A paediatrician in Guinea-Bissau: Treating Baby Aua

Mårten is a paediatrician from Sweden, currently working for MSF in Guinea-Bissau. He blogs about how the team rallied around a tiny baby who was born too early...

The little girl, later named Aua, was born too early. Exactly how early we don’t know, because her mother Fatumata had no checkups during pregnancy and no ultrasound was done, which is not unusual for the newborn babies we see in our department. Given the silkiness of her hair, the smooth soles of her feet, her ears without cartilage and a weight of only 980g (about two pounds), we estimated her age at about week 28-32 of pregnancy – around seven to eleven weeks early.


When a baby is born so early, and so tiny, there’s a high risk of mortality

When a baby is born so early, and so tiny, there’s a high risk of mortality. Complications resulting from premature birth are the most common reason for the death of children under five years old. The lungs are not fully developed and are incapable of essential gas exchanges. The nervous system is not mature, which can lead to spontaneous respiratory arrest. The skin is thin, and the fat reserves are small, so it is difficult for the baby to maintain a correct body temperature. The liver has very limited sugar reserves and blood sugar levels are unstable, which can be life-threatening. Even the immune system is undeveloped, so there is a high risk of contracting a serious infection. In Bafatá, unlike in Sweden, there are no technological resources like respirators to help a patient breathe. Many premature babies die in respiratory distress here.

Aua survived everything that came her way

Aua, though, survived everything that came her way. We helped her with oxygen when she had difficulty breathing. She was given caffeine to reduce breathing irregularities. She received antibiotics to fight fever and blood poisoning, and extra glucose when her blood sugar was low. She stayed tightly wrapped against her mother’s skin, enabling her body temperature to stabilize. At the beginning she didn’t have the reflexes to be able to breastfeed, but with the help of a probe to the stomach she absorbed her mother’s nutritious milk and day by day, gram by gram, she grew bigger and stronger.
She reached the magic weight of 1500g after six weeks of fighting for her life. Her body had finally begun to acclimatize to life outside the womb to the extent that she could feed herself from her mother’s breast and was gaining weight. She then went home with her mother and the rest of the family.
When Aua came to visit us one month after returning home, she had gained one kilo and was almost as big as a fully-grown newborn baby. Seeing her like that was one of the times that makes it worth going to work every day.