Coalition for the Premature - 12 years of fighting for the health of the little ones. Episode 87

Ela Brzozowska
There is even talk of post-traumatic stress syndrome, which mothers and fathers of premature babies experience as they did after the war. Research shows that mothers have two such nagging feelings of guilt and fear. These are things that doctors can say if they know based on their experience that it will be okay.

Ada Misiewicz
It is a huge success for all of us that this has been done and the law will come into force on 19 March.

Ela Brzozowska
Anyway, in the hospitals we know that there are still not enough psychologists and the needs are many. Their fear, their terror, their crying. I don't think I will ever forget that.

Monika Rachtan
Hi, Monika Rachtan, I would like to welcome you to another episode of the programme First Patient. It's a special Wednesday, because it's the Wednesday before the finale of the Great Orchestra of Christmas Charity. And very often the heroes of the orchestra were premature babies, and today we are going to talk about them. And my guest, but above all your guest, is Ela Brzozowska and Ada Misiewicz. Hello, a very warm welcome to you.

Ela Brzozowska
Thank you for the invitation.

Ada Misiewicz
Welcome, welcome.

Monika Rachtan
Girls, you represent the coalition for the premature baby. How beautiful it sounds. I think back to the finals of the Great Orchestra of Christmas Charity, where incubators with hearts appeared en masse in Polish wards. It was probably the first time we saw for the first time, on such a large scale, how much good the orchestra does, but also how great the needs of the Polish healthcare system are, and that these needs do not concern adults, but also the youngest. Ela, tell me, how do you recall those years of playing with the orchestra and those first collections for premature babies, when premature babies are so close to your heart, because you have been active in the coalition for many years.

Ela Brzozowska
Yes, our Coalition for the Premature has been running for 12 years. It was invented and the coalition was created thanks to Professor Maria Katarzyna Boryszewska Kornacka. She is a legend, history, an icon of Polish neonatology. Mrs Boryszewska was head of the Neonatal Intensive Care Unit at Karowa Street for many years. She was the president of the Polish Neonatology Society for many years, regional consultant for Mazowsze, and for the last 12 years the three of us have been the board of directors of the Coalition for Prematurity Foundation. Magda and Asia also belong to our foundation. Asia after a difficult transition. The loss of her daughter. Magda a mum of an extremely premature Michalinka. And we are joined by our hearts and I think we act from the heart for the parents of premature babies, just like Jurek Owsiak, who is probably the man with the biggest heart in this country. And we admire, we respect, we support. And premature babies are a very special group because, as you say, the parents of premature babies spend several months by the incubator with the heart, by the various apparatuses through which the babies breathe, are treated. Cameras, ultrasounds, various other equipment that are used to diagnose and treat babies. And I always watch with great emotion as the premature babies we know have piggy banks.

Ela Brzozowska
Yesterday I was very touched by Marianka from the friendly foundation Mali Wojownicy from Białystok, who had her ninth birthday the day before yesterday and says that she doesn't want presents. She asks to donate to her piggy bank. So we popularise Marianka's piggy bank with little warriors. The twins Lena and Filip are amazing. The children of Natalia Szewczak, who started our whole campaign about the change in the labour code and maternity leave for parents of premature babies and sick newborns. The twins have put up an amazing item for auction. It's a photo of the legend most associated with martial law, the Day of the Apocalypse. And you can also go to Lena and Philip's piggy bank and charity auctions and bid on it. It's an unbelievable photo that can't be bought. And for this particular cause just from the premature babies you can bid on the photo.

Monika Rachtan
If you found our conversation interesting and are looking for more valuable content, subscribe to us on YouTube and Spotify. Monika Rachtan. You are very welcome! Well, yes, the Orchestra will be playing this Sunday, and we also encourage everyone to participate in the collections, because we are actually taking care of our health by participating in these collections. Sometimes we collect for premature babies, sometimes we collect, as we did this year, for children, sometimes for seniors. In fact, we all benefit from the money we collect, so we encourage you to contribute to either the moneybox or the collection box, which we will be meeting volunteers with throughout Sunday, but I think that even today or in the coming days, these moneyboxes will appear in our cities. We encourage you, let's play together, let's enjoy and let's be good to each other on that day, because it's a really beautiful celebration of us all. Girls. Adam Maybe I'll ask in general, why did you decide to join the coalition those 12 years ago? Well because it is charitable work and very demanding. What made you specifically decide to join?

