By Virginia Ironside
Last updated at 9:11 AM on 22nd April 2010
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As the number of babies born weighing just 2lb doubles in two years, a provocative view from respected advice columnist VIRGINIA IRONSIDE.
At first glance, it seems such wonderful news. The number of babies born weighing only 2lbs has more than doubled over the past two years.
Their survival is miraculous, and often seems like a feat of tiny, wilful endurance against overwhelming odds. One can only imagine the joy of these vulnerable children's anxious parents as it becomes clear their child will live.
And it is thanks to the advances of modern medicine that these little miracles have now become an everyday reality - after all, these are babies who are often no bigger than a bag of sugar. Without the support of modern technology, how else could they possibly have survived?
Small miracle: But premature babies can have serious problems
Small miracle: But premature babies can have serious problems
It is a natural response for us all to rejoice along with these families and their exceptionally premature babies - by which I mean those children born before 24 weeks.
We all hope that these little ones can go on to live long and fruitful lives. But, sadly, the hard fact must be acknowledged that in many cases, this will not happen.
None of us likes to even think of children being in pain, so it is tragic to realise that half of these children born at such an early stage of pregnancy will suffer from cerebral palsy.
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Many will also have bowel, kidney, respiratory or developmental problems. Often, the hours spent waiting in hope at the side of an incubator as these tiny babies battle for life will be replaced in later weeks, months and years by hours inserting feeding tubes, doing painful physiotherapy work, or comforting a child in distress.
There are thousands of devoted parents of disabled children who do just this, day in, day out. They do a fantastic job and are to be much admired.
Despite such devotion, and although I know my thoughts go against the current tide of opinion, I want to plead on behalf of these children.
Faced with a desperately premature and undeveloped baby, I can't help but wonder whether in some instances it is the right thing to fight to keep them alive.
Should modern medicine be saving these babies who often face a life dominated by pain and illness? I feel uncomfortable saying this, but I don't believe it should in every case.
Why do I feel this way? A lot of people say that life is worth preserving at any cost. And yes, thankfully, some of these extremely premature children will have healthy, happy lives. Every one must be counted a blessing.
Controversial view: Agony aunt Virginia Ironside
Controversial view: Virginia Ironside believes nature should decide whether premature babies survive
But the sad fact is that it is a huge gamble to resuscitate a premature baby, and may risk bequeathing those tiny babies a lifetime of agony.
Often there is a reason a child is born early - because they have either a disability or weakness. Isn't this Mother Nature's way of saying that they are not meant for this world?
But then we intervene with all our gadgets and scientific advances. Sometimes, of course - and I can't emphasise this enough - intervention can be absolutely the right thing to do.
There is nothing more heartening than reading the story of a baby that has triumphed against the odds, who has passed its milestones unscathed by his or her premature birth.
But often prolonging the life of a tiny baby that would otherwise have died can be irresponsible.
In practical terms, keeping these exceptionally premature babies alive places huge pressure - some £125 million a year - on the already heavily burdened health service.
The resources that are keeping these babies alive are, by necessity, being taken away from those who have a strong chance of life: the young mothers and fathers hit by cancer, or the sick five-year-olds desperately in need of treatment.
But most of all, and more importantly than any financial cost, is the human cost to the baby.
As an agony aunt, I read about so much suffering. Allowing these babies to die isn't an easy option - far from it. It can cause parents and families pain and guilt for years.
But I believe that it can sometimes be an unselfish and loving act not to prolong the life of a child who will never leave hospital or be free from intrusive and distressing medical intervention, before he or she can suffer.
Parents who make that tough decision should be supported. Instead, though, it is often the parents who - albeit unwittingly and with the best of intentions - prolong their child's suffering who are praised. I have written extensively about the pain of bereavement, of losing a loved one.
But there does come a time when you have to accept that death comes to us all. While I know my argument may sound hard-hearted, anyone who saw this week's BBC programme Caught in the Machine, about the children being cared for in the Intensive Care Unit (ICU) at Great Ormond Street Hospital, will empathise - and perhaps even share my concerns.
Female nurse examining a newborn baby in an incubator
Lifetime of treatment: None of us likes to even think of children being in pain, but some premature babies will need constant care (file picture)
Take tiny Uzoma Igwe. The eight-month-old little girl had never left the hospital in the course of her young life, and had been admitted to ICU four times with respiratory failure.
Her delicate face covered in bandages holding an artificial ventilator in place, she was born at just 27 weeks and faced the harshest of battles from then.
Indeed, the child's consultant, Dr Christine Pierce, said: 'Her lungs aren't strong enough for her to do the things normal babies do at her age. She is still the same size she was seven months ago - all the energy she has is used in surviving, not in growing or developing.'
It was heartbreaking watching nurses trying to sit her up in a baby chair.
One said: 'I do feel sometimes we do things you wouldn't do to an animal. Sometimes the treatment is futile.'
She was given a tracheotomy, a hole in her throat to help her breath, but became increasingly distressed.
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Eventually, after a month in ICU and an operation on her stomach, she died. Another minute baby was born on the very cusp of survival, at 24 weeks.
By eight months, she had suffered almost every complication possible, from severe chronic lung disease, to bleeding in the brain causing severe brain damage.
She eventually went home, but will face continuing problems. I would never wish to proscribe what is right or wrong in individual cases, but as a general principle I worry that just because medical science can keep more and more desperately premature babies alive, it doesn't always mean it is the right thing to do.
That may sound cruel and uncaring. But in many cases I believe the opposite to be true. Sometimes letting go can be the bravest - and most unselfish - decision a parent can make.
Read more: http://www.dailymail.co.uk/femail/article-1267878/VIRGINIA-IRONSIDE-Ill-vilified-shouldnt-let-nature-decide-premature-babies-survive.html#ixzz0lxgSpYs0
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