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Taking care of a premature baby at home

DR BOIMA

HEALTH ISSUES


Last week the world celebrated World Prematurity Day on the 17th of November. This is a day commemorated internationally on an annual basis to raise awareness about the issues associated with prematurity or preterm birth. It also spreads information about how to help and support the affected families. At least 10% of families are affected around the world from the 15 million babies who are born prematurely every year. This is especially higher in our continent, the Sub-Saharan Africa and some parts of South Asia.

Prematurity is associated with very high morbidity and mortality, as discussed last week, being the leading cause of death in children under 5 years globally as per World Health Organization (WHO) reports. So diligent care, and high quality measures are needed in taking care of these small human beings. Medical technology has made it possible for premature babies to survive the first few days, weeks or months of life until they are strong enough to make it on their own.

 

When the time comes for these babies to be discharged home most parents relish the return to the privacy and comfort of their homes but many would often get scared and nervous not knowing how to handle these babies or what the future holds for them.

‘Kangaroo care’ –Kangaroo Care also known as Skin-to-Skin Care refers to the method of holding a premature baby in an upright position on its mother’s bare chest for a period of time.  Clothing or blankets are wrapped around the infant to provide a secure kangaroo-like pouch. Usually parents are taught a proper technique of skin-to-skin care and as soon as the baby does not need full-time machinery support the care can be commenced.

Intermittent kangaroo care is widely recognized as a beneficial component of holistic care provision for sick or preterm infants. The benefits for the infant include increased physiological stability, longer periods of quiet sleep, improved heat-regulation development, increased breast feeding incidence and duration, decreased pain perception and reduced stress and crying.  

Parental benefits include enhanced parent-infant attachment with a reduction in the negative effects of having a sick or preterm infant, greater parental ability to recognize their infant’s cues, increased self-confidence, decreased parental depression and increased maternal breast milk supply.

Keep the baby warm –  As mentioned last week preemies are more prone to hypothermia (low body temperature); because of the little fat stores and inability to shiver they cannot generate and maintain their own body heat. So make sure your baby is kept warm at all times and avoid leaving the baby undressed for prolonged periods of time. The best way to keep them warm is making sure you dress them up in layers; for example, a vest, and jumpsuit and wrapped with blanket and a hat and socks. Avoid frequent or prolonged outdoor exposure.

Feeding – Breast milk remains the best in a baby of any age. The mother may have been used to expressing her milk or making a formula feed while in the hospital when the baby was unable to breastfeed due to underdeveloped suckling reflex. An intravenous line or nasogastric tube would have been used to feed some babies. By the time a premature is ready to be discharged they would no longer be in need of tube feeding. The hospital staff would have taught the mother the proper way of breastfeeding and made sure they are doing it competently and confidently before they discharge the baby.

 

They will also have showed her how to encourage the baby to suck, gradually moving him/her towards the breast or formula bottle. Remember that preemies are more prone to hypoglycaemia (low blood sugar) than term babies, which can cause convulsions and produce long-term brain damage. So the wholemark of feeding is to make sure these babies are fed regularly (every 3 hours) and to practice good hygiene habits while at it (washing hands with soap, washing and sterilizing bottles, access to clean/boiled water etc.) to prevent infections. Special ready-made formula milk which is sterile may be recommended in some instances. Weight gain is paramount in the progress of premature babies!

Preventing infections – Premature babies are at particular risk of infection, because their immune system is still developing. It is worth taking care to maintain high standards of hygiene during the early months and years. Parents are encouraged to wash their hands with clean water and soap after changing nappies, when preparing food, after using the toilet and when they have a cold. Visitors should also wash their hands when they enter the baby’s room, and the number of people who hold the baby in the early months should be restricted as much as possible. Pets should also be kept away from the growing baby.

Bathing – How often you wash your baby will depend on how premature s/he is and the condition of his or her skin. For most babies; whether premature or term plain water is fine for the first few months of life. This includes at nappy changing – where only water and soft cotton wool can be used. A premature baby does not need to be given a bath every day. To ensure the baby maintains body warmth make sure you dry them quickly after a bath and immediately wrap them up with a blanket. Sophisticated soaps, shampoos and moisturizers can cause more harm than good, so they are unnecessary!

