Having featured the stories of Dewi and Joycelyn, two mothers whose babies were born prematurely, we now examine the causes of premature labour and some health issues which pre-term babies face.

CAUSES OF PREMATURE DELIVERY
A study in the Singapore Medical Journal defines a premature baby as “a child born earlier than 37 completed weeks of gestation”. The article estimates that between ten and 12 per cent of the births in Singapore are premature.

Although over half of the women who deliver prematurely do not have any known risk factors, a study of 20,723 single births at NUH between January 1986 and November 1991 found that teenage mothers, women with lesser education, those with no antenatal care, and mothers who have had three or more previous deliveries have a higher risk of delivering prematurely.

In addition, the Ministry of Health’s 2001 Clinical Practice Guidelines for Management of Preterm Labour found that underweight women, smokers, those with previous pre-term deliveries, multiple pregnancies, cervical incompetence, uterine abnormalities and pregnancy complications have a higher risk of delivering prematurely.

Just as unexpectedly as premature labour begins in some mothers, Baby Centre estimates that it may also stop by itself in roughly 50 per cent of women, while premature delivery cannot be prevented in the remaining cases.

HEALTH ISSUES IN A PREMATURE BABY
As the organs and muscles of a premature baby have had less time to develop compared with those in a full term baby, premature babies may be born with health problems, or have developmental issues later in life. Depending on how early the baby was born, he or she may also have the following problems:

Apnea
As the part of a premature baby’s brain which controls breathing is not fully developed, such babies may suffer from apnea, where they may stop breathing for fifteen to 20 seconds at times. Premature babies are monitored closely, and should they stop breathing, nurses will stimulate the baby by rubbing his back, hands and legs.

Patent Ductus Arteriosus
When the baby is in the womb, its lungs are not in use as the foetus receives oxygen from the mother through its umbilical cord. Thus, blood does not need to flow from the heart to the lungs, but is diverted to the rest of the body via the ductus arteriosus, a “hole” connecting two major blood vessels.

In a full term baby, this hole normally closes substantially within twelve to 24 hours of birth, and is sealed within three weeks. However, it may remain open in a premature baby with a birth weight below 1,500 g, resulting in an incorrect blood flow. Such babies may have breathing difficulties or a heart murmur. This hole may be closed through surgery, or by giving the baby medication.

Hernia
The abdominal muscles of a premature baby may not be fully closed or sufficiently strong at the time of birth. Thus, a hernia, or lump under the skin, may be formed as a result of fluid, tissue or internal organs like the intestines protruding out of the tummy or groin through a gap in the muscles. Surgery is required to close this gap.

Retinopathy of Prematurity (ROP)
This condition occurs when the blood vessels in the eyes of a premature baby develop abnormally. Babies with a birth weight under 1,500 g are at higher risk of developing ROP.

Depending on the severity of the condition, ROP may recover by itself, require laser therapy or even surgery. In mild cases, babies may recover completely, while severe cases may lead to short-sightedness or blindness.

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Health bosses have been criticised for carrying out a review of treatment and care of a baby who died from pseudomonas — five months after the tragedy. It has emerged the Western Health Trust will carry out a formal review of the care of Caolan Burke at the neonatal unit at Altnagelvin Hospital.

The trust has sent a letter to his parents stating that it has now decided to carry out its own formal review from the time of his premature delivery in the Londonderry hospital until his death in December at just 10 days old.

Stormont health committee member Kieran McCarthy said the trust should have carried out a full investigation once the outbreak was declared in December. “It is important we learn lessons to ensure nothing like this ever happens again, but you do wonder about the timing of this review being carried out by the Western Trust,” he said.

“I would have thought it should have been looking carefully at all its procedures immediately.”In total, four babies died during the outbreak of pseudomonas in December and January. Three died at the Royal Jubilee Maternity Unit in Belfast. As details of the outbreaks emerged earlier this year, the Health Minister came under increasing pressure to act.

Following the third death of a premature baby at the Royal Jubilee Maternity Hospital in January, Edwin Poots announced an independent review of the outbreaks by Professor Pat Troop, alongside the Regulation and Quality Improvement Authority (RQIA).

