By Christabel Ligami
At Pumwani Maternity Hospital in Kenya, Gladys Njoki, 17, is holding her two-months-old baby girl tightly on her chest.
The baby was at 28 weeks weighing 800grams. Njoki is at the Kangaroo ward at the hospital where she is practising the kangaroo method of caring for her premature baby to ensure that she attains the recommended body weight.
“The baby is strapped tightly onto her chest to ensure skin-to-skin contact between her and the baby, maintain a healthy body temperature and prevent the baby from any movement that can lead to loss of weight,” said Kezia Njau, a nurse and counsellor at the hospital.
Njoki has been at the hospital for the last one and half months and she will only be discharged when the baby attains the weight of 1.8 kilograms.
“A day after delivering the baby, my stomach started swelling and so I had to be rushed to Kenyatta National Hospital for emergency surgery. It was too painful and the doctor said that I had an ovarian cyst,” said Njoki.
She said she stayed at Kenyatta Hospital for two weeks after surgery.
By this time, her baby was in the nursery. Luckily, the baby did not miss out on breast milk as she was being fed on donated breast milk at the hospital.
“When I came back I was shocked to learn that my baby was being fed with another mother’s milk. I didn’t like it at all because I thought it could even make my baby sick. But when the nurse explained to me why it is important for the baby, I understood,” she said.
Her baby now weighs 1.7 kilograms and she expects to be discharged in a few days.
Njoki is among the many young girls admitted at the Kangaroo ward with their premature babies, some too shy to talk about their stories.
Tina Nekesa, 18 years of age, delivered preterm twin boys. Unfortunately, she lost one soon after birth.
“My baby developed breathing problems and died a few hours after birth,” said Tina adding that the twins were born prematurely weighing less than 1 kilogram.
“The nurse told me that I had to stay at the hospital until my baby attains the required weight. I have been here for the last two weeks and the baby is improving.”
She said that she was told to tie and hold the baby tightly on her chest all the time so that he can grow faster.
Tina said she never breastfed her baby at all. She had no milk and even after trying to eat every food recommended to her she could not produce milk.
Luckily her baby is also one of the beneficiaries of the breast milk bank at the hospital.
“I bottle-feed him with the milk every one hour and the milk given is enough for him,” she said.
“It was difficult for me to accept to feed my baby with someone else’s milk but after two days of trying and the baby was ok, I relaxed. Also, I saw other mothers feeding their babies with the milk and it made me even more comfortable to feed him.”
Anne Nduku who delivered at the hospital on November 23, 2020, is among the over 500 breast milk donors.
“My baby was born through a caesarian section and I had high blood pressure. The doctor recommended that I stay at the hospital for more days until my blood pressure stabilizes,” said Anne.
“I had so much milk. My breasts were so painful that I couldn’t sleep well. The nurse then requested me to donate my milk for the other babies. This was weird at first then after she explained that the milk is meant for the babies whose mothers are dead I agreed to volunteer.”
She said that she expresses 150 millilitres of milk at the milk bank unit at least three times a day.
“But I have to make sure that my baby has had enough first before I can donate,” she said.
Pumwani Breast Milk Bank was launched in 2019 by the Health ministry and the Program for Appropriate Technology in Health, USAid and the African Population and Health Research Center with the aim of reducing newborn deaths at the hospital.
The unit cost $57,000 to set up.
The hospital records the highest number of births of between 70 and 100 every day with a majority of the mothers being teenage mothers.
In the month of November alone, the hospital recorded up to 300 teenage births of between age 11 and 19 years.
Mary Waiyego, a neonatologist and Head of the Breast Milk Bank Unit said for a mother to qualify to be a donor, she must have delivered at the hospital, in good health and must be producing excess milk.
“We prioritize preterm babies especially those who have lost their mothers or sickly. Also, term babies who are sick and/or whose mothers are struggling to produce milk,” said Dr Waiyego adding that most of the preterm mothers at the hospital are teenagers.
“The donated milk is also given to only babies born at the hospital and once the babies are discharged they stop taking the milk. The donor mothers, too, stop donating their milk as soon as they are discharged.”
The milk, she said, helps the babies to grow faster and those who are sick recover faster. It is also highly tolerated by infants.
The World Health Organization (WHO) recommends exclusive breastfeeding for six months as it is one of the most effective ways to ensure child health and survival.
Breast milk also protects babies against diseases like diarrhoea, pneumonia and helps reduce risks like overweight and obesity in childhood and adolescence.
However, Njoki and Tina are among the teenage mothers who are likely to drop out of school as a result of pregnancies during the times of COVID-19.
The Kenya Health Information Systems data indicates that the number of teenage pregnancies in Kenya for the period of May 2020 was 151,433 compared to the same period in 2019 which was 175, 488.
The United Nations Population Fund (UNFPA) last year warned that the COVID-19 lockdown is likely to see 47 million women in low and middle-income countries miss out on contraceptives use which could result to 7 million unwanted pregnancies.
“We have been seeing more teenage mothers from the month of October and the numbers keep on increasing,” said Ms Njau the hospital nurse.
“The sad part is that these are schoolgirls and the majority of them do not know the fathers of their child or the fathers are also fellow teenagers.”
There is a day, she said, that the hospital admitted 15 teenage mothers, one was 13 years old and the rest were below the age of 19 years. A majority of them were 17 years.
“We have had cases of even much younger girls like last year we had a 9-year-old girl who delivered twins and had been raped by her stepfather. Then we had a 7-year-old who didn’t know the father of her child,” she said.
Njoki says her biggest worry now is how will she take care of a baby as a single mother without a job?
Njoki said she lives with her grandmother and was in form four when she got pregnant with a boy 15 years old.
“I have never met my boyfriend ever since I told him that I was expectant. My grandmother has also tried to contact his parents and they said they didn’t want to be involved,” she said adding that she was unsure if she would go back and sit for her final exams.
Tina said she dropped out of school at form three when she learnt that she was pregnant.
“My boyfriend works as a casual labourer. I don’t know if he will agree to stay with me and the baby. He has not confirmed that. If he doesn’t then I will travel to my rural home to stay with my mother,” said Tina.
According to WHO, the leading cause of teenage deaths is pregnancy and childbirth complications among girls aged 15 -19 years which can be prevented by reproductive health education in schools.
In Kenya, it is estimated that 9 per cent of teenage girls die in the hospital while giving birth.
However, for those who survive childbirth, approximately 98 per cent drop out of school, according to a study by Plan International.
In 2019, the Kenyan government committed to ending teenage pregnancy by 2030 at the International Conference on Population and Development (ICPD) held in Nairobi which included upholding girls’ rights to sexual education and provision of sexual and reproductive health services to all girls as per the Maputo Protocol.
Christabel Ligami is an independent journalist based in Nairobi, Kenya. She reports on gender, science/health, business, development, environment, climate change issues in Africa. Her work has been broadly published in the EastAfrican Newspaper, CNN, The Lancet HIV publication, United Nations Africa Renewal, Equal Times, University World News, Climate Home News among others. She has a Bachelor’s of Science degree in Biochemistry and a Masters in Communication Studies.