Ada Misiewicz
I have always wanted to be a paediatrician. It was my dream to become a doctor and be a paediatrician. It didn't work out. But when the opportunity to act for children arose, I thought to myself that this was also my debt. I don't have any premature babies, my two daughters were fortunately born on time. But with both pregnancies, at 28 29 weeks, there was such a risk that the birth could be premature. We managed thanks to the doctors, thanks to the pharmacotherapy, because I admit that I simply had to take medication to support the pregnancy. I managed to carry the pregnancy to term. On the other hand, working with children has always been a dream of mine and working at the foundation. The Coalition for Prematurity is a bit of a dedication, a debt of gratitude for what the doctors have done for me and for the fact that I'm not a mother of a premature baby. But it gives me a lot of pleasure and a lot of satisfaction now. It's for those parents of premature babies. I can do something and and help in some way.

Monika Rachtan
And what was it like for you? Why did you decide to join the coalition 12 years ago?

Ada Misiewicz
Exactly the same.

Ela Brzozowska
History. I am a mum of four children at the time the coalition was formed. I was a mum of two and all my pregnancies have always been high-risk pregnancies, at risk of preterm birth. Something like this happens to me that at 31 weeks I go into labour. I find myself in hospital on support and. And also just out of gratitude. The hospital on Karowa is particularly close to me, because all my pregnancies were towed there until the 38th week and I have a great fondness for. And gratitude to the doctors. And I also witnessed when I was lying on pregnancy support. The moments when the girls who were in the room with me were in labour at 26 27 weeks. Their fear, their terror, their crying. I don't think I will ever forget that. And I think I was too young then to understand the risks. I even remember negotiating with the doctor that I had to go back to work after all, I had to finish my projects and the doctor in the emergency room explained that if I left here, it could be very bad for my baby and I was hospitalised. I think in the public space at that time there was no talk of premature babies at all.

Ada Misiewicz
Moreover, I think there was a misconception. I have encountered such a claim that it is better to have a baby in the seventh month of pregnancy than in the eighth month. I don't know why.

Ela Brzozowska
That the lungs are not yet developed, so if you give surfutant, it will be better. And in this eighth month it is not known whether to give it or not. Such myths are indeed circulating.

Ada Misiewicz
We started at the foundation it was on the subject of premature babies, prematurity. I have the impression that very little was said, that and probably until now there is a kind of conviction among people who don't have contact with such children, that it's just a small, smaller newborn, such a miniature of a child actually born on time, and unfortunately this is not true. And it was only when I was working at the foundation and talking to doctors that I realised some things that I didn't know either. I also, when I was lying in the hospital at 28 29 weeks, I was thinking ah, I'm just going to get Surface and. And even if the girls are born it will be fine. Well it's like a person doesn't realise what it entails. Actually giving birth prematurely and at such a week 12.

Ela Brzozowska
We have just and witnessed great progress and have had the great pleasure of working with neonatologists. And this is such a special group of doctors, so dedicated to children, Exceptional. A very special group. And we also have constant daily contact with the parents. These are also people who have a huge burden that they carry on their shoulders. Because when a baby is tiny in an incubator, there is anxiety every day. It is sometimes one step forward, two steps back. Today is better, in a moment it is life-threatening. It is living with a sense of fear. I won't forget the mum who told me. I was afraid to love my baby because I had already lost one and the other was born weighing 500g. I didn't know if I would lose my second child. Parents who leave the ward every day feeling that they are abandoning their child And in fact, with our hearts, we feel that these parents should have the right to be with their child throughout.