She raised concerns over the handling of the outbreaks and said some of the deaths may have been avoided if health bosses had acted sooner. She also criticised communication in the trusts.

The parents of Caolan have also expressed concerns their son may have survived if the trust had strictly followed hygiene on managing the infection. Mr McCarthy added: “I have no doubt action by the trust and department on the outbreak at Altnagelvin and the later outbreak at the Royal Jubilee Maternity Hospital is as a direct consequence of pressure from the media.

“I doubt we would ever have known about the death of this poor baby had it not been from pressure from the media.”A trust spokeswoman said: “The trust, in line with normal good practice, is reviewing the clinical care the baby received in Altnagelvin.

“The trust can also confirm that members of the RQIA team were advised, prior to their meeting with the parents and their solicitor, that the trust was undertaking such a review and the RQIA team confirmed that this was good practice.”

Background
Pseudomonas is a bacteria found in damp environments and can be extremely serious in patients with low immunity, such as premature babies. One baby died at Altnagelvin Hospital in December 2011, and three at the Royal Jubilee Maternity Hospital in Belfast at the start of this year. An interim review found the most likely source was contaminated tap water.

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Parenting is mixture of hard work, heart, exhausting, commitment, enjoyable, fun and Important! Based on Baumrind's initial study of 100 preschool children, researchers have conducted numerous other studies than have guide to a number of conclusions about the affect of parenting styles on children. Guardians follow many types of parenting methods and it results in dissimilar affect on the kids in the long run to become parents is the best feeling. These are: Authoritarian parenting style is one from which kids are likely to pursue severe rules of their parents to follow.

If you fail to follow these rules usually results in punishment. These parents can not explain the reason behind the rules. The children follow the rules simply because their parents said. These children grow up and become obedient and competent, but are inferior in happiness, self-esteem and social skills. Permissive parenting style is one from which the parents request that their little children. These parents often regulation their children because they don't have much expectations from their children. Permissive parents tend to feed and communicate with their children. These kids are much more probable to have issues with authority and be inclined to carry out badly in college. Positive parenting is a very easy thought to go after when out of order into its essential elements.

Simply put, positive parenting is to say what you need for your child. By using the words affirmative action and it tells for your kid to tell what you want and wait for from them instead of effective them the performance you don't want them. Positive parenting should and can be used in daily life, in every condition and every call. Here are few examples of positive parenting in everyday situations. If you are doing positive parenting, instead of proverb "end playing with the foodstuff" you will say: "I want you to consume best foodstuff", don't have to sayo"end jumping on couch" apply this and say "just be seated adequately on the couch ", or even not saying" be cautious while riding your bicycle or you may plunge "and a positive guardian will say," be cautious while riding your bicycle so that you remain safe."Just note down that the act language is in positive. These are easy thoughts to go after. It just takes lot and lot of practice and not anything as well. Make use positive parenting, and this will give your kid a sense of optimistic self-esteem. This will make them feel happier and confident that you said what you need and look forward to have their good behavior instead of constantly harass and tell them what is wrong.

Some people even don't know that is it possible that the costs of  parenthood are measured. There are fiscal figures hovering around in media deemed the cost of increasing a kid to college to be measured. The economic price can look pretty intimidating. Food, Diapers, clothing, Christmas, birthdays, extracurricular activities, ad infinitum, school, colleges and the economic price is adding up speedily certainly!

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There are few places that illustrate the fragility of life better than a neonatal intensive care unit. Premature babies, hooked up to tubes and monitors, their tiny legs sticking out of the smallest of diapers: it’s a sight can bring tears to your eyes and a prayer to your lips. One in 10 children are born prematurely every year around the world. That comes to about 15 million babies. You may think developing countries like Belarus and Libya have more preemies than the United States. Think again.

A new study – the first of its kind – ranks preterm birth rates around the globe. The United States comes in at 131 on the list of 184 countries. According to the new report, Born Too Soon: The Global Action Report on Preterm Birth, twelve in every 100 babies born in the U.S. are premature. Belarus has the lowest preterm birth rate in the world (4.1 in 100) while Malawi has the highest (18 in 100).

