This podcast series, packed with trusted medical advice and insight, plus real-life stories, is for anyone who is pregnant or has just had a preemie baby, people in their support network, as well as those who would like more information in the event of an earlier than expected arrival.

[00:00:00] Voice Note: My daughter was born four weeks premature and one just generally feels pretty vulnerable and in the dark.

Voice Note: I think [00:01:00] especially having a premature baby where they are just so much, often so much more vulnerable and extra fragile. Um, it can leave you feeling very overwhelmed. And my daughter's five years old now. And I think if I look back at, um, myself back then being a first-time mom, I think I would have, um, had a lot more grace for myself.

Voice Note: We're, we're hard on ourselves because, um, It was so hard, but looking back, um, yeah, I don't think we could have done anything differently, even knowing what we know now.

Voice Note: I've had two pregnancies, a high-risk twin pregnancy and a singleton normal pregnancy. My experience in the NICU was life-changing. I learned so much. The biggest impact for me once we were in the NICU was how kind and educational the nurses were to me and my husband. They taught us how to take care of our baby in these extreme circumstances.

Voice Note: They encouraged us to hold the baby and do things, even though we were scared and nervous and didn't know better. The nurses can make a world of difference in your experience and help support you even though this is not the experience that you or anyone else probably wished for.

[00:01:41] Vanessa Pickford: For many people who plan to have children, they will have imagined holding their newborn baby – glowing and exhilarated after the birth, and excited for everything to come. But, according to global figures, one in ten births is premature.

[00:01:52] Vanessa Pickford: In South Africa, that figure is even higher – one in seven infants is born before 37 weeks, and might need to spend some time in special care before growing strong enough to be delivered into the arms of their families. So the perfect newborn scene we often see in movies isn’t a reality for everyone.                                               

[00:02:15] Vanessa Pickford: But there's hope. Mothers of premature babies still have their own incredible and meaningful birth stories and go on to have happy, healthy children. The Neonatal Critical Care Unit, or NICU as it is more commonly known, is a specialised space at a hospital designed to keep infants safe, warm, well-fed, and under the watchful eye of experts.

[00:02:44] Vanessa Pickford: Welcome to the Health Wrap, powered by Mediclinic Baby. I'm your host, Vanessa Pickford. In this special mini-series, we're focusing on premature births. Every year, on the 17th of November, World Prematurity Day is observed to raise [00:03:00] awareness of preemie births and the interests of preterm babies and their families around the globe.

[00:03:05] Vanessa Pickford: This podcast series, packed with trusted medical advice and insight, plus real-life stories, is for anyone who is pregnant or has just had a preemie baby, people in their support network, as well as those who would like more information in the event of an earlier than expected arrival. Please note that the views shared by any of our guests in this podcast may not necessarily reflect the views of Mediclinic, so please consult a medical professional if you have any concerns.

[00:03:35] Vanessa Pickford: In this episode, we chat with paediatrician and neonatologist Dr Samantha O’Ryan, a specialist at Mediclinic Panorama in Cape Town, where she expertly cares for preterm babies in the NICU, so she knows first-hand what to do and say so the families of her little patients have peace of mind. Welcome, Dr O’Ryan.

[00:03:58] Dr Samantha O’Ryan: Hi Vanessa.

[00:04:00] Vanessa Pickford: Well thank you so much for taking the time to speak with me today. I know that your wisdom will be so useful to the mums of preterm babies as well as their family members and their friends and in fact, anybody who needs more resources on this topic. So first of all can you please define when you would call a baby premature or a preemie?

[00:04:21] Dr Samantha O’Ryan: Sure, so a premature baby, or a preemie baby as we call them often, is any baby that's born below 37 weeks gestation. Right. Um, anything above 37 weeks would be a term baby, so between 37 weeks and 40 weeks. Um, and, well yeah, sometimes pregnancies go beyond 40 weeks, but those would then be post-term or post-date babies.

