Introduction
My first child Alvin is 3 now, but if we were to go by corrected age, he should be 2 years and 10 months. Alvin is born at 29 weeks with a birth weight of 1.16 kg at Hospital Ampang, and was discharged from the NICU and subsequently Ward 4A on his 53 DOL, when he's almost 1.8 kg. The cause of Alvin's premature arrival was finally known after my second pregnancy - it's due to cervical incompetence. Thanks to an emergency cerclage done at HUKM during my second pregnancy, Alvin's brother, Aaron was born past the 36th week after the removal of cerclage.
"The Premature Baby Book" is one of the books published under the Sears Parenting Library series, authored by the Sears family. Dr William Sears is an American pediatrician who had appeared on numerous TV talkshows (known as Dr Bill), and had written many parenting books. Dr Robert and Dr James, both pediatricians as well, are Dr Sears' sons. Mrs Martha Sears is a registered nurse and lactation consultant. Authored by a team of experts, you can be assured of accurate information and advices from this book.
Where did I buy the book?
As I seldom walk-in to bookstores in town, I am not sure which bookstore in Malaysia sells this book or whether it is available locally. I bought the book online from Amazon, and was happy that the delivery was quick. It took less than a week for the book to arrive via courier from the US.
Timing factor
By the time I bought the book, Alvin was already close to a year old. It was a late purchase, if only I knew about this book earlier. Although there are plenty of information about premature babies available over the Internet, they are mostly very general.
The Premature Baby Book ("The Book") and some real experience
The book provides an overview of the NICU, the health issues and risks with regard to prem babies, how to introduce breastfeeding to a prem baby, tips on various latching and feeding techniques, exclusive pumping (very useful for moms with non-latching babies e.g. prem babies who receive EBM via tube-feeding in NICU), preparations to bring a prem home, diet and when to introduce solid food to a prem, and so on.
Based on my personal experience, introducing a baby who's already used to tube-feeding requires extra work in the beginning, compared to a newborn who starts drinking milk either directly from the breast or bottle from day 1. Starting off with syringe-feeding at first, followed by a bit of non-nutritive sucking, and then only serious direct latching. Even then, many tiny babies (below 2 kg) are prone to get tired more easily when they only latch directly, resulting in slow weight gain, and even weight loss.
At the time of writing out the review, I do not have the book in front of me. Anyway, let me share what I can recall, have tried based on tips provided by the book (I have failed during the first time, but I tried applying some of them during the second time and it works).
Quite a large part of the book touches on breastfeeding, an area which turns out to be a challenge for many mothers of prems. What is a prem's mom to do in the absence of direct latching cum stimulation from a baby to ensure continuous lactation? Preferably to look for a hospital grade pump, to express milk at short intervals, but short duration - once in every 2-3 hours, max 15 minutes for each side, bearing in mind that pumping for too long may cause soreness.
The main aim of expressing milk here is not primarily to empty the breast, but to ensure that they are sufficiently stimulated, which is important to make sure that lactation does not cease.
The book puts a heavy emphasis on a diet (when it comes to the solid food stage) rich in DHA e.g. oily fish, flaxseed oil, for prems. As extreme/very prem babies tend to be born with immature brains, DHA helps in promoting brain development.
Based on ultrasound scan on the 4DOL, Alvin has no IVH. But immature brain was noted and a repeat scan was scheduled to monitor its growth. Imagine an immature brain as looking like a rugby ball, and a matured brain looking like cauliflower... The last result before discharge noted "grossly normal". I am grateful that Alvin is physically like most of his full-term counterparts. However, in relation to immature brain, it seems to have some effect upon him.
E.g. hypersensitivity towards noises, as a baby he used to suddenly wake up screaming for no reason and his outbursts were very difficult to sooth, certain behavorial issues, and language delay (at the age of 3, his pre-verbal skills are still at a low level). Those who are familiar with such problem may be able to guess what's probably plaguing us here without me sharing the further details.
Do I feed him with oily fish? Yes I did put some salmon into his diet in the past, and he eats sushi sometimes (he loves salmon). Diet, to couple with suitable stimulatory activities. The latter is easier said than done, given the limitation of time at home esp on weekdays. Here, therapies come in crucial, and for the benefit of whoever in the same shoes, perhaps I should share about these one day.
The book provides a precise, comprehensive and useful information/reference for every parent of prem babies from newborn to 1 year of age. It is written in plain English, yet explains the terms commonly used in the NICU, thus making it easy to read, understand, and to relate to what the doctors and nurses tell.
For the second pregnancy, the book again came into picture on my first day at HUKM. My first ward-mate, had PPROM. Her baby girl was 26 weeks when delivered, < 1 kg, and was admitted to the NICU. She works in KL, while her husband, a British, was some 300 km away for work-related matter at the time of delivery, and the latter arrived a few hours later (that place, which I shall not reveal here, to KL is far, about 300 km away).
Thought of giving the book to her, I thus called my husband to bring it to the ward on the next day. But when the book finally came in, I suddenly had to be transferred to the HDU due to threatened preterm labour... ouch, I did not manage in time to pass her the book. From then on until my discharge 2 months later, the book had remained my companion in bed, where I went through it all over again. I felt sorry, I wish I have given her the book, and deep inside I wish her family and her baby all the best.
Conclusion
If you were to ask me whether I would recommend anyone to read this book, I would say yes. It is a good book to have, the earlier the better. Besides parents of prem babies, this book will also be a good read for anyone who takes care of such baby. From what I know so far, this book is available only in English. Nurses in the public health sector, like my mom last time, may find this book of interest (perhaps... but I never had the chance to show my mom this book). Lastly, if you're interested in the book, please feel free to ask and I shall be glad to share it. :)
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