Monika Rachtan
Time, All the time. And this is difficult now because, as we know, conditions in neonatal units vary in our country and we can say that in big cities it is a bit better. In smaller towns it is worse, but it can also be quite the opposite. On the other hand, I would like to go back to, because we have already talked about how the baby is born, what it all looks like. But I would also like to return to that moment when a woman receives this very difficult diagnosis, this very difficult information, that something worrying is happening with the pregnancy, that something worrying is happening with the child. Because usually it is the case that we, when we are pregnant, everything is fine. The prenatal test results are ok, it's like around the 20th week or maybe even the 15th week, and we say uffff. The worst is behind me. The unpleasant nausea ends, we feel better in this second, third trimester. In fact, we regain our strength And then comes that moment when just such information from the doctor can come, that dear mum-to-be, there is unfortunately a problem with your baby's health. And now you have to go to hospital.

Monika Rachtan
At first there is probably a need to rest and stop working. Then after a while there is the information that you have to go to the hospital. And like you said, that at the moment of receiving this information, not every girl is ready for it at all and not every girl is aware of the consequences that may be associated with not following the medical advice or even following it, but something just goes wrong. Are you already providing support to parents at this stage? If I get this information from my GP, can I call you, write to you, contact you in any way to get the support and information that I think is crucial at this very stage so that I don't make this mistake of omission.

Ela Brzozowska
It's that we have an over-achiever, Professor Maria Katarzyna Boryszewska Kornacka, who always says Please give me my phone number, please call me. So she consults and talks in pandemonium. I, in turn, had dozens, if not hundreds, of conversations with mothers who had already given birth to premature babies and had trouble getting into the ward because the hospitals were closed. And I will never forget those conversations, because the ones we have today are, let's say, ordinary conversations. Today, there are also many forums where parents can communicate with each other in closed groups in a safe environment. However, those 12 years ago, there were few such spaces. There were few such spaces. But it's when you're in hospital in an emergency situation that what you need is you really want hope and you really want to hear that it's going to be okay. And I think there's also this very big mistake that loved ones make, that they have no idea if they're going to be OK, and very often they say that. So. And my appeal is not to say If we don't know and we can't give such guarantees, there are things that doctors can say if they know based on their experience that it's going to be okay.

Ela Brzozowska
The question is what does it mean to be well? Because when a premature baby is born extremely early, at 24, at 25 weeks, anything can happen. That baby could die, it could have a stroke, it could have intestinal necrosis, it could have a lot of different health problems because all its systems are still immature. And I think that's the kind of moment when very few people can say that everything is going to be okay. What you can say to parents, and what it's good for loved ones to say, is to ask them what they can help with, to take care of an older child, for example, so that the mum can come to her premature baby in peace when she's already discharged from hospital. To simply be there to do the shopping, to help with the housekeeping, but not to say it will be OK. You can call us, you can write to us and we always talk to parents and give support. Fortunately, there are already many foundations like ours in Poland, and we are also a member of the National Alliance Together for Prematurity, so there really are a number of such spaces where you can find close, reliable people who have also gone through such a journey.

Ela Brzozowska
There are organisations that are also formed by parents of premature babies. Our Magda, Michalinka's mum, is also open to talking to parents, because I think there's nothing like talking to someone who has already been in those shoes, walked that road.

Monika Rachtan
Yes and that kind of person is also more reliable, more empathetic, they don't make those communication mistakes that you said, which is that everything is going to be fine, they're just more able to give that kind of support, that listen, I've been there, then maybe it would be worthwhile for you to consult this doctor, this doctor. It's worth going to this specialist. This doctor is well versed in premature babies. You come out of the hospital, then go to him, because you will definitely be well guided or led by him. So I think actually that kind of contact with the parent I call it, I had the same way. It's just a very good way to get reliable information.

Ela Brzozowska
And it is also a good idea to ask for help from a psychologist. In hospitals with third level of referral it is usually possible to talk to a psychologist who specialises in helping parents of premature babies. And there is no need to be afraid to talk to a psychologist, to be afraid that you will cry or that you do not have the strength to talk. The psychologist is able to surround you, to smother these emotions, and understands what a parent is going through. From research, we know that there are two emotions that are so overwhelming - the guilt in the mum who thinks she must have done something wrong during the pregnancy.

