Kathmandu, Jan 3: A young couple, Ramesh Chhetri, and his wife, Sadana Chhetri (name changed) from Bidur Municipality, Nuwakot, was sighted kangaroo caring for their firstborn in the Neonatal Intensive Care Unit (NICU) section of the Paropakar Maternity and Womens' Hospital (PMWH), Thapathali.

"My pregnant wife of six months started to feel the sharp pain suddenly after dinner, because of which, we had to rush her into the Nuwakot hospital, but, were referred to Kathmandu. It was a long and painful way for us." said, Chhetri.

“The doctor at PMWH said that it was best to perform the Cesarean but, my baby was way underweight, around just one kg. After the news, we feared the life of our firstborn and that is still vivid in my memory."

"After the cesarean, our firstborn was taken to the NICU unit, under the Department of neonatology and after a month our baby weighed 1200 grams, we were handed our baby and were asked to give kangaroo care," he added.

It has been 20 days since the young parents are caring for their babies in the kangaroo care units.

Similar is the story of Bina Shah (name changed), a six-month pregnant with twins, wh0 is from Dolakha. She too felt the sharp pain and heavy burn on her chest because of which she visited her consulting doctor. The doctor said that that one baby was coming out and she was immediately referred to PMWH. In the hospital, she was advised that it is better to take out the babies.

According to her, even though she gave birth naturally, but, both her twin boys, were underweight, therefore, had to be placed in the NICU section. The elder son was 1500 grams and the younger son was just over 900 grams at birth, after a month’s stay in NICU one gained weight and was handled over. Then they're asked to perform the kangaroo care to the elder son, however, the little one is still inside.

“I don’t know when I will see my other baby, it leaves a huge gap in my heart. This has taken a toll on me mentally,” said new mother Shah, who was lying in bed with her elder twin performing kangaroo care. 

These new parents can have to stay as long as six months in the hospital if their preterm babies are not well developed and are under-weight. The preterm babies are shifted to NICU units soon after delivery and are given to parents for kangaroo care if they are seen improving. Even after months-long kangaroo care, preterm babies are kept in the constant care of doctors, and only after the approval of doctors, they are sent home.

Dr Shailendra Bir Karmacharya, Senior Consultant Peadrictrican at NICU unit, in PMWH said that preterms babies are underweight and behind in the normal development process. Therefore, besides general care, care in the NICU unit and kangaroo care is essential for saving preterm babies.

"Soon after the delivery of preterm babies, we shift them to the NICU unit. As per the need, we provide them services. Some preterm babies need a ventilator only, some need to be kept inside the cube, and some just temperature maintenance. If the weight, a marker of the development and growth of newborns, of the preterm baby and development is going well then we shift them to the kangaroo care units." He said.

Informing about Kangaroo care, Dr Karmacharya said that it is the care that saves lives of preterm babies. Not only does it maintain temperature as newborns are likely to get hypothermia, but, it gives the opportunity to develop love, warmth, and bonding moments between parents and their child and a sense of responsibility to parents about their stillborn.

The other main concern after stabilizing their health is to make them habitual in milk feeding. Exclusive breastfeeding is the only to secure protein and maintain the glucose level in a child as other formulas if fed inadequately can cause diarrhoea, vomiting and sometimes takes life as well.  In the NICU unit, we feed the expressed milk of the mother and suggest parents’ breastfeeding in the kangaroo care unit.

“We only send babies home after making their growth that the weight must be at least 1,800 gram and with the confidence of parents that they can care their newborn,” He added.

What invites pre-term birth?

According to Dr Riccha Nepal, DM resident doctor at the Bir Hospital, high blood pressure, sugar, and thyroid are the leading cause for pre-term babies as they are likely to affect the health of mothers and children, so doctors advise for premature delivery.

Some deformities in the womb and cervical opening as well as stress are among the factors that can invite pre-term deliveries.

She suggested regular follow-up of the high blood pressure, sugar, and thyroid level of the expectant mothers to avoid any pregnancy and birth difficulties.