[00:04:47] Vanessa Pickford: Right. Okay. So essentially, that's any babe born more than three weeks ahead of its due date. Yes. Right. But is there not also some categorising of preterm babies? I mean, [00:05:00] surely a baby of 36 weeks and five days is far less premature than a baby born at say, 24 weeks?

[00:05:06] Dr Samantha O’Ryan: Yes, that is true. Um, those babies that are born between 34 weeks and 36 completed weeks.

[00:05:15] Dr Samantha O’Ryan: Those we call late premature babies, or late preterm infants. And those born between 32 and 34 weeks, we call those moderate preterm babies and those between 28 and 32 weeks would be very premature babies. The ones born before 28 weeks are extremely premature infants.

[00:05:37] Vanessa Pickford: I imagine. I imagine now, you know, there's a lot of anxiety around babies being born premature or preterm.

[00:05:45] Vanessa Pickford: Why is this? You know, why is it so, what I should say is so significant about those last few weeks of development in the womb for a full-term baby?

[00:05:55] Dr Samantha O’Ryan: Yes, so, within those last few weeks, There's a lot of [00:06:00] weight gain that happens. Babies need to increase in size, but that's not all that happens in those last few weeks.

[00:06:06] Dr Samantha O’Ryan: Um, as gestational age increases, there's a lot of maturity that happens still all the way through to the end of pregnancy. Um, and there are loads of processes that still continue in the third trimester. So the maturation process involves every organ system like the lungs, so that babies can breathe and gas exchange can happen at that level.

[00:06:33] Dr Samantha O’Ryan: The brain continues to mature so that when at term, babies are not born with a fragile brain that is easily injured. The kidneys continue to mature so that they can maintain fluid balance as well as other processes and the gastrointestinal tract or the gut needs to mature so that babies can drink their milk and absorb their milk and grow as a result of receiving [00:07:00] nutrition.

[00:07:00] Dr Samantha O’Ryan: But also there's brown fat that still needs to be deposited, um, within those last few weeks. And it's that brown fat that keeps babies warm so that they are able to be in the external environment without the assistance of something like an incubator to keep them warm.

[00:07:22] Vanessa Pickford: Nature's deemed it ideal then for babies to be born as close to their due date as possible.

[00:07:28] Vanessa Pickford: So, what then would be some of the reasons why a baby may be born prematurely?

[00:07:34] Dr Samantha O’Ryan: Yes, so premature delivery can happen either for spontaneous reasons or for medically indicated reasons. And spontaneous events may happen such as a mom just spontaneously going into free-term labour or she may rupture a membrane spontaneously Before labour has actually happened or her cervix may dilate for whatever reason.

[00:07:59] Dr Samantha O’Ryan: [00:08:00] So those are all spontaneous causes of premature delivery but there are medically indicated reasons And those babies might then be born via cesarean section as a planned delivery, or may, we may induce labour in those moms. But there are many, many reasons for delivering prematurely. There are lots of paternal factors that may be a cause, so there may be infection issues, or moms may have, um, And various number of chronic diseases that may result in having to deliver the baby, um, prematurely because of mom's concern for mom's health.

[00:08:40] Dr Samantha O’Ryan: Um, and one of the big things is also pregnancy-induced hypertension. Um, that's one of the big reasons for premature delivery that we see. But there may be infant or fetal-related factors. So, you may have a baby that's just not growing any longer and that might be [00:09:00] running to trouble as a result.

[00:09:02] Dr Samantha O’Ryan: Infection may be one of the reasons in this group as well, but then you may also have babies who have an anomaly or anomalies and the safest thing would be to deliver them early. Um, but you might also have a pregnancy or a multiple fetus type pregnancy, such as twins or triplets and those kinds of pregnancies sometimes come with various complications.

