaŸ??s case, her preterm baby was born is 30 weeks of gestation with a birth weight of just 1 Kg 200 gms. Due to the preterm delivery and RDS, the newborn had to be admitted in MotherhoodŸ??s NICU and nurtured to health for more than a month.

The mother came with the history of 7 and half months of pregnancy with the history of previous caesarian section and she had a cervical stitch in view of a uterine anomaly. She had leaking of amniotic fluid and very little fluid around the baby. She underwent an emergency caesarian section and the baby needed an NICU admission with previous lSCS. This led to Neha having cervical stitches in situ with a bicornuate uterus (Recurrent pregnancy loss), premature rupture of membrane and anhydramnios (lack of amniotic fluid). Due to this condition, NehaŸ??s newborn had to be kept in MotherhoodŸ??s NICU. However, with the help of advanced technology, support and care provided by the sisters and doctors at NICU, the baby is now doing well. According to Dr. Prashanth Gowda, Consultant Neonatologist and Pediatricians, the baby is healthy with normal neonatal screening and age appropriate developmental milestones. NehaŸ??s little one was discharged on 8th of April, 2017, and is doing fine post discharge. Dr. Prashanth Gowda also adds that the bundle of joy is in perfectly good health and the parents are very happy with the NICU team, the doctors and management at Motherhood hospitals.

World Prematurity Day?? Giving birth to premature twins

World Prematurity Day Giving birth to premature twins

Sapna was in a bitter-sweet sense of state when she was rushed to the hospital to give birth to her first set of twins. Sweet, because she was anticipating this day from the moment she saw the faint red line on the home pregnancy kit. She was going to meet her babies after months of nurturing them in her womb. Bitter, because she was being rushed for a caesarian, 33 weeks after conceiving. She knew she was going to give birth to not one, but two premature babies, and the thought of them not being healthy enough to survive was killing her inside.

The miracle of childbirth

Many such mothers face the fear of giving birth to their children well before they are completely formed. The thought of giving birth to a premature baby and nurturing them to good health in the neonatal wing of a hospital is quite frightening. At Motherhood, we understand this , which is why our Neonatal team ensures care is delivered with compassion to both babies and their parents.

Our level 3 Neonatal Intensive Care Unit (NICU) is equipped to care for and nurture the tiniest and sickest of newborns. The well-qualified staff consists of world class neonatologists, neonatal nurses and respiratory therapists who specialize in care of newborns. Apart from caring for premature babies, the NICU unit also caters to babies born with serious illnesses.

Care and treatment for premature twins

In Sapna’s case, both her babies were premature, with one having the birth weight of 1 Kg 400 gms and the other at 1 Kg 100 gms. Due to preterm delivery and RDS (Respiratory Distress Syndrome ), the babies had to be admitted to the NICU of Motherhood Sarjapur Road. Dr. Prashanth was the primary Neonatologist along with Dr. Quazi Fazal Ali and other NICU team members. The baby whose birth weight was 1 Kg 100 gms had to be in the NICU for almost one and a half months and the other baby for more than 15 days.

Sapna had already undergone a premature childbirth at 33 weeks and 3 days of gestation with severe preeclampsia, which led to keeping the baby in the NICU. However, pre-term twin babies are a whole different league. Though the care given to preterm twins is the same, managing your emotions and preparing yourself to care for your preterm babies is the biggest challenge. We, at NICU, are elated that Sapna and her partner left no stone unturned in following all instructions provided to them.

According to Dr. Prashanth Gowda, Consultant Neonatologist and Pediatrician, the babies are now doing extremely well, both physically and developmentally, because of the utmost sincerity and patience shown by the parents. The babies got discharged on 17-08-2017 and 25-07-2017 and are doing phenomenally well. They are in perfectly good health now and the parents are well satisfied with the NICU team and the services of Motherhood hospitals. They also added that they would definitely recommend Motherhood to their close friends and family, to welcome their offspring to this world through professional and trust-worthy hands.

Complementary Feeding by Archana Reddy

Expert advice on complementary feeding for infants, offering valuable insights - Motherhood Hospital India
  • What is complementary feeding?

The transition from exclusive breastfeeding to family foods referred to as complementary feeding. From 6 months of age your baby needs breast milk and solid foods to promote health, support growth and enhance development.

  • When to start/what is the right age?

As per WHO baby has to be exclusively breastfed for first 6 months (if breast milk is not sufficient then formula milk can be given). So complementary feeding should be started when the baby reaches 6 months of age.