Monika Rachtan
And today still with such opinions. And I'm not talking about the fact that mothers may have this perception that they have done something wrong, but, for example, they hear from the environment such Unfortunately.

Ela Brzozowska
Unfortunately, it's common among grandmothers-in-law that it's better to try to separate yourself from toxic people. At a time like this, I think it is too.

Monika Rachtan
I don't know what your experience is, but that we women have, we tend to be such a Samaritan mother, yes? That is, we have a difficult situation, we have a baby born prematurely. The second child is often still at home, we have to embrace the care of this child. The husband works, so. Well, it all happens rather overnight. It's not like we have. When we get pregnant, we say Aha, if there was such a problem though, I have version A, B, C, D. It tends to take us by surprise and we have this tendency to blame ourselves, to shoulder even more, to say I can't cry, I can't survive.

Ela Brzozowska
Psychologists even call it the mourning of an undelivered pregnancy, of those dreams that just spoke of a pink baby bean. And here we have a blue baby with every vein visible and almost transparent skin and.

Ada Misiewicz
About the belly that isn't there. And yet we expected that in the seventh or eighth month of pregnancy this belly would be so big. And when the baby is born prematurely, it just doesn't have time to grow yet. So the mum has to, like Ela says, go through the mourning. That after everyone.

Ela Brzozowska
Those dreams, after plans, after pregnancy sessions, after walks, three days after leaving the hospital, after meetings with friends who were pregnant at the same time. And here there is a series of tasks and difficult situations getting ready, too.

Monika Rachtan
There are many decisions that have to be made, because of course the doctors who guide these parents try to answer all the questions, but sometimes it is the case that the parents have to decide on certain things. These are difficult decisions that they have to make and even such a difficult decision is when it comes to the care of the second child. Because when such a mother goes to hospital for six months, it is not at all said that this child will be in hospital for two months, three months. I'm sure you know of cases where children are in hospitals for even six months, yet this second child also has a bit of mourning for the mother, After a healthy sibling? Yes. So here, too, these are really very difficult situations already, and I think that this psychological support is crucial. And is it like this. Adam, maybe you know what it looks like, or. Because Ela said that in every hospital, but.

Ela Brzozowska
Third degree of reference.

Monika Rachtan
Third degree of reference, where.

Ela Brzozowska
Premature babies are born or transported, extremely premature babies who require very intensive care.

Monika Rachtan
But you know, it's often said that there is a psychologist on cancer wards, that there is a psychologist on the ward, that the obese patient should be looked after by a psychologist. And it's a bit of a case that there should be, and there isn't always. And in the case of premature babies, what are your experiences? Is there really this access to psychologists, and do the doctors also sort of push for this cooperation to be present here?

Ada Misiewicz
Doctors even tell us that they have to convince parents, because not all parents want to take advantage of such help, even if a psychologist is actually on hand in the ward where the child was born. Well, from our experience and from the conversations we have, it seems that these hospitals, third-degree referrals do indeed provide such psychological assistance. This is in line with.

Ela Brzozowska
The standard of perinatal care and the standard of care for a child born prematurely. So it's also the case that the health system is already forcing this psychologist to be available. Because what I hear from parents is that there are still not enough psychologists in relation to the needs of parents, especially practising parents, that parents don't really. Whether the mother doesn't want to talk, well it also takes time to open her up, to build an atmosphere conducive to such an opening up. And not to wait until the last call, when she's already at the limit of her own endurance, so probably that kind of care. Anyway, in hospitals, well we know that there are still not enough psychologists and there are many needs. What we can do and how we help is always to prepare materials that. That is the principle. All our materials are freely available to parents. And just in terms of the area of psychology and taking care of the subject of siblings, what you said is also in the trauma Older Siblings. It was supposed to be. There was supposed to be a little brother or sister to play with, and a seriously ill child is born.

