Dr. Shivashankar Diggikar recently appeared on Public TV Kannada’s health program Nithya Sanjeevini, in a detailed discussion on premature baby care alongside fellow pediatrician Dr. Lathiesh Kambam. The segment covered everything from what actually counts as a “premature” birth, through NICU care, common parent worries, and the critical first minute after delivery.
Below is a topic-by-topic recap of Dr. Diggikar’s remarks from the interview, followed by the full original broadcast.
1. What Is Prematurity? Causes & Categories
ಅವಧಿಪೂರ್ವ ಜನನ ಎಂದರೇನು? ಕಾರಣಗಳು ಮತ್ತು ವಿಧಗಳು
Premature birth is categorized by gestational age: babies born between 28-32 weeks are classified as very preterm, 32-34 weeks as moderate preterm, and 34 weeks to 36 weeks 6 days as late preterm.
India has one of the highest numbers of premature births in the world. Dr. Diggikar notes that of roughly 2.5 crore (25 million) births in India each year, about 13% — nearly 33 to 37 lakh babies — are born prematurely. Within that group, about 1% (roughly 3 lakh babies) are born before 28 weeks, the most fragile category.
This scale is why the financial and hospital burden of preterm care is so significant nationally. The causes are often preventable or manageable with awareness: marrying and conceiving at a very young age, a first pregnancy, twin pregnancies, and untreated urinary tract infections during pregnancy all raise the risk. Dr. Diggikar stresses that choosing the right hospital to deliver at — one equipped with Level 3 NICU care, incubators, and proper infrastructure for a premature delivery — is one of the most important decisions a family can make.
“ಭಾರತದಲ್ಲಿ ವರ್ಷಕ್ಕೆ ಸುಮಾರು 2.5 ಕೋಟಿ ಮಕ್ಕಳು ಜನಿಸುತ್ತಾರೆ, ಅದರಲ್ಲಿ 13% ಅಂದರೆ 33-37 ಲಕ್ಷ ಮಕ್ಕಳು ಅವಧಿಪೂರ್ವವಾಗಿ ಜನಿಸುತ್ತಾರೆ.”
(“About 2.5 crore babies are born in India every year, of which 13% — 33 to 37 lakh babies — are born prematurely.”)
2. When Can a Premature Baby Leave the NICU?
ಅವಧಿಪೂರ್ವ ಶಿಶು NICU ಬಿಡುವುದು ಯಾವಾಗ?
Parents often ask how long a premature baby needs to stay in the NICU. Dr. Diggikar explains that just ten years ago, a baby born under 1 kg in India was viewed with grave concern — doctors were unsure if such a baby would survive at all. Neonatology has advanced enormously since then: today, even a baby under 1 kg has roughly a 70-80% survival chance, and babies between 1-1.5 kg are now expected to survive with proper care.
“We are not like gods, but we have that confidence,” he says. Generally, once a baby crosses 1-2 kg, they usually don’t need an extended ICU stay. For babies under 1 kg born after 23 weeks, doctors now offer parents the option of full intensive treatment — facilities exist to support babies up to the equivalent of 36-37 weeks of development.
“ಹತ್ತು ವರ್ಷಗಳ ಹಿಂದೆ 1 ಕೆಜಿಗಿಂತ ಕಡಿಮೆ ತೂಕದ ಮಗು ಹುಟ್ಟಿದರೆ ಉಳಿಯುವುದೇ ಅನುಮಾನವಿತ್ತು; ಈಗ 70-80% ಬದುಕುಳಿಯುವ ಸಾಧ್ಯತೆ ಇದೆ.”
(“Ten years ago, if a baby was born under 1kg, survival itself was in doubt; now there’s a 70-80% survival chance.”)
3. Myths, Risk Categories & Growth Milestones
ತಪ್ಪು ಕಲ್ಪನೆಗಳು, ಅಪಾಯದ ವರ್ಗಗಳು ಮತ್ತು ಬೆಳವಣಿಗೆ
There’s a common myth that something the mother did caused her baby’s prematurity. Dr. Diggikar addresses this directly: it isn’t a complete myth, but it isn’t a complete truth either — not every premature baby’s problems can be traced back to the mother.