[00:09:29] Vanessa Pickford: Certainly far more reasons than I would have thought of for prematurity. Now we know that once this little one is born, and they're born prem, it doesn't seem that all prem babies go to spend time in the Neonatal Intensive Care Unit, or the NICU as it's often called. Could you please give our listeners some insight as to why a prem baby may need more intensive care and possibly prolonged hospitalisation?

[00:09:57] Dr Samantha O’Ryan: Yes. Well, in our hospital we tend [00:10:00] to admit almost all of the babies that are born before 37 weeks. Uh, sometimes you may find babies who are 36 weeks old that might be able to stay with moms. Um, but the big reason for babies needing to be admitted into the NICU would be that they need the assistance of an incubator.

[00:10:23] Dr Samantha O’Ryan: To keep them warm, essentially, because they aren't able to do that on their own. But they also might need monitoring of all sorts of things, like their heart rate, their blood pressure, their oxygen saturation, and their blood glucose. They might need, the lungs might need support, so they might need the assistance of oxygen, or we might actually, if they aren't breathing adequately, or if their lungs are extremely immature, Then we might actually need to assist with breathing by placing them onto a ventilator.

[00:10:56] Dr Samantha O’Ryan: They might need blood pressure assistance where we would have [00:11:00] to maintain a normal blood pressure with medication. Um, very often, almost all premature infants need feeding assistance. Um, especially the very premature ones definitely cannot feed and maintain their own nutrition. And even in the NICU, we do various things to make sure that they get adequate nutrition.

[00:11:23] Dr Samantha O’Ryan: But they also need, sometimes just need drips for fluids and to maintain hydration. And yeah, so the list goes on, but those are some of the reasons why babies might need the NICU.

[00:11:36] Vanessa Pickford: Gosh, that sounds like very specialized care of a tiny little human, but so are there then particular qualifications and or special skills that the doctors and the NICU staff need to work in this environment?

[00:11:52] Dr Samantha O’Ryan: Yes, I think, um, well, obviously as doctors, we all need to be qualified as paediatricians first, [00:12:00] and then the majority of us working in NICUs are qualified neonatologists. Um, but the nursing staff go through their routine nursing training and then get all of the rest of the experience while working in the NICU.

[00:12:19] Dr Samantha O’Ryan: But I just have to say that you need to be quite, uh, passionate about what you're doing because, um, you need to have a very special interest in these little ones. The work itself is quite stressful. Dealing with the parent's emotions is quite stressful. And you have to be quite level-headed and definitely have some skill at working with tiny, tiny babies who have tiny airways.

[00:12:46] Dr Samantha O’Ryan: It's tiny, with veins and arteries. Everything about them is just minute, and you have to have steady hands that can work with them.

[00:12:54] Vanessa Pickford: Tiny. So, given the type of specialist that you have just [00:13:00] described, it really does sound like the NICU is the best place for a preterm baby. Could you perhaps give us some insight into what a day in the life of a NICU baby may look like?

[00:13:10] Vanessa Pickford: As in, are there important procedures done there on a daily basis?

[00:13:16] Dr Samantha O’Ryan: Yes. Um, so from the time of their birth, our initial aim is to assess whether they need resuscitation. So assess whether they are able to breathe on their own or not. The majority of prem babies, especially the smaller ones, have the ability to breathe on their own but need the assistance of machines that constantly give them oxygen with a bit of pressure to keep their lungs open.

[00:13:45] Dr Samantha O’Ryan: Um, and so, that sort of care is ongoing until their lungs mature enough for them to breathe. Um, they, they leave the theatre in an incubator and we continue to care for them in an incubator throughout their stay in the [00:14:00] NICU until they are big enough to maintain their own temperatures. Once in the NICU, they get all sorts of drips put up for them to run intravenous fluids, to give them antibiotics if they need them.

[00:14:13] Dr Samantha O’Ryan: They've got sterile lines that we place so that we can run, um, intravenous nutrition into them. We, um, constantly care for them in the incubator with their drips running, on their oxygen, uh, maintain warmth, and watch their skin, actually, as well, all the time, because their skin is quite fragile, and so skin care is one of the very important things.

