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South Africa’s battle against premature birth complications: Specialised care offers hope, says expert

Complications often arise due to compromised immune systems in preterm babies, making them more susceptible to infections and sepsis. Picture: Unsplash/ Aditya Romansa

Complications often arise due to compromised immune systems in preterm babies, making them more susceptible to infections and sepsis. Picture: Unsplash/ Aditya Romansa

Published Nov 14, 2023


In South Africa, the arrival of a new life is sometimes met with challenges, as eight out of every 100 babies are born prematurely, marking the nation among the highest in newborn deaths due to complications related to preterm birth.

Despite these staggering numbers, there’s light at the end of the tunnel for the tiny fighters.

Preterm birth is defined as babies born alive before 37 weeks of pregnancy or fewer than 259 days since the first day of a woman’s last menstrual period.

As the world prepares to honour World Prematurity Day on November 17, Aliné Hall, Clinical Quality Specialist at Mediclinic Southern Africa, highlights the critical role of specialised care in nurturing the fragile newborns.

Hall said: "The first hour after a preterm birth is crucial for providing immediate specialised care, which continues as the baby grows and triumphs over the challenges they face.

“From breathing assistance to maintaining body temperature in incubators and carefully introducing expressed breast milk, we strive to build these babies’ strength and health, eventually reuniting them with their families.“

Prematurity remains the leading cause of death in children under five globally, with an estimated 15 million babies born prematurely each year.

Revealing the local impact, Hall points to the fact that Mediclinic Southern Africa admits between 2 500 and 3 000 preterm and sick newborns into its neonatal units annually.

Gauteng, Limpopo and Mbombela stand at the forefront, witnessing the highest number of obstetric services and neonatal admissions within the country.

Complications often arise due to compromised immune systems in preterm babies, making them more susceptible to infections and sepsis.

Breathing problems, retinopathy of prematurity (eye problems), neonatal jaundice, and feeding difficulties are among the most common challenges faced by premature infants.

The medical and support staff in Mediclinic's neonatal intensive care units are trained to respond swiftly to premature births, intervening early to prevent further complications.

Small actions, big impact

“We strongly encourage as much skin-to-skin contact between mothers and premature babies as possible.

“Research conducted by the World Health Organization has shown that this ‘kangaroo mother care’ is highly effective in reducing infections and conditions such as hypothermia,” Hall said.

In neonatal units, a variety of interventions and treatments are used to care for preterm infants and support their growth and development.

The interventions and treatments include:

Respiratory support

Preterm infants often require respiratory support due to underdeveloped lungs.

This may involve the use of mechanical ventilators to assist with breathing, continuous positive airway pressure to keep the airways open, or non-invasive ventilation methods to support adequate breathing and oxygenation.

Nutritional support

Premature babies have unique nutritional needs, and neonatal units provide specialised nutritional support to meet the requirements.

This may involve feeding preterm infants with breast milk, fortified human milk, or specialised preterm infant formula to ensure they receive essential nutrients for growth and development.

Maintaining the appropriate body temperature is crucial for preterm infants. Neonatal units use incubators or open warmers to create a controlled environment that helps regulate the baby’s body temperature and conserves their energy, supporting optimal growth and development.

Additionally, continuous monitoring of vital signs, such as heart rate, respiratory rate, blood pressure and oxygen saturation, is a key aspect of care in neonatal units.

Preterm infants may require supportive care, such as IV medications, blood transfusions, or treatment for conditions like jaundice.

Neurodevelopmental support

Preterm infants are at increased risk of neurodevelopmental challenges, and neonatal units provide specialised care to monitor and support their brain development.

This may include positioning techniques, early intervention services and developmental screenings to identify and address potential developmental concerns.

An integral part of neonatal care involves health-care professionals educating and supporting parents, providing guidance on infant care, offering emotional support and encouraging parental involvement in care-giving to promote bonding and enhance the well-being of the baby and family.

This aligns with this year’s theme for World Prematurity Day – “small actions BIG IMPACT: immediate skin-to-skin care for every baby everywhere”.

Mediclinic was committed to taking such measures to improve outcomes for preterm babies and provide their families with the best medical support possible, said Hall.

“Our obstetric services are guided by a holistic approach that prioritises the health and well-being of both mother and their baby, both are equally important to us, to the families involved and to our communities as South Africans,” Hall said.

World Prematurity Day is an intercontinental movement, initiated by the European Foundation for the Care of Newborn Infants and its partners, and has been observed across the world since 2008.

In addition, South Africa is also a signatory to the UN’s Sustainable Development Goals, one of which is to reduce neonatal mortality, a large proportion of which is caused by premature birth.

Purple, which represents “sensitivity and exceptionality” is the trademark colour of World Prematurity Day, observed in various ways throughout the world.

In the coming weeks, South Africans are encouraged to do their part by wearing purple ribbons, supporting awareness drives and educational initiatives, and sharing their stories of hope on social media.