More than a million premature babies die each year. It’s the No. 1 cause of death among newborns. And it’s a major health concern because babies born prematurely can have breathing problems, cerebral palsy and intellectual disabilities.

“This report should be a call to action,” says Chris Howson, vice president for global programs at the March of Dimes, one of the groups behind the report. “We are one of the countries with one of the highest survival rates, but we are not leading in preventing preemies.”So why is the premature birth rate higher in the U.S. than in countries like Iraq and Afghanistan?

Howson says it’s largely because women are having babies later in life, the increased use of fertility drugs and more C-sections and inductions. Another thing at play, says Howson, is the lack of care some women – in particular minorities – get during pregnancy. For example, if diabetes is diagnosed early, it can be treated more successfully. That, according to Howson, doesn’t happen enough.

“It is absolutely critical that we provide the services that make it accessible to all women in this country, especially in the early stages of pregnancy,” he says. The study also looks at American premature births state-by-state. Funding the report were the Partnership for Maternal, Newborn & Child Health, Save the Children and The World Health Organization.

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A new mom and dad in Mississauga, Ont. who both have cerebral palsy are fighting to keep their newborn son at home, after social workers threatened to take the boy away over concerns about their ability to care for him.

Maricyl Palisoc and Charles Wilton became parents to a healthy baby boy named William last month. But before the child was even born, the social worker at the hospital had called in the Peel Children's Aid Society.

CAS workers told the couple they were not convinced they could care for William and threatened to remove him from their home unless they found an "able-bodied person" to offer 24-hour care.

The couple has now met that demand, but wants to be given the right to care for their son on their own terms. Linda Soulliere, of the Coalition for Persons with Disabilities says the whole situation is unfortunate and is the result of misunderstanding about disability.

"I think a lot of it is attitudes and perceptions and a lot of misunderstanding about what cerebral palsy is," she said in a telephone interview. The personal support workers the CAS demanded cost $2,000 a week and a staff member at the Coalition has dipped into his own line of credit to pay the fees. But Soulliere says her group is confident Maricyl and Charlie can manage just fine without someone watching over them 24 hours a day.

"We feel they should be given the chance to be parents," she says. "And they deserve the chance to have some privacy. Right now, the attendant is there all the time. I think they deserve the opportunity to spend some time alone with their child."

Soulliere says the couple already receives a few hours a day of care from support care workers at the building, which is run by a group called AbleLiving. All they would need, she says, is a few more hours a week of care, which AbleLiving  says it's willing to provide. "I'm not saying they don't need some assistance. And they do get it through the AbleLiving program. But they are able to do a lot more than people give them credit for," says Soulliere.

Charles uses a power wheelchair but has good upper body strength, she says. Maricyl is more mobile and while she has some hand mobility issues, she's still able to change diapers, breastfeed, and other daily activities.

Soulliere says the Children's Aid Society is an "admirable organization" that helps many children who need protection, but she wonders whether people have jumped to the wrong conclusions about Maricyl and Charlie. "Their speech is affected and when speech is affected, it's much easier for people to assume their cognitive skills are affected, but that's not the case," she says.

"They're both really intelligent people, but because their communication skills are not there, people tend to talk down to them like they're not as bright."The couple is due to meet with the Children's Aid Society on Friday. That's when Soulliere's group plans to present their ideas for a care plan, in hopes that all sides can work out an arrangement.

Until then, though, Soulliere says Maricyl is anxious and losing even more sleep than most new mothers already lose. "She's scared of losing their child. She loves her baby," she says. "She wants to be given the opportunity to be a good mom. That's all she wants."

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The number of babies born in the United States with signs of drug withdrawal has tripled in a decade because more pregnant women are using narcotics, according to a new study. The rate of infants born with withdrawal symptoms reached about one every hour in 2009, researchers report in this week’s issue of the Journal of the American Medical Association.

