Small steps have big benefits for prems

Premature babies are at high risk of developmental delays, but intervention by physiotherapists and other caregivers can help to avert those, says speech-and-drama therapist Faizah Toefy.

“Small actions can have a big impact”, the theme of this year’s World Prematurity Day, marked annually on November 17, emphasises how small but important steps can have a profound impact on a premature baby’s development, says Ms Toefy, the director of Bhabhisana Baby Project in Belgravia.

The kangaroo care method, where the baby is placed on a parent’s bare chest, is one such step, she says, noting that it allows the baby’s heart rate and body temperature to regulate with the parent. This skin-to-skin contact – something premature babies are often deprived of during long hospital stays – has important developmental benefits.

And kangaroo care is not only limited to the baby’s parents – grandparents can also provide this contact.

“There are huge benefits for moms and babies. It helps with the trauma of the premature birth and establishes a bond between mom and baby. Prem babies spend a long time in hospital hooked up to machines and moms don’t have an opportunity to bond. This drive highlights the importance of a bond between parents and baby.”

Bhabhisana Baby Project, a non-profit organisation, was established in 2015 by therapists who saw the need in poor areas for early intervention during the first 1 000 days of a child’s life. It offers treatment to children up to 2 including physiotherapy, occupational therapy, language and speech therapy.

Ms Toefy says teenage pregnancies often lead to premature births and she noticed an increase in the number of teenage mothers at state hospitals. Teenage pregnancy, she adds, should not be seen as a “death sentence“ as help is available.

“There’s hope. There are lots of prems who survive. At Bhabisana, we concentrate on therapy and stimulation between birth and 2 years old.

“The first 1000 days are the most critical time for children because lots of development of the body and brain happens. If we can give babies as much input in that stage as we can then the outcome is far greater than receiving therapy at a later stage.”

Because of the high risk of developmental delays in premature newborns, early intervention by occupational therapists, physiotherapists, and, speech and language therapists is important because they can help to stimulate development, she says.

Unfortunately, such support is minimal in state hospitals and there are long waiting lists, she says.

“We are saying that every month that passes is a month lost in a prem baby’s development. If they still need therapy after 2 years old, we will give a referral to government clinics.

“The parents go through an emotional roller-coaster as some babies stay in hospital for three months. By the time they come to us, they are so exhausted, physically, emotionally, and financially.

“When they leave us, we give them a questionnaire, and they always say that the emotional support they received was very helpful and on a much larger scale than at government hospitals.”

Darweeza Salaam, from Hanover Park, says doctors discovered a bleed on her son Imtiyaaz’s brain after he was born at 26 weeks in October 2018. The brain bleed resolved on its own, but the 198 days he spent in hospital was the longest time of her life.

Imtiyaaz was in an incubator in the intensive care unit. He suffered brain damage because of a lack of oxygen to his brain and had to get multiple blood transfusions.

“His paediatrician referred us to another clinic in Mowbray and there his development doctor referred us to Bhabisana for further treatment for physio, and speech therapy,” says Ms Salaam.

“I was away from my baby for such a long time, travelling back and forth. The nights were so long because I couldn’t sleep, just wanting to get back to my baby.”

Imtiyaaz is now 5, but he has still not started walking and he can only say single words.

“He is developing but at a very slow pace,” says Ms Salaam.

She adds: “Never give up hope. There is help out there. I researched a lot which kept me positive and made me not give up hope for my child.”

Another mother, Dorothea Abrahams, from Hanover Park, says the worst time in her life was the three months her son, Garth, spent in hospital after being born at 29 weeks. Garth, who is now 9, had fluid on his brain, and was put on oxygen to help him breathe.

“He’s okay now, although he has a limp. When he was born, he had a feeding tube, and doctors said he could never walk or talk, but he is doing both now. It’s really a miracle that he made it.”