Ela Brzozowska
So we prepare booklets like this, for example. Why is my brother premature? A story about a super-fast teddy bear. So that the child himself understands what happened to him. Why was he born too early? Dorothy, a superheroine about a little sister who came into the world prematurely. Just a psychological guide for parents, So that both dad and mum can face what happened to them? A guide on stimulating the development of a premature baby, which also includes a chapter from a psychologist, a neonatologist, a physiotherapist. It is music therapy for the premature baby.

Monika Rachtan
We have a QR code that we can scan. Beautiful, beautiful, really materials and it's also evident that everything is published with such care so that it also looks very, very nice. And thank you very much for these materials. I would like to thank you, above all, for the fact that they are free of charge, but I would also like to thank you for the fact that you are offering this reliable, verified knowledge right here, because thanks to this, parents have a reliable source of information, and they are not searching in the dark. We know that the problem of misinformation in health is enormous, so in any area, if such material appears, it is very valuable and very useful.

Ela Brzozowska
It's great that you say parents can find information, because in general fathers of premature babies are treated very neglectfully. And this dad of a premature baby? After all, he too has these dreams, fears, emotions, he feels like he has to tug on a mum who is shaken, scared. Because I've just started saying that research shows that mums have two such nagging feelings of guilt and fear, and fathers don't give a damn. There's also this stereotype in our society of the father who's supposed to be strong, he's supposed to be a rock. And he's not on maternity leave, he's not on leave. He still has the strength, he still has to have the strength to go to work every day and perform his duties in that job. There is even talk of post-traumatic stress syndrome, which mothers and fathers of premature babies experience just like after the war. And this is a gigantic topic and problem to work on. And not every dad also finds that space to ask for help, to turn to a psychologist and talk about his pain, his fear, his burden.

Monika Rachtan
We are about to enter February, a month in which we particularly talk about rare diseases. We know that such a premature birth can also be the first symptom that a rare disease is present in a child. And now, after this first bombshell, when we have a premature baby, comes the second suspicion of a rare disease and the diagnosis of a rare disease. Are these situations familiar to you too? And what help can you offer parents then? Is the system even ready for such a major crisis?

Ela Brzozowska
It is not just a question of rare diseases, but diseases in general that accompany prematurity. We know of cases of children who, after being discharged from hospital, spend up to 20 days a month in health centres because they have so many different complications of prematurity, and these are neurological, cardiological, ophthalmological, nephrological, gastroenterological. There's a lot of that. Plenty, because all their organs are immature. Is the system ready? Unfortunately, premature babies are said to be the same as any other child, only much more expensive. In the sense that parents unfortunately receive too little help and care from the State and organise, for example, rehabilitation privately and have to pay for it so that the child. Well, he or she still has to catch up with children who are their age. And in order for them to work at all and for there to be progress and not even more backwardness, well, they invest their own money in this. Fortunately, Kord, the coordinated care programme, has been set up in several places in Poland. But again, it's the case that it's luck depends on the postcode and either you're in a city and you're born in a hospital where the baby was referred to a hospital where the code is implemented or you're not.

Ela Brzozowska
And the court relies on the fact that in one place and at one time several specialists can see the premature baby and determine the management. However, the system is still far from perfect.

Monika Rachtan
But recently, with your great commitment, among others, we managed to get a very important thing passed in the Sejm, and then a bill appeared on the desk of Mr President Andrzej Duda, which amends the Labour Code and changes the rules for granting maternity leave to parents of premature babies and children who are born ill and who spend a long time in hospital after birth. Fortunately, the President did not hesitate to sign this law and we have this good news that the changes are coming into force. Tell us something about it: where did the idea come from? Was it difficult and, well, here I think the Minister was very much involved in helping.

Ada Misiewicz
Yes, it's true, it's a huge success for us, if not our biggest success. Certainly, last year we ended the year with such a beautiful event, which was just the passage of this law through the Sejm, the Senate and then the President's signature. But it really started in January and from January we started working with Minister Agnieszka DziemianowiczBąk from the Ministry of Family, Labour and Social Policy. But it wasn't just us, because the whole Together for Prematurity Agreement, which Ela has already mentioned, was involved. 10 10 organisations. We were joined by two organisations that work for children with heart defects, the Children's Heart Foundation and the Dearest Scar Foundation. And experts, of course. It all started with a petition, which I'm sure Ela will tell you about in a moment, and why this petition is there, which Ela will also tell you about in a moment. However, it was indeed a year of hard work, but one which, in the end, brought great satisfaction to us and, I think, to the whole environment and to all parents, because the progress of the work was immediate, sensational. And the commitment of the minister and her whole team was simply incredible.

