Saving the babies who are born too early

Kangaroo Mother Care, which is simply skin-to-skin contact between parent and child, can help to regulate the baby's temperature, reduce the risk of infection and strengthen the bond between parent and child. — Photos: Dr NAVEEN NAIR GANGADARAN

At 2am, the hospital corridors are still.

While the city sleeps, the neonatal intensive care unit (NICU) glows with purpose.

“Doctor, the triplets are coming, 26 weeks.”

Within minutes, the theatre stirs to life – incubators warming, ventilators humming, resuscitation bags ready.

The first cry comes – faint and fragile, yet enough to make hearts lift.

Then another.

And another.

Relief floods the room until a nurse gasps: “Doctor... there’s another one.”

A hidden sibling; a quadruplet.

For a heartbeat, everyone freezes.

Then instinct takes over.

Amid the beeps and whispered prayers, resuscitation of the fourth baby begins immediately.

Against the odds, four premature lives take their first breaths.

By sunrise, the team stands in quiet exhaustion.

The babies – each smaller than a water bottle – lie in a cocoon of warmth and wires.

It isn’t just another night on call; it’s a reminder that in neonatology, miracles happen every day.

Young fighters

Prematurity is defined as birth before 37 completed weeks of gestation (or pregnancy).

Delivered prematurely at 30 weeks gestation with very low birth weight, this two-week-old is currently still in the hospital and will only be allowed to go home after gaining enough weight to hit the scales at 1.8kg, among other factors.

With advances in healthcare and technology, even babies born as early as 24 to 25 weeks – once considered unsavable – now have a fighting chance at survival, thanks to modern neonatal intensive care.

In Malaysia, the rate of premature births is about 12-13%.

Common causes of prematurity include maternal infections, multiple pregnancies, pre-eclampsia, premature rupture of membranes, and chronic conditions such as diabetes or hypertension (high blood pressure).

In many cases, however, the cause remains unknown – a reminder that despite all our progress, nature still holds mysteries that medicine has yet to unravel.

For these preemies, life begins not in a cradle, but in an incubator, where every breath is a battle and every gramme gained is a victory.

Their challenges are immense: immature lungs, fragile hearts, infections that lurk in the shadows, etc.

Yet somehow, they endure.

The premature baby doesn’t choose the timing of their birth, but from the moment they arrive, their story becomes one of pure courage.

Dedicated professionals

Behind every tiny survivor stands a team of unsung heroes: obstetricians who fight to delay labour, neonatal nurses who care for these little ones like their own, and paediatricians and neonatologists who measure success not in numbers, but in the lives they save.

From the outside, the NICU looks calm: softly lit rooms, blinking monitors and sleeping babies.

But for those who work within, every beep carries the weight of possibility.

Nurses whisper encouragements and stay beyond their shifts because a baby’s oxygen levels are dropping.

Doctors make split-second decisions that balance science and instinct.

Not all victories are visible.

Some days, the alarms don’t stop. Some nights, a life slips away despite every effort.

The loss is quiet and personal, but before grief can take hold, another baby needs saving.

It’s a rhythm of resilience and compassion that few outside the NICU ever see.

Courageous parents

For parents, the first meeting isn’t a warm cuddle in their arms, but through the transparent wall of an incubator.

The younger of twins who were delivered prematurely at 28 weeks, this baby, who was six weeks old in this photo, had to stay in the hospital for four months before being allowed to go home. The delivery was so unexpected that the mother, who is a doctor, had to drive herself while in labour to the hospital as her husband was outstation at the time.

They count tubes instead of fingers, and learn to read monitors before lullabies.

Yet, their courage is extraordinary.

Many practise Kangaroo Mother Care, i.e. skin-to-skin contact that regulates temperature, reduces infection and strengthens the bond between parent and child.

Beyond the science, it’s a love story – the warmth of a parent becoming the first medicine their baby receives.

ALSO READ: Skin-to-skin a must for newborns

When breathing steadies, feeding strengthens and weight gain is steady, the day finally comes: homecoming.

Parents walk out of the hospital carrying not just a child, but a miracle.

The journey, however, doesn’t end there.

Many preemies require follow-up visits, physiotherapy or developmental assessments.

Some take longer to crawl or walk, but their determination outpaces the odds.

Behind every milestone stands a multidisciplinary team – physiotherapists, occupational therapists, dietitians, audiologists – all working hand in hand to ensure healthy growth and development.

Children once no bigger than a palm now run, laugh and dream freely.

Preventing prematurity

Prematurity remains one of the leading causes of death among children under five years of age.

Yet, so many cases are preventable with proper antenatal care, infection control and timely access to neonatal facilities.

Every expectant mother needs and deserves regular check-ups.

Every high-risk pregnancy should be managed near a hospital with NICU support.

Communities must understand that early detection saves lives.

Simple acts – quitting smoking, managing stress, attending antenatal classes – can change outcomes dramatically.

World Prematurity Day – previously observed on Nov 17, but marked on Nov 15 from this year (2025) on – is more than a date on the calendar.

It is a call to awareness for policymakers, parents and the public to strengthen the ­safety net for our smallest ­citizens.

Visit a NICU tonight and you’ll find a team still wide awake, adjusting drips, soothing cries and watching over lives no bigger than your hand.

They don’t seek praise or headlines.

Their reward is the sound of a steady heartbeat and a parent’s whisper of “Thank you”.

We often celebrate the babies, and we should.

But behind every tiny survivor is an invisible “village” – people who trade their sleep for ­purpose, fear for faith, and exhaustion for love.

As we celebrate World Prematurity Day 2025 under the theme “Healthy Beginnings, Hopeful Futures”, let’s remember the little fighters who began their journey before time – and the hands that carried them through.

Every preemie is not just a patient.

They are proof that courage can be measured in grammes, love can be felt through glass, and hope can sound like the rhythmic beep of a monitor.

We might call them premature, but ­perhaps, they’re simply brave enough to begin early.

Dr Naveen Nair Gangadaran is a paediatrician at Hospital Tuanku Ja’afar, Seremban, and council member of the Perinatal Society Malaysia and Malaysian Paediatric Association respectively. For more information, email [e-mail]. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.