LIFESTYLE NEWS - People and organisations in over 100 countries around the world unite on 17 November each year to celebrate World Prematurity Day.
The day is an international effort to highlight the global health burden of preterm births, raising awareness that with good management, neonates born too early can thrive and survive.
The theme this year is "A parent’s embrace: a powerful therapy - Enable skin-to-skin contact from the moment of birth."
According to the WHO, 15 million babies are born prematurely each year globally, accounting for 1 out of every 10 births worldwide. In South Africa, the ratio is as high as 1 in every 7 children, with around 84,000 babies being born preterm in each year.
According to WHO data[i], babies born preterm are more vulnerable to various health problems, like difficulty breathing, feeding problems, and infections[ii], than their full-term counterparts. Preterm births and their associated complications are thought to be a leading cause behind high rates of infant and child mortality, especially in low-income settings[iii].
Every year about 30 million small and sick newborns do not access the care they require, many of them in the African Region. In SA, the under 5s' mortality rate stands at about 33 deaths per thousand live births[iv].
Overall, in the African Region, almost a third of the 1 million newborn infant deaths that occur every year are due to premature birth, or resulting complications[v].
Executive Director at South African Breastmilk Reserve, Staša Jordan says that although the mortality rate for under 5s' has improved over the last few decades, the rates of preterm (premature) births are getting worse[vi].
The WHO's research suggests that three-quarters of premature babies could be saved with feasible, cost-effective existing care solutions, such as Kangaroo Mother Care (KMC), antenatal steroid injections, and antibiotics for newborn babies with infections[vii].
"Premature birth is a bottleneck which is hampering national efforts to decrease infant mortality rates and a major focus area for public health interventions," she explains.
"Apart from the human tragedy of losing these infants, the 11 000 premature babies who die from preventable infections and complications each year incur considerable costs for maternity wards and neonatal ICU facilities and contribute to the enormous pressure on our public health systems," Jordan says.
Kangaroo care involves a lot of skin-to-skin contact between mother and baby, and frequent breastfeeding.
“While many parents now know that "Breast is Best!" new mothers may not realise that breastmilk is particularly important for preterm babies to stave off infection and Necrotising Enterocolitis.
"Breastmilk, mothers-own primarily and donated are a lifesaving intervention for this very vulnerable population group as it protects very low birth weight babies from infection. protect them from infections," she says.
The South African Breastmilk Reserve is a non-profit organisation that runs human milk banks which supply neonatal ICUs at 85 hospitals for premature and sick babies - with a focus on rural and under-resourced areas.
The Organization believes that breastfeeding is one of the key clinical strategies for addressing premature morbidity and mortality at the hospital level.
In addition to nationwide human breastmilk emergency delivery for preterm babies, the Organization offer postpartum referral for breastfeeding support for new mothers.
They've also been among the central actors championing related causes like ante-natal health, HIV prevention and treatment, immunisation, and family planning.
Prof Ute Feucht, Paediatrics Professor at the University of Pretoria and Tshwane district paediatrician notes that there are several things that expecting women can do to reduce the risk of preterm birth. “Attending 8 antenatal visits as per the Banc+ national guideline, managing any pre-existing medical conditions like diabetes or hypertension, that the mother might have, and lifestyle changes like quitting smoking and drinking alcohol.
Healthy food choices during pregnancy, including a well balanced diet full of green veg every day, as well as folic acid supplementation also play a role in making full-term delivery much more likely”, she says.
“The South African government recommends at least 8 antenatal check-ups during pregnancy[viii] - in line with international WHO guidelines[ix] - to ensure proper medical care, and to timeously identify any high-risk pregnancies”.
"Sometimes preterm births are unavoidable, and the SARB can help new mothers access human breastmilk for hospitalised ‘premmie’ babies, should they be unable to breastfeed themselves at first" Jordan says.
"For this, we rely on the mothers who donate milk to the milk banks. These donor mothers, who are willing to give while also breastfeeding their own babies, are heroes in our eyes. We urge everyone to spread the message in calling for breastmilk donations and improved breastfeeding support for new mothers
"For 20 years the SABR's pioneering human milk banking model has provided life-saving breast milk to bridge the gap between birth and the time when mothers begin to lactate.
"Our strategy focuses not only on delivering donated breastmilk to hospitals but also on helping hospitals become 'Breastmilk Smart' and establishing 'SOStainers' - mobile health facilities for mothers and children in under-served rural communities that are too far from the nearest clinics for the mothers to access[x]."
This year we call on civil society to strengthen breastfeeding support of new mothers and we encourage healthy breastfeeding moms to consider donating their breastmilk to the human milk bank nearest to them.
If you’d like to become a breastmilk donor, please get in touch via our website.
[i] https://www.who.int/news-room/fact-sheets.
[ii] https://www.mayoclinic.org/diseases-conditions/premature-birth/symptoms-causes.
[iii] https://www.who.int/news-room/fact-sheets/detail/preterm-birth
[iv] https://knoema.com/atlas/South-Africa/topics/Demographics/Mortality/Under-5-mortality-rate.
[v] DoH confidential document? - DRAFT CONCEPT DOCUMENT FOR WORLD PREMATURITY (17 November 2022)
[vi] https://www.ufs.ac.za/templates/news-archive/campus-news.
[vii] https://www.who.int/news-room/fact-sheets/detail/preterm-birth
[viii] https://www.ncbi.nlm.nih.gov/pmc/articles.
[ix] https://srhr.org/rhl/article/who-recommendation-on-antenatal-care-contact-schedules.
(How many visits are in focus antenatal care? four ANC visits
The focused ANC (FANC) model, also known as the basic ANC model, includes four ANC visits occurring between 8 and 12 weeks of gestation, between 24 and 26 weeks, at 32 weeks, and between 36 and 38 weeks.)
[x] https://www.sabr.org.za/project-challenges_and_opportunities.html
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