Dr. Muhammad Mahtab Hossain Mazed

November 17 (Sunday) is World Premature Newborn Day 2024. Bangladesh is one of the countries in the world where the most number of children die from premature birth complicationsAccording to the Department of Health, 1 out of every 5 newborns in Bangladesh die from premature birth complications. Immature and low birth weight babies are advised to ensure kangaroo mother care to avoid the risk of neonatal death.
About 600,000 children are born prematurely or prematurely in Bangladesh every yearAbout 1.5 million premature babies are born worldwide every year. One in ten babies are born prematurelyGlobally, preterm birth is the leading cause of death in children under 5 years of age and approximately 1 million children die each year due to premature birth aloneis doneIt is said about prematurity, currently 31 deaths per thousand children under 5 years of age occur in the country. 20 per thousand newborns die. In addition, 5 lakh 73 thousand premature or immature children are born in Bangladesh every year. Which is 19.1 percent of the total number of children born. 22 percent of these premature and low birth weight babies die under 5 years.

In order to prevent child mortality, it is said that if Bangladesh is to achieve the SDGs by 2030, the current under-5-year-old child mortality should be reduced from 31 to 25 per thousand, and newborn mortality from 20 to 12 per thousand. Some measures should be taken to reduce this premature mortality rate.

> What does premature baby mean?
Before knowing about the day let's know a little about who the day is for. First of all, who are premature babies? This can be explained in two ways:

All babies born before 37 weeks are called premature babies.

Also, if a baby is born 3 weeks or more before the EDD or Expected Delivery Date, it is also called premature.

> Prematurity Day and its history
Worldwide, every year November 17th is observed as World Prematurity Day or World Prematurity Day.

The European Foundation for Newborn Care (EFCNI) and partner European parent organizations first took the initiative to celebrate this day in 2008. This day is specially chosen, because on this day a founding member of EFCNI became the father of a daughter who was pre-maturityHe lost his child due to related complications.World Prematurity Day has been observed on 17th November every year since 2011 mainly to create awareness about the issue of prematurity and to create solidarity among families with prematurity babies.

> Why is the day so important?
Although the day was celebrated only 13 years ago, it is now celebrated in more than 60 countries around the world. Every year more new countries are added to this list. So naturally the question may arise as to why the day is so important.

The first reason is that the birth rate of premature babies is increasing day by day. The number of premature babies is increasing alarmingly in many countries of the world including America. Some of these babies are born by caesarean section. In this case, cesarean section is done ahead of time according to the decision of all the family including parents Lately, this type of caesarean section is becoming common in Bangladesh. The baby is being delivered two to one weeks before the expected date. Outcome, prematurity and related complications. A baby is usually born between 38 and 42 weeks. If born before 38 weeks and weighs less than 1,500 grams, it is called premature.

Around 34 to 37 weeks, the baby is called a late preterm baby. In this case, post-natal complications are relatively less. But if the baby is born before 32 weeks or earlier, there are many problems related to heart, lungs, brain and vision. Many may have problems like learning disability, hearing loss.

In the developed world there are precedents of saving micro preemie babies at 25 or 26 weeks But many third world countries including Bangladesh do not have this facility. Even if there is no capital or two big cities of the country, there is no necessary equipment and skilled manpower to provide 'primary care' to immature children.

> Screening
ROP is not present at birth. The disease occurs within 3 to 4 weeks due to prematurity only. For this reason, it is best if ROP screening is done within 3 to 4 weeks. Because it grows so fast that a little delay can cause damage to childrenRemember, newborns born before 35 weeks and weighing less than 2,000 grams must have their retinas examined within 30 days, and newborns born before 28 weeks and weighing less than 1,200 grams must have their retinas examined within 20 days.

> Why are premature babies born?
The exact cause of preterm birth is not known. But it has some risk factors-

* Diabetes * Maternal High Blood Pressure * Multiple Pregnancy * Vaginal Infection * Smoking * Stress etc.

Premature birth can also occur due to maternal poverty, malnutrition, alcoholism, structural abnormalities of the uterus, UTI or urinary tract infection.

Various placental problems such as placenta previa and placental abruption can also lead to preterm birth.

> What are the possible health complications of premature babies?

Babies born before 37 weeks can have various health complications. For example :_* Difficulty breathing * Low weight * Uncontrolled body temperature * Baby not being able to breastfeed * Seizures * Pale or yellowish skin * Heart failure * Dehydration
* Retinopathy of prematurity can also lead to various life-threatening problems including brain hemorrhage or bleeding in the brain, pulmonary hemorrhage or bleeding in the lungs, hypoglycemia or excessively low blood sugar, pneumonia, anemia, respiratory distress syndrome (RDS).

> How can premature birth be prevented?
Prevention of complications from neonatal death and premature birth begins with a mother having a healthy pregnancy.

* Primary care

Various risk factors such as diabetes, infection, pre-eclampsia, diarrhoea, anemia, low BMI, these problems should be controlled in advance by expectant mothers.

* Secondary care

Regular screening test of the mother should be done. So that if there is a problem, it is detected earlier and action can be taken accordingly. Sometimes it is possible to reduce uterine contractility by using tocolytic agents. Thus using tocolytics can wait 3 days or more.

* Tertiary care

Corticosteroids are often given to the pregnant baby for lung maturity. This reduces the risk of respiratory distress and inter ventricular haemorrhage.

> How to make people aware about World Prematurity Day
There is still not much discussion about this day in Bangladesh. However, many hospitals, NGOs and health organizations in the country organize various events, campaigns and seminars to celebrate the day in a special way.

> Homeosolution:- Premature neonates
Homeopathy is an advanced and reliable treatment method for children's problems. A proper homeo treatment can bring about permanent changes in such children in most cases. But for this it is necessary to take treatment under the advice of an experienced homeo doctor otherwise it is difficult to expect good results. In this case, homeopaths do not treat only superficially because behind it there is genetic material of PTS, PRS and incurable diseases inherited from parents or ancestors. Therefore, in this case, the current condition of the child, parents, grandparents, i.e. family history, the genetic condition of the child should be analyzed and the treatment should be started. Then by following certain rules and following the principles of homeopathy, the child continues to improve day by day and a permanent change is observed which is not possible in any other medicine except homeopathyTherefore, the success of homeopathy in the treatment of immature children and the hassle-free treatment method is gradually increasing the confidence of the patients towards this treatmentDoctors with experience in immature children select medicines based on symptoms in the early stages, taking into account the 'miasm' of the patient Thuja, Medorinum, Syphilinum, Tuberculinum, Sorinum, Sulphur, Calcarea carb, Calcarea phos, Calcarea flor, Causticum, Belladonna, Bryonia. , Marxl,Medicines like natram-mur, natram-sulph etc. are used.So instead of self-medicating, it is better to seek treatment from a doctor who has experience in treating immature children.

Finally, immature children have to struggle not only physically but also mentally. Along with them, all the family members also have to join the battle of life. Even if there is no lack of love, sometimes parents don't know what to do. The mountain of challenges combined with home care, social restrictions, extra expenses, neglect etc. makes it difficult for the family to survive.
There are linguistic limitations, and physical disabilities make this life struggle very difficult for the innocent children. But with the collective efforts of all, compassion, modern environmental systems, improved mentality, etc., even immature newborns can return to normal life, and even conquer the world.

The writer is a, physician and columnist Founder and Chairman, Jatiya Rogi Kallyan Society