Holding the Ballweg Triplets, Madison, Wisconsin.

by Betsy Ballweg (mom)

Our boys came barreling into our lives on July 9 at 27 weeks, 4 days. A tad premature but thanks to the amazing NICU staff at St Mary’s SSM hospital in Madison, WI these boys have come such a long way. It has been quite the roller coaster with really high highs and really low lows but these boys are resilient and have such a strong fight in each of them. We have quite the adventure ahead of us (even though it already has been a chaotic adventure up to this point). For all the sleepless nights, the diapers full of poo, the numerous times getting peed on, and for all the projectile spit up- there is that much happiness and love and that much more snuggles. Worth every moment.

ETHAN born at 2lbs 4oz. He was Baby A and started this escapade as he was the one that couldn’t wait to meet his awesome parents and caused all the ruckus leading to my emergency C-section. He has never looked back since and like the stereotypical oldest child he was the first to reach many of the milestones- first to get off the ventilator, first to master bottle feeding, first to come home, and the first to reach double-digit in weight. He is extremely chill and content and one of the best cuddlers. He’s the brute of the three and will undoubtedly watch out for his little brothers for life.

BRYCE born at 1lb 15oz. He was Baby B and the tiniest from the get-go. What he lacks in size he’s determined to make up for in his large loveable personality. He has the infamous alarm clock cry and thrives on getting everyone’s attention, but when he stares at you with his beautiful blue eyes, you forget all about how he was screaming at 4am to “hurry up momma and get my bottle”.

OWEN born at 2lbs 2oz. He was Baby C and always the feisty, restless one since in utero. He has had the toughest road yet keeps surprising everyone at what he’s been able to overcome. He had been known to do one-arm push-ups in his isollette, but his inner strength has helped him endure several blood transfusions, fighting off an infection in his lungs a couple times, and intubation after extubation after intubation after extubation, etc. He still has a bit of a path ahead but like everything else he will overcome and thrive. He’s a sweetheart with his daddy’s dark brown eyes and long eyelashes. No wonder mom’s a sucker for this kid.

It is an indescribable awful feeling to not always be able to be with each of my babies in their most vulnerable state while they fought day in and day out, night in and night out in the NICU. The Zaky hand has provided comfort to each of my sons since they were born. Whether it would be draped over the body, laid right next to them, or even palmed over their head, The Zaky hand soothed them in their most fragile moments. Now with all three boys sprung out of the NICU and finally all home, The Zaky hand continues to provide comfort (as indicated in the pictures).

Audiology and Speech-Language Therapy student training in a KMC unit

“The final-year students from the Department of Speech-Language Pathology and Audiology, University Pretoria, South Africa, are involved in the KMC unit of Kalafong Hospital. This year, there are 61 students (33 Audiology and 28 Speech-Language Therapy) participating in rotating groups. The KMC unit was started in 1999 and serves mothers of prematurely born infants from the surrounding urban, semi-urban, and township areas. Over 60% of premature births globally occur in Africa and South Asia. Extra care for small babies, including KMC, could save an estimated 450,000 babies each year (WHO, 2012).

The students provide feeding therapy to the preterm infants in the ward and highlight developmentally appropriate stimulation. The mothers in the ward also receive a weekly talk by the students on a pertinent topic such as feeding difficulties, communication and hearing milestones and otitis media.

At the follow-up clinic, the students conduct early communication, feeding and hearing screenings. The students train the mothers to encourage communication and listening development using books, toys and stimulation techniques. Mothers are given hand-outs that they may refer back to at a later stage. Therefore, information is generally given for the range of birth to approximately two years of age. As South Africa has 11 official languages; home language is prioritized and hand-outs are given in the more common languages of English, isiZulu and Sepedi when possible.

Many South Africans struggle with poverty and nearly two thirds (58%) of children in South Africa live below the poverty line (R604/month or approximately $42/month) (Child Gauge, 2013). Great effort is taken to show mothers how they may use resources already in their homes to provide stimulation. Mothers are shown how to make books and toys for language stimulation and how to adapt these as the child grows. Language stimulation is also focused on as premature infants are at risk for developing communication difficulties which may affect later academic ability. Early communication intervention not only treats existing difficulties but also educates mothers on stimulation from a young age in order to prevent or reduce difficulties.

During the practicals, the supervisor oversees the students, monitors interactions with the mothers and supports the students in the more difficult-to- treat cases. Working in the ward teaches the students how to interact with the team including nurses, doctors, dietitians and occupational therapists. In 2012 a database was started in order to track the families the students have treated. As of the end of 2015; approximately 1500 mothers and babies have been seen by the Audiology and Speech-Language Therapy students from the University of Pretoria. The benefits of the practical were demonstrated when a mother approached the students and supervisor on the day of her discharge home with her baby. She had collected all the hand-outs from her 8 week stay. She informed us that she was going to copy the hand-outs and give them to her friends, family, mothers and the preschools near her. This moment demonstrated the ability to touch many families with one mother.

On completion of the module, the students receive a practical mark and write a reflection report evaluating their ability to apply their theoretical knowledge in a clinical setting. This module provides experience as the students enter hospitals and clinics the following year for their compulsory community service year. The students remark that they develop skills for interacting with mothers as equal team members and for providing early communication intervention for preterm infants. Many students have gone on to the either start KMC units at their community service hospitals or to encourage a greater focus on early intervention.”

~As told by Professor Alta Kritzinger and Ms. Renata Mosca

Professor Kritzinger and Ms. Mosca form part of the early intervention team at the Department of Speech-Language Pathology and Audiology at the University of Pretoria in South Africa, training students in the assessment and treatment of early communication disorders in the Clinic for High-Risk Babies (CHRIB) using a family based approach. Both are Hanen-certified therapists and are involved in encouraging Early Intervention in a variety of South African contexts and communities.