August 11, 2018
By Mike Ziemerink
Preemie twins Brian and Theoneste were admitted to the neonatal unit at Rinkwavu Hospital in Rwanda. Their 21-year-old mother Denise arrived from Mukarange village in Kayonza, one hour away by taxi. Born two months early, the boys were prone to feeding difficulties so Denise learned about breastfeeding.
“During the training, participants taught Denise how to hold her babies in good position to promote breastfeeding, even trying a position that allows her to feed both twins at once!” said Dr. Chiquita Palha De Sousa, PIH/IMB Pediatrician.
Denise praised the training, saying she feels more confident in breastfeeding her boys and recommended the training for other mothers. “They can teach others to breastfeed the way I learned,” she said. At the end of the training the twins were ready for discharge and will be followed as outpatients in order to monitor their nutrition, growth and development.
Rinkwavu Hospital is run by Partners in Health (PIH), locally known as Inshuti Mu Buzima. PWRDF supported the two-day breastfeeding training session that taught healthcare workers how to address challenges associated with breastfeeding and provide support to mothers breastfeeding infants prone to difficulties, such as those who are born prematurely and/or with low birth weight, hypoxic brain injury, or cleft lip/palate and may not be alert enough to feed or able to adequately latch or suck. This vulnerable group of infants is at high risk of developing malnutrition in infancy and childhood that has long-term negative consequences on their growth and development.
The PIH-hosted training was conducted by professionals from the UK-based organization MAITS, as well as PIH staff who will continue the training throughout Rwanda.
“Each day consisted of 50% lecture-based content with 50% practical sessions that allowed participants to practice concepts learned and obtain feedback as they worked with mothers whose babies,” said Dr. De Sousa.
Sixty kilometers south at Kirehe District Hospital’s neonatal unit, the importance of breastfeeding and maternal nutrition was evident in the case of Mukandoli Sifa and her twin babies, Gakuru and Gato.
Sifa and her newborn twins were at the hospital during an orientation week for two new nurse mentors. Merab Nyishime, a PIH Maternal and Child Health National Support Manager, entered the neonatal unit with the two mentors in training and approached Sifa and the twins.
“When I got closer, I saw Gakuru had a totally different colour to his brother. He had generalized jaundice, but it had not yet been detected,” said Nyishime.
The only issue regarding the twins that was mentioned during the handover from the nightshift was the twin’s poor nutrition due to insufficient breast milk. It was determined that Sifa had been under-eating while at the hospital.
Together with the new mentors, the head nurse and the doctor at the clinic, Nyishime completed an examination and the doctor ordered phototherapy and additional IV fluids to improve nutrition and treat Gakuru’s jaundice.
Nyishime and the mentors then called the head cook and nutritionist at the hospital in order to show them the effects poor nutrition can have on breastfeeding and infant health. “Together we agreed on the improvement of the quantity and quality of food in the unit,” she said.
Now with the support of PWRDF’s All Mothers and Children Count program, all mothers in neonatal care at the hospital receive an additional meal of porridge and clean drinking water to help support breastfeeding.
– with files from Merab Nyishime and Dr. Chiquita Palha De Sousa