Ada Misiewicz
So it really is a huge success for all of us that this has been done, and the law on 19 March will come into force this year, and from then on, parents will be able to reclaim the time they lost when their child was in hospital, And maternity leave, as it were, continues. Because, unfortunately, the law in Poland, but not only in Poland, is such that a woman has to start her maternity leave when the baby is born and she cannot interrupt it for the first eight weeks, and after that, whether the baby is in hospital for two weeks or ten weeks, the mother loses that leave, and now she will be able to get those weeks back, week after week. Depending on whether the baby is extremely preterm or a little more mature preterm, it will be either 8 weeks or as much as 15 weeks. Also we are really very happy with the way it has worked out.

Monika Rachtan
And how do you recall the job last year? Because it was hot. I only saw the coverage just from the Sejm, when you were there waiting for the MPs' opinion. How does it feel to win so much at all?

Ela Brzozowska
I call this law the Co-operation Act. It was something unbelievable. How did it unite? Like an avalanche of petition signatures? 16,000 signatures are also in total rarely such topics that electrify so much, They risk. And it has to be said that.

Ada Misiewicz
The signatures of people who will no longer, as it were, benefit from this law or the changes that have come in. We've also always talked about the fact that we're actually doing this for parents-to-be who maybe don't even know yet that they're going to be parents of premature babies, because even those mums who signed the bill last year and who are on maternity leave at the moment, some of them unfortunately won't be able to take advantage of those extra weeks anymore. So it was also amazing that both doctors and nurses, just parents of premature babies, who are now 9 10 years old, are saying I won't benefit, but I'm signing. So yes, amazing.

Ela Brzozowska
Also, it was something unbelievable. What was the avalanche of sharing, of messages? How can we help? How can we get involved? And it all started in November 23, when it was World Prematurity Day. And we basically talked about it every year, in letters to past governments, and we always made the point that something had to be done about it, that it was unfair that mothers of premature babies lose their maternity leave when the baby is in hospital, and the mother just misses out. And that went completely unheeded. And on a global day. Natalia Szewczak, a journalist from Business Insider Poland, was preparing a report and contacted me. She contacted experts, while she herself is a mother of extremely premature twins born at 28 weeks. Lena and Philip were born in a pandemic, so she felt perfectly what she was writing about. And she also wrote about how much a premature baby costs, how much the state spends to secure the health of a premature baby. And so we were together. We were giving an interview In two media we were going in a taxi. And she turned me on so much that I think to myself no, this can't end.

Ela Brzozowska
On the interviews themselves, something has to be done. And in the evening I sat down, I wrote a petition, I wrote to Ada, to the professor, are we doing, are we doing. I wrote to these eight organisations of ours that make up the Together for Prematurity agreement. I'm writing a petition. You sign it, we are doing it together we are doing it. And we just worked hand in hand. Professor.

Ada Misiewicz
Helwich, Professor.

Ela Brzozowska
Helwich National, the consultant in neonatology, then Professor Ryszard Lauterbach, and later your successor, Professor Tomasz Szczapa, that is, the presidents of the Polish Society of Neonatology. Yes, of course, because after all, this substantive support was also necessary. Well, and in January we went to Agnieszka DziemianowiczBąk, who was the newly appointed Minister of Family, Labour and Social Policy. There were still unpacked cardboard boxes in the ministry. I think we were the first team that wanted something.

Ada Misiewicz
We brought two more cartons with printed signatures.