[00:14:39] Dr Samantha O’Ryan: So that's what a NICU baby looks like, in an incubator, with oxygen support, maybe on a ventilator. with lots of leads on the chest, monitoring everything, um, with drips going everywhere, arterial lines going everywhere, um, and sometimes the actual baby itself is barely visible.

[00:14:59] Vanessa Pickford: So, whilst all of this is going on, and that little preemie is receiving the best care possible to help them grow and develop, what should the parents be doing whilst their baby is in the NICU?

[00:15:12] Dr Samantha O’Ryan: Yes, it can be a very, uh, scary experience for parents sometimes but we encourage our moms and dads to be present and to visit often and to touch your baby, hold the baby's hand, talk constantly to your baby. Mom, the thing that's very important with moms is that we need them to provide breast milk from the beginning and we assist with that and we encourage that but we also make sure that we don't make moms very anxious about providing breast milk. It's also very important for parents to have a very healthy relationship with all of [00:16:00] the NICU staff.

[00:16:02] Dr Samantha O’Ryan: We have to have, we have to understand each other when we talk to each other. Parents need to feel comfortable enough to ask all the questions that they have and so yes, we try and make the NICU as comfortable for them as possible. But yes, we understand that it's extremely scary.

[00:16:23] Vanessa Pickford: You've painted the picture of quite a tethered little baby with lots of monitors and drips and various other devices that are monitoring their well-being.

[00:16:33] Vanessa Pickford: And then mums and dads who are sort of standing by and trying to get a little bit of time with this new one. You know, I imagine asking a question that many mums would have front of mind is, at what stage do they get to hold their baby? Is there criteria for that?

[00:16:48] Dr Samantha O’Ryan: We try and get moms to hold their babies as soon as possible, but sometimes it's very difficult if the baby is [00:17:00] attached to lots of machines and to lots of monitors.

[00:17:05] Dr Samantha O’Ryan: There's no set time for when you are allowed to hold your baby. As soon as we are able to disconnect some things or do away with some drips. Even if your baby is on a ventilator or an oxygen machine like CPAP, you are definitely able to hold your baby as long as your baby is stable.

[00:17:31] Vanessa Pickford: Right, I'm sure that's a very special moment for every parent.

[00:17:35] Vanessa Pickford: You've mentioned yourself that often premature births are unexpected. So, after all, no parent wishes for their baby to be born premature so, given your experience... Do you possibly have some advice about how parents can prepare emotionally, practically and financially in the event of a preemie baby?

[00:17:57] Dr Samantha O’Ryan: That's a tricky question because I don't think that any parent wants to be thinking along those lines. I mean, you know, no pregnant mom wants to consider the possibility of a baby being admitted to a neonatal ICU. Um, but I think the most important thing is for moms to be as healthy as possible during the pregnancy and so constantly think about, um, what medication you are taking, you know, am I smoking? Am I taking in any sort of alcohol or any other illicit substances?

[00:18:41] Dr Samantha O’Ryan: You know, that's just from the medical point of view, but also It's very important for moms to just, along with staying healthy, to just enjoy the pregnancy as well and not to be anxious about it and don't overly prepare for the possibility of a NICU admission. Um, [00:19:00] When being practical, NICU might be a possibility.

[00:19:06] Dr Samantha O’Ryan: Make sure that you won't be under financial stress if I can say it that way because a NICU admission on its own is stressful so be sure that you've checked on your medical aid, that you know where admission is allowed, that you know what your plan covers and what they don't, and what service providers they allow and what they don't.

[00:19:30] Dr Samantha O’Ryan: But more than that, I don't think you can prepare more than that.