"What we found was that from 2000 to 2009, the number of babies having drug withdrawal increased by three times," said the study’s lead author, Dr. Stephen Patrick of the University of Michigan's division of neonatal-perinatal medicine in Ann Arbor. Babies with withdrawal, called neonatal abstinence syndrome (NAS), commonly show:

Irritability.
Difficulty feeding.
Difficulty breathing.
Low birth weight.
For the study, Patrick and his co-authors reviewed hospital billing data from across the U.S. They looked at how many women were using opiates at the time of delivery as well as whether the newborns showed drug withdrawal symptoms. In 2009, at least 1,057 babies were born in Canada with NAS, an 18-per-cent increase over the year before, according to the most recent figures available from the Canadian Institute for Health Information.

Complex and costly hospital stays
The incidence of the syndrome increased from 1.20 per 1,000 hospital births per year in 2000 to 3.39 per 1,000 hospital births at the end of the decade, the researchers found. Not all babies born to women who used opiates during pregnancy showed symptoms.

The newborns included babies like Savannah, whose mother stopped abusing painkillers and switched to prescribed methadone early in pregnancy. Savannah has trouble sleeping peacefully, sometimes cries all night, and has had diarrhea and trouble feeding.

"It's really hard, every day, emotionally and physically," said her mother Aileen Dannelley, 25. "It's really hard when your daughter is born addicted."Dannelley said a neighbour introduced her to crack at age 14 and she's also abused Vicodin prescribed to her for back pain as well as other prescription painkillers and heroin.

The hospital length of stay for newborns diagnosed with the syndrome averaged 16 days and remained about the same throughout the study. In Canada, the average hospital stay for for NAS infants was 15 days, CIHI said.

"In conclusion, newborns with NAS experience longer, often medically complex and costly initial hospitalizations," the study authors wrote. The researchers said many pregnant women were legitimately taking pain-relieving opiates prescribed to them.

Opiates 'overprescribed'
The researchers said they want more done to find ways of protecting the unborn from the drugs that offer pain control for cancer and chronic pain.

A journal editorial accompanying the study called opiate medications "overprescribed, diverted and sold illegally, creating a new opiate addiction pathway, and a public health burden for maternal and child health."

Marie Hayes of the University of Maine, Orono, and Dr. Mark Brown, chief of pediatrics at Eastern Maine Medical Center in Bangor agreed with the researchers that research needs to establish the best ways to treat opiate dependence in pregnancy. That may include starting methadone treatment early in pregnancy, monitoring alcohol use and providing psychiatric care.

The babies are dependent on methadone or other opiates because of their mothers' use during pregnancy. The infants are given small doses of methadone to wean them off. That's safer than cutting them off cold turkey, which can cause dangerous seizures and even death, Brown said.

Scientists are gaining clues to dependence by studying how opiates cross the placenta and analyzing infant stool samples. The research was funded by the Robert Wood Johnson Foundation Clinical Scholars Program.

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KANSAS CITY, Kansas (Reuters) - In a debate every parent of a six-year-old can relate to, the Kansas legislature is deciding who can pull baby teeth. The problem is that rural areas in the United States have a shortage of dentists, and one proposed solution is to license "dental practitioners" who could do things such as fill cavities and pull baby teeth.

But the lobbying group representing dentists in Kansas wants no part of non-dentists messing with people's mouths, saying that only a person with a four-year graduate degree and additional training should be allowed to extract teeth.

"When a dentist cuts into a tooth, that's surgery, even though the public may not think of it that way," said Kansas Dental Association Executive Director Kevin Robertson. Tooth extractions, even of loose primary teeth in children, can get complicated, he said.

About half the 105 counties in Kansas have two or fewer dentists and there are 15 counties with no dentist at all, according to a state report. Rural counties across the United States struggle to attract dentists as dental school graduates tend to favor the higher pay and amenities of larger communities.

The United States has been slow to adopt dental practitioners, with only Minnesota and Alaska allowing them, although 15 states are considering the idea. A recent study by the W. K. Kellogg Foundation, a Michigan-based child healthcare advocacy group, found that dental practitioners permitted in 54 countries provide safe and effective dental care to children.

In Kansas, the debate has landed in the state legislature. One group that advocates child healthcare is pushing legislation to allow practitioners to fill teeth and remove baby teeth, along with teeth cleaning that dental hygienists already provide. The bill would require practitioners to spend their first 500 hours of practice under supervision of a dentist. Once on their own, they would still have to refer non-routine care to dentists.