Introduction of solid food to be led by infants developmental signs like

  • Baby can sit with or without support.
  • Showing interest towards food when others are eating
  • Likes to put things in their mouths

At this age frequent breastfeeding should continue despite foods being introduced. During the next few months the variety and amount of foods can be increased, while breastfeeding still continues.

  • How to start?

Solid foods to be started gradually after 6 months of age. At 6th month solid can be given once/twice. One feed /month needs to be increased.

So by 9th or10th month baby should be taking 3 meals + one or two snacks along with Breast milk/formula milk.

  • What type of foods to be given?

Good choices for complementary foods are those rich in energy, protein, essential fatty acids and micronutrients (particularly iron, zinc, calcium, vitamin A, vitamin C and folate). These will be supplied when breast milk and a variety of suitable complementary foods are given to a baby.

Gradually increase food consistency and variety as the child ages, adapting the diet to the infant’s requirements and abilities

At 6 months: Feed mashed and semi-solid foods, softened foods

Feed energy-dense combinations of soft foods.

At 8th month:Introduce “finger foods” (snacks that can be eaten by children alone),textured foods

At about 12 months of age: Most children can eat what rest of the family eats (Family Foods).

Principles of Complementary Feeding

  • No Sugar,No Salt, No Honey till one year of age
  • No other liquid form of food to baby other that water,Breast Milk/Formula milk.
  • Always make baby sit in upright position and feed.
  • Water 30-40ml/day till 12 months.
  • No cow milk to be given to baby as a drink till 12months,but it can be used as a cooking ingredient.

Practice responsive feeding

  • Feed infants directly and assist older children when they feed themselves.
  • Offer favorite foods and encourage children to eat when they lose interest or have low appetites.
  • If children refuse many foods, experiment with different food combinations, tastes, textures, and methods for encouragement.
  • Talk to children during feeding.
  • Feed slowly and patiently and minimize distractions during meals.
  • Do not force children to eat.

By

Archana Reddy,Nutritionist, Sahakara Nagar

Breastfeeding Postures

Breastfeeding is not just about milk, it is all about mother’s love & care for her little one. Breastfeeding sometimes requires moms to be in one position for quite a long-time due to which many moms may be predisposed to developing pain on their neck, shoulders, forearms, wrist and low back. New mums sometimes find breastfeeding uncomfortable due to wrong feeding positions, or lack of support. This can lead to breast and nipple discomfort. Physiotherapy plays an important role here to help overcome the discomfort and swelling of breast engorgement ad make the process comfortable and happy for both the mom and baby.

How Physiotherapy is helpful for a lactating mother?

  • One of the first things physio can help is in educating a good posture when mom is feeding. The mom should be able to sit comfortably and relaxed during the feeding time.
  • It is important to sit with good posture, so that the strain to the body, neck and shoulders is less. Good posture will help the baby to latch well. A good latch can help minimise the amount of damage and irritation to the nipples
  • It will also help ensure that the breast drains well during feeds, and therefore decrease risk of developing blocked ducts and mastitis.
  • Physiotherapy can help reduce breast engorgement, inflammation and swelling, and instruction in gentle lymphatic massage to help reduce swelling.

PRINCIPLES OF ERGONOMICS WHILE BREASTFEEDING

Support your arms and baby while feeding

Positioning yourself and supporting your little one with pillows throughout the feeding will also help to avoid overuse of your arms and shoulders.

Be cautious of your positioning

Be conscious of your position throughout the feeding process. Try not to slide down into a slouched position, especially if feeding in bed or on the couch. It will put stress on your back and neck.

Try feeding

your baby while sitting upright with your back supported and your little one at the height of your breast.

Relax your muscles

You can get sore muscles caused by too much tension in your body. Unless necessary, always try to sit or lay down while breastfeeding. It will allow for extra support for your arms, neck, and back and will help to limit tension that youŸ??d get from poor support while breastfeeding.

COMMON BREASTFEEDING POSITIONS

FAMILIAR PHYSICAL CHALLENGES OF BREASTFEEDING

  1. Breast pain
  2. Neck strain
  3. Upper back & shoulder pain
  4. Hunched posture of shoulder
  5. Hand and wrist pain
  6. Low back pain & Tail bone pain      

TIPS FOR NURSING MUMS

  • Milk flow can be restricted by a poorly fitted bra, poor positioning of you and the baby or due to compression from your fingers holding the breast, if too firm.
  • Positioning yourself and your baby correctly to avoid back and neck pain as well as avoiding compression of the ducts is very important.
  • Breastfeeding helps your uterus to shrink to return to its pre-pregnancy size more quickly at about six weeks postpartum.