[00:19:33] Vanessa Pickford: Yeah, but good sound advice. We’ll be back with Dr O’Ryan shortly, but for now, I wanted to remind you about the Mediclinic 24/7 Helpline. You can call the number +27 86 023 3333. The 24/7 Helpline is no longer only for medical enquiries, but can even go as far as assisting you with making a booking for the doctor.

[00:20:01] Vanessa Pickford: So, now we've covered some of the more foundational facts of premature birth. I hope that you can share your experience once again in looking ahead to the future. So, my first question in this regard is probably the one that you were asked by every parent whose baby spends time in the NICU. How do you know when a baby is ready to be discharged or graduated from the NICU into the care of their parents?

[00:20:29] Dr Samantha O’Ryan: Yes, we get asked that question by every single parent and usually within the first three days. I have no doubt. But, um, basically you want a baby to be safe. Um, and so that means outgrowing the prematurity dangers and so, you need to have a baby who's not relying on heat from an incubator any longer.

[00:20:57] Dr Samantha O’Ryan: The baby shouldn't be [00:21:00] relying on, uh, feeding assistance from us via a feeding tube. You should have a baby who's able to breastfeed adequately, or bottle feed adequately, without any assistance. Um, what we also do is we, very often use, um, central nervous system stimulants in these babies as a reminder for them to breathe.

[00:21:24] Dr Samantha O’Ryan: And so before going home, those babies shouldn't be relying on those sort of nervous system stimulants any longer. And they should be growing on and gaining weight on whatever the mom's feeding choice is. They shouldn't have any medical problems. Yes, sometimes babies are discharged with chronic issues, but they shouldn't have any problematic medical issues that would put them in danger at home.

[00:21:53] Dr Samantha O’Ryan: And one big thing also is jaundice happens very often in premature babies and so when we discharge [00:22:00] them, we need to be absolutely sure that jaundice is not going to rebound again and they don't need phototherapy lights to treat the jaundice any longer. So those are just a few, um, points that we tick off when we decide on discharging a baby.

[00:22:16] Vanessa Pickford: So if the baby has then met those milestones and is now deemed ready for discharge, I mean, what a spectacular day that must be. Will that then mean that the baby will be just like any other term infant? Or are there special care requirements that need to continue in the home environment?

[00:22:33] Dr Samantha O’Ryan: Yes, the majority of babies when they get discharged, can be treated as any other term, infant, yes.

[00:22:41] Dr Samantha O’Ryan: And moms then follow the basic newborn care, and they make sure that they practice safe sleep, and they take their babies in for routine paediatric checkups, yes. Which may happen more frequently just because the baby's been a premature infant. But some babies get [00:23:00] discharged with, um, more requirements. So sometimes we just, we discharge babies on oxygen, and sometimes we discharge babies, um, with feeding tubes because they aren't able to feed unaided.

[00:23:16] Dr Samantha O’Ryan: And so sometimes those babies need at-home nursing assistance. That happens sometimes. But then you might also get babies who, um, have, where they have a neurological impairment and, um, have significant motor dysfunction or other issues and they might need constant watching by a physiotherapist. Um, so, yes, unfortunately sometimes some babies have various needs.

[00:23:46] Dr Samantha O’Ryan: Some babies need at-home nursing assistance. They need their physiotherapist, they need their speech therapist, um, and maybe even their occupational therapist as well.

[00:23:56] Vanessa Pickford: But, certainly those support structures are then available to them, [00:24:00] I would assume.

[00:24:01] Dr Samantha O’Ryan: Yes, so we, we always discharge babies with a plan.

[00:24:05] Dr Samantha O’Ryan: And they are always discharged knowing who, what their team consists of. Their paediatrician, their speech therapist, their physiotherapist, etc.

[00:24:15] Vanessa Pickford: So fortunately, and most certainly from what you've described, the medical care of preterm infants is better than ever. So can you share some recent improvements from possibly growing research to advancements in tech that parents of preterm infants can look forward to if ever they happen to find themselves in the NICU?