Ela Brzozowska
Yes, just all the signatures and all the comments. And there were thousands of these comments too. Why do different people sign? Because they were. There were parents of premature babies and parents of not premature babies who felt this subject and doctors and nurses. And I have to say that having worked for so many years, dealing with health, health education, acting for the benefit of the health care system, I have never before come across such a personal involvement of a politician, that it was this sensitivity, this openness, this real respect for the social side, the willingness to listen to the minister, that she could just play a purely drunken game and say here in the light of flashes that she accepts the petitions and one day the ministry will deal with it. On the other hand, there was an immediate decision to set up a working group at the Ministry, to which all our organisations and the medical side, the Ministry of Health, the Children's Ombudsman and the Patients' Ombudsman were invited. Anyway, it was also amazing, because immediately after we published the petition, Minister Monika Cieślak, the ombudsman for children's rights, called me herself, immediately declaring her support, inviting me to a meeting. Similarly, Ms Aleksandra, an MP who is also a mother of a premature baby.

Ela Brzozowska
She felt the subject perfectly and also said I will do my best to help you. So it was something unbelievable, how simply like a magnet this subject attracted people who felt and who had sensitive hearts. Well, and in March there was actually already a draft prepared by the ministry, a bill. Well, and we still threw a little bombshell into that bill. And the minister, with great patience and such openness, listened to our arguments and granted our request and the bill was amended. It was about the parents of extremely premature babies, that is, those under 28 weeks gestation. Well, because these are children who usually spend a few months, not a few weeks, in hospital, Because in general, for those who don't know, the clue is that after the birth of the child, according to European Union law, our local law, the labour code protects the mother for the duration of the confinement to recover. So maternity leave cannot be suspended until eight weeks have passed. That is the time for the woman to recover. Well, but this turns against the mum of a premature baby or the mum of a sick newborn.

Ela Brzozowska
Well, because the child is in hospital, the mother is discharged. And she is not with the child 24 hours a day. Not to mention that when you have a child who may die, who is in a very serious condition, well, it is difficult to say that she is on maternity leave with this child. Well, we have just shown, Minister, what an extremely premature baby looks like and that such a mum really needs and dad needs more than 8 weeks. The Minister herself also took the initiative and proposed that our request, which was in the petition, should be extended to include fathers and legal guardians, so that foster carers could also benefit from this law. If a premature baby comes into the care of foster parents, and that it should be optional and not compulsory, which I also think is very fair, because we have different professional situations and some people will want to take advantage of it, while others will not. So this openness, this equal approach of the Ministry really captured me very much and a huge respect for us. I have to say that, unfortunately, it is with pain and a little tear in my eye that I do not observe a similar approach on the part of the Ministry of Health, to which we also write, having many topics to discuss, and we have not yet experienced such openness.

Monika Rachtan
And tell me, my dears, what other maternity leave has just taken place? Super task for 2024 done. And what in 2025 would you like to get. What should the Ministry of Health introduce? Maybe not the Ministry of Health, but maybe there are some other institutions that should bend to the problems of the parents of premature babies?

Ada Misiewicz
We have some of these themes. We have.

Ela Brzozowska
We established the RSV coalition at our coalition over a year ago. This is a coalition that includes the greatest experts in family medicine, neonatology, paediatrics, vaccinology, gynaecology, public health pharmacoeconomics, who and non-governmental, parent, pro-patient organisations. And our goal is that prevention of RS infections should be available to all infants, not just preterm infants. We also fought for premature babies here hand in hand with the neonatal society and the national consultant in neonatology for 12 years and today we have one of the best programmes for premature babies. On the other hand, medicine has evolved and we have several tools at our disposal. There are vaccinations for pregnant women and there is monoclonal antibodies in one dose for the whole season. And already 17 countries give them to all infants. We, unfortunately, are still not able to talk to the Minister, but we were able to talk to Director Urbanska about this. I know that the ministry does too. In fact, Minister Leszczyna has declared publicly in Facts that she is committed to funding. However, there is still nothing concrete about this.

Monika Rachtan
But also such a conversation with people who are close to the parents, who are close to the children of newborns, could confirm to the Minister whether this is right or wrong. If there are any doubts now, or how to introduce these new regulations so that they serve. It is not really in.