Helping your baby sleep – You can help your baby develop good 'sleep hygiene' by doing things such as providing a quiet, dimly lit environment at night time. In the early months, however, there's only so much that you can do, because babies get hungry. Also, the smaller the baby, the more often they need to feed. The most important thing about putting babies to sleep is for parents to ensure that infants are slept in a safe environment according to the SIDS recommendations.

SIDS stands for Sudden infant death syndrome which is a syndrome in which apparently healthy babies die in their sleep, usually during the first six months of life. Premature babies are at higher risk for SIDS than term babies. It is still not known exactly what causes SIDS, but we do know a number of things that help reduce it. So before the mother gets discharged healthcare workers educate them on the precautions and tips for reducing cot death.

Dealing with colic – Crying is normal physiological behavior in young infants. Excessive crying is often referred to as "colic". There could be all sorts of reasons why the baby could be crying continuously; s/he could be hungry, very tired, wanting the mother’s attention, or feeling discomfort from wind (known as colic). If the crying happens around the time of feeds, it could be colic or wind or it could be a change of temperature, an unfamiliar smell, or a range of other causes.

If you are concerned that your baby may be unwell, go see the doctor, especially if there are any other symptoms that you are worried about. Preemies are prone to infections and other complications so there might be something wrong worth checking. Using any colic mixtures (both drinking and bathing) like gripe water in infants of any age is discouraged!

Dealing with disability – Premature birth can affect the way your child develops. Early intervention is important, so assessments from your healthcare team are crucial in ensuring that your baby gets the right care. Support from a range of therapies like physiotherapy, occupational therapy and speech therapy, medications and sometimes surgery are usually needed and the earlier they are started the better. Extra support at school might also be needed later on in life. Parents of preemies need to be fully equipped with the information of the therapists is their community.

On a brighter note, premature babies can have a smooth sail in their health and development and catch up with their mates without experiencing any difficulties. For comments and questions please email agboima@yahoo.com

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Export Processing Zones: How to Get SEZA to Sizzle

23rd September 2020
Export Processing Zone (EPZ) factory in Kenya

In 2005, the Business & Economic Advisory Council (BEAC) pitched the idea of the establishment of Special Economic Zones (SEZs) to the Mogae Administration.

It took five years before the SEZ policy was formulated, another five years before the relevant law was enacted, and a full three years before the Special Economic Zones Authority (SEZA) became operational.

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Egypt Bagged Again

23rd September 2020
Samson

… courtesy of infiltration stratagem by Jehovah-Enlil’s clan

With the passing of Joshua’s generation, General Atiku, the promised peace and prosperity of a land flowing with milk and honey disappeared, giving way to chaos and confusion.

Maybe Joshua himself was to blame for this shambolic state of affairs. He had failed to mentor a successor in the manner Moses had mentored him. He had left the nation without a central government or a human head of state but as a confederacy of twelve independent tribes without any unifying force except their Anunnaki gods.

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‘RO, ‘RO ‘RO YOUR ‘BOT

23rd September 2020

If I say the word ‘robot’ to you,  I can guess what would immediately spring to mind –  a cute little Android or animal-like creature with human or pet animal characteristics and a ‘heart’, that is to say to say a battery, of gold, the sort we’ve all seen in various movies and  tv shows.  Think R2D2 or 3CPO in Star Wars, Wall-E in the movie of the same name,  Sonny in I Robot, loveable rogue Bender in Futurama,  Johnny 5 in Short Circuit…

Of course there are the evil ones too, the sort that want to rise up and eliminate us  inferior humans – Roy Batty in Blade Runner, Schwarzenegger’s T-800 in The Terminator,  Box in Logan’s Run,  Police robots in Elysium and  Otomo in Robocop.

And that’s to name but a few.  As a general rule of thumb, the closer the robot is to human form, the more dangerous it is and of course the ultimate threat in any Sci-Fi movie is that the robots will turn the tables and become the masters, not the mechanical slaves.  And whilst we are in reality a long way from robotic domination, there are an increasing number of examples of  robotics in the workplace.

ROBOT BLOODHOUNDS Sometimes by the time that one of us smells something the damage has already begun – the smell of burning rubber or even worse, the smell of deadly gas. Thank goodness for a robot capable of quickly detecting and analyzing a smell from our very own footprint.

