RADHICA DE SILVA
radhica.sookraj@guardian.co.tt
Desperate to save the fragile premature babies languishing at the nation's hospitals, newly appointed director of Women's Health Dr Adesh Sirjusingh is planning to set up a human milk bank in T&T, the first of its kind in the English speaking Caribbean.
Sirjusingh, who was appointed by the Health Ministry six months ago, is in charge of a new unit called the Directorate of Women's Health. The purpose of the human milk bank is to reduce the infant and maternal morbidity and mortality rate.
In an interview, Sirjusingh said 12 babies per 1,000 live births have died in T&T for 2017.
"These include babies with major abnormalities who usually die or pre-term babies. This year we also had six maternal deaths. Annually it is between seven to ten, so it's been better over the last three years," Sirjusingh said.
Woefully short of specialized midwives and neonatal nurses in all hospitals, Sirjusingh said it usually costs the State $1 million to care for a premature baby from 28 weeks (seven months) to when the baby is in good health and discharged.
Sometimes when they are not fed breast milk, premature babies can develop necrotizing enterocolitis, the most common and serious intestinal disease which occurs when tissue in the small or large intestine is injured or begins to die off, Sirjusingh explained.
Saying breast milk provides the nutrition to get premies healthy, Sirjusingh said the babies have to undergo surgery to remove the bowel if they get the disease. This is a further cost to the State, and this is why Sirjusingh thinks a human milk bank is the best option.
"There are many mothers with excessive breast milk who can donate to save the lives of these fragile babies. There is also a cost benefit to this because babies will be discharged alive and they will spend less time in the neonatal units," Sirjusingh explained.
Brazil to provide technology and support to T&T
In November, Sirjusingh said he and a team attended a Caricom workshop with a human milk bank specialist to discuss the idea.
"Out of that, we arranged a followup visit to Brazil involving senior nursing staff and paediatrics staff. We found that in Brazil over the last 20 years, they cut the mortality by half because of a wide network of human milk banks."
He said mothers who are nursing normally can collect and freeze the milk in jars.
"Each mother is screened before the milk is collected and then assessed. After undergoing a rigorous quality assurance test, the breast milk is pasteurized so there is no risk of transmission of disease. Each bank is attached to a neonatal unit so the milk is given like a prescription," Sirjusingh said.
He said the Government of Brazil has committed to providing the technology and support to T&T. However, there will be no incentive to volunteer mothers.
"You are doing it totally to save humanity. That is how we have to sell this and get the entire society on board with it. It is the early phase of development so we have to educate the doctors and nurses first so they can tell everyone else."
Sando hospital needs upgraded neonatal unit and more staff
Meanwhile, consultant neonatologist at the San Fernando General Hospital Dr Barry O' Donoghue said the hospital needed an upgraded neonatal unit and more staff.
"In one shift , sometimes we have five nurses looking after 30 babies and that includes 12 in Intensive care and seven on ventilators. It is a busy environment and we have a team of dedicated doctors, nurses and medical staff who work well together," O' Donoghue added.
While the ministry has purchased three new ventilators, O' Donoghue said more incubators were needed.
"We have 12 functioning incubators and some others which are not functioning as they are awaiting repairs. We also want another eight incubators. There are times we run short and we have to prioritize and give to babies who need it most," O' Donoghue added.
Agreeing that the milk bank will go a long way to helping the babies, O' Donoghue said there was also a need to have a regular supply of essential medication at the hospital.