Breast Milk – The Elixir of Life

Ÿ??BREAST FEEDING IS A MOTHERŸ??S GIFT TO HERSELF, HER BABY AND THE EARTHŸ?-Pamela K Wiggins

Of every 1000 children born in India, 39 infants do not live to see their first birthday. Almost fifty percent of infant deaths in India are due to respiratory infections and diarrhoea. Breast feeding alone can reduce the infant deaths significantly. Exclusive breast feeding for 6 months protects the infant against pneumonia, diarrhoea, malnutrition, allergies and chronic illnesses. It is also said that breastfed babies score higher in IQ tests. Breast feeding contributes to the health and wellbeing of mothers also. In India only 64.9% infants are exclusively breastfed for first 6 months.

To enable mothers to establish and sustain exclusive breastfeeding for 6 months, WHO and UNICEF recommend:

  • Initiation of breastfeeding within the first hour of life
  • Exclusive breastfeeding Ÿ?? that is the infant only receives breast milk without any additional food or drink, not even water
  • Breastfeeding on demand Ÿ?? that is as often as the child wants, day and night
  • No use of bottles, teats or pacifiers

The first milk-colostrum is rich in antibodies which helps in building babyŸ??s immune system. Breast milk provides all the nutrients required for first six months. For the first week after birth, it is recommended that mothers breastfeed their newborns 8-12 times in 24hrs.

Breast milk can increase if the mother eats well, drinks well and rests well. The more your baby breastfeeds Ÿ?? the more milk you will produce! All mothers should remember that-Ÿ??Caring is more important than worryingŸ??.

Adequacy of breast feeding in this critical period should be monitored. Danger signs like not feeding well, decreased activity, developing fever, less than 4 urinations per day after day 3, continuous cry should be watched for in the first week of life. Excessive weight loss (>10%) and weight faltering requires immediate treatment. A proper positioning and latching will prevent from sore, painful and cracked nipples. Mother should continue breastfeeding even if suffering from minor infections like cold, or fever.

Juggling work and breastfeeding is not easy. Have confidence in yourself. You can do this! Make a commitment before you return to work. Expressed breast milk can be kept at room temperature for up to 6hrs, in insulated cooler for one day and in refrigerator for 5-8 days.

Breast feeding should be given exclusively for first six months of age and then till two years along with complementary food.

Mother should communicate, look into the eyes, touch and caress the baby while feeding. Mothers need to practice responsive feeding. Breastfeeding is the best gift a mother can give her baby which lasts a lifetime. Breastfeeding is not a choice itŸ??s a responsibility.

Content Credits: Dr. Priya Shivalli

10 THINGS YOU SHOULD KNOW ABOUT NEWBORN BABIES By Dr. Pradeep Kumar

  1. New-born babies should pass meconium (First stool) within 24 hours and urine within 48 hours.
  2. Breastfeeding should be started as soon as possible, usually within 30 minutes of normal delivery and within 4 hours in case of caesarean section.
  3. First 2 -3 days milk secretion will be less in most mothers but it will be sufficient for the baby as it is rich in energy. The milk secretion will increase only if baby keeps sucking at breast which leads to prolactin reflex and increase in milk secretion. So please make baby sucks every 2 hours.
  4. Red rashes over the face and body is common which needs no treatment.
  5. On second or third day new-born babies develop jaundice which is physiological and only few babies will require phototherapy if jaundice level is high. Frequent feeding will help to bring down jaundice.
  6. Nowadays in most of the hospitals BCG, Hepatitis B and Vitamin K are given at birth or before discharge.
  7. New-born and preterm babies should be nicely wrapped and kept warm.
  8. Honey, oil or other things should not be given to the baby as they are of no benefit and sometimes can result in serious problems.
  9. White discharge or bloody discharge from vagina in female babies are normal which does not require any treatment.
  10. All new-born babies lose weight in first 7 days as they lose excess water from the body. They regain birth weight at 10-12 days of life and from then onwards they should gain 30gms every day for first 3 months.
By Dr. Pradeep Kumar

Fit Mothers, Fit Babies!

Physical exercises help in enhancing and maintaining body wellness and health. And during pregnancy, exercises are a must. However, there will be a slight change in the course of exercises from the normal regime. It is said that fit mothers have healthy and fit babies.

As much as stress and high amount of physical toil should be avoided during pregnancy, exercise on the other hand must be undertaken by all the mothers-to-be. Moreover, research is witness that women who stay fit during their pregnancy term are instrumental in the development of healthy hearts of their babies.

In addition to having healthy hearts, the babies also have healthy blood vessels which help in resisting any sort of problems in the arteries. And the positive consequences of exercising are extended to their adulthood. They develop a good immunity level as they grow older.