He outlines three risk categories based on birth weight. Babies above 1.5 kg are considered low risk and usually do well without complications. Babies between 1-1.5 kg, typically born before 32 weeks, fall into a moderate risk category, with some possibility of developmental issues — though this doesn’t happen to every baby in this group. Babies under 1 kg are high risk, where even mild developmental delays are possible, though good NICU care significantly improves outcomes.
Regular follow-up is essential regardless of category: doctors check at 3 months (is the baby sitting up), 6 months, and by 1 year (is the baby walking) to track developmental milestones and catch any delays early.
“1.5 ಕೆಜಿಗಿಂತ ಹೆಚ್ಚು ತೂಕದ ಶಿಶುಗಳು ಸಾಮಾನ್ಯವಾಗಿ ಯಾವುದೇ ತೊಂದರೆಯಿಲ್ಲದೆ ಬೆಳೆಯುತ್ತಾರೆ.”
(“Babies weighing more than 1.5kg usually grow without any problems.”)
4. Antenatal Steroids: Protecting Baby Before Birth
ಹೆರಿಗೆ ಮೊದಲು ರಕ್ಷಣೆ: ಆಂಟಿನೇಟಲ್ ಸ್ಟೀರಾಯ್ಡ್‌ಗಳು
When doctors identify a risk of premature delivery in advance, they can give the mother antenatal steroid injections — and sometimes magnesium sulfate — before the baby is born. Dr. Diggikar explains that these medications help the baby’s lungs mature faster and provide meaningful protection for the brain after delivery, significantly reducing the risk of future complications.
“ಹೆರಿಗೆ ಮೊದಲು ನೀಡುವ ಸ್ಟೀರಾಯ್ಡ್ ಚುಚ್ಚುಮದ್ದು ಶ್ವಾಸಕೋಶ ಮತ್ತು ಮಿದುಳಿನ ರಕ್ಷಣೆಗೆ ಸಹಾಯ ಮಾಡುತ್ತದೆ.”
(“The steroid injection given before delivery helps protect the lungs and the brain.”)
5. The ‘Hole in the Heart’ Explained (PDA)
‘ಹೃದಯದಲ್ಲಿ ರಂಧ್ರ’ ಎಂದರೇನು? (PDA)
One of the most common worries parents of premature babies have is being told their baby has a “hole in the heart.” Dr. Diggikar reassures that this isn’t really a hole at all — every baby, premature or full-term, has a natural connection between the heart and lungs called the ductus arteriosus, which is essential for survival inside the womb.
“We don’t call it a hole, we call it an extra pipe,” he explains. In most cases, it closes on its own naturally after birth. If it doesn’t, medication can often help it close; surgery is reserved only for extreme, rare cases.
“ಅದು ರಂಧ್ರವಲ್ಲ, ಅದು ಒಂದು ಹೆಚ್ಚುವರಿ ನಾಳ – ಸಾಮಾನ್ಯವಾಗಿ ತಾನಾಗಿಯೇ ಮುಚ್ಚಿಕೊಳ್ಳುತ್ತದೆ.”
(“It’s not a hole, it’s an extra duct — it usually closes on its own.”)
6. Brain Bleeds & Eye Screening (ROP)
ಮಿದುಳಿನ ರಕ್ತಸ್ರಾವ ಮತ್ತು ಕಣ್ಣಿನ ತಪಾಸಣೆ (ROP)
Premature babies’ brains are especially fragile, and even routine stresses — noise, travel, being moved — can increase the risk of a brain bleed (intraventricular hemorrhage). Dr. Diggikar also highlights Retinopathy of Prematurity (ROP), a condition that can cause blindness if undetected.
Eye screening before NICU discharge is mandatory for every premature baby — skipping it, he says plainly, would be the doctor’s fault. Catching ROP early allows timely treatment and prevents permanent vision loss.
“ಡಿಸ್ಚಾರ್ಜ್ ಮೊದಲು ಕಣ್ಣಿನ ತಪಾಸಣೆ ಕಡ್ಡಾಯ – ಇದು ಭವಿಷ್ಯದ ಅಂಧತ್ವ ತಡೆಯುತ್ತದೆ.”
