Dealing with a Premature Baby
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Consultant Paediatrician Su Laurent guides the Baby Channel around the Barnet Hospital Children’s Ward and introduces us to some of the patients and their ailments: premature baby


Estelle Matthews: Now there is a very exciting story here on the Starlight Neonatal Unit. We're going to meet parents Nimesh and Arti Patel. Their little baby daughter was born just 26 weeks old. She is doing really well. Let's going to meet the family. Hello Nimesh. This is Prina. Nimesh Patel: Yes, she is. Estelle Matthews: Now there is a great story to this. You have waited 12 years to have her. Tell us your story. Nimesh Patel: Well, we've waited for 12 years and after various attempts naturally nothing works, so we went to see one of the consultants on a private basis and we went, Arti went on as usual and it didn't work. So eventually we were go to the UCH clinic where we have the IVF done. And this took place some time in December and we know it was conceived on the 6th of February. Estelle Matthews: But it hasn't doing gone smoothly. Has it Arti, do tell us some. What happened why she premature you think? Arti Patel: And well to begin with the IVF treatment I had hyper stimulation of the ovaries at very early stages. That was when about six weeks into after having the embryo transferred. Since then I hadn't been to work. I was really on bed rest and weekly checkups at Barnet, in fact. Prina was one of the -- it was basically a twin pregnancy but had 14 weeks. The waters of the first twin actually broke. Therefore my visits actually increased to two times a week. And then blood testing things done on the weekly basis just to see that I did have any infections or not. And then at 26 weeks my cord actually prolapse with the first twin, therefore Prina had to be born basically. Estelle Matthews: So she is a real a miracle baby, isn't she? Arti Patel: She is actually is. Estelle Matthews: At one stage even have to have her life saved by one of the consultants here. Nimesh Patel: Yes, one time. Estelle Matthews: Tell me about your – here. Nimesh Patel: Well it happened. This is Mr. Tim Wickham and so he was there as well. She is the other consultant and Prina, she was born on 11th of August on Thursday and she did well for the week. We going up to Monday and she had a real downfall where she had what they call a preliminary bleedings or lungs and everything went down. And we were here. Arti was in the maternity ward and I was running up and down. And this was about 5 O'clock in the evening and Tim and so we were working on him and finally Tim comes on to tell me, well, we just give her another half an hour and if she makes it, she makes it or not, I mean it's difficult. So you can imagine how much we were really in a down. After such a long time, you know Prina born and then she has to go down. We were very anxious that she gets well. And finally she pull through and from that you can now see where she is. She is now coming up to her two months in the neonatal unit and she is doing very well. Estelle Matthews: The prognosis is good too. Nimesh Patel: Oh yes. Arti Patel: Yes, yes, she is been pretty well. Nimesh Patel: All the doctors, the nurses and everyone have been looking after her very well. Estelle Matthews: Okay. Nimesh Patel: And we were very happy with them. Estelle Matthews: Well I think we should go and meet the consultant, that was actually in charge of helping save your little girl's life. Arti Patel: That's right. Estelle Matthews: Thank you. Nimesh Patel: Thank you. Estelle Matthews: Tim you had a lot of involvement with the Patel family. When did you first meet them? Dr. Tim Wickham: I met Mr. and Mrs. Patel when they were about 24 weeks of gestation and I was honest to see them because there were concerns about one of the twins. Mrs. Patel was pregnant with twins. Because one of the twins is very small and the waters is broken around that twin. There’s a lot of concerns about how that twin is going to do and whether the twin was survived and the potential effects on the other twin. So I was asked to talk about what they may expect to try and prepare them for the delivery and the problems that we might experience. And I think all of us generally felt that there wasn't much hope for the small twin. The baby was still alive but we didn't feel that the baby would survive at any stage when the baby was born. As it turned out, that was 24 weeks, only a few weeks later, Mrs. Patel came in and deliver it and the tiny twin that we were worried about sure enough didn't do very well and then he survived about -- I think about an hour and 40 minutes. And was only about 600 grams. I am really nervous that the child had very very tiny lungs and we sort of expected that and I think the parents expected it. Estelle Matthews: When Prina was born, she had quite a rocky