There are a lot of advantages of exercising during pregnancy. For the mother-to-be, exercises are recommended because they help in providing relief from backaches and also help in improving the posture of the body and preparing it for labor. If not at all days of the week, moderate intensity level exercises are recommended for pregnant woman timed at about 30-40 minutes per day. This helps in reducing constipation by accelerating the bowel movement and also helps in avoiding any kind of joint wear and tear which usually happens during pregnancy due to hormonal changes with the help of lubricating fluids in the joints.

If you are going to be a mommy, then the most important thing is for you to sleep well and be relieved of any type of stress and anxiety which might make you restless during the nights. Exercising on a regular basis during pregnancy increases the blood circulation in the body and results in a healthier glowing skin. Not only do you start looking more beautiful, you also are prepared to cope with labor pain and it is easier for you to get back into shape after the delivery of the child if you exercise while you are pregnant.

The biggest upside to being fit during pregnancy is that the risk of low birth weight, complications during pre-term delivery, or early pregnancy loss is minimized and the baby is born with a healthy heart and metabolism. The quality of the blood vessels in the pregnant women who exercise regularly is higher as compared to those who do not exercise.

When you exercise during pregnancy, there are significant changes in your vascular muscles that line the arteries which are of high importance in maintaining cardiovascular health. As a result of which, the baby is born with a strong inbuilt cardiovascular system and is helpful in avoiding a lot of diseases in future.

How Do Vaccinations Work

Protective benefits of vaccination: Essential components of immunization - Motherhood Hospital India

A newborn is immune to some infections because it receives antibodies from its mother; this is called “passive immunity“. Passive immunity lasts for a few weeks or months. Ironically, that immunity begins to fade away in the first few months of life. So, it’s very important to follow an immunization schedule.

What is vaccination?

Vaccination protects you from specific diseases that can make you very sick, disable or even kill you. Vaccines help develop immunity by imitating an infection as it would react when it recognizes and fights the real infection. They trick the body into thinking it is under assault & trigger the immune system to produce its own antibodies (substances produced by the body to fight disease), as though the body has been infected with a disease without actually infecting us and harming us with the disease. This is called “active immunity“.

Thus, vaccination is like a dress rehearsal for your immune system so it is prepared for the real show .

How does it work?

When germs, such as bacteria or viruses, invade the body, they attack and multiply quickly. This invasion is called an infection , which causes the illness.

  • The vaccine contains antigens: harmless substances (such as dead bacteria or molecules) associated with the disease.
  • The body assumes the antigens are the actual disease, and its immune system stimulates white blood cells to activate and create antibodies – proteins that can fight the disease’s bacteria or viruses – the invading organism.

How are vaccines created?

Viruses and bacteria can be produced in the laboratory by infecting cells grown in tissue culture; thereby weakening or attenuating it by growing it repeatedly to carefully select a strain that’s less dangerous.The treated pathogen is then combined with stabilizers and preservatives, to produce a vaccine dose.

Does it have any harmful side-effects?

Seldom, vaccination can cause minor symptoms, such as fever. They are normal and can be expected as the body builds immunity. If a child was given 11 vaccines all at the same time, it would only use a thousandth of its immune system, so it does not harm the baby!

How long is the vaccine effective?

Generally vaccinations provide lifelong protection against a disease, but others need boosting. The duration depends on the disease that is being protected against, the vaccine and the person’s inbuilt immunity.

Some vaccines provide high levels of protection like MMR provides 90% protection against measles and rubella after single dose. Others are not as effective typhoid vaccine provides around 70% protection over three years; Tetanus may need boosters.

The antibodies don’t disappear even after their work is done. If these germs reappear, whether it’s a few weeks or many years later, the antibodies are ready to protect & prevent the infection.

Is one vaccination enough to give my child immunity?

The antibodies are very specific. They have been created to combat to a specific disease. The mumps virus, cannot to work against rubella. Thus, one should follow the immunization schedule. Young children are vulnerable to many potentially dangerous infections.

Can vaccination eliminate diseases?

The disease can be eradicated completely if the vaccination is given to most people, as has happened with smallpox and polio. If enough people in a community are vaccinated, it’s harder for a disease to infect even those people who have not been vaccinated. This is called “herd immunity“.

Post Pregnancy Care

Post-pregnancy is a crucial phase of motherhood. Your responsibility doubles once you deliver your little one. Few things that have to be kept in mind after the delivery are to get enough rest and nutrition in order to be able to breastfeed and nursing your baby. This is the phase where you give your body ample of rest and follow a proper diet plan to recover properly.

