When most people hear of kidney failure, they assume it is a condition for older people who have diabetes and hypertension. Little do they know that kidney failure can affect even a newborn baby.
Josephine Mulwa, a mother of four from Kavilinguni Village in Kangundo Sub-County in Machakos County found herself nursing a newborn baby diagnosed with acute kidney injury a week after delivery.
She could not understand why her new baby was unable to pass urine and was looking so pale.
“When my baby started turning yellowish and cold, I knew there was a big problem so I rushed her to the nearest health centre. However, they immediately referred me to Kangundo, then to Machakos Referral Hospital where the baby was diagnosed with acute kidney injury,” Josephine narrates.
Her baby was then transferred to Kenyatta National Hospital where he was taken through dialysis for a week before he was given a clean bill of health, although they had to stay at the hospital for a few more days as the doctors monitored the child.
“Nurses told me my child developed acute kidney injury because I did not breastfeed well in the first hours of birth,” she explained, “when I gave birth, I could only express about five per cent of milk but now I am supplementing it with baby formula.”
“Breastfeeding is a very important aspect in preventing kidney disease in newborns,” says Rose Gitau, a health officer at Kakuyuni Level 3 hospital, “dehydration sets in immediately because the baby was used to the intrauterine environment where fluids were always plenty.”
According to Gitau, a mother should be prepared for breastfeeding way before delivery, both psychologically, physically and economically such that they are aware of why it is important to breastfeed immediately after delivery.
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“Mothers should have a strong support system in the hospital and at home, where the nurses show her how to hold the baby correctly to aid in latching and proper breastfeeding and if she is unable to produce enough milk, she should be given supplements to boost their lactation,” she explains, “at home, this new mother should be helped by family members to give her time to concentrate on nursing.”
Children with acute kidney injury may present with different signs and symptoms such as severe dehydration, a baby may look weak and lethargic, some may have convulsions while others may be too weak to wake up and breastfeed, dry skin with very cold hands and feet but the inability to pass urine is the main test used by doctors to diagnose acute kidney injury in newborn children.
According to Dr Peninnah Musyoka a paediatrician at Machakos Level 5 Hospital, some blood tests are run to check potassium levels which go up when the kidney is injured, then the sodium test, and a test to check urea and creatinine levels.
If the urea, creatinine, potassium and sodium levels are high, then the doctor will determine if the child ought to be put on dialysis or simply rehydrated.
Dr Musyoka explains that there are two types of dialysis; hemodialysis and peritoneal dialysis. Most doctors recommend peritoneal dialysis for children.
With peritoneal dialysis, a small incision is made near the belly button to access the peritoneum which is the inside lining of the abdomen.
Fluid is then pumped into the peritoneal cavity using a catheter and as blood passes through the blood vessels in the peritoneum, waste products and excess fluid are drawn out of the blood and into the dialysis fluid.
Dr Musyoka says that this fluid will be replaced hours later with fresh fluid and within a few days, the baby will be able to pass urine and the kidney will function normally.
She advises that after the dialysis, the baby ought to be observed and well hydrated normally.