[00:24:39] Dr Samantha O’Ryan: Yes, I think big, um, research, um, many of the positive things that have come out of research recently, um, have been basic things like giving moms, steroids before delivery if we are [00:25:00] expecting a premature or preterm delivery. And something that basic results in a reduced mortality rate and reduction of some of the complications or morbidities that may happen in a preterm infant.

[00:25:18] Dr Samantha O’Ryan: Um, but there is ongoing research in terms of neonatal resuscitation as well and those guidelines are updated frequently, and sometimes there are minor changes to resuscitation guidelines, resulting in a big difference. Um, but the other big, the other big, uh, area of development is how we ventilate these tiny babies.

[00:25:49] Dr Samantha O’Ryan: So, the CPAP machine has made a huge difference to survival, and it has resulted in less lung [00:26:00] trauma that might happen as a result of ventilating with a mechanical ventilator. Um, and in that area, there's lots of development, ongoing research regarding how to ventilate, um, our little ones.

[00:26:16] Vanessa Pickford: Doctor, thank you for that explanation.

[00:26:17] Vanessa Pickford: You've, you've used the term CPAP. Would you mind taking a moment to explain to our listeners what that actually means?

[00:26:25] Dr Samantha O’Ryan: Oh, yes. Sorry. It's a machine that connects via a mask around the baby's, um, nose and it gives, it administers continuous positive airway pressure while the baby.

[00:26:45] Dr Samantha O’Ryan: breathes on his own or on her own. Um, and so literally we are only supporting premature lungs that want to essentially collapse down, um, and that [00:27:00] impacts gas exchange. But otherwise, the baby is strong enough to have adequate respiration. We only really need to go beyond that and intubate and put the baby onto a ventilator, or what most people, um, would know as a life support machine.

[00:27:21] Dr Samantha O’Ryan: We only need to use that if the lungs, if the CPAP machine is not enough to support those very premature lungs, or if the baby doesn't have an adequate respiratory drive, or isn't able to work hard enough at breathing.

[00:27:39] Vanessa Pickford: Doctor, thank you so much for that, that clear and understandable explanation. Now, despite these wonderful advances, having a preterm baby is jolly scary.

[00:27:51] Vanessa Pickford: Can you please share some inspiring true life story of a preemie birth from your experience, someone you've [00:28:00] cared for that, can reassure our listeners?

[00:28:04] Dr Samantha O’Ryan: Yes, I, we've got a very big unit and we've got very tiny ones. Um, all the time, actually. And so every story has a real impact. Um, we see many miracles on a daily basis.

[00:28:21] Dr Samantha O’Ryan: Um, but we've had a few babies who were born weighing, um, below 500 grams. Some of them have been born in our hospital and I can very clearly remember one that was born outside of our hospital but at a hospital that doesn't have a NICU that's equipped, um, to look after such a tiny baby, and at the time of delivery, um, the mom was counselled on her baby having a very poor prognosis and, um, and was told that [00:29:00] this little one would not survive, which was extremely understandable.

[00:29:04] Dr Samantha O’Ryan: This was an extremely premature baby, but this baby clearly had other plans. And I received a phone call because I was on call for our unit that we, there was a baby weighing, um, below, well at 500 grams, actually, who they had thought wouldn't make it, but was still alive and was very vigorous and breathing unaided.

[00:29:29] Dr Samantha O’Ryan: And this was a good couple of hours after birth and could we please give this little one a chance? We accepted her and ventilated her for a very long time, and we also weren't sure about her prognosis But after many, many, many weeks, she was discharged. As a very Healthy baby, absolutely nothing wrong and he's still absolutely fine today.

[00:29:53] Dr Samantha O’Ryan: So we have lots of those stories, actually. Gosh, that is

[00:29:57] Vanessa Pickford: extraordinary. 500 grams is, is like a [00:30:00] block of butter. Yes. Absolutely tiny, but, but very, very encouraging. So thank you for sharing that. Now, I imagine that many of our listeners are still pregnant and no parent wants their babe to spend their first few days or, weeks or even months on this earth in the NICU.