(“Eye screening before discharge is mandatory — it prevents future blindness.”)
7. What Causes Premature Birth?
ಅವಧಿಪೂರ್ವ ಹೆರಿಗೆಗೆ ಕಾರಣಗಳೇನು?
Dr. Diggikar identifies undetected infection as the single highest risk factor for premature labor. Urinary tract infections are extremely common among pregnant women and often go unnoticed — which is exactly why doctors perform a routine urine test at antenatal visits. If the result is positive, a full course of antibiotics can prevent the infection from triggering early labor.
High blood pressure is another major, common cause of prematurity. Even dental infections aren’t exempt — they release bacteria and inflammatory chemicals into the bloodstream that can trigger early labor. His advice is simple: don’t skip antenatal visits, take the prescribed urine tests seriously, and always complete the full antibiotic course if an infection is found.
“ಗರ್ಭಿಣಿಯರಲ್ಲಿ ಮೂತ್ರ ಸೋಂಕು ಪತ್ತೆಯಾಗದಿದ್ದರೆ ಅವಧಿಪೂರ್ವ ಹೆರಿಗೆಗೆ ದೊಡ್ಡ ಕಾರಣವಾಗುತ್ತದೆ.”
(“Undetected urinary infection in pregnant women is a major cause of premature birth.”)
8. Breathing Support: Surfactant & CPAP
ಉಸಿರಾಟ ಬೆಂಬಲ: ಸರ್ಫ್ಯಾಕ್ಟಂಟ್ ಮತ್ತು CPAP
Babies born before 34 weeks often lack sufficient surfactant, a substance that keeps the tiny air sacs in the lungs from collapsing — and nearly every baby born before 28 weeks has this deficiency. Dr. Diggikar explains that this is treated with surfactant replacement therapy, followed by ventilator support if needed; milder cases are managed with CPAP, a gentler breathing-support device.
Reassuringly, he notes that most prematurity-related breathing problems are not lifelong — the majority of babies recover fully as their lungs mature, though in rare cases some lasting lung issues can persist.
“28 ವಾರಕ್ಕಿಂತ ಮೊದಲು ಹುಟ್ಟಿದ ಬಹುತೇಕ ಎಲ್ಲಾ ಶಿಶುಗಳಿಗೆ ಉಸಿರಾಟದ ಬೆಂಬಲ ಬೇಕಾಗುತ್ತದೆ.”
(“Almost every baby born before 28 weeks needs breathing support.”)
9. The Golden Minute: Why the First Minute Matters
ಗೋಲ್ಡನ್ ಮಿನಿಟ್: ಮೊದಲ ನಿಮಿಷದ ಮಹತ್ವ
Dr. Diggikar calls the first 60 seconds after any birth — premature or full-term — the “golden minute.” About 90% of babies cry and breathe on their own immediately. Around 1 in 10 need some stimulation to start breathing, and roughly 1% require intensive resuscitation.
If a baby doesn’t breathe within that first minute, blood flow to the brain can be disrupted first, followed by the kidneys and heart — a serious condition called birth asphyxia that carries a real risk of permanent brain damage the longer it goes uncorrected. His message to every expecting parent is direct: before delivery, always confirm that a qualified doctor — ideally a neonatologist, or at minimum a nurse trained in newborn resuscitation — will be present in the room. Delivering without this safeguard, he says, puts the baby at serious and avoidable risk.
“ಜನನದ ಮೊದಲ ನಿಮಿಷದಲ್ಲಿ ಮಗು ಉಸಿರಾಡದಿದ್ದರೆ, ಮಿದುಳಿಗೆ ರಕ್ತ ಪೂರೈಕೆ ನಿಲ್ಲಬಹುದು – ಅರ್ಹ ವೈದ್ಯರ ಉಪಸ್ಥಿತಿ ಕಡ್ಡಾಯ.”
(“If the baby doesn’t breathe in the first minute after birth, blood supply to the brain can stop — a qualified doctor’s presence is essential.”)