How Mediclinic’s NICUs can save your baby’s life

Premature babies are at risk of health problems and need extra care to grow and develop. Mediclinic’s specialised neonatal intensive care units (NICUs) provide the support they need.

A baby is considered premature if it is born before 37 weeks, says Dr Andrew Ferreirinha, a paediatrician at Mediclinic Kloof. But the health risks for premature babies vary. “It’s a continuum,” he says. “Generally, from 34 weeks on and with a weight above 2kg the babies do quite well, but below that, the risk for complications of prematurity increases.” That is why the neonatal intensive care unit (NICU) is so important.

Premature baby risk factors

“The reason a baby is meant to stay in the womb until 37-40 weeks is so that all the organs can develop to cope with life outside the womb,” says Dr Ferreirinha. Underdeveloped organs make it difficult for the baby to function independently. Some of the most common risks are:

• Difficulty breathing: The number one risk is the lungs, according to Dr Ferreirinha. Babies born prematurely (particularly before 34 weeks) are often deficient in a substance called surfactant, which the lungs only start producing in the third trimester. We need surfactant to prevent our lungs from collapsing when we breathe.
• Brain bleeds: Babies under 30 weeks are particularly at risk. Brain bleeds occur because the blood vessels are not fully formed and bleeds can be triggered by stress, blood pressure fluctuations, pain or infection.
• Poor gut health: An underdeveloped gut means that feeds can’t be absorbed as easily. Breastmilk is more easily digested than formula for premature babies and is packed with gut-protective bacteria.
• Cold: Premature babies struggle to keep themselves warm, which is why they’re kept in heated incubators in the NICU.
• Dehydration: Babies under 28-30 weeks may lose fluid through an underdeveloped skin barrier, so the incubators are also humidified up to 90%.
• Infection: An immature immune system struggles to fight off infections. That’s why handwashing is crucial in the NICU.

How Mediclinic’s NICUs help premature babies

Sometimes preterm delivery is unavoidable. Good-quality care from the time of delivery increases the likelihood of good outcomes. “We move the babies from the delivery room to the NICU as quickly as possible, so they don’t get too cold,” says Dr Ferreirinha. “The humidified incubators are a game-changer in caring for premature babies.”

Babies also get different types of ventilation support in the NICU to help them breathe, depending on their needs. Medical surfactant may be given into the lungs on the first day if needed. 

NICU nursing staff are specially trained

“You won't find a NICU-trained nurse working in an adult ward and often not even in a general paediatric ward. They are very specialised staff and have a huge passion for managing these little ones,” says Dr Ferreirinha. Premature babies must often undergo tests and procedures, and the staff are trained to keep these as non-invasive as possible. They keep the ward quiet, with low lighting to soothe the babies. NICU staff also support the parents by guiding them and helping them bond with their baby. Kangaroo-mother care (skin-to-skin contact) is good for bonding and helps get good bacteria into the baby’s gut, he adds.

Undoubtedly, premature babies have a more difficult start in life, but with good-quality care in the NICU and regular follow-ups when they leave, most can catch up developmentally by the age of two, says Dr Ferreirinha.