Birth trauma among liveborn infants in Mulago Hospital, Uganda.

In this retrospective review, data is presented of birth trauma seen among 4288 live born infants admitted to the special care unit of a large hospital over a three year period. Hypoxaemic brain injury resulting from birth asphyxia was by far the commonest form of birth trauma in this sample and it was the main cause of death, in many infants. All infants diagnosed as having sustained intracranial haemorrhage died while none of the other types of birth injuries were associated with any deaths. The need is emphasised to handle "high risk" deliveries with extra care while at the same time seeking solutions to the risk factors as well as lifting the overall standard of living of women in the community.

A 12-month lactation clinic experience in Uganda.

A review of case histories of mother-infant pairs who attended a lactation clinic between January and December, 1989 is presented. The results show that the majority of mothers consulting the clinic perceive their lactation problems as 'insufficient breast milk production'. Factors which might have contributed to early lactation failure include: delayed initiation of breast feeding, use of prelacteal feeds, infrequent breast feeds by day and night, and early supplementation. The latter was especially common in this clinic sample: 69.6 per cent of infants were on regular supplementation by 4 months of age. The need is stressed for research into such breast feeding failures, revitalize community-based breast feeding support, as well as assessing the knowledge, attitude, and practices of health workers concerning breast feeding.

Morbidity and mortality in the Special Care Baby Unit of New Mulago Hospital, Kampala.

The morbidity and mortality of admissions to the Special Care Baby Unit at New Mulago Hospital, Kampala are described for 1598 infants seen during the 12-month period of 1989. The overall neonatal mortality rate on the Unit was 18.0%, which has shown only slight improvement during the period 1984-1989. The major causes of death were, in descending order of frequency: birth asphyxia, respiratory distress syndrome, aspiration syndromes, very low birthweight, infection, anaemia and congenital malformations. Birth asphyxia was the most common cause of death in infants weighing over 2500 g while respiratory distress syndrome predominated among deaths below 2500 g. Birth injuries and transient tachypnoea of the newborn were also common reasons for admission. Difficulties of caring for infants requiring special care in a developing country are emphasized. These include inadequate equipment and supplies, poor investigative facilities and scarcity of well trained personnel. The situation is further aggravated by low morale among health workers due to poor working conditions.

Observations on kangaroo baby care.

PIP: The author's visit to "kangaroo care" programs in Guatemala and Colombia has led Uganda's University of Kampala to consider the introduction of this innovation in its neonatal special care unit. Such programs, which place premature infants in direct contact with their mother's skin during breastfeeding, represents a simple, inexpensive strategy for infant survival in developing countries and eliminates the need for mechanical incubators. Research conducted at the Hospital Universitario de Valle in Cali, Colombia, found that falls in the infant's body temperature. In the Latin American programs, premature infants are entered into the breastfeeding program immediately after delivery.^ieng

A 12-month lactation clinic experience in Uganda

A review of case histories of mother-infant pairs who attended a lactation clinic between January and December; 1989 is presented. The results show that the majority of mothers consulting the clinic perceive their lactation problems as 'insufficient breast milk production'. Factors which might have contributed to early lactation failure include: delayed initiation of breast feeding; use of prelacteal feeds; infrequent breast feeds by day and night; and early supplementation. The latter was especially common in this clinic sample: 69.6 per cent of infants were on regular supplementation by 4 months of age. The need is stressed for research into such breast feeding failures; revitalize community-based breast feeding support; as well as assessing the knowledge; attitude; and practices of health workers concerning breast feeding

The Use of Prelacteal Feeds in Uganda:Implications for Diarrhoeal Disease Control in Infancy

For a long time; clinical observation has indicated that many Ugandan Mothers offer artificial feeds to their newly delivered infants in the immediate post partum period; contrary to the recommendation by the World Health organisation. In an attempt to further document the use of these prelacteal feeds survey of 488 mothers was carried out at Mulago and Mbarara University teaching hospitals. Results show that 25.2 percent of mothers in this sample gave prelacteal feeds to their infants; confirming an earlier observation in the Uganda Breastfeeding Situation Analysis of 1991 that either there was no milk flow yet or that the babies were crying too much. The dangers associated with the use of prelacteal feeds are discussed. In conclusion; it is recommended that measures be taken to discourage this harmful practice among mothers delivering in our health facilities. The need is expressed to try and document the extent of prelacteal usage among mothers who deliver outside the formal health sector