This is a welcoming news for all parents of premature baby.  I hope they are encouraged after reading about Amilla Sonja Taylor who is is the youngest surviving premature baby, born after just 21 weeks and six days in the womb.

Having been through the turmoil of   premature baby care, I know Amilia will be the heroine.  Please surf over to ABC News for the full story.

A Bright Future for Preemies

There is hope that Amilla’s survival will help doctors reassess viability for premature babies.

A database run by the University of Iowa’s Department of Pediatrics lists seven babies born at 23 weeks between 1994 and 2003.

Another news report regarding pre-mature babies which I really do not know whether to support or find shocking. My son was born 28 weeks and he was fully formed and a very active baby. I really do not know how he would be at 6 weeks earlier. But if I am the mother, I probably would insist for life-support to keep a child born alive, alive.

I hope the doctors will take into consideration that not all calculation of the gestation weeks are accurate. Some ob-gynae rely on the date of the last period, some depend on the scan and size of the fetus. Let’s pray that each baby born will be given the best care they can get and at the same time, their parents will have the wisdom to ‘release’ them too.

Babies born at or before 22 weeks should not be resuscitated or given intensive care, a report says.

The recommendation is being put forward by the Nuffield Council on Bioethics, which considers ethical questions raised by advances in medical research.

For those born after 23 weeks, the recommendation is that doctors should review the situation with the parents and take their wishes into account.

But doctors warned no two babies born at 22 or 23 weeks would be the same.

(source)

I hate sharing this piece of news but then, it is good for parents to face up to this. When my son was very, very ill, there were moments when I do wish that something can be done to ease his sufferings, even if it means taking the easy way out. However, I was always rewarded with his recoveries and those ugly thoughts would be wiped away.

When he finally did not responded to resuscitation, I was frustrated why he didn’t make that struggle to continue breathing and living. But some part of me, willingly let him go because I knew he has chosen that path. So, I hope all doctors and parents will somehow place that faith in our premature and very ill babies and children that whatever outcome, it is their chosen path. They will have that inner ability to decide if they want to continue breathing, living and growing or they will shut their eyes and sleep permanently.

My opinion is - If the medical staffs have the means and machines to keep a baby alive, they should. The child will make his/her own decision if they want to respond to it. That next breath, that next struggle to keep their foods and lots of medicines down, that last push for the heart to pump - these are the child’s effort. Each child is a gift from God and only God has the right to take the life back.

My advice to parents is to have faith in that child of yours and have faith in God. I pray that all the medical staffs will be guided by God and not their own intellect. I pray that it is a life of a child that they think of and not the money factor and the challenges of the family members. Doctors’ duties are   to save lives, not be the economy planner or meddle with families wellbeing.

The news…

Plea to let doctors kill babies with disabilities

NICHOLAS CHRISTIAN

SENIOR doctors are urging health professionals to consider permitting the euthanasia of seriously disabled newborn babies.

The proposal, by the Royal College of Obstetricians and Gynaecology, follows the increase in the number of such children surviving because of medical advances.

The college is arguing for “active euthanasia” to be considered for the overall good of parents, sparing them the emotional burden and financial hardship of bringing up the sickest babies.

Their submission to an ethical inquiry into increased survival rates reads: “A very disabled child can mean a disabled family. If life-shortening and deliberate interventions to kill infants were available, they might have an impact on obstetric decision-making, even preventing some late abortions, as some parents would be more confident about continuing a pregnancy and taking a risk on outcome.”

Geneticists and medical ethicists are supporting the proposal - as are some mothers of severely disabled children - but a prominent children’s doctor described it as “social engineering”.

The college’s submission continues: “We would like the working party to think more radically about non-resuscitation, withdrawal of treatment decisions and active euthanasia as they are ways of widening the management options available to the sickest of newborns.”

Although the college says it is not formally calling for active euthanasia to be introduced, it wants the mercy killing of newborn babies to be debated by society.

John Wyatt, consultant neonatologist at University College London, said: “Intentional killing is not part of medical care. The majority of doctors and health care professionals believe that once you introduce the possibility of intentional killing into medical practice you change the fundamental nature of medicine.”

(source from here)

07.26.06, 12:00 AM ETWEDNESDAY, July 26 (HealthDay News) — One of the biggest problems in treating premature infants is that their tiny lungs simply aren’t developed enough to nourish their bodies and brains with the oxygen they need.

Because of this, many premature infants end up on mechanical ventilation to assist their breathing. And two new studies suggest that adding nitric oxide to that ventilator therapy may reduce the risk of serious breathing problems and prevent brain injury in at least some premature infants.

“This is a very simple intervention — blending a gas with the breathing machine — that can have long-term benefits,” said one of the studies’ authors, Dr. Steven Abman. He is a professor of pulmonary medicine at the University of Colorado School of Medicine’s Pediatric Heart Lung Center, and The Children’s Hospital, in Denver.

Unfortunately, nitric oxide therapy doesn’t appear to benefit all premature babies. That’s why Dr. Ann Stark, chief of neonatology at Texas Children’s Hospital, said more studies needed to be done before widespread use of nitric oxide in preemies begins. She said there are just too many unanswered questions regarding this therapy right now.

“We don’t know which patients to use this in; we don’t know when to start therapy; we don’t know how long to continue therapy; we don’t know what the most effective dose is. And, this drug is really expensive. That cost is justified if you know there’s a benefit, but we need to prove the benefit to justify that cost,” Stark said.

Full story on Forbes 

21:50:27 EDT Jul 13, 2006 (CBC News)

AMANDA GARDNER/HEALTHDAY REPORTER

THURSDAY, July 13 (HealthDay News) - The growing number of premature births in the United States costs at least $26 billion a year, a new government report says, so doctors should think twice before trying the popular infertility treatments that often lead to problematic multiple births.

