To the editor,
I wanted to comment on the May 6 article entitled "15 million babies are born prematurely."
Published May 2, the report "Born Too Soon: The Global Action Report on Premature Birth" contained some alarming statistics, collected by the Save the Children organization in conjunction with the March of Dimes and the World Health Organization, from more than 100 experts representing nearly 50 separate agencies and groups. It also contained the first ever country ranking of preterm birth rates.
Of the countries with preterm birth rates over 15 percent, all but two are in sub-Saharan Africa. However, the United States has one of the highest numbers of premature births - 517,400. Our rate is about 12 percent, meaning one in nine babies are born prematurely, double the rate in China and most European countries. The preterm rate in 2009 was as high as 17.5 percent for black Americans, while white Americans had 10.9 percent.
The age of the mother also affected the birth rates. Women 20 to 35 had an 11 to 12 percent preterm rate, while women under 17 and over 40 ranked at 15 percent.
Other risk factors seen in higher income countries include; older women having babies; increased use of fertility drugs that result in multiple births; and lifestyle challenges.
Among those challenges are smoking, obesity and diabetes.
Medically unnecessary inductions and elective Cesarean deliveries have also contributed to the increase in preterm births.
In low-income countries, more than 90 percent of infants born younger than 28 weeks will die within a few days. In higher income countries, less than 10 percent of those extremely premature babies will die.
Among the evidence-based solutions were; the use of prenatal steroid injections for mothers in premature labor - which helps the infant's lungs mature and helps prevent breathing problems; the use of Kangaroo care - also called skin-to-skin; and antiseptic cream to prevent birth cord infection and antibiotics to fight infection.
Kangaroo care has been extensively researched and is documented as a safe and effective method of stabilizing fragile infants. Dr. Susan Ludington-Hoe of Case Western University has been a leader in this research.
She has proven that at-risk infants, wearing only a diaper, do better when they are positioned on the mother's bare chest. The infant's heart rate, respirations and temperature are better maintained in skin-to-skin than when placed in the most modern "incubator."
Pregnant moms, whether they choose to breastfeed or not, need to be aware of the dangers of premature birth. Medical necessity should dictate whether an induction or Cesarean delivery is done, not convenience.
No matter how the baby is delivered, our moms need to insist on Kangaroo care - or skin-to-skin - the first one to two hours after delivery.
They need to insist that their baby be kept in the room with them and continue skin-to-skin as often as possible.
Evidence shows that's the best place for baby.
Kathleen L. Miller,
RN, CLC, IBCLC