"We are seeing a lot of people going without care or having to wait a tremendous amount of time to get basic dental care," said Suzanne Wikle, director of policy and research for the Kansas Action for Children. "Others have to travel great distances to get that care."

But Robertson said practitioners could further reduce the number of dentists in rural areas. Dentists would be less likely to move to an area where they see that dental practitioners are already in business, he said.

The dental association is pushing legislation in Kansas that would expand the services of hygienists to include temporary fillings and adjusting dentures. On the subject of baby teeth, the dentist lobby would allow extractions only if the teeth are very loose. The bill has passed the state House and is awaiting approval in the Senate.

The dental association proposal falls far short of meeting the needs of patients but is "a very small step in the right direction," said Wikle. Her group has vowed to return next year to again seek a broader bill that permits dental practitioners.

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Sharjah The condition of a newborn baby who was thrown down a garbage chute in Sharjah is still critical, doctors have told Gulf News. The baby boy has been in the intensive care unit of Al Qasimi Hospital since miraculously surviving the nine-floor fall at a building in the Al Taawun area in Sharjah on Monday.

Dr Arif Noryani, director of Al Qasimi Hospital, said the baby had suffered a fractured skull and internal bleeding. "Even though the heart and lungs are unharmed, he has infections and is constantly being monitored," said Dr Noryani said.

Doctors said the baby had been wrapped in a piece of cloth and aluminium foil before being put in a plastic bag — something which they attributed as having helped the baby survive the fall.

However, they noted that oxygen supply had been reduced as a result and this had resulted in neurological problems. The baby was admitted to the ICU in the hospital's wing for premature children and has since been administered medicines to help fight the infections.

According to the police, the incident took place early on Monday morning, between 4am and 5am, when the baby's mother — a Filipina housemaid in her 30s — tried to kill the newborn by throwing him down the rubbish chute from the ninth floor of the building.

Baby found at 6am
The child was found by the watchman who was on his morning rounds at around 6am.
The watchman informed the police after which a team from the Criminal and Investigation Department (CID) at Sharjah Police then went to investigate at the crime scene before establishing the identity of the baby's mother.

The baby was rushed to the hospital.
According to Brigadier Abdullah Mubarak Al Dukhan, deputy director of Sharjah Police, the maid was recruited illegally by an Asian family who did not check her credentials and history when they employed her. The police arrested the maid.

Timeline
April 9, 2012: Three abandoned babies are found in separate locations in Sharjah, according to Al Qasimi Hospital.
March 18, 2012: A newborn baby girl is found abandoned on the doorsteps of a mosque in Ajman.
March 12, 2012: An 11-day-old baby girl is discovered outside a villa in Al Hera area, Sharjah.
March 16, 2012: A newborn baby is found abandoned next to a building under construction in Al Badea area, Sharjah.
November 27, 2011: A newborn baby is found in a bag hanging on the side mirror of a car in Abu Shagara area, Sharjah.
September 9, 2011: An Emirati man walking home from prayers is shocked to discover a baby at his doorstep in Ras Al Khaimah.
June 27, 2010: An infant is found in a cardboard box near a mosque in Al Zahra area, Ajman.
June 7, 2011: Two abandoned babies are found in separate locations in Sharjah.
March 2, 2010: Two baby boys, believed to be five months old and six weeks old, are found outside a mosque in the industrial area, Sharjah.

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If you are a mother that has recently given birth to a baby, you may find it to be quite strange taking care of the baby as it will be a totally new experience for you. Some mothers are also not very keen on doing the babysitting and may otherwise also be clueless about what it takes to properly care for their babies. It would pay for such mothers (and more experienced mothers as well) to make use of a baby care tips to help them learn about how to care for their newborn babies.

Bathing Frequency
The first baby care tip that every mother will need to follow is learning about how to bathe their babies. Normally, you will be advised that your baby only needs to be bathed twice or even thrice in a week, or whenever he or she becomes dirty enough to warrant giving them a bath. Other than that, there is also a need to give the baby sponge baths following a change of diapers and also after the baby has eaten a meal.

