A premature infant weighing only 400gr was born in September 2021 at the National Hospital of Obstetrics and Gynaecology in Hà Nội. After three months of intensive care, he was able to gain 1,800gr. — Photos courtesy of the hospital

In 2010, when a premature infant weighing only 453gr was saved by doctors of the National Hospital of Obstetrics and Gynaecology in Hà Nội, everyone called it a miracle.

Now after 13 years, doctors and nurses at the hospital’s Neonatal Care and Treatment Centre still continue their tasks and have saved hundreds of other premature babies weighing only 400-600gr.

The "captain" in the race to bring premature babies hovering on the brink of life and death safely to their parents is Dr Lê Minh Trác, the centre’s director.

He said when he started to work at the centre in 2003, thanks to the initial equipment, doctors could save infants weighing as little as 1 kg. Then with improved professional experience, they could save babies under 500 grams.

Caring for a premature and low-birth-weight baby is not an easy job, but extremely difficult and demanding, he said.

In the early days, with little equipment, the doctors had to take turns applying breathing aids to the babies, without a moment's rest, he told Sức Khỏe & Đời Sống (Health and Life) newspaper.

“Imagine the baby is as small as a water bottle, with thighs only the size of a little finger; feeding the baby is extremely difficult. For extremely low birth weight babies, in the early days, doctors used electric syringes to pump milk,” he said.

According to Dr Trác, more premature babies are born every year. The Neonatal Care and Treatment Centre every year treats thousands of newborns, the majority of whom are low birth weight and premature infants.

Many weigh less than 1,500 grams and have a gestational age of less than 30 weeks. Some weigh only 400 to 600 grams. As soon as they are born, they must be accompanied by a doctor. The child must be kept warm and protected from infection, in which infection prevention is a key in the treatment process, he said.

The infant he remembers most is a 400gr baby born during the COVID-19 pandemic, who was also the lightest infant ever born in Việt Nam.

“The mother almost gave up and wanted to go home as she lost hope of her baby’s survival.

“Only when she was called to have skin to skin contact and feed the baby, did she burst into tears. She could not believe the baby could be saved.”

After three months of care, the baby recovered in a miraculous way, Dr Trác said.

The baby, born during the peak of COVID-19 in 2021, nevertheless overcame all difficulties, gained weight and developed well.

“When the baby reached 1,800 grams, we gave him back to his family. When the baby turned one year old, the family brought him to the hospital to thank the doctors and nurses,” he said.

He said caring for, treating and nurturing premature and low-birth-weight babies is extremely difficult. Doctors must monitor the babies every minute and every hour under strict hygienic and medical conditions.

In the recovery area, each nurse will be responsible for taking care of about 20-25 babies. In the intensive care unit, every nurse takes care of 9-10 children. While abroad, one to two nurses must take care of one baby. In other countries, other nurses are also in charge of intubators, veins and rehabilitation, but in Việt Nam, nurses have to take on most of these tasks.

From 2011 to 2023, the rate of premature babies born under 1,000 grams being saved has increased from 18 to over 40 per cent.

In October 2022, doctors at the centre saved twins born prematurely at 25 weeks and weighing only 500 grams each.

In July 2023, the National Obstetrics and Gynaecology Hospital announced they saved an extremely premature baby born at the 25th week and weighing only 600 grams with many diseases.

After birth, the child suffered from malnutrition, respiratory failure, hiccups and very slow reflexes.

“Treating this baby, sometimes we felt hopeless in the face of his deteriorating health conditions. When he was born, he was as small as a water bottle, so removing the baby from the mother's womb was very difficult. This is also the premature baby receiving the longest treatment (nearly five months) at the hospital, with 52 days of invasive ventilation and 10 blood transfusions,” Dr Trác said.

Depending on the baby’s weight and condition, treatment methods and length of hospital care also vary.

Trác said normally, extremely premature babies have to stay in the hospital for three to five months and taking care of these "tiny angels" is fraught with challenges. Sometimes medical staff just need to hear the beeping or whirring to distinguish between signs of apnea, cyanosis, hypothermia or changes in incubator parameters.

Talking about caring for extremely premature newborns, he said taking care of babies requires dedication, thoughtfulness and high techniques. The successful application of strategies to prevent respiratory failure, stabilise body temperature, prevent infection, massage and early feeding are all vital.

All rooms at the centre are equipped with multi-level anti-infection measures, as this is a key issue in the treatment of premature, low-birth-weight newborns, he said.

Before starting their shift, employees must comply with absolute sterility requirements, from using sterile clothes to disinfecting and washing hands. Not only are medical instruments and equipment regularly disinfected, but treatment rooms must also be disinfected every four to six weeks by an air steriliser system, he said.

He said having to be separated from their mother since birth, sometimes premature babies lack a bond with their mother in the first days of life. On the other hand, being away from their children and worrying about them also makes mothers easily fall into depression. Therefore, it is necessary to build a mother-child bond from the time they are in the hospital.

A mother has skin to skin contact with her premature baby.

Instead of complete isolation, the hospital allows mothers to have early contact with their children. Doctors provide psychological advice for mothers to visit their children regularly, talk and interact with them, he said.

The mothers are instructed on how to care for their babies, having skin-to-skin contact in a special nursery so the baby can receive warmth from the mother. Mother's breathing stimulates the baby to breathe, and helps the baby stabilise the heart rate, reduce apnea, and digest and absorb food better, while actively supporting brain development, he said. — VNS