Venezuelan hospital encourages 'kangaroo' baby care to spare incubators

[October 04, 2018]  By Vivian Sequera

CARACAS (Reuters) - Venezuela's largest maternity hospital is asking mothers to care for non-critical premature babies with skin-to-skin contact known as "kangaroo care" rather than in incubators, as wards struggle with a lack of equipment.

At the Concepcion Palacios Hospital last week, doctors held tutorials to show nurses and mothers how to hold newborns against their bare chests inside a pouch or cloth wrap.

Researchers have identified kangaroo care - which has gained adherence in countries including the United States, Norway and Finland - as a way of lowering infant mortality and improving developmental outcomes for premature and underweight babies.

In Venezuela, where public hospitals face shortages of basic medicine and the flight of nurses and doctors abroad after five years of economic crisis, kangaroo care can also provide a way to reduce pressure on scarce resources.

A senior doctor at Concepcion Palacios, speaking anonymously, said the hospital lacked almost all material needed to treat patients, such as water, disinfectant, hospital beds, and useable cubicles.

Venezuela's Information Ministry did not respond to a request to comment about the lack of equipment in hospitals.

According to the last statistics released by Venezuela's Health Ministry, infant mortality, or death of children aged under two, climbed 30 percent to 11,466 cases in 2016 from the year before.

The report cited neonatal sepsis, pneumonia, respiratory distress syndrome, and prematurity as the main causes.

Lide Diaz, the 'Kangaroo Mama' program's coordinator at Concepcion Palacios, said the new focus on skin-to-skin care ensured incubators were available for babies considered to be critical condition.

"We take the baby out of the incubator ... and place it here," said Diaz, gesturing to her chest.

Concepcion Palacios is the only public hospital in Venezuela with a kangaroo program, as others are not able to provide the year of necessary follow-up care, Diaz said. The program's rooms are well-maintained, with pictures of kangaroos on the walls.

The United Nations children's agency (UNICEF) has provided the hospital with technical assistance and medical equipment to evaluate babies' health.

"The kangaroo method saves the lives of premature babies ... and for that reason we support the program at the Concepcion Palacios Hospital," UNICEF said in a September press release.

HIGHER CHANCES OF SURVIVAL

Diaz, a 60 year-old pediatrician, said about 880 premature babies had been treated with kangaroo care since the program started in 2015, and in September they had started to train doctors and nurses to expand the system within the hospital.

"The experience was gratifying. I understood it was important for him to feel my heat," said 33-year-old Milagros Marquez of her son Sebastian, who was born at 33 weeks.

Doctors in Colombia first came up with kangaroo care in the late 1970s in response to limited incubators and a high death rate among premature babies. Researchers discovered that babies held close to their mothers' bodies for several hours each day had a much higher chance of survival.

Kangaroo care also includes exclusive breastfeeding, early discharge, and close follow-up care at home.

The babies experience the same movements as they do when they are in the womb and are comforted by the beating of the mother's heart, said Nathalie Charpak, a French pediatrician and one of the founders of Colombia's Kangaroo Foundation.

"What most impressed me was the quality of sleep. It's deep, the baby doesn't have that sort of sleep in an incubator," she said in a phone interview from Bogota.

If the mother is busy or ill, the father or a grandparent can substitute.

Joel Martinez, a 53 year-old special needs teacher, spent a month and a half at Concepcion Palacios caring for his two grandchildren. His daughter, Cristina, needed help after separating from her husband during pregnancy.

The twin boys were born at 35 weeks and the smallest, Miguel, weighed just 1.5 kilograms (3.3 lb), but now, eight months later, weighs a healthier 7.6 kg (16.7 lb).

"At first I was anxious ... but I knew the benefit that it would have in the long run," said Martinez.

(Reporting by Vivian Sequera, Writing by Angus Berwick, Editing by Rosalba O'Brien)

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