The second important baby care tip that you will need to follow has to do with how the baby should be cared for when he or she is being given a bath. It is absolutely not advisable to leave the baby on his or her own for even a single second while he is in the bathroom. Mothers and parents and baby caregivers must always be within arms length of the baby while he is in the bath.

A third baby care tip that you will have to follow is learning how to prevent your baby from suffering from diaper rash and from suffering from skin irritation. The simplest solution in this regard is to ensure that you change the baby's diapers either prior to or after feeding him and also soon after he has relieved him. There is nothing quite as bad as letting a baby sit in dirty diapers because that is a sure way of causing him to suffer from skin irritation.

The fourth baby care tip that mothers and parents need to learn about is learning to buy diapers for the babies. It is recommended that the diapers should fit him or her without being too tight or too loose. Too tightly fitting diapers are sure to cause irritation to the skin, especially near the thighs and also around the stomach.

Besides following these and other baby care tips, as a mother and parent you also need to do your best to bond well with your newborn baby. There are also many other useful baby care tips worth learning about, and if you are interested in knowing how to address different aspects of proper baby care, you must then make it a point to read books and magazines as well as go online and search for more information in this regard.

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A sophisticated new microscope makes it possible for fertility doctors to monitor the developing fertilised egg continuously for up to five days. It means any abnormal changes can be spotted and the egg discarded so only the best quality ones with the best chance of creating a healthy pregnancy are transferred to the womb. The technique has led to one in every two couples achieving a successful pregnancy, doctors said. The remarkable images show the egg dividing first into two cells, then four and so on until the developing embryo 'hatches' out of the egg and is ready to implant in the womb. Parents who successfully have a baby using the new technique can obtain a video of this "magical" moment.

Currently clinic staff have to remove the developing embyro from its incubator to look at it under a microscope and this can only be done once a day. This may miss vital mistakes and abnormal changes in the development which could jeopardise the chance of a successful pregnancy. Care, the UK's biggest private provider of fertility services, has installed the Embryoscope at its Manchester clinic. It is the first time it has been used to treat patients in Britain.

So far over 1,500 embryos from 200 patients have been monitored using the device and it has boosted pregnancy rates. With traditional monitoring one in three patients fell pregnant at Care and this has increased to one in two following Embryoscope monitoring. The first babies have been born and there are 74 other women currently pregnant after using the new technique.

Alison Campbell, Head of Embryology at Care said: “Currently, assessment of embryos in IVF is limited to brief snapshot glimpses at defined time points, usually one per day, involving removal from the incubator. "However, embryo development is a dynamic process and the use of time lapse imaging with the EmbryoScope enables the growth and activity of each stage to be observed continuously by the embryologist without removing them from incubation.

“The ability to view continuous embryo growth helps us to observe abnormal development, and exclude embryos that are not ideal for implantation. "Eggs are injected with sperm and then placed into the EmbryoScope for fertilisation and development to take place. "Images are taken every few minutes and viewed as time lapse video by the embryologists until the point of embryo transfer, usually three or five days later. The ability to study these images in a closed system allows us to more accurately select the most viable embryo for transfer into the patient. "Early assessment of this technology demonstrates that the new, valuable information is delivering improved pregnancy rates.”

Isabella Potter from Wigan is just three weeks old and was the first baby born using the technique.
Her mother Gemma Potter, 27, a primary school teacher, said: “She is our little miracle. We are so happy, we have been shouting from the rooftops for three weeks. "To see her as an embryo was so special. Up until now no parent has seen their child at that magical moment of life.

"To think that Isabella, lying in my arms now, was that tiny speak when she started out, as we all are, was so precious. None of us have ever seen ourselves at the very start of life but Isabella will be able to.
"We will show her the time lapse video when she older along with all the pregnancy scans."

Mrs Potter and her husband Simon, 33, a software engineer, had been trying for a baby since 2007.
Mr Potter said: "Seeing the time lapse images was mindblowing."They were referred to Care Manchester and conceived Isabella on the first cycle of IVF. The treatment was funded by Ashton, Wigan & Leigh Primary Care Trust. Embryoscope monitoring is being charged at £750 per cycle and includes videos of the developing embryo that the parents can keep. A typical cycle of standard IVF treatment costs around £5,000.

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