Titi Falade was 29 weeks pregnant at the time she ruptured her water bag while returning home from her night shift duty in one of the factories in Lagos.
The driver of the commercial vehicle she boarded was kind enough to take her to a nearby Private Hospital because Titi said she has noticed the baby’s head was almost out. Luckily, the Nurses at the hospital, attended to her and helped to deliver a small baby boy.
But there, the problem began, the baby was confirmed a premature and weighed just 1.66kg. There would be the need to keep him in the incubator but the hospital has none and would need to refer the baby to a bigger hospital.
Titi’s was asked to call her husband who arrived about an hour later when he was told to get the newborn to the nearest General Hospital at Orile Agege.
Sola Falade, Titi’s husband immediately got a Taxi to transport the baby to the General Hospital, but there was no vacant incubator to put the baby.
He tried the Maternal and Child Centre (MCC at Ifako Ijaiye but all the incubators were occupied.
He was referred from the MCC to the Lagos University Teaching Hospital, LUTH in Idiaraba where an incubator was eventually provided. This was about six hours after the baby was born and transported by commercial vehicle.
Unfortunately, on the third day, Baby Falade died as a result of complications from being born prematurely and having no prompt care and attention soon after he was delivered.
The lot of Baby David Akinwole was however different.
His mother, Mrs Rebecca Akinwole at 28 weeks was returning home after an antenatal visit to the hospital when she suddenly ruptured her membrane.
According to Akinwole, “I immediately returned to the clinic where the Docotr referred me to LUTH because he said the baby was premature and would need an incubator which the hospital does not have.
“I was taken in the hospital ambulance to LUTH and was promptly assisted in delivery of the baby who weighed 1.2kg at birth.
“He was put in the incubator thereafter and after five weeks, I was taught how to make use of the Kangaroo Mother Care (KMC method by the Nurses at the Neonatal unit.
“I was told that after we are discharged, I would need to continue to use the KMC in providing the needed warmth for my baby. After six weeks in the incubator at LUTH, we were discharged home and between myself and my husband as well as my mother, we practice KMC for David who is now weighing 1.99kg”.
Explaining how the KMC method works, Professor Chinyere Ezeaka, Consultant Paediatrician and Neonatologist, Lagos University Teaching Hospital (LUTH Idiaraba, during a media training programme organised by Mamaye, Evidence for Action in Lagos, said, “because most of the deaths in preterm babies are as a result of low body temperature and respiratory difficulties, providing the much needed warmth equivalent to or near to, what the womb offers a foetus such as the incubator or the chest of a mother or care giver at such a critical time, do help protect the preterm born”.
According to Ezeaka, “The birth of any baby before 39 to 40 weeks gestation is often a problem especially when such babies are born with low birth weights.
“Up to 80% of newborn deaths are among small babies yet most health facilities cannot care for these babies”, she observed.
“And so, Evidence-based, affordable alternative to incubator care – the KMC is regarded as the best method to safegiuard the lives of preterms”.
Defining Kangaroo Mother Care method, Ezeaka said, “According to Acta Paediatrica 1998; 87:440-5, “It is the early, prolonged and continuous (as allowed by circumstances) skin-to-skin contact between a mother (or a substitute of the mother) and her low birthweight infant, both in hospital and after early (depending on circumstances) discharge, until at least the 40th week of post-natal gestational age, with ideally exclusive breastfeeding and proper follow-up”.
She pointed out that while the hospital remains the best facility to deliver a preterm and the incubator is the most idle place to keep such a baby, “however, in the event of sudden rupture of the membrane and unexpected delivery of a preterm out of an equipped facility, such a baby can be easily transport to the nearest facility using the Kangaroo mother care method.
“This Kangaroo position helps to provide the immediate warmth needed to save the baby from becoming frozen during transportation as the heat from the mother’s chest of anyone carrying the baby helps in offering protection”.
She however warned against relying only on the method at home without professional guidance as “the birth of a preterm is often associated with more complications other lack of warmth.
“Preterm babies are prone to infections (due to immature immune system, respiratory difficulties, low blood sugar, feeding problems, cardiac problems, jaundice, bleeding into the brain among others”.
She warned that if not propery managed by professionals, a preterm is on the long run is at the risk of Learning difficulties, brain damage, Mental subnormality, Deafness, Partial or complete blindness, Chronic lung disease, Poor growth, Increased NCD like diabetes, hypertension all later in life”.