Behind the first cries of many babies is a team of doctors fighting day and night saving lives. At the Neonatal Treatment Department, Lao Cai Obstetrics and Childrens Hospital, their work takes place 24 hours a day, quietly but full of pressure.

Dr Luong Thi Le Quyen, Deputy Head of the Neonatal Treatment Department, said the department treats all neonatal patients in the province, from premature and low-birth-weight infants to cases of severe infection. It is the final referral center for neonatal care in Lao Cai.

Each year, the department receives hundreds of seriously ill newborns, most transferred from district hospitals or from the hospital’s Obstetrics Department. Some babies are still delivered at home with umbilical cords cut using scissors, mainly in remote areas where medical conditions are limited and awareness of healthcare remains insufficient.

“On average, the department admits about 7–10 newborns each year with severe infections due to home births. When they arrive, many are already in critical condition while their families are extremely poor,” Dr. Quyen said.

Some families, exhausted financially or physically, or influenced by spiritual beliefs, ask to take their children home and stop treatment midway. At such moments, doctors must not only provide medical care but also patiently explain, encourage, and seek support from the hospital’s Social Work Department to preserve the child’s chance of survival.

Child mothers

Among many cases she has treated, Dr. Quyen cannot forget a 13-year-old girl who gave birth at 27 weeks of pregnancy. The baby weighed just 1 kg at birth and was in critical condition, requiring mechanical ventilation. The mother was too young, the baby’s father was absent, and the grandmother, born in 1991, was almost in a state of panic.

“The family insisted on signing discharge papers to take the baby home, accepting that living as long as possible while still on a ventilator,” Dr. Quyen recalled.

The entire medical team patiently explained that treatment costs were covered by health insurance and that the baby still had a chance to survive if hospitalization continued. Eventually, the family agreed to stay. The young mother was guided step by step: kangaroo care, changing diapers, and breastfeeding. From instinctive actions at first, she gradually learned how to care of her child.

“At the follow-up visit, the baby weighed 8kg, was healthy, and agile. The day both the grandmother and mother carried the child back to the hospital during a seminar on premature babies is a memory we will never forget,” Quyen said.

According to Quyen, the premature birth rate in the locality currently accounts for about 30-35 percent, higher than in previous years. The causes come from many factors such as mothers being too young or too old, a history of premature birth, uterine pathology, or infection during pregnancy. Recently, the department has received many cases of congenital syphilis, premature babies with liver failure, and severe blood clotting disorders, causing many difficulties in treatment.

Hardships beyond the hospital room

Challenges exist even when the child passes the critical stage. After discharge, follow-up examinations for premature and low-weight children are mandatory, but not every family complies. “If we don’t call to remind them, many families will not bring their children back for a follow-up appointment on time,” Quyen said.

The Neonatal Treatment Department currently has five doctors and 10 nurses, mostly young people, accustomed to continuous sleepless nights and the non-stop alarming of ventilators. “Neonatal care requires absolute meticulousness and caution. Every three hours, we change diapers, feed, and monitor the ventilator. With such a big workload, if you don't have enough strength and heart, it's very hard to stay,” Quyen said.

Every day, although working hours start at 7:30, Quyen often arrives much earlier to examine severe cases and grasp the situation from the night shift. “If the department has a critical case, I come to the hospital even earlier,” she said.

In Lao Cai, many patients are ethnic minorities, mothers are often too young or too old, and economic conditions are difficult. Doctors not only treat but also must consult and guide very carefully on how to care for children after birth. The department's follow-up clinic creates an appointment list, and as the date approaches, nurses must call to remind families.

Phuong Thuy