A*Library Bot The A*Star (Singapore) developed library bot which when books are equipped with RFID location chips, can scan shelves quickly seeking out-of-place titles.  It manoeuvres with ease around corners, enhances the sorting and searching of books, and can self-navigate the library facility during non-open hours.

DRUG-COMPOUNDING ROBOT Automated medicine distribution system, connected to the hospital prescription system. It’s goal? To manipulate a large variety of objects (i.e.: drug vials, syringes, and IV bags) normally used in the manual process of drugs compounding to facilitate stronger standardisation, create higher levels of patient safety, and lower the risk of hospital staff exposed to toxic substances.

AUTOMOTIVE INDUSTRY ROBOTS Applications include screw-driving, assembling, painting, trimming/cutting, pouring hazardous substances, labelling, welding, handling, quality control applications as well as tasks that require extreme precision,

AGRICULTURAL ROBOTS Ecrobotix, a Swiss technology firm has a solar-controlled ‘bot that not only can identify weeds but thereafter can treat them. Naio Technologies based in southwestern France has developed a robot with the ability to weed, hoe, and assist during harvesting. Energid Technologies has developed a citrus picking system that retrieves one piece of fruit every 2-3 seconds and Spain-based Agrobot has taken the treachery out of strawberry picking. Meanwhile, Blue River Technology has developed the LettuceBot2 that attaches itself to a tractor to thin out lettuce fields as well as prevent herbicide-resistant weeds. And that’s only scratching the finely-tilled soil.

INDUSTRIAL FLOOR SCRUBBERS The Global Automatic Floor Scrubber Machine boasts a 1.6HP motor that offers 113″ water lift, 180 RPM and a coverage rate of 17,000 sq. ft. per hour

These examples all come from the aptly-named site www.willrobotstakemyjob.com    because while these functions are labour-saving and ripe for automation, the increasing use of artificial intelligence in the workplace will undoubtedly lead to increasing reliance on machines and a resulting swathe of human redundancies in a broad spectrum of industries and services.

This process has been greatly boosted by the global pandemic due to a combination of a workforce on furlough, whether by decree or by choice, and the obvious advantages of using virus-free machines – I don’t think computer viruses count!  For example, it was suggested recently that their use might have a beneficial effect in care homes for the elderly, solving short staffing issues and cheering up the old folks with the novelty of having their tea, coffee and medicines delivered by glorified model cars.  It’s a theory, at any rate.

Already, customers at the South-Korean  fast-food chain No Brand Burger can avoid any interaction with a human server during the pandemic.  The chain is using robots to take orders, prepare food and bring meals out to diners.  Customers order and pay via touchscreen, then their request is sent to the kitchen where a cooking machine heats up the buns and patties. When it’s ready, a robot ‘waiter’ brings out their takeout bag.   

‘This is the first time I’ve actually seen such robots, so they are really amazing and fun,’ Shin Hyun Soo, an office worker at No Brand in Seoul for the first time, told the AP. 

Human workers add toppings to the burgers and wrap them up in takeout bags before passing them over to yellow-and-black serving robots, which have been compared to Minions. 

Also in Korea, the Italian restaurant chain Mad for Garlic is using serving robots even for sit-down customers. Using 3D space mapping and other technology, the electronic ‘waiter,’ known as Aglio Kim, navigates between tables with up to five orders.  Mad for Garlic manager Lee Young-ho said kids especially like the robots, which can carry up to 66lbs in their trays.

These catering robots look nothing like their human counterparts – in fact they are nothing more than glorified food trolleys so using our thumb rule from the movies, mankind is safe from imminent takeover but clearly  Korean hospitality sector workers’ jobs are not.

And right there is the dichotomy – replacement by stealth.  Remote-controlled robotic waiters and waitresses don’t need to be paid, they don’t go on strike and they don’t spread disease so it’s a sure bet their army is already on the march.

But there may be more redundancies on the way as well.  Have you noticed how AI designers have an inability to use words of more than one syllable?  So ‘robot’ has become ‘bot’ and ‘android’ simply ‘droid?  Well, guys, if you continue to build machines ultimately smarter than yourselves you ‘rons  may find yourself surplus to requirements too – that’s ‘moron’ to us polysyllabic humans”!

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