It was a bitter-sweet moment for nursing staff in the neonatal intensive care unit at Netcare Alberlito Hospital, when they said their goodbyes to prematurely born Tayla Grace Christie who, weighing a mere 995grams at birth, was recently discharged after spending the first 75 days of her life in their care.
Doctors had to deliver Tayla early, at 31 weeks, when she was diagnosed with extreme intrauterine growth restriction (IUGR), a condition in which a baby’s growth slows or stops while in the womb.
After her birth, Elrize Kruger, Tayla’s mother was unable to produce enough colostrum to feed her fragile little baby and the tiny neonate’s weight dropped to just 805grams within a few days after birth. It was then that Netcare stepped up to offer to supply donor colostrum and human milk from their Ncelisa human milk bank facilities to provide Tayla with the much needed boost which would not only help her to survive but to gain sufficient weight.
Produced by a mother in the initial days after birth, colostrums provides not only perfect nutrition tailored to the exact needs of a newborn, but also contains high concentrations of antibodies, which can destroy disease-causing bacteria and viruses.
“Babies who are compromised in some way or another receive the most benefit from age appropriate human milk, particularly colostrum, and this can play an invaluable role in speeding up growth and recovery, ensuring these babies can go home to their families much sooner,” explains Sr Eloise Strydom, unit manager of Netcare Alberlito Hospital’s neonatal ICU.
“And while it is completely normal for babies to lose some weight after birth, premature babies are particularly vulnerable to infection and various other complications. Very underweight babies also struggle to maintain their body temperature. So by feeding Tayla exclusively on colostrum initially and then later on donated human milk, the aim was to get her to gain as much weight, as quickly as possible,” she explains.
In addition to colostrum and human milk, baby Tayla was kept in a protective bubble so-to-speak, with her incubator being covered with a layer of cling film, to assist in keeping her warm and shielding her from noise and light.
“It is extremely traumatic for babies who come into the world prematurely as they face an almost complete sensory overload. It is very important to ensure that their surroundings are as stress-free as possible. The neonatal ICU is therefore kept as warm and quiet as possible, with subdued lighting. The addition of a layer of cling film to the incubator promotes the comforting feeling of being back in the womb,” adds Sr Strydom.
Commenting on the sometimes difficult road she travelled with the neonatal nursing staff and baby Tayla, Kruger says she is overjoyed to finally be able to take her daughter – now weighing 2,1 kg – home.
“I cannot thank the nursing staff enough for all the care and support they showed our family. The work these nurses do can only be described as phenomenal. Not only do they treat these babies as they would their own, but the advice and encouragement they give to the families plays an invaluable role in lessening the burden on a seemingly long and difficult journey,” she recounts.
“Despite her time outside the womb, Tayla is in real time just three weeks old, but thanks to the colostrum and human milk is as plump as any neonate can be. The hospital has also supplied me with an additional human milk supply. It was hard saying goodbye to such a wonderful support structure at the hospital but I will think of the nursing team every time I put on the classical music I played to Tayla in the neonatal ICU.”
As a mother to a prematurely born baby of her own, nursing neonates is something that is particularly close to Sr Strydom’s heart. “I can truly relate to what these mothers go through, and I know that it is not always easy. Every time we send one of these tiny babies home it is extremely gratifying, and it makes what we as nurses do all the more worthwhile.
“Going forward I am tremendously excited about the fact that we now have access to donated colostrum for the first time, and baby Tayla is living proof that it can make a real difference in assisting compromised babies to grow and thrive until they reach the stage that they are strong enough to go home,” she adds.
After initially being fed via a tube, Tayla received supplementary feeding via a syringe after a few weeks and then later with the aid of a bottle until she was ready at around 60 days for the tube to be removed completely.
“Fortunately she had an extremely good sucking action from birth, which helped a lot. However, it is still extremely stressful experience for any family to go through and all I can really say to other mothers of premature babies is to stay strong and take it one day at a time,” says Kruger.
Commenting on Netcare’s recent initiative to extend its human milk bank service offering to include colostrum donations for babies in critical need, Linda Pretorius, Netcare’s human milk bank co-ordinator, says the purpose of the in-house Netcare Ncelisa human milk banks is to ensure that as many babies as possible receive age appropriate milk.
“In addition to complying with the stringent regulations set out by the South African Department of Health requiring human milk to be tracked and traced from donor to recipient, the aim of our Netcare Ncelisa human milk banks is to closely align the donor-recipient matching process to ensure better outcomes for these vulnerable babies,” she says.
According to Pretorius their research only uncovered one other project to collect and store, namely in Greece, which meant they had to do a great deal of their own research and development. The system and technology behind the now up-and-running Ncelisa human milk banks is, as a result, wholly South African sourced and developed.
“Part of our research involved approaching experts at the Onderstepoort Veterinary Institute who have working knowledge of the bovine colostrum pasteurisation process that currently takes place in the bovine milk banks present on various dairy farms around the country.
“As it turns out the pasteurisation process is in fact very similar when it comes to human breastmilk, and based on that we recruited a team of local technical experts to develop both the pasteuriser, storage facilities, as well as the online donor-to-recipient tracking system, thereby putting Netcare and South Africa at the forefront of human colostrum and human milk bank expertise,” concludes Pretorius.