Crash diet should not be an option because if you are breastfeeding, you will not have sufficient nutrition in your body to keep the breast milk flowing. A well-balanced diet must be followed which helps you in the process of recovering and keeps your body well-nutritional for your baby. However, if you are concerned about your weight and body shape, you can follow a diet which has excessive nutrients but low on calories.

Your choice of food must be based on the simple theory that you must consume food that is low in calories but bulk in quantity so that you are full like fruits, steamed vegetables, baked eats, whole- grains, pulses etc. Calcium is essential for you because the baby needs proper amount of breastfeeding. About four to five portions of calcium and protein rich food is necessary.

It has been researched that the mothers who breastfeed their babies lose weight at a comparatively faster pace because production of milk in the body helps in burning down about 500 calories a day. It is strictly advised by the doctors that newbie mothers should not put themselves on a weight-losing diet immediately after delivery. They need abundant amount of energy and strength for they have to nurse their new-born.

Few women are obsessed with the idea of losing weight post-pregnancy to retain their weight pre-pregnancy. And they end up going on a crash diet which results in the bad interest of both, the mother and the baby. Instead of taking up a stringent diet, going on a sensible diet that is fulfilling but low in fat will help in gaining better results. Newbie mothers are expected to nurture their babies first and then set goals to lose weight after pregnancy.

It is not impossible to lose weight post-pregnancy, but it is highly realistic to accept that it will take some time. If you want to go back to looking how you were before pregnancy, a well-balanced diet and good (not hectic) amount of exercises will be useful. But it might just take more than a couple of weeks to get there. So, be patient and follow a good routine of exercises to fetch your pre-baby body back backed by sufficient nutrients.

Introducing solid foods to your baby

A babyŸ??s digestive system is not ready for solid food until after the baby is about 4 to 6 months old. Until then it is recommended that the baby is exclusively breast-fed or formula-fed. Breast milk or formula milk has the nourishment and calories required for your babyŸ??s development in the first 6 months of her life.

Most mothers want to be sure that they introduce solid food at the right time. There are some signs you can look for in order to know when your baby is ready to include solids in her diet. However, make sure the baby can hold her head up, can lean or sit upright on a highchair.

Signs to watch out for in the baby

  • Starts to put things into her mouth
  • Opens mouth when you take food close to her mouth
  • Asks for more frequent feeds or cries for more after her bottle is empty
  • Shows interest in food that others are eating
  • Can hold small bits of food in the mouth and push it to the back of the mouth
  • Her weight has doubled from her original birth weight

What should I feed my baby the first time?

Babies should ideally be given liquid or semi-solid foods with a spoon to see if they are ready and also to make it easier for them to go through this process. One important thing to remember here is to feed the same kind of food for the first few days just to make sure that your baby is not allergic to a particular food, and also observe if her stools are normal. Move on to a new variant if there are no allergic reactions like vomiting, rashes and diarrhoea. You can try the following options:

  • Boiled and pureed vegetables like pumpkin, carrot, potato, avocado, etc.
  • Boiled and pureed single-grain cereals like rice, ragi or lentils
  • Mashed fruits like banana or apple puree
  • Yogurt
  • Custard

Things to remember when introducing solids to your baby

  • Avoid using vegetables like spinach, beetroot that are high in nitrates. Nitrates can cause a type of anaemia in small children.
  • You donŸ??t need to enhance the flavour of the food with salt or sugar.
  • Start with a few spoons at a time and increase the quantity gradually.
  • Make sure that there are no lumps in the food as the baby can choke on it.
  • If you are using commercial baby food, ensure you use boiled water while preparing it.
  • Avoid giving solids in a bottle so that the baby understands the difference between solids and liquids. This will also help the baby adapt to other solid foods eventually.

Once your baby is about 8 months old and has tried different kinds of pureed foods, you can begin introducing some more solid varieties of food. Your baby will most likely begin to chew at this stage although she doesnŸ??t really have any grinding teeth. This is a good time to switch to Ÿ??finger foodsŸ??. These are small bits of foods that can be easily mashed when in the mouth. Babies will begin grasping the food in their hands

  • Soft cheese,
  • Small pieces of boiled vegetables,
  • Cooked pasta,
  • Cut or thinly sliced fruits like banana,
  • Minced meat or chicken are good options during this stage.

Feeding a baby can be a messy affair! So make sure you have a bib and some cleaning cloth in place to clean spills. Another essential ingredient is to have lots of patience. It is not necessary that your baby will like and eat the food in the very first attempt. Feed the baby in a place where there arenŸ??t many distractions so that feeding time is not just a nutritive but a fun learning process for your baby.

For further details or queries , kindly contact us at tomotherhoodindia@gmail.com