So many tiny babies. . .
We have had a premature baby explosion in the last 2 weeks. Slowly, as we have refined and expanded our neonatal intensive care unit, we have developed a bit of a reputation for our care. . .
Last month, at the Kenyan Pediatric Association conference, they reported neonatal mortality at the 10 biggest hospitals in Kenyan, looking at how many babies under 1 month admitted in each hospital died. And the best neonatal mortality reported was 10% (1:10 babies died). Most were 15-20% (1:5 babies died), and several were 30% (1:3 babies died). Neonatal death is a huge problem in Kenya, and we have a lot of work to do.
In Kijabe, though, of all babies, down to the tiniest prem to the sickest ICU baby, our mortality is 2.6% (down from 6% 6 years ago). Our obstetrics colleagues, our midwives, our nursery nurses, our clinical officers, our interns, and our consultant pediatricians, providing 24/7 coverage and unprecedented attention to detail, have created a place with a 5x better neonatal mortality than the best hospital in the country. We still look at every death in detail, cry over it, make changes to be better based on it, and mourn with our families, but I am amazed every day how much we do with so little.
Last week, when we admitted less term babies because of the national health insurance crisis, we made more room for these tiny ones, and now I have 10 babies, each under 2.5 pounds, fighting along side one another.
The mom of our tiniest one has lost 4 other babies and her face shines with joy every time she comes in to see her tiny miracle. Another one is caring for her second tiny prem, a pro in the first days of feeding. Another had dangerously high blood pressures keeping her baby from growing, and OB delivered before the pressures caused her body to shut down. Another has triplets, all born under 4 lbs, and is working tirelessly to feed them all, to hold them all, to care for them all (we have been helping with every feed too so she can at least sleep a little).
Early this morning, our 50 day old who is still only 2.7 lbs was restless in her incubator, so we Kangaroo’d her with mom (put her under the gown on mom’s chest) and she snuggled right in and fell asleep. Mom looked at me and smiled “I am completely happy,” she said to me in Swahili, then English.
There are lots of battles ahead for these little ones. But today, they are all fighting with us, growing from wisps that can fit in your hand to chubby 4 lb babies ready to go home.
Yesterday, we sent home another set of triplets after 35 days in the hospital. I ran in in the afternoon in the midst of a very busy call to pray with their mom before she went home. She was out of her hospital gown, dressed up, and she danced into the room radiant. Her two boys and one girl were wrapped in warm blankets, feeding well, and ready to go start the rest of their lives. . .