I know that I am alway putting my foot down about things on this website being “All about Mamas!!” But recently I received an e-mail from a mama of a preemie and as we talked, she told me about a product that had been used when her son was in the NICU. Prolacta Human Breastmilk Enhancer provides much needed nutrients and calories to premature infants. Prolacta is the only human breastmilk enhancer available and it is derived from donor breastmilk that is tested and purified and made available to NICU’s around the country. My daughter needed donor milk when she was first born and in the NICU, so this is a topic near and dear to my heart.
I had the grand opportunity to interview Ms. Terry Johnson, APN, NNP-BC, MN, CLEC. Terry has over 30 years of experience in a variety of clinical settings including the NICU, Special Care Nursery, Normal Newborn Nursery and Developmental Follow-Up Services. She is also a Certified Lactation Educator and Counselor. Today Terry shares insight into neonatal and preemie nutrition, the role of Prolacta and how parents can advocate for their babies and how Prolacta BioScience can help. She also offered another resource for parents, The Helping Hands MilkBank.
I’ll never forget the first time that I held my daughter. It was around 8am, a full 12 hours after I had given birth to her via a dicey c-section. We were both pretty much “undone” from the experience, and that morning the neonatologist brought my baby to me in a little isolette on her way to the NICU.
No mama nor family is ever prepared for a preterm birth. The very nature of preterm labor and preterm birth mean birth under emergent circumstances. So while mama has not had time to prepare herself mentally or physically for the iminent birth of her child, likewise, her child has not had adequate time to prepare for existence in the world outside of the womb. As such, preterm infants are at risk of severe health and developmental problems and lifelong disabilities. According to the March of Dimes, Prematurity is the #1 killer of newborns. 1 out of every 8 infants will be born prematurely in the United States annually and 15 million infants are born prematurely worldwide.
In 2003 The March of Dimes launched the Prematurity Campaign in order to raise awareness about premature birth and the strain it places on families and our society. The March of Dimes is also working with global partners to raise awareness, fund research and to support families of premature infants. It is a well established fact that babies who are born before 39 weeks are at increased risk of complications, and these risks and complications increase the earlier the babies are born. The March of Dimes and its global partners are doing all that they can to support families so that they will have the health care, support and resources that they need to carry infants to term and give birth to healthy babies.
So Mamas, tomorrow November 17, 2012, please lift your voices and share with your families, friends, neighbors and communities the rising problem of prematurity globally. Many Mamas on Bedrest know better than many other mamas what its like to have a preemie. Share your stories and also use this time to ask for help with your bed rest experience. Yes, share with those around you that you need help to go as far towards term as possible to give your baby the best possible start. Humble yourselves and ask for the help that you need-whether it’s around your home, with older children, giving your partner/spouse a hand or just stopping by to help keep your spirits up. I know that asking for help is so difficult for many of us, but if you can’t do it for yourself, do it out of love for your baby.
September is National Infant Mortality Awareness Month and there are numerous events, campaigns and activities taking place all designed to raise awareness about infant mortality. The United States has an embarrassingly high infant mortality rate in contrast to many other countries. But what is even more disturbing is the fact that according to an article published in The Lancet, May 2010, the country isn’t keeping up with global gains in reducing child mortality, despite significant health care spending.
Citing an article published on DOTmed.com summarizing The Lancet publication,
According to the World Bank, the U.S. has the highest infant mortality rate among 33 countries that the International Monetary Fund defines as having “advanced economies.”
At the time of the DOTmed summary, The U.S. ranked 42nd in the world in child mortality.
“What is surprising is that the U.S. continues to fall even farther behind, while other developed countries such as Australia and New Zealand have shown much better improvements in child mortality. If we look at progress over time, we see the U.S. was ranked 29th in the world in 1990 and has dropped to 42nd now (2010). What that tells us is that we’re not making as much progress as other high income countries.”
~Julie Rajaratnam, assistant professor with IHME and one of the study’s authors.
While our infant mortality rate is dismal and not readily improving in comparison to many other nations, researchers have found that there are some identifiable reasons for our high infant mortality rate. The leading causes of infant death in America are congenital defects, preterm birth and low birth weight and sudden infant death syndrome. They believe that if the US addresses those issues, the infant mortality rate will surely improve.
Birth Before Due Date
The US has an unusually high preterm birth rate in comparison to many other countries. According to a 2009 report by the National Center for Health Statistics, compared to Europe, America has a higher percentage of preterm births, likely the main cause of its higher IMR. (Preterm is defined as birth before 37 completed weeks of gestation.) Not only do we see many babies born before the recommended 37 weeks gestation, there are also thousands of babies born before 39 weeks gestation, the acceptable length of “term birth”. The March of Dimes has repeatedly advocated for education and policy changes within hospital and birthing centers encouraging physicians and families to do their best to allow babies 39 weeks without any sort of intervention (induction or cesarean section) unless absolutely necessary (i.e. mama or baby at risk).
Dr. Scott Berns, a pediatrician and a senior vice president with the March of Dimes Foundation reiterates that there is important development that occurs between 37 and 39 weeks gestation. Because we have gotten so accustomed to seeing “good” outcomes at 37 weeks, we’ve been lulled into a false sense of security. Dr. Berns notes that if we were to look at the overall numbers, we’d see the dip in positive outcomes in babies born before 39 weeks gestation.
The US also has a higher percentage of older mamas and mamas who have used assisted reproductive technologies. Mamas who become pregnant using ART are at increased risk of having a multiple pregnancy which carries with it an increased risk of preterm birth.
Many experts also draw links between America’s vast socioeconomic disparities and infant death. According to Dr. Gregory, half of U.S. births are to mamas on Medicaid. While both preterm birth and SIDS can happen to any family, these conditions are more prevalent among poorer families. Additionally, a 2008 NCHS report found that the infant mortality rate for black women was 2.4 times the rate for white women in 2005 (and this disparity exists today!!).
According to IHME’s Rajaratnam, looking at the U.S. child mortality rates by counties would likely identify areas that are performing just as well as Europe, and others on par with the world’s poorest countries.
“We are starting to do some of that local level research now and those results will help us get closer to putting our finger on what needs to change in order to save more lives.”
Both Dr. Gregory and Dr Rajaratnam admit that socioeconomic factors and access to care can’t account for the entire higher infant mortality amongst lower income ethnic minorities. However, they play a major role and must be addressed if infant mortality rates are to be lowered nationwide.
Both Drs. Gregory and Rajaratnam agree that there needs to be more research into the possible causes of infant mortality and both advocate that the National Institutes of Health, the National Institute of Child Health and Human Development and other research and policy organizations allocate funds and research efforts into infant mortality.
It must also be noted that advances in treatments, such as the use of progesterone injections for preterm birth, Magnesium Sulfate’s impact on protection of preterm infant brains, improvements in neonatal intensive care and improving access to perinatal health care will all improve infant outcomes.
Neonatal, postneonatal, childhood, and under 5 mortality for 187 countries, 1970-2010; a systematic analysis of progress towards Millennium Development Goal 4. Julie Knoll Rajaratnam PhD et al. The Lancet, Volume 375, Issue 9730, Pages 1988 – 2008, 5 June 2010. doi:10.1016/S0140-6736(10)60703-9