Is your new born baby fit enough to leave hospital?

To describe Yvonne Benegusenga, an accountant from Gisozi, as a very happy woman is an understatement. Even though she is visibly tired like any other mother would be, she insists on looking at the different photos that have been taken and picks out the one in which she is smiling while holding her four-day-old baby boy, her first child. Childbirth is a source of joy for many mothers, but more so if the baby is healthy. Is your newly born baby healthy? When babies are born, says, Dr Ian Mugisha, a paediatrician, special attention is given to those with malformations and those who are at risk, for instance, babies born to HIV-positive mothers. Otherwise, he says, if a general medication examination on the four major systems; the brain, the heart, the gastro intestinal tract and the lungs reveals no cause for worry, then it is safe to take the baby home. Beyond the routine medical examination, Dr Stevenson Musiime, a paediatrician at King Faizal Hospital in Kigali, says there are other functions that a healthy baby should be able to perform within the first two days. A baby, for instance, should be able to breastfeed within the first three hours after birth. However, Dr Musiime says a baby refusing to suckle does not always mean that they have a medical condition. It may be that the mother’s nipple is either too big or retracted or the baby is straining to access breast milk. Healthcare givers provide training and assistance in this regard. A healthy baby should also have regular bowl movements and should be able to pass urine and stool within 48 hours after birth. After that, and/or if the baby is vomiting, new mothers are advised to contact a medical professional since a baby might be suffering from intestinal malfunctions. New mothers are also advised to observe the weight gain of newly born babies whereby they are supposed to gain 25gms a day. This is especially important for babies with low birth weight. Low birth weight and related health risks Benegusenga’s baby has to alternate between its mother’s chest and the incubator. This is because it was born pre-maturely. “I was diagnosed with pre-eclampsia in my seventh month of pregnancy, and a few weeks later, the condition worsened and I risked falling into a coma. I was rushed to King Faizal Hospital, where the baby was removed immediately,” she says. Benegusenga practices kangaroo care on her infant Benegusenga’s baby is only one of many infants born pre-maturely as a result of pre-eclampsia. Pre-eclampsia can be described as pregnancy-induced hypertension and it is a common condition. According to Alice Umukunzi, a midwife at King Faizal Hospital, the condition can develop at any stage during pregnancy, and once it becomes severe, the only solution is to remove the baby from the mother’s womb. Pre-mature birth is a major cause of low birth weight. However, twins (triplets or more), babies with an inherited medical condition and babies whose mothers get a health-related or emotional problem during pregnancy may also have low birth weight. According to experts, a baby can be said to be underweight when they fall below the 2.5kg weight mark at birth. Although it may be cause for worry, Dr Musiime says the baby can be nursed to health through proper feeding. However, he advises follow up on the baby’s weight gain for the first three months. One of the commonest health risks associated with low birth weight is hypothermia. This is a medical condition in which one has an abnormally low body temperature and it is for this reason that underweight babies are placed in incubators. However, kangaroo care also goes a long way in preventing hypertension and increasing weight gain. Kangaroo care, Umukunzi explains, is a method of caring for a pre-mature in which a baby is held skin-to-skin contact with a parent, mostly a mother, for as long as possible every day. Kangaroo care does more than prevent hypertension and increase the baby’s weight gain. In kangaroo care, the baby is held on the mother’s chest. This way, the baby’s and mother’s heartbeats are in sync. Not only is it a way of bonding but it makes the mother emotionally stable as well. “When a mother is emotionally stable, she is easily able to form breast milk,” Umukunzi explains. Traditional herbs may be harmful to infant’s liver and kidneys After leaving hospital, mothers or their relatives are fond of bathing their infants in local herbs. It is also common to see people chewing herbs and then spitting the content into an infant’s mouth. It is largely practiced within the African culture. Janette Nshuti Neza, a mother of three, proudly claims that the herbs went a long way in keeping her children safe during their infancy. “Infants are exposed to all sorts of infections at home. They are held and kissed by all sorts of people and this poses a risk to their health. Herbs are good disinfectants,” she says. However, medical professionals say traditional herbs offer no health benefit to the baby other than psychological satisfaction to the mother or relatives. Although they are usually harmless and the baby’s liver filters out the toxins, Dr Musiime says that they could be harmful to the baby’s liver and kidneys. Umukunzi feeds a baby in an incubator “An infant’s liver and kidneys are not as fully functional as that of an adult. Therefore, the toxins from those herbs could damage those organs,” he warns. Another common practice is the administration of herbs to an infant’s fontanel with the hope of closing it. The fontanel is the space between bones of the skull in a newly born baby. Paediatricians say that with time, the gap closes on its own, and therefore, herbs are uncalled for. Watch out for cytomegalovirus Perhaps, another thing to put into consideration before allowing relatives to administer herbs from their mouths to the baby’s mouth is the cytomegalovirus. Cytomegalovirus is a herpes virus and it is very common. It can easily be passed on to a baby through body fluids such as blood, urine, saliva, breast milk, tears, or through the placenta of an infected mother during birth. According to research by US-based Mayo Clinic, the virus produces mild or no symptoms if a person is healthy. However, for people with compromised immune systems for instance those who are suffering from HIV, it is likely to cause severe neurological damage. According to Dr Eminent Kamara, a resident paediatrician, the cytomegalovirus may cause hearing loss and vision impairment in infants. The signs and symptoms of this condition in babies include yellow skin and eyes, enlarged and poorly functioning liver, pneumonia as well as seizures. Stay keen on baby’s health It is no secret that infants require a lot of care. Because they are vulnerable to infections and because their immune system is not yet fully prepared to fight off diseases and infections, Dr Mugisha advises us to keep babies in warm clean environments. It is also important to ensure that infants sleep at least 18 hours a day because it is during sleep that the growth hormone is excreted. However, they should not be allowed to sleep for more than four hours at a time since they will get hungry. Dr Kamara and Dr Musiime also advise parents to take their infants for medical check-ups if they notice any changes such as yellowing of the eyes or skin. “And I cannot emphasise this enough, take your infant for vaccination,” says Dr Kamara. ****************************************** How best can parents take care of their newborn babies Aline Uwimana, new mother Aline Uwimana Newborns are very delicate and susceptible to infections. A mother should cover up her baby to keep away the coldness that may make the baby sick. Sifa Nabitanga, mother Sifa Nabitanga Babies should be kept very clean and whoever holds them should be free from any sicknesses so as to keep the baby safe. A mother should also watch her hygiene. Asina Uhiriwe, nurse Asina Uhiriwe Parents should follow the advice of doctors on how to care for the infant rather than doing what they hear from non-professionals. For example, a new mother can be told than some herbs cure baby colics (crying at night), yet it is a stage the baby goes through naturally. Angelique Murekatete, nurse Angelique Murekatete Mothers should endeavor to ensure their babies are properly covered to keep away coldness which might cause vomiting or pneumonia. Mothers should also ensure high levels of cleanliness. Diana Muhungirehe, housewife Angelique Murekatete I advise women to watch what goes in the babies mouth as some people give newborns food which is dangerous. Also the environment of the new baby should be clean; avoid things like smoke around your baby. Compiled by Shamim Nirere