Working on the neonatal unit, I’d worked out by now that if a student nurse came into the ward and stood respectfully just over the threshold, with a bundle of rags in their arms, that there may be a newborn baby in that bundle. And they may or may not be breathing. And if you looked closely at the student nurse they normally looked pretty terrified.

 

In this case Baby N was trying to breathe very very hard, his whole little body doing massive gasping movements with each breath. He’d been born at 27 weeks gestation (around 3 months premature) on the gynae ward, and the student had run with him across the whole hospital site to bring him to us. We resuscitated him and stabilised him, and put him into an incubator on oxygen. He was breathing about 100 times a minute and his oxygen levels were really low despite the oxygen we were giving, so I didn’t feel too hopeful about his chances when I left the ward. But every day he was still there - his breathing getting worse and worse initially, then after about a week he slowly slowly started to improve.

 

He had the typical lung disease that premature babies get – Respiratory Distress Syndrome – and his parents were desperate to do anything to help him. His dad asked me about transferring to Kampala, but I didn’t think he’d survive the journey without oxygen, and even when he got there I didn’t think they could do much more than us. The medicine he really needed, Surfactant, costs hundreds of pounds for a tiny vial and you can’t get it in Uganda, so instead we just had to wait. As he got bigger and his lungs grew, he didn’t have to work so hard fighting for every breath. Every time I said to the parents – just try and be patient, he has a good chance, he’s done so well and every day his lungs grow is one day closer to not needing oxygen. I think his dad stopped believing me after about 2 weeks when Baby N was still going blue on and off (especially with power cuts – those darn power cuts...). But his mum had a quiet patience and determination and one day she said to me – I think he’s improving now. And she was right. After 6 weeks on the neonatal unit he was well enough to be discharged off oxygen, weighing over 2kg. His little chest still heaved whenever he breastfed, but he was growing and every day he got a little bit better. We discharged him from follow up when he weighed 3kg, both parents having proudly brought him to clinic to show off that he was now looking around and smiling.