World Prematurity Day: Reflections of a Neonatologist

Sreenath S. Manikanti*

Senior Neonatologist and Pediatrician, Kauvery Hospital, E-City, Bangalore, India

*Correspondence: Tel.: +91 9901541501; email: sreenath.manikanti@gmail.com

World Celebrates World Prematurity Day on 17th November.

I am delighted that, after having worked for the health and welfare of premature babies for over two decades, and having been at forefront of Human Milk Banking in Karnataka, I have been invited by Editor-in-Chief Dr. Venkita S Suresh to share my experience through a Guest Editorial for the Children’s Day, Nov 14th – India special edition of KAUVERIAN, the electronic medical journal of Kauvery Hospitals.

Approximately one in every ten new-borns is born prematurely (i.e. before completing 37 weeks of gestation), amounting to an estimated global 15 million preterm births every year. The objective of World Prematurity Day is to raise awareness about preterm birth and the concerns of both preterm born infants and their families. Complications of preterm birth are the leading cause of death in children under 5 years of age. Those infants who survive preterm birth are at risk for a range of severe complications in the neonatal period (the first 4 weeks of postnatal life). One such dreaded complication in Necrotising Enterocolitis (NEC), a severe form of gut infection with high mobility and mortality in these vulnerable premature babies.

Human Milk offers complete nutrition to babies including preterm babies. However, mothers who deliver preterm babies often don’t produce enough breast milk in first 1-2 weeks to feed their babies. If formula feeds are offered to these vulnerable babies, it poses high risk of “Necrotising Enterocolitis”. Studies all over the World have shown, in the absence of MOM (Mom’s Own Milk), these babies benefit immensely from PDHM (Pasteurised Donor Human Milk). Establishment of Human Milk Banks not only helps these babies to reach full feeds early, but also promotes breastfeeding of these infants later on.

After I returned to India in 2014 from UK, where I served in NHS for 11 years, I found out that there was no Human Milk Bank in a city like Bangalore with more than 40 NICUs. In 2017 I helped set up Karnataka’s 1st Public Human Milk Bank “Amaara “with the help of Breast Milk Foundation. Our aim was to provide PDHM to all the vulnerable preterm babies admitted in NICU’s in and around Bangalore. We set up a state of art Public Human Milk Banks with best infection control measures & SOPs for collection, storage, pasteurisation & transport of donor milk. We screened all the donors at the comfort of their homes & collected milk at their door steps. We set up robust collection & delivery system for transport of donor milk to & from the milk bank. We charged nominal cost to private hospital NICUs and served PDHM free of cost to Government NICUs.

Since the concept was new, we had to put in lot of efforts to create awareness about benefits of Human Milk Banking both amongst medical fraternity and the public. With the support of NNF-Karnataka we conducted CMEs for Neonatologists / Paediatricians, Obstetricians, Lactation Consultants and Nurses. Created awareness in public through talks in conferences, publishing articles in print & electronic media, TV interviews & programs in Kannada & English, Facebook campaigns, Celebrity endorsements etc. As a result more hospitals started requesting Donor Milk and more donors came forward to voluntarily donate the breast milk. We also conducted workshops where we invited donor & recipient mothers to share their experiences.

In first 2 months we reached 6 NICUs, 21 NICUs in 6 months & 31 NICUs in 12 months. Soon we reached a stage where demand exceeded supply & we had to prioritise donor milk for smaller preamature babies. Till June 2021 we have supplied staggering 10,77,770 ml of PDHM to 553 preterm babies in 53 NICUs across Bangalore! We worked through the COVID pandemic meeting challenges posed by the pandemic. Now I believe we’ve created an atmosphere in Karnataka for more Human Milk Banks to thrive. Two more Human Milk Banks are opening shortly. Work has already started to set up 7 more Human Milk Banks in Karnataka with Govt of Karnataka & organisations like Rotary showing keen interest with the support of NNF Karnataka. There is a huge demand for Human Milk Banks in a country like India where about 3.5 million preterm babies are delivered every year. Establishment of more Public Human Milk Banks across India has the potential to save thousands of these vulnerable premature babies every year.

Dr.-Sreenath-S.-Manikanti

Dr. Sreenath S. Manikanti

Senior Neonatologist and Pediatrician

Journals

Find Doctor
Book Appointment