Behind every premature baby’s fight for survival is a team running on grit, skill, and zero sleep. This article pulls back the curtain on the NICU — the alarms, the adrenaline, the heartbreak — and the unforgettable night when an unexpected fourth baby pushed a medical team to its limits and showed what real dedication looks like.
WORDS DR NAVEEN NAIR GANGADARAN
 FEATURED EXPERTDR NAVEEN NAIR GANGADARAN Paediatrician Hospital Tuanku Ja’afar |
In Malaysia, the rate of preterm birth is approximately about 12.3% of all births.
- Premature birth, defined as birth before 37 weeks of gestation, is more than just an early arrival.
- Among those born before 32 weeks, over three-quarters experience at least one major
complication from fragile lungs needing oxygen, to infections, to conditions like retinopathy
of prematurity that threaten vision.
GIVING PRETERM INFANTS (PREEMIES) A CHANCE AT FULL LIFE
Behind every surviving preemie is an army of people whose work often goes unseen.
- The obstetricians who fight to delay labour, giving the baby just one more precious
day in the womb. - The midwives who hold their breath during those tense minutes before the cry.
- The paediatric teams who stand ready — sometimes in the middle of the night —
with tiny tubes, warmers, and steady hands. - The neonatal nurses — the quiet guardians of the neonatal intensive care unit (NICU) — who feed, soothe, and nurture these babies that are too small to cry aloud, becoming their surrogate parents.
The world often celebrates the baby’s survival, as it should, but few see the emotional and physical toll carried by the healthcare teams who keep these tiny hearts beating. This piece is my tribute to them
A NIGHT I WILL NEVER FORGET
It was 2 AM when the call came through.
“Doctor, the triplets are coming — twenty-six weeks.”
The hospital corridor was silent, but my heart wasn’t. I hurried to the NICU, where my team
was already preparing the warmers, ventilators, and resuscitation trolleys. In the operating
theatre, three teams of medical officers stood ready — one for each baby.
Minutes later, the first cry pierced the air — faint, but enough to make hearts lift. Then came the second, and the third. Relief washed over the team — until a nurse looked up, eyes wide.
“Doctor… there’s another one.”
A hidden sibling.
A quadruplet.
For a heartbeat, time stood still. Then instinct took over. My officers were each occupied with a baby. I was still in the NICU, attending to another newborn who had just been intubated, when I received the urgent call to the operating theatre.
My pulse quickened. Something was wrong.
When I entered, I saw my three medical officers already resuscitating their assigned babies.
Then, at the corner of the room, a nurse and my house officer stood over another — tiny, still, and pale. I ran to them. The fourth baby lay motionless, limp in my hands.
Resuscitation began.
Intubation was swift — breath, pressure, rhythm.
And then… a gasp.
A flicker of life.
The room, once heavy with tension, exhaled in unison.
We transferred all four babies to the NICU — each smaller than a bottle of mineral water, their skin paper-thin, their futures uncertain. My nurses moved with quiet urgency — setting lines, mixing medications, checking ventilators, each step guided by precision, compassion, and prayer.
By sunrise, all four were still fighting. One by one, lines were secured, drips adjusted, oxygen levels stabilised. As the hospital stirred awake — footsteps echoing, wards coming to life — our team stood in quiet exhaustion, hearts full.
It wasn’t just another night on call.
It was a night that became a symphony — of faith, science, and teamwork.
A reminder that in neonatology, miracles aren’t rare. They’re routine.
THROUGH THE EYES OF A HEALTHCARE WORKER
From the outside, the NICU looks calm — rows of incubators, blinking and beeping monitors
and sleeping babies.
However, every alarm, every change in oxygen saturation, every sigh from a ventilator carries the weight of possibility.
We, the healthcare workers, live between those beeps.
We measure time not in hours, but in heartbeats and oxygen levels.
We celebrate grams gained as if they were kilograms.
And when we lose one, we carry that loss quietly — because another baby still needs us.
The nurses who work day and night often form unbreakable bonds with these babies. Some speak to them gently, call them by name, and smile through exhaustion. I’ve seen nurses stay past their shift when there is a resuscitation ongoing.
Paediatricians and medical officers, too, live on adrenaline and empathy — making hundreds of calculations, adjusting ventilator settings, deciding whether to escalate or hold back. These are decisions no algorithm can make. This is where the experience matters.
Sometimes the gut feeling plays a major role.
Not every battle in the NICU is fought with machines and medicines – some are fought with words and silence. We sit with parents and explain lab results, brain scans, heart sounds.
Sometimes they listen with hope; sometimes with fear, and sometimes with denial — because accepting how fragile their baby is, feels unbearable.
There are days when questions come faster than answers, when anger or tears fill the room, and we remain steady not because we are unaffected, but because they need someone who isn’t breaking.
We reassure, we re-explain, we pause when they cry. We remind them gently that while we cannot promise outcomes, we will never stop trying. That is also part of the work — holding their hands while their hearts tremble.
And when a baby finally goes home, healthy and strong, it feels like sending a part of
ourselves with them.
A FINAL REFLECTION
On 17 November 2025, we celebrate World Prematurity Day — a day not just to raise
awareness, but to honour the unseen heroes who stand at the fragile border between life
and loss every single day.
So tonight, as the city sleeps, remember that in a NICU somewhere, a team of doctors and nurses are wide awake — fighting for a baby no bigger than your palm. With steady hands and unbelievable faith, they do everything possible to give these tiny warriors a chance at life.
We might call these babies premature but perhaps, they’re simply brave enough to begin early.
A salute to all in making these tiny ones mighty.
| This article is part of our series on tips and advice for parents to provide the best TLC to their children. |
