It was a day to remember for proud parents, their children and hospital staff at the Premature Baby Unit (PBU) at Castle Street Hospital recently. Kumudini Hettiarachchi reports He walks, he talks, he plays with his Nanga but most of all he sends the spirits of his humble parents soaring, for now their eldest boy [...]

The Sundaytimes Sri Lanka

Little miracles


It was a day to remember for proud parents, their children and hospital staff at the Premature Baby Unit (PBU) at Castle Street Hospital recently. Kumudini Hettiarachchi reports

He walks, he talks, he plays with his Nanga but most of all he sends the spirits of his humble parents soaring, for now their eldest boy is in Grade 2 and there is contentment.
Sadev is the cherished son of D.K. Chandra Kanthi (35) and N. Priyantha Kumara of Kottawa. At his birth on October 18, 2006, unlike for many parents who would rejoice on seeing their newborn, for Kanthi and Kumara there was only anxiety and fear.

Four little girls in their party-best on February 22. Pix by M.A. Pushpa Kumara

For Sadev was teeny-weeny when he was born prematurely, only 585gms, just a little over half-a-kilo. A newborn’s average weight in Sri Lanka is 2.8 kilos. While his mother shed silent tears and his father was gripped by fear, their hopes of parenthood teetering on the brink of disaster, a team of dedicated doctors and nurses of the Castle Street Hospital for Women in Colombo under Consultant Paediatrician Dr. Shakila Nanayakkara were not prepared to sit back and allow ‘the survival of the fittest’ concept to take its course.

With the life-saving battleground being the hospital’s Neonatal Intensive Care Unit (NICU), it was here that the staff began its delicate and arduous task of caring, nursing and nurturing Sadev to gain weight slowly and surely and ward off the accompanying difficulties that make premature babies critically ill.

To this premier women’s hospital in the country, not only come but are also referred expectant mothers with complications to have their deliveries, it is learnt. There are about 1,500 births per month at the Castle Street Hospital with the NICU seeing as many as 60 babies passing through it every month.

And so it was that on the Friday morning of February 22, it was not only Sadev but all of 49 more children, clad in their party-best who along with their proud parents came to show off their skills at the Premature Baby Unit (PBU). Gaily decorated with bunting and balloons, there was laughter and clapping from the older ones and grumbling and mumbling from the infants bored with the proceedings until lulled to sleep in their carriers, while some parents had the unenviable task of following their wobbly toddlers inquisitive of anything and everything that met their fancy.

Each little one or parent sported a brightly-coloured flower handcrafted out of Bristol board with their name and year of birth, at how many weeks they were born and that all-important birth weight.

The date comes easily to mind for both Rasika Sasanka Ranugge and wife Sulochana. May 31, 2011 is imprinted on their minds like it were yesterday. Theirs was a happy and comfortable life. Having married in 2010, the duo would become a trio with the birth of their first child.

“It was a normal pregnancy,” says Sulochana. The baby was due in September. Without an inkling life changed drastically. The pains began and she was in labour. It was a normal delivery. The only glitch was that the baby was born at 27 weeks plus two days, way before the due time, three months ahead.

Baba godak chuutiyata hitiye, says Sulochana, recalling how tiny Asali was then. Godak bayavuna, she adds, explaining that they were terrified of what the future held.
Rushed to the NICU, Asali was on the ventilator for 92 hours, then another three weeks off the ventilator but under observation, all the while with Sulochana expressing milk and the nurses feeding the baby every three hours through a tube, until the turnaround came.

A baby in the NICU. Pic courtesy NICU

It was only two months and five days and four sessions of laser treatment under Consultant Ophthalmologist Dr. Dharma Irugalbandara after that Asali went home.
As Rasika and Sulochana chat to the Sunday Times, bright-eyed and precocious not-yet-two Asali lisps that “Nendi should draw a baby” looking at my pen pointedly.

Most of the stories are similar but different. For some parents it’s just one baby and for others two (twins), while for another couple it’s three (triplets) and for still another it’s four (quadruplets).

The common thread entwining the lives of all these babies and children is that they came into the world from the comfort of their mothers’ wombs much too soon – premature or “pre-term” between 26 and 36 weeks welcomed with doubts of “will they or won’t they survive”. Usually, a baby born after 36 weeks, is considered “term” or fully grown.

“There are two types of babies who will find a temporary home at the NICU,” says the Neonatology Unit’s Medical Officer Dr. Sankalpa Marasinghe, explaining that they may include pre-term babies born before 36 weeks or term babies born after 36 weeks but who have other serious issues.

Those born between 26 and 36 weeks are difficult to manage as not only their lungs but also some other organs have not matured. Their skin is so tender that it cannot bear either heat or cold. In some pre-mature multiple births, they are also underweight and come with the double jeopardy of congenital deformities and malformations. In the case of term babies, they may be dogged by congenital malformations such as a cleft-lip or other more severe deformities or heart disease, he says, painting a grim picture of their early days. The added danger is that they are tiny, having very low birth weights.

“If there is no cry at birth, we know the baby is in distress. Unlike in bigger children, there are only two common external signs that a newborn is in trouble – a high rate of respiration and the fact that they don’t suckle,” says Dr. Marasinghe. These are the “critical babies” who are taken to the NICU’s six incubators with tubes snaking out, fixed to monitors beeping and seeming to be playing musical chords in competition with each other.

The babies’ “vitals” (heart beat) and oxygen levels are monitored while syringe pumps deliver minute (in micrograms), amounts of fluids, drugs or saline to them. The pressure is checked time and time again and alert staff, both doctors and nurses, keep a close eye for the slightest change in the figures displayed on the monitors and a sharp ear for an alarm, to rush to the side of the baby.

As the babies’ survival signs improve, from one section of the NICU they are moved to the “observation section” on the same floor, later into the high-dependency unit, the low dependency unit, the ward and finally home.

Dinudi born in 2010 had been 850gms, Sehensa born in 2010 950gms, Thihansa born in 2006 1,085gms and the list goes on. Of the 50 who were part of the celebration of life that Friday only three had cerebral palsy and 15 problems with their eyesight. All, however, had won the “life and death battle” although the odds had been heavily weighted against them not so long ago.

As we leave the precious “little flower-bearers”, they are oblivious to the fact that they are making history.

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