Premature child birth is always challenging and tough situation to handle, not only for parents but also for doctors and hospital staff. So when a tiny baby boy was born with a birth weight of just 660 gms at 32-weeks gestational age and with severe IUGR, Dr. Vivek Gupta knew a huge rollercoaster lay ahead. Firstly, the gynecologist had to do a caesarian section on the mother due to her history of leaking and decreased fetal movements with increasing fetal distress. However, when the baby was welcomed on 9th March, 2018, he didn’t cry at all. The little soul had to be resuscitated with bag and mask ventilation which led his heart to start beating. Shocked at his feeble condition, the parents completely entrusted upon the doctors to save their baby’s life. Dr. Gupta and his team dedicatedly looked after the new born till he could go home with his parents.
Dr. Vivek Gupta, Neonatologist, CK Birla Hospital – RBH, Jaipur explained, “The baby had no spontaneous respiration after the birth. Immediately, we had to intubate him with endotracheal tube and bag for ventilation. The whole team rejoiced when we saw the baby’s spontaneous breathing efforts, increasing heart rate, and changing color from blue to pink. It gave us hope and we instantly shifted the baby to NICU. He was put on a ventilator to support his respiration. We continued the treatment with inserting lines (UAC & UVC) at the bay that required long stay along with medications and samplings. Surfactant, a drug that makes lungs mature, was also directed to ease up the procedure. To begin with, the baby had imbalanced blood pressure as well, so some life-saving vasopressor drugs were also administered for that.”
The mother was desperate to scoop her child in her arms and she had tears of joy when Dr. Gupta finally told her that the baby needed her milk. As the baby started improving, continued feeds in minuscule quantity through orogastric tube was given, since his intestines were still delicate. Being extra cautious at this stage was significant as any mistake in feeding could lead to damaging the intestines, NEC (necrotising enterocolitis) and even could cause perforation.
Dr. Gupta added, “In our NICU we follow strict aseptic techniques and due to that not even a single blood culture was positive in our baby, though there was minimum immunity in them. With time the baby was clinically doing well, his respiration became regular and ABGs were good. So we decided to wean our baby to CPAP and then HHFNC. Our moment of sheer relief finally came when he cried. Henceforth, we decided to increase his feeds slowly.”
Followed by such stressful days, ultimately the mother could properly hold her child for a long time through kangaroo mother care and non-nutritive suckling techniques. Dr. Gupta introduced them in the treatment plan so that the baby’s weight could have a steady rise. Eventually, supplements were administered for weight gain. Dr. Gupta and his team primarily begun with full orogastric feeds, and once the baby tolerated that, they tried Katori spoon feeds and subsequently breastfeeds. Gradually his condition improved and became stable. After about 50 days of NICU stay, the baby was discharged from the hospital in a normal condition at the weight of 1.550 kg.