When you step out of the lift on the first floor of the CEmonc (Comprehensive Emergency Maternal Obstetric and Neo-natal care) building inside the Government Medical College and Hospital, Theni, you encounter something totally unexpected.
The wall on the right is pasted with life size posters of macho men holding tiny babies in their hands. You expect to find more mothers and grandmothers inside the ward and corridors of a ward that caters to pre-term babies. But here an equally good number of men are to be seen united by their desire to care and nurture for their sick new-borns.
“It cannot be a journey for the mother alone. There is a need to create a supporting and enabling environment to give mothers the best possible starting point when the child born is severely ill and can cause mental trauma to the new mother,” says Dr.Nandini Kuppusamy, Head of Paediatrics Department.
She has worked hard to create an environment where parents share an intimate experience. The depths of emotion in the newly born relationship is felt when fathers are allowed inside the NICU (New Born Intensive Care Unit) to hold their pre-term babies and talk to them or mothers by the same instinct go through the gamut of emotions touching their newborns who lay hooked up to monitors, ventilators and tubes in temperature-controlled units. Many times it causes their breasts to produce milk or the milk nourishment for the baby comes from the Breast Milk Bank (BMB) here.
A 35-year-old woman who gave birth to twins, each weighing less than 1000 gms had been crying for three days as she was unable to feed her babies. But they did not go hungry nor were they fed formula feed. They were given breast milk donated by other new mothers with engorged breasts. This afternoon, she sat in the lactation room sparse with a chair and table and industrial grade pumps and neatly organised cooling and heating stations. But there was an air of efficiency.
There was no humming of any machine but a soothing music played in the background to initiate relaxation in the worried and anxious mother. Hooked up to the suckling machine, she said, “I feel no pain and am discovering the beauty of breastfeeding after three days.”
There are so many like her, says Dr.Nandini, who feel sad at being physically detached from their child but when a mother’s milk reaches the child, it helps the baby to heal. Often, the act of pumping milk is one of their first acts of parenthood, she adds.
Simple and wonderful concerns and compassionate smiles are more intense than the expensive equipment in the corridors here. Ever since the medical college and hospital came up a decade ago in Andipatti, one of the eight and most backward blocks in Theni district, it has been Dr.Nandini’s endeavour to motivate and guide families during difficult post-partum period.
Every mother, every family wants to be blessed with a healthy happy baby. But for every 100 births, 30 babies are born pre-term in our country. To add to the guilt, breastfeeding doesn’t come easily to all mothers. It can be painful and scary. Some just can’t make it work and associated with stigma and shame it often ends in the feeling of failure for a new mother.
At the beginning of this decade the World Health Organisation declared “Born-Too-Soon” pre-term global emergency when it realised that pre-term babies were not allowing the IMR (Infant Mortality Rate) to decline in many countries. Last September, world leaders committed to 17 Self-Development Goals to end poverty, protecting the planet and ensuring prosperity by 2030.
These 17 goals have been given 17 different colours in this year’s World Breastfeeding Week logo and the theme is getting people value their own wellbeing from the start of life and realise how breastfeeding is a key element in the care.
"Breastfeeding is not only the cornerstone of a child’s healthy development; it is also the foundation of a country’s development,” points out Dr.Nandini.
Seven of the 19 Government medical colleges in Tamil Nadu have set up the BMBs in the last one year. Throughout India, there are only 14 such banks and Tamil Nadu accounts for 50 per cent of those. The beauty of the one at Theni is that it is the youngest and the only rural medical college when compared to the ones in Madurai, Coimbatore, Thanjavur, Tiruchi, Salem and Chennai. And for the efforts and team work of the staff, the BMB at Theni Medical College tops in collection of breast milk.
“It was not easy to convince not just the new mothers but also their entire families and the village about the importance and benefits of breastfeeding, lactation support immediately after birth and throughout the first months of an infant's life,” says Dr.Nandini.
Now after giving birth, lactating mothers regularly come and donate their breast milk. It costs them nothing. “Thinking about infants whose mothers died, I feel sad. Initially I was unable to feed my baby because he was too weak to suckle. He survived because of the life support system he had here and the breast milk from the bank that he was fed with,” says a mother.
When a young mother is unable to breastfeed her new born, many families start giving them formula feed or cow’s milk mixed with water. The babies suffer from low immunity and often rushed to the hospital and people do not realise that their condition is so because they were not receiving mother’s milk, which is the ideal food for healthy growth and lifelong immunity.
The BMB at Theni Medical College and Hospital collected 210 litres of breast milk in the last one year. It saved the lives of 1,030 babies from untimely death, says Dr.Nandini. For this if the credit goes to the 786 donor mothers, it also goes to her entire staff rallying behind her in providing the support system.
Factoid:
While IMR of Hong Kong, Japan and Singapore is 2/1000, it is below five in Scandinavian countries, below 10 in UK and Europe and below 15 in the U.S. As per the Sample Registration System, India’s IMR is 38/1000. Tamil Nadu’s is 20/1000 and it ranks second after Kerala at 12/1000.
The creation of Human Milk banking has given a big push to neo-natal care in the State.
While the Breast Milk Bank at Madurai Medical College and Government Hospital collected 19.6 litres of breast milk since August 2015, about 100 litres were collected at Coimbatore Medical Colleges. The other BMBs in the State are also behind Theni BMB’s collection during the corresponding period.
The breast milk pump draws the milk out into 150 and 200 ml bottles. The milk is sterilised using the pasteurisation process. It is agitated at 62 degrees C for 30 minutes, labelled and frozen at -20 degree C for three days after a sample of the milk is sent for sensitivity tests. Once the reports are clear, the milk is kept in the normal refrigerator to be used before 24 hours. Before the baby is fed, the milk is kept in water bath at 37 degree C for warming.
