Making a case for investing in small and sick newborn care

Abstract

Why are there spaces and hospital policies for healthy newborns that allow their families to be the main actor of care; but, on the other side, for small and sick newborns, is there not this opportunity? We are two midwives who work at the regional hospital of Ngozi, the third largest city in Burundi, where we managed more than 3,700 deliveries per year; Among these deliveries, approximately 10% are asphyxiated newborns, others have low birth weight but also others have congenital malformations, requiring transfer to neonatology. A few days ago, we were taking care of twins (one weighing 1,700kg and the other 1,300kg), born at 34weeks of gestational age, by emergency caesarean section. These twins were stable with good adaptation to extrauterine life. Immediately after birth, still in the maternity operating room, the caesarean section being in progress, we placed the newborns skin to skin and we helped both to begin breastfeeding within the first thirty minutes of life, let us point out that they had a good sucking reflex. Their stable health conditions and
the absence of a person who came with the mother, made us think and reflect on the possibility of continuing kangaroo care but, once the intervention was completed, the mother was transferred to recovery room, a common room where other women who have undergone surgical procedures are monitored for two hours before transferring them to hospitalization; we had to transfer the two premature babies to the neonatology and therefore separate the mother from her newborns because We don’t have a dedicated room and staff to be able to monitor the three in kangaroo care, so trying to achieve “zero separation”.