[00:30:19] Vanessa Pickford: Is there anything that expectant mothers can do to improve their chances of a healthy full-term delivery?

[00:30:28] Dr Samantha O’Ryan: Yes, I think that moms, that process needs to start before the pregnancy itself. So if it's, if moms or women know that they intend to fall pregnant, then they should already be on, uh, their pre-pregnancy supplements and vitamins and folate.

[00:30:53] Dr Samantha O’Ryan: Um, and bad habits should stop. So, no smoking during pregnancy, no alcohol [00:31:00] during pregnancy. Moms should be very mindful of what medication they take and always check if it's safe to take during pregnancy or not and they should see their gynae as early as possible and have that first ultrasound done very early.

[00:31:19] Dr Samantha O’Ryan: And just manage their chronic illnesses well. I think that's, that's probably more than that moms can’t do.

[00:31:26] Vanessa Pickford: Right, but that is practical and worthwhile advice, so thank you. Now before we end our time together, is there anything else important that you'd like to mention that I perhaps haven't thought to ask you?

[00:31:42] Dr Samantha O’Ryan: Maybe just that, you know, we've spoken a lot about what happens within the NICU and, um, what we do to get babies to survive, um, and I think that, um, we usually have [00:32:00] very good outcomes, um, but I think that sometimes we just have to be mindful of the fact that we strive for survival quite often, but we forget about, we shouldn't, or I should say we shouldn't forget about it.

[00:32:14] Dr Samantha O’Ryan: The morbidities that come along with very prem, um, babies, uh, sometimes, sometimes and we should always be mindful of their quality of life. And as a parent, the NICU journey is a long and winding road and it's probably quite emotionally traumatic and tough. But in the majority of cases, it's absolutely rewarding at the end of the day.

[00:32:47] Vanessa Pickford: That's wonderful. Wonderful. It's been so valuable spending time with you, Dr. O’Ryan. I hope that this episode leaves our listeners more informed and empowered in the event of a premature baby, knowing that their lives are [00:33:00] truly in the very best of hands. So thank you very much for your time today.

[00:33:05] Dr Samantha O’Ryan: Thank you.

[00:33:05] Vanessa Pickford: Let's turn to some more true life stories from our Mediclinic community.

[00:33:11] Voice Note: I was very fortunate to have a very easy, um, healthy pregnancy, um, with no problems or complications. I attended my first antenatal class and I suddenly thought that maybe it was my water that was starting to leak and I was a bit concerned.

[00:33:31] Voice Note: So on my way to work I stopped at the gynae and upon his visit he said that I needed to go straight into hospital so I didn't even go home and I was meant to lie in hospital so that my baby could develop further and just to protect the pregnancy but the following day she was born at 25 weeks weighing just [00:34:00] 830 grams and it was a tough journey.

[00:34:03] Voice Note: We spent three months in the hospital where she also got the RS virus. Today, I am very excited to say that she is almost 16 and, Sarah Lee was very blessed never to suffer any problems. She can see, she can hear. She is really an example of a miracle micro preemie.

[00:34:30] Vanessa Pickford: If you have any questions about preterm birth, remember that there are many resources available to help you, including specialists, forums, and support groups.

[00:34:41] Vanessa Pickford: If you have a question you’d like us to cover, please email your suggestions to We'd love to hear from you. Thank you again to Dr O’Ryan for being with me today. And to all of you who joined me, Vanessa Pickford, in listening to this episode of The Health Wrap podcast, powered by Mediclinic Baby. If you haven’t yet done so, please consider subscribing to our podcast channel, and look out for our weekly newsletters.

[00:35:10] Vanessa Pickford: You can also download the Mediclinic Baby app for everything a soon-to-be parent needs before, during, and after pregnancy.