November is Prematurity Awareness Month. I have been “profiling” special babies who beat the odds of prematurity and are still fighting to develop each day!! It is very important for everyone to know that all babies who are born early don’t all develop the same. Every baby is very much their own person with their own fighting spirit .
The BBC is reporting that babies born at or before 22 weeks should not be resuscitated or given intensive care.
The recommendation is being put forward by the Nuffield Council on Bioethics, which considers ethical questions raised by advances in medical research.
For those born after 23 weeks, the recommendation is that doctors should review the situation with the parents and take their wishes into account.
But doctors warned no two babies born at 22 or 23 weeks would be the same.
The report has been released after two years of research.
It also gives guidance on how parents should resolve arguments with doctors over the fate of their babies.
The report comes against a backdrop of medical advances which have been able to sustain the lives of very premature babies.
However, research shows that many of these babies do not live very long, or go on to develop severe disability.
Part of the problem is that despite advances in modern medicine, it is not always obvious to doctors which babies will survive and thrive.
Professor Margaret Brazier, who chaired the committee that produced the guidelines, said: “Natural instincts are to try to save all babies, even if the baby’s chances of survival are low.
“However, we don’t think it is always right to put a baby through the stress and pain of invasive treatment if the baby is unlikely to get any better and death is inevitable.”
About 300 babies are born in the UK each year at 23 weeks.
They have a 17% survival rate, compared with 50% for those born at 25 weeks.
Figures suggest that no baby survives at 21 weeks, while only 1% survive to leave hospital at 22 weeks.
“We strongly endorse the recommendation that assessment of care for the most vulnerable infants needs to be a joint decision between parents and clinicians.”
The inquiry also looked at longer-term support for families, and resource implications for the NHS.
- Born before 22 weeks: No intensive care
- 22-23 weeks: No intensive care, unless parents request it after a thorough discussion of the risks and doctors agree
- 23-24 weeks: Parents, after a thorough discussion with the healthcare team, should have the final say
- 24-25 weeks: Give intensive care, unless the parents and the doctors agree there is no hope of survival, or the level of suffering is too high
- Above 25 weeks: Intensive care as standard
There is a big difference in the development of a 22 weeker and a 24 weeker. The changes that goes on inside the womb in those 2 weeks is incredible. Every child is their own person and there is such a fine line between disconnecting life and giving your baby a chance to show you how strong they are.
Cale, one of the babies profiled for Prematurity Awareness Month, was born at 27 weeks but stopped growing at 23 weeks (by doctors estimation). He needed to be oscillated early on in his life and also had a chest tube, but he is a normally functioning infant who is hitting most of his milestones on time.