World Prematurity Day, which is commemorated this year on Tuesday 17 November, is an important reminder of both the progress achieved so far in the care of babies born prematurely, as well as the immense need for ongoing partnerships to further improve outcomes for these especially vulnerable babies.
“The theme for World Prematurity Day 2020 is ‘Together for babies born too soon: Caring for the future, working together’. Even though we are in a global pandemic, work and awareness to reduce the causes of prematurity and enhance outcomes for these tiny babies is continuing,” says Verena Bolton, national coordinator of Netcare Ncelisa Human Milk Bank and Netcare mother and baby wellness clinics.
“This year’s campaign emphasises supporting families and healthcare professionals, and strengthening healthcare systems to improve care for premature babies, also known as ‘preemies’. Through various initiatives and contributing to local and international partnerships, Netcare is striving to help create more conducive conditions for preemies to thrive.”
International collaboration on data-driven quality neonatal care
Netcare neonatal intensive care units (NICUs) throughout South Africa contribute to the Vermont Oxford Network (VON), an international information platform that promotes data-driven quality improvement through benchmarking.
“Not only does Netcare’s participation in VON help to ensure we are continuously measuring each baby’s care in our NICUs in terms of international best practice, we are also doing our part in building the body of information available to the international healthcare community to drive better understanding and outcomes for premature babies worldwide,” Bolton says.
“Netcare’s involvement with VON started in 2007, and has since grown to include 36 of our units. In the past year, these have contributed information based on 5 108 newborn NICU admissions so far. Through our collaboration with other international neonatal facilities contributing to VON, healthcare systems are strengthened and healthcare workers are better supported through clinical benchmarking and objective world-class standards in the specialised care premature babies require.”
Human breast milk bank supports healthier preemies
In February 2019, Netcare Ncelisa Human Milk Banks started providing breast milk to hospitals in the public sector, including Rahima Moosa Mother and Child Hospital (RMMCH) and more recently Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), in addition to providing certain babies in our own NICUs with this life-saving substance.
Dr Joy Fredericks, head of the neonatal division at RMMCH, says: “All mothers are encouraged to provide their own breastmilk for their babies, but unfortunately this is not always possible and this is when the substantial benefits of donor breast milk are important. Breast milk protects against neonatal health conditions such as necrotizing enterocolitis, late onset sepsis, retinopathy of prematurity and improves neurodevelopmental outcomes. These benefits extend well into the adolescent years.”
Dr Fredericks says that since the inception of this public private initiative with Netcare Ncelisa Human Milk Banks, the RMMCH has seen premature babies’ hospital stays shortened, a decline in the rate of necrotizing enterocolitis and improved survival rates for premature and underweight babies.
Dr Tanusha Ramdin, senior neonatologist and acting head of the CMJAH neonatal unit, adds: “Donor breast milk has saved the lives of many of our precious premature babies. I can’t express in words the generosity and life-saving collaboration with Netcare to provide the donor milk to Charlotte Maxeke Johannesburg Academic Hospital neonatal unit. A massive thank you on behalf of all our premature babies.”
Breastmilk is donated by eligible women who are breastfeeding and have excess milk, which they express under specific hygienic conditions and deliver it to Netcare Ncelisa human milk banks or depots based at 37 Netcare maternity facilities. The milk is then pasteurised, and then it is tested, frozen and safely stored.
Through Netcare Ncelisa human milk banks, the Netcare Foundation supplies this milk free of charge for certain identified premature and underweight newborns with compromised health, both within the public and private sectors.
“The Netcare Foundation recognised the importance of securing stocks of breastmilk for babies in South Africa because of the immense health and developmental benefits associated with age-appropriate human breastmilk and colostrum,” says Mande Toubkin, Netcare’s general manager of emergency, trauma, transplant and corporate social investment.
Complying with the proposed regulations set out by the South African Department of Health, and aligned to international protocols on the management of human milk banks, Netcare Ncelisa human milk banks employ a state-of-the-art digital system to track and trace breastmilk donations every step of the way from donor to recipient, and record all details relevant to matching age appropriate donor milk to the recipient babies,” says Toubkin.
Supporting healthcare workers with baby-specific resuscitation skills
“One in 10 babies require healthcare interventions at birth, and of those one percent will need major resuscitation. Netcare has developed its own neonatal basic life support course that ensures that the majority of nursing staff working in areas of the hospital where a newborn baby may present are appropriately skilled in the special technique required for performing basic life support on tiny babies,” Toubkin adds.
The neonatal basic life support course is an eight-hour training course and assessment tool for competency in resuscitation of newborn babies, including premature babies. This builds on the requirement for all registered and enrolled nurses working in a hospital to be trained in American Heart Association cardiopulmonary resuscitation (AHA CPR), which is primarily focused on adult CPR techniques.
“Ensuring staff are equipped to provide immediate life-saving care to babies in the proper manner when it is needed, not only improves survival for tiny neonates – it is also associated with better long-term outcomes,” Toubkin says.
“This year’s World Prematurity Day is an opportune reminder that even as we contend with a global pandemic, there are little miracles being born all over the world who have special requirements. Through collaboration, knowledge sharing and careful adherence to international best practice, medical intervention and assist premature babies to thrive. This resonates with the third Sustainable Development Goal to ‘ensure healthy lives and promote wellbeing for all at all ages’, including those babies who are born too soon.”