Inside the cubicle, the midwife cautiously handed over the tiny infant to K’s husband and instructed him on how to start skin-to-skin contact with the newborn.
K, 30, a first-time mum had just delivered the baby prematurely at 35 weeks gestation by Caesarean section. She had profuse vaginal bleeding from premature separation of the placenta. The baby boy weighed 2.4kg and was crying well at birth, with a good Apgar score of 9. Thankfully, he was in a stable condition.
What is premature birth? Premature or preterm birth is defined as a live birth before 37 weeks of gestation. Depending on the gestational age, it is further subdivided into the following:
extremely premature (less than 28 weeks of gestation)
very premature (28 to 32 weeks of gestation)
moderate to late premature (32 to 37 weeks of gestation).
The younger the preemies, the lesser the chances of survival. For those who survive, the majority go on to live a relatively normal life. However, some may have long term health issues such as hearing and sight problems, delayed development and cerebral palsy.
How common is premature birth in Singapore? In Singapore, about 1 in 11 babies are born prematurely. This is similar to the worldwide incidence of 10%.
What is Kangaroo Maternal Care (KMC)? KMC is the care of a premature baby with continuous and prolonged skin-to-skin contact between the mother and the infant immediately after birth. It is an easy-to-use method, first proposed by doctors in Bogotá, Colombia in 1983.
It has the following advantages:
It is evidence-based. Survival rates for preterm and low birthweight babies have been noted to improve.
It helps regulate a baby's temperature, breathing and blood sugar levels.
It helps babies gently adjust to life outside the womb.
It helps initiate and establish breastfeeding.
With improved bonding, mothers would feel more confident with better self-esteem and would have a sense of fulfilment.
It leads to less anxiety and depression for the mothers.
If the mother is not available (e.g., after a C-section), fathers, partners and other family members can also provide KMC.
There is less incubator care for premature baby
Baby can be discharged earlier from the hospital.
What are the prerequisites of KMC?
According to the new guidelines released by WHO this November, KMC should start immediately after birth, without any initial period in an incubator. Research has now shown that starting immediate KMC saves many more lives, reduces infections and hypothermia, and improves feeding.
Breastfeeding should be exclusive and initiated immediately.
The infant should be clinically stable, able to breathe spontaneously after resuscitation and is not in shock or needs mechanical ventilation.
The infant’s clinical condition (including heart rate, breathing, colour, temperature and oxygen saturation) must be monitored.
K’s baby thrived well and was discharged with the mother on the third day after delivery.