Care for premature babies in Bogotá and tips for families

Care for premature babies in Bogotá and tips for families

On World Premature Child Day, the District Health Secretariat highlights the work of the Maternal and Child Institute, the hospital that registers the highest number of deliveries attended in Bogotá and is recognized as a model of public health care for pregnant women and newborns , not only in Bogotá but in Colombia.

We consulted with the neonatal service leader of the Central East Subnetwork, the neonatologist Ximena Garavito, who directs the provision of services in this sector of the city, and explained to us how care for these patients works, especially at the Maternal and Child Institution.

Portal Bogotá: What are the special care offered by Bogotá for premature patients?

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Ximena Garavito: The care provided to premature or low-weight patients in Plan Kangaroo includes care in pediatrics, neonatology and nursing, physical therapy, speech therapy and language; evaluations by pediatric cardiology, ophthalmology, orthopedics, physiatry and, depending on the associated pathologies or comorbidities that the patient presents, other subspecialties such as pediatric endocrinology and hematology, among others, will be indicated.

As the social aspect of patients is very important to us, in our hospital all premature or low birth weight patients and their families are assessed by social work and psychology.

PB: What are the causes of preterm birth?

Atención para bebés prematuros en Bogotá y consejos para las familias

XG: There are many risk factors that can lead to this situation. We have social causes such as low income, maternal ages under 18 or over 40; mothers with multiple gestations who have histories of spontaneous abortions or who have presented maternal hemorrhage in the first or second trimester.

There are also maternal behaviors that can be determining factors, such as the consumption of cigarettes, psychoactive substances, alcohol, mothers exposed to severe stress, with an unbalanced diet or marked malnutrition, and who have a lack of prenatal control. There are other causes that may be anatomical or due to fibroids or other pathologies. Difficulty in intrauterine growth, among other conditions associated with the formation of the fetus or the placenta, can also lead to this problem.

PB: What are the risks of preterm birth?

XG: The greatest risk is a preterm premature newborn. They are classified as children under 37 weeks of gestation weighing 2,500 grams. These children, at birth, enter the in-hospital Kangaroo Plan in the newborn units where training begins.

The kangaroo mother method was conceived and implemented at the end of the seventies at the Maternal and Child Institute by Dr. Edgar Rey Sanabria. This plan has evolved over the years and is characterized by basic methods such as:

• Determination of a target population (less than 37 weeks of gestation or less than 2,500 grams of weight regardless of gestational age)

• The second thing to consider is the kangaroo position. This has, as a hallmark, that the child must have skin-to-skin contact with the mother 24 hours a day, in an upright position between the breasts and under the clothes. This position not only maintains the proper temperature, but also facilitates feeding and stimulation.

• The feeding and nutrition of the kangaroo must be based on breastfeeding. This covers the needs of the low birth weight and premature child.

• It is necessary to have very important feeding and nutrition strategies for the premature child in order for them to achieve stable growth.

PB: What is the advice for girls with preemies?

XG: Within the Mother Kangaroo program, the family is the main pillar and they must be trained in patient management. We have to have clear hospital discharge and outpatient discharge policies. Within our institution, special care and warning signs and recommendations are explained throughout the hospitalization. The mother enters a program in which she receives training in nursing, medicine, psychology and therapies that the patient must receive directly in her home. In addition, they are given a verbal test and a written test to make sure that they are properly trained in handling patients at home.

The recommendations are:

• Stay in the kangaroo position 24/7 and sleep in a semi-sitting position

• Wear only a hat, sleeveless shirt open at the front, diaper, and socks or skates.

• Persons assisting with care must be of exceptional grooming, not wearing jewelry, perfumes or lotions.

• Babies cannot have contact with people who have any kind of illness (such as the flu, some viruses or diarrhoea).

• They should not be bathed until they weigh more than 2,500 grams

• Favor breast milk as the only food for the first six months of life and breastfeed them frequently and get rid of gas to avoid colic and regurgitation.

• Be aware of the warning signs and go to the emergency room if the baby has a fever, turns purple, vomits or is allergic to food; if she has bloody stools or urine; if they turn yellow or refuse food; if she has signs of shortness of breath or if she has trouble waking up or is very sleepy; if she cries inconsolably.

Bogotá has the capacity and experience to offer comprehensive services to premature babies and their families in the public hospital network. Early childhood care is essential to ensure healthy adults in the future and this is precisely the pretext for focusing all efforts on achieving this goal.

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