ride, didn't she? It didn't happened very easily for the first few weeks of her life? Dr. Tim Wickham: Indeed. He has, she had a lot of problems. She was extremely poorly, I’d say, she is probably -- No, she was about as poorly as you can get really. She has problems with her ventilation. She popped one of her lungs and got some air in the wrong place inside the chest, which we can deal with. But it complicates things. It makes life a bit hard for us. She had infections and then have a really big problem that she had, she had pulmonary hemorrhaging which is where baby bleeds into the lungs. She fills the lungs up with blood instead of air and so you could imagine that's not a good thing. And she was poorly that afternoon and in fact, she can very close to, about as close as you can get to die and she had a period where her heart wasn't beating for probably about 10 or 15 minutes, probably 10 minutes. But obviously we were resuscitating her through that period. And she pull through and I think she is a very good example of -- you see these tiny, fragile babies and you think, oh my God, how can they survive. But they are remarkable resilient and she pull through. I mean we did everything we could do but actually she did, she did most of that. I mean if a baby pulls through that sort of thing, it's -- there is something inherent in the babies, in the strength that they can -- you know get through something like that. Estelle Matthews: Now one of the most effective, non-invasive methods of helping premature babies like Prina is to involve an osteopath and here at Barnet they have a team of osteopaths on hand to help them out. So let us Andrew, what exactly do you do here? Andrew Maddick: Osteopathy is very much concerned with movement and shape and these babies, because they are born so early, cannot move as they should be doing. So we do a lot of work with movement, mainly at the chest and other parts of the body to try to improve the health of the babies. Estelle Matthews: Now obviously with someone so small and so fragile, you have to treat very very delicately. But how different would it be to treating a larger toddler or an adult? Andrew Maddick: It's quite different from treating adults, the same principles still apply. With an adult, osteopaths are well known for – and leaping on making horrible cracking noises. With children, it's the same principles on the line, if they are using different techniques. With the babies like this, we have to use very very gentle techniques because they are so fragile. Estelle Matthews: You told about working on the lungs but how much work can you do and have you seen an improvement? Andrew Maddick: Yes, we really see improvements. Prina has done particularly well. Estelle Matthews: She looks very peaceful, she is yawning. Andrew Maddick: She is. We can do an awful lot of work with the lungs. From watching my hands, it looks like nothing is happening it to. I am just making very very small movements with my hands and I think I have adjusted them, to make profound changes to the movement of the chest from doing what looks like very little. Estelle Matthews: Now when Prina was born at 26 weeks, she has had nothing but needles and invasive methods invoked in her little life. And just she jump when you touch her or she nervous. Andrew Maddick: She get to start with I think -- well they are very small, they can recognize parental touch which is a nice soothing touch and it sounds funny but I think at that age, they do recognize parents. If it somebody else, they are very nervous. But within a few treatments I think they begin to recognize an osteopathic touch as being something that is at least not unpleasant, and usually quite happy to be touched. Estelle Matthews: So how long do you think Prina will need some osteopathic treatment? Andrew Maddick: Well, I would say, ongoing but I think everybody should be treated with osteopathic treatment for whoever an osteopathic treatment is advised. Estelle Matthews: And some the osteopathic center in London, they actually work on the mothers as well. Do you think that's quite an important feature of osteopathy. Andrew Maddick: It is, yes. And we'll trying the mother to help after delivery is really straightforward, and it's a vital part of looking after the child as well. If you got a mother that can't breastfeed or can't look after a child and there is an easy straightforward osteopathic answer to it. It makes sense that we, we treat them as well as the children. Estelle Matthews: Now is this available to everyone on the NHS? Andrew Maddick: Not only NHS, we work here just as a visiting team of osteopaths. We have centers in Manchester and London, where we offer care to all kinds of children and we work on a donation basis. So we just ask for donation to the costly treatment. Estelle Matthews: Well, thank you very much and we’ll need to work on little Prina.