In 2005, 12.5 percent of all babies born in America were born at least three weeks ahead of their delivery date, the study from the Institute of Medicine of the National Academies found. And although infertility treatments are responsible for some of that percentage, the researchers noted they are still at a loss to explain why there are significant racial and ethnic differences in premature birth rates.

“The rate of preterm births has increased by more than 30 percent since 1981,” said Dr. Richard Behrman, chairman of the committee that wrote the report and executive chairman of the pediatric education steering committee of the Federation of Pediatric Organizations. “Infants delivered preterm are at greater risk for a variety of health and developmental problems. The birth of a preterm baby can result in emotional and economic costs for both families and communities,” Behrman said.

The report, which was made public Thursday, offered a detailed, multidisciplinary agenda to address the problem. In conjunction with the release of the report, the March of Dimes called for passage of federal legislation to address the issue.

Pediatricians wholeheartedly endorsed the program. “It’s a great agenda item for the country, because if children are disabled, they have a significant impact on society,” said Dr. Adam Aponte, medical director of North General Hospital’s Diagnostics and Treatment Center in New York City.

(continue reading here)

With my marathon stays in the hospitals taking care of my premature son, I had got close to several medical caregivers.  Through them, I learnt that sometimes, whether a baby lives or dies depends on the location where he was given birth, the facilities available and the timing.

These are told to me by at least four different doctors, both in private and public hospitals.  One of them is an ob-gynae and the other three, neonatal care doctors.  This is sad but true.  Sometimes, the doctor will have to decide which baby to save if there is not enough ventilators.  At times, if the parents can afford it, they will be referred to private hospitals.  However, costs in private hospitals can run into hundreds of thousand ringgit.

When I was about to deliver my premature baby, I was repeteadly reminded of this cost constraints.  I was given many suggestions to deliver in a public hospital.  The assurance was the public hospital has better facilities. Costs in the ICU per day is around RM1,000 to RM1,200 per day in a private hospital.
However, whether this is true or not, no one can determine.  A doctor whom I got to know much later (few months after my son was borned) told me otherwise.  He told me that survival rate in a public hospital, unless in a very top neonatal care unit, is much lower.  He told me that I had done the right thing to opt to deliver in the private hospital (not the place where he is attached).

Not many people, including the medical caregiver, knows the intricacies involved in the care of premature babies.  Medical equipments which can cost millions of ringgits are not easily available.  Therefore, sadly, many babies will not survive because of this.  I can only hope that one day, our country will be able to afford the best neonatal care unit in all the states in our country.  Right now, only specific large, teaching hospitals in the Klang Valley  have these units.  Whereas, for the rest of the country, there are only basics support.  Therefore, life and death of these babies are very much at the mercy of the generousity of our Government.  How much are they willing to spend to save the lives of tiny babies?  How high is the priority?  Would it be easier for the doctors to announce, “We are sorry, we have done all we can’? to the parents?

Thank God, we have some very dedicated doctors in the public sectors who often champion for fund raising to buy medical equipments for these neonatal care.  And thank God for generous organisations whom had donated to improve the chances of survival.  The quality of life of these children who survived their early births also depends on the care they received during the first few weeks and months.
Related article from BBC - The double bombshell     

Another research to motivate mothers with ill newborn and premature babies to breastfeed. Find out how to lactate and express milk by reading, asking your medical caregivers for help and finding support from other mothers in the same situation. Log on to MyMomsBest website and its forum for more help.

July 7, 2006, 11:26PM
Breast milk shown to help preemie brains develop
Research finds benefits for newborns weighing less than 2 pounds, 3 ounces

By CARLA K. JOHNSON
Associated Press

CHICAGO - Among the tiniest premature infants, those fed with breast milk in the hospital did better on tests of mental development later in life than did others fed only formula, a new study has found.

The research is the first to show the benefits of breast milk for babies born weighing less than 2 pounds, 3 ounces. With medical advances, hospitals are saving more of these babies, some born more than three months early.

For these infants, brain development that normally would happen in the womb during the third trimester of pregnancy must take place in the neonatal intensive care unit of a hospital, said study co-author Dr. Betty Vohr of Brown Medical School.

Ingredients in breast milk, particularly fatty acids, seem to help the brain develop properly, she said.

Feeding breast milk to the smallest, sickest babies on the edge of viability could save schools money in special education services later, Vohr said.

The study appears in the July issue of Pediatrics.

A separate study showed that children breast-fed longer than three months were less likely to become bed-wetters later in childhood.

There is strong evidence that in many cases bed-wetting can “result from delayed neuro- development,” said the report from the Robert Wood Johnson Medical School in New Brunswick, N.J.

Researchers tracked 1,035 extremely low birth-weight infants born at 15 hospitals. About three-quarters of the babies received at least some breast milk in the hospital.

One-quarter received only formula.

Even when the researchers took education and income into account, the breast-milk babies scored higher on tests of mental development when they were 18 months old than the formula babies.

The more breast milk the babies consumed, the better they did on the tests. Breast milk had no effect on rates of cerebral palsy, blindness or hearing problems.

The American Academy of Pediatrics recommends that premature and other high-risk infants be fed breast milk.

Some preemies can be fed at the breast, but the very early babies in the study hadn’t developed the ability to suckle. Some of their mothers pumped breast milk, which was then fed to the infants by tube or bottle.

Most infant formula is made from cow’s milk, said Dr. Sheela Geraghty, who directs a breast-feeding program at the Cincinnati Children’s Hospital Medical Center and was not involved in the study.

“We’re the only species on the planet that drinks another species’ milk,” Geraghty said. “Human milk is what these babies need.”