A few years back, when we were in the old block, our neonatal intensive care unit was small but had no dearth of tiny new citizens. Some of them were brief visitors: they would check in, hurriedly gobble up some oxygen molecules, and rush back to relish the colostrum in waiting. Some weren’t that quick and would stubbornly secure a spot under the warmer, as if it was a Bodhi tree, and wouldn’t vacate for days or even weeks. Sometimes things were worse: terrorists and sleeper cells—nicknamed Klebsiella and Pseudomonas—would clandestinely breach a newcomer’s barriers.
Our little friend, a “very low birth weight” was in the middle of such a battle. He lay under the warmth of the Bodhi tree with mottled skin and a bloated abdomen, necrotising enterocolitis, sepsis, and shock. His body was barely visible under the camouflage of tubings, wires, plasters, and ECG leads. Infusion pumps laden with inotropes, antibiotics, and IV fluids had silently stacked themselves, giving rise to a Christmas tree next to the Bodhi tree. Our best antibiotic bullets gave no response. Surgeons believed exercise with their scalpel would be futile. So with the grave prognosis looming, we counselled the frail mother. She decided to take our little friend home but the sound of her sobs stayed with us.
Six weeks later—a Wednesday afternoon—our usual under 5s clinic was brewing with the standard ingredients of injections, screams, and consoling mothers. From nowhere, our little friend showed up with his mother. Despite the old man looks, he was quite vigorous with preserved buccal pads of fat. He was alive against all medical odds.
“What did you give him?” we asked the mother.
“Just my milk.”
Perhaps the separation from the nosocomial terrorists (including us?) plus the immune power of his mother’s milk had helped our little friend survive.
Adhisivam Bethou is additional professor of the department of neonatology at the Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
Nivedita Mondal is associate professor of the department of neonatology at the Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
Nishad Plakkal is assistant professor of the department of neonatology at the Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
B Vishnu Bhat is professor and head of the department of neonatology at the Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
Competing interests: None declared.
Patient consent obtained.