Instead, the head nurse of the neonatal intensive care unit (NICU) at a medical centre in Sunway Velocity here says the cries and wails have become a motivating melody that drives her to go the extra mile in ensuring the comfort of these babies.
Premature babies, in particular, come with their own challenges that demand not only knowledge and skills but also immense patience and mental strength to ensure they are returned to their parents in the best possible condition.
“In my 18 years of service, I have cared for many premature babies, some as small as the size of a hand, weighing between 600g and 800g. Typically, babies of this size are born around 26 weeks of gestation,” Siew told Bernama in conjunction with World Prematurity Day yesterday.
“Some experience complications due to underdeveloped organs, so caring for them is truly challenging,” she said, adding that she has to continually prepare herself to cope with difficult situations, such as when premature babies cannot be saved.
A baby is classified as premature if it is born before 37 weeks of gestation. The normal pregnancy duration for a full-term birth ranges from 37 to 42 weeks.
According to Siew, premature babies require various forms of care to support their growth, with an incubator serving essential functions such as regulating the baby’s body temperature, protecting them from infections, and monitoring their heart rate.
In addition, premature babies require high attention from their caregivers, whichi includes understanding the infants’ body language.
“For example, unlike full-term babies, premature babies are fed using the orogastric method, where a tube is inserted directly into the stomach through the nose, as they are not yet able to suck, swallow, or breathe naturally,” Siew explained.
“This feeding method does not fully satisfy the baby. So, when the baby starts to whimper, squirm, or open their mouth, it’s their body language indicating hunger and a desire to nurse.”
‘Kangaroo care’
NICU senior nurse Melanie Anne Rowe, 38, said a premature baby admitted to the unit must be separated from the mother from the first day of birth, and will only be discharged once the necessary developmental milestones are met.
“The duration of care for a premature baby in the NICU depends on its health status and gestational age at birth. Generally, premature babies stay in the NICU until they reach an appropriate developmental stage, which can range from a few weeks to several months,” she said.
“Premature babies are typically discharged when their weight stabilises (around 2kg or more), they can breathe on their own without the assistance of a machine, they are able to nurse well, and there are no critical health issues.”
She added that during this time, the baby still requires the presence and nurturing touch of the mother to support growth and emotional development.
“To meet these needs, we use the ‘kangaroo mother care’ method, which involves skin-to-skin contact. The baby is placed on the mother’s chest to foster bonding, and we also encourage mothers to provide breast milk. This helps the baby feel comforted and supports growth.”
Meanwhile, citing data from the Malaysian National Neonatal Registry 2020, paediatric and neonatology specialist Dr Lee Mei Ling said Malaysia records about 300,000 births each year, with about 10% being premature births.
“The survival rate for babies born between 28 and 32 weeks of gestation and receiving treatment in the NICU now stands at 80-90%,” she told Bernama.
Lee expects the number of premature births to continue rising in the coming years, with most being born at 23-25 weeks of gestation, which is earlier than before. This is owing to lifestyle factors affecting pregnant women, such as stress, smoking, vaping, alcohol consumption and drug use.
“Health issues in the mother, such as hypertension, diabetes or infections, also contribute to premature births,” she said, adding that pregnancies with multiple foetuses also increase the risk of premature birth.
Socioeconomic factors further contribute to the issue, especially in rural areas, where mothers may not pay adequate attention to antenatal care or balanced nutrition due to financial constraints.
“Regular antenatal checkups for expectant mothers, adopting healthy lifestyle practices, maintaining a balanced diet, and ensuring sufficient rest are crucial in preventing premature births,” she said.