Medical technology: Health and well-being of the premature infant

Sano Shingiro Honore, a midwife at Muhima Hospital in Kigali City, said that babies born prematurely are not all treated equally.

" a baby born at 32th weeks is different from a baby born at 36th weeks. We determine that any baby born from 28th weeks or less is pre-mature which is at the highest level, because the weeks are fewer.  One who was born at 32nd weeks is premature but in the middle,  34th weeks is also premature in the average age. And the one born at 35-37 weeks is premature but it is higher. The period they are in and how the baby is born is different depending on the weeks," he said.

However, a DHS survey conducted in 2019/2020 by the National Institute of Statistics of Rwanda shows that since 2000, Rwanda's health has improved in terms of the quality of care provided to mothers and newborns, including premature babies. 

It shows that the rate of maternal care has increased, with the infrastructure used to provide care from 27% in 2000 to 93% in 2020. At the same time, the number of skilled assistants has also increased significantly [has tripled] from 31% in 2000 to 93% in 2019-20.  from 31% at that time, they reached 93% in 2020 and the number of mothers who give birth in institutions has increased significantly.

This is related to the fact that the rate of child mortality also decreased from 44 per 1,000 children at that time, to 19 per 1,000. At the same time, the under-5 mortality rate also decreased from 196 per 1,000 children to 45 in 2020.

Sano Shingiro Honore, a midwife at Muhima Hospital, says that there are usually ways to help premature babies that contribute to their health.

“When a child is born prematurely, we take him/her to the pediatric service, mostly called Neonatology, where he is monitored. The first thing is to look at the condition in which the child was born. Is this a baby born at maybe 36th weeks? Is it breathing properly? Is there any risk that he/she will have some infection from his mother? You put all these children in different categories and you give them different treatment, " he said.

He says that any child born prematurely, even if he/she does not show any problems, is taken into Neonatology for a certain period to ensure that he does not face any health problems after birth.

"it depends on the weeks the baby was born, some children are placed in incubators to help them. The incubator is one of the basic ways used to help the premature baby to feel like he/she is in the place where he/she should be, even though he has already arrived in the world," he noted.

 “… it depends on the circumstances in which they were born. But the first thing we go to is the weeks when the child was born, because the 36th may be fine, but you also take that baby there because the time was not yet because there may be other reasons that problems may arise. After all, not all the organs of the body are mature, the weeks that were left to say that he has arrived would not be enough. That's why we have to take that baby there to be near the doctors. We don't immediately give those babies to their mothers to go home and live with them and then there will get some problem", Sano added.

 “That one (36) is different from the other one at 28, 30 weeks. The latter still needs a lot of help. they need to be in the same place as when they were growing up. they need their body to pursue growth because there is a lot that has not yet grown for them, that's why we immediately put them in the incubator."

He also says that a child born before 30 weeks has organs that are not yet grown to the proper level, and their development is assisted by an incubator.

“That's the first reason why we take the baby to the incubator. It is so that we can give him/her time for the undeveloped tissues to see how they grow. Another thing that helps us is the temperature of the child because it is very important for his/her growth. Because outside it might be cold or it would be sunny. Another thing that helps us is that the heat makes him/her grow and gain weight, so even if you treat him/her like a newborn baby, there is a risk or risk of getting an infection that can be prevented, we give him/her medicine because he/she was born prematurely. And because the lungs are not yet developed as they should be, we see how we give him/her air in the right way" he said. 

Sano says that a child born prematurely is characterized by the inability to breastfeed. He just says that "there is a mechanism in the incubator that is used to give the baby what he/she needs without requiring to take him/her out of the incubator."

He said, “If the baby is unable to do so, we will put him in the NGT: Nasal-Gastric tube that goes through the nose and goes down to the stomach. That's where we could feed him. In the incubator, there is a party where you can use your hands and give him or put what we call a lunette or a mask to help us give him air, and you can give him medicine without taking him out. When the child is in the incubator, he stays there until his doctor decides that it is time to take him out  and put him on his mother's chest [Kangaroo Mather care]."

"...if it's for a child who is allergic to breastfeeding and it would cause a problem, we give him serums because that is also possible. Among the components of the incubator, there is a way to enter and meet the child without bringing him infection from outside," Sano mentioned.

A premature baby grows well!

Sano Shingiro; a midwife at Muhima Hospital, says that a baby born at 28 weeks is the one whose lungs are not well developed, only the Incubator helps him grow as required that even a baby born weighing 800 grams can survive. And the only place where the diagnosis is developed, the 500-gram baby lives and grows so well.

He adds that a premature child requires a lot of attention and takes care of more than another baby born at a normal time. Those help him to grow as well as normal.

"And he can be born at 35 and grow up to be a girl or a young man than as someone as born at 41st weeks. Due to the condition, he was born in, the way the child is cared for, the love of the parents, how they feed him...that makes the child grow and look better than someone else born at required weeks" he said.

He says that children born with problems that include malformation of certain parts of the body or without them have a high risk of dying.

 “It happens! If he is born without a brain, you understand that even if he was born [at] 40th weeks, he would not have lived. it's not that he was born before the right time[ immature] but that his body has a problem....”

Nowadays, many health services with these machines to help premature babies [incubators] have reduced the death rate.

Sano Shingiro says that this medical technology has reached a lot in the medical services so that even if a child can be transferred to another hospital, he can gone in the ambulance with an incubator.