Project PREMIEs (PREserving Mother’s milk and Improving Encephalopathy in Neonates)

As part of our Global Grant and District 3232’s Project Indica (Maternal & Child Health) focus, we partnered with Rotary Club of San Antonio, Texas, USA, in providing essential equipment to set up a Human Milk Bank Unit for the very sick premature babies (premies) of mostly poor parents, a Cerebral Function Monitor (CFM) and a Hi-tech Whole Body Cooling System, to the Neonatal Intensive Care Unit (NICU) of Kanchi Kamakoti Child’s Trust Hospital (KKCTH), Chennai at a total project cost of US$ 60,000.

The grand inauguration of our 14th GG Project (#1862965) took place on Children’s Day, November 14, 2017, at Kanchi Kamakoti Child Trust Hospital (KKCTH), Chennai in presence of over 100 guests.

Chief Guest Shri T N Manoharan, Chairman, Canara Bank lauded the efforts of our club connected with this project and said, “Such humane projects are required to ensure that the poor and the downtrodden get the best neonatal care for their babies.”

Shri Chandramohan, CEO of KKCTH highlighted the long relationship Rotary has with the hospital since it’s foundation days, community services rendered by the hospital and the future vision.

Dr. Rahul Yadav, Head NICU stressed the significance of the project for his unit and it’s positive impact in providing advanced healthcare to very sick preterm babies.

Do you know the first 28 days of life in the neonatal period is the most vulnerable time for a baby’s survival? The worldwide neonatal mortality rate fell by 47 per cent between 1990 and 2015 from 36 to 19 deaths per 1,000 live births. One of the major challenges that Indian healthcare faces is the high neonatal mortality rate. Only five countries account for more than half of the world’ 3.3 million new born deaths – India, Nigeria, Pakistan, China and Congo. India carries the highest share of neonatal deaths in the world and contributes to around 1/4th of these neonatal deaths. Of the 26 million babies born in India, every year one million babies die before the age of one month. These neonatal deaths are usually due to premature births, with adequate antenatal care still not reaching to all, with poor, malnourished mothers giving birth to sick premature babies. They usually need intensive care immediately, otherwise succumb to birth asphyxia, respiratory and other sepsis, respiratory failure and encephalopathy.

It is charitable Trust hospitals like KKCTH that are flooded with “out born babies” from around Tamil Nadu, and provide the low cost/ subsidized to free care to economically backward families wanting to save their babies. The issue is not only that of mortality, but also to bring up ‘strong, healthy and intelligent’ children for the future growth of the community.

The NICU team in KKTCH is the largest NICU in the Chennai region, and is the referral centre for the

sickest neonates from Tamil Nadu, Andhra Pradesh, Goa, Andamans and other parts of South India. NICU sees an admission rate of 1,100 babies on average every year with nearly 600 of them being preterm and 200 babies with prenatal asphyxia. The team analysed its patient data retrospectively and identified an exponential increase in the number of deaths in preterm neonates.

The team assessed and identified probable interventions necessary to improve outcomes in these babies. Most of the preterm babies did not have adequate supply of breast milk in their critical period. This resulted in a vicious cycle of late onset sepsis, necrotizing enterocolitis, malnutrition and prolonged hospital stay. Exclusive breast feeding is the time tested intervention and the strongest measure to reduce neonatal mortality. A human milk bank, having adequate ready stock of breast milk, would address this issue and improve neonatal survival. This would also save the mothers (usually themselves sick and lacking breast milk) from being emotionally and physically drained and not be under pressure to express breast milk. They would also not be vilified by the extended family for not nursing the ‘family’s’ newborn.

Birth asphyxia is the commonest cause of neonatal mortality and severe neurological disabilities, with majority of these babies being comatose or paralyzed at birth. They have severe neurological compromise during early phase of illness. They are at increased risk of having recurrent seizures and multi organ dysfunction. Many of these seizures are not evident in a comatose baby and this requires a cerebral function monitor to identify the seizures. This enables timely treatment of seizures and reduces further neurological impairment. The West has proved that Therapeutic hypothermia administered to these babies, along with Cerebral Function Monitoring, has drastically improved their neurological outcomes. Both of these interventions reduce the manifestations of cerebral palsy.

For the Human Milk bank, we provided world class premium products of Medela Symphony Hospital Grade Double Breast Pumps, Milk Warmers, Pasteuriser, Deep Freezer, Sterliser, Fridges and RO Water Purifier.

Natus Cerebral Function Olympics Brainz Monitor is considered the Gold standard across the globe and the Mennen Medical & MTRE Criticool Whole Body Cooling Therapy equipment is considered to be the best in it’s segment were provided to the NICU unit.

KKCTH is a reputed 38 year old tertiary care Pediatric Hospital in Chennai. CHILDS is an acronym for Children Health Institute, Laboratory and Diagnostic Services. The NICU sees 1,100 admissions on average every year, and is also well-known for its excellent teaching and training, with many well-known Pediatricians in the city having trained there. KKCTH is a recognized center for Diplomate of National Board (DNB) and PhD courses in Neonatology.

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