Ela Brzozowska
The general doubt from the medical side is that prevention is better than cure. And if we are dealing with a child who was born on time, who was developing well, and in the tenth month contracted RSV with complications, today the boy is 4 years old and hardly speaks because he was hypoxic in infancy due to infection with this virus. Of course, not every child is so acutely ill, it is just that we do not know exactly which child will end up in hospital, under a ventilator, which will end up in hospital not requiring a ventilator but oxygen, and which will pass the infection quite mildly. That is why it is better to keep children safe.

Monika Rachtan
Of course, in the context of each vaccination, we will say exactly.

Ela Brzozowska
And here, too, in order to remove the burden of vaccination, which unfortunately also raises doubts in our society, which should not be the case at all, this is not vaccination, these are ready-made antibodies. In other words, the body is given such ready-made knights who, on contact with the virus, with the enemy, immediately fight back. That is to say, unlike a vaccine, the child's body does not have to produce antibodies, but gets ready-made antibodies which, throughout the season, which lasts from October to April, simply defend against the onslaught of this enemy. We know that last year there were more than 20,000 avoidable hospitalisations with 23.

Ada Misiewicz
Last year there was even more.

Ela Brzozowska
Because there was no register before now and testing.

Ada Misiewicz
What the experts confirm and say is that precisely 95% of these babies who are in hospitals are babies who were born on time, who were previously healthy, who had neither risk factors nor comorbidities. The reason premature babies don't end up there is because premature babies are protected. And this only confirms how good and effective such prevention is.

Ela Brzozowska
On the subject of prevention, we have a dozen points. We would very much like to be able to discuss them in a letter to the Minister, because it is also a question of the fact that we are at the tail end of Europe when it comes to combined vaccinations. It is simply embarrassing that a country in central Europe does not protect its children with combined vaccines. Another issue is meningococcal vaccination. Premature babies should be guaranteed this vaccination by the state. There are recommendations for this. We do not have this either. Pneumococci. We have a vaccine reimbursed by the state that does not contain this stereotype, which is the most common in Poland. That is, the state spends money and children are not protected. Another paranoia, which means that we need to talk in general about approach, about strategy, about thinking, about prevention, so that it corresponds to the epidemic situation in the country, well, and so that it gives the broadest possible protection, because this will give benefits not only in terms of health, emotional, social, but also financial. Children will not need to be hospitalised, they will not need to be rescued from sepsis, from asthma, as is a complication of RSV infection.

Ela Brzozowska
You need a bit more of a long-term perspective on this, rather than over the course of your term of office.

Monika Rachtan
That is precisely it. And this year, in 2025, when Poland is leading the European Union, it seems that prevention, in the context not only of vaccinations but also of other diseases, is a subject which should be of particular interest to the Ministry of Health. I would like to appeal to the Minister for Health, Izabela Leszczyna, to start talking about prevention and also to introduce measures which will simply allow preventative action to be taken. As far as my dear viewers are concerned, I would like to remind them that on 26 January the Great Orchestra of Christmas Charity will be playing, and all of us, just like my guests Ela and Ada here, will certainly play for the Orchestra, so we would also like to encourage you to wear the hearts of the Great Orchestra on your jackets, sweatshirts, sportswear and T-shirts. Girls, are you going? Playing?

Ada Misiewicz
We will be to.

Ela Brzozowska
The end of the world and one day more.

Ada Misiewicz
My older daughter will be volunteering for the second time this year. So yes, definitely.

Ela Brzozowska
My son also volunteered many times. I was always very proud of that. We have here. Every year we publish a calendar with premature babies, We have Frank, who is also a volunteer and says. The orchestra saved my life. Today I play for the orchestra. It's fantastic and let's just unite in this good that Jurek has created. And I think that each of us actually benefits or will benefit from the equipment that, thanks to Jurek and all of us who contribute to the Great Orchestra of Christmas Charity piggy banks, we benefit from.

Monika Rachtan
At my place today on the couch Ada Misiewicz. Ela Brzozowska. Thank you very much, girls, for our meeting today, for the beautiful stories about premature babies. Thank you very much for your attention. This was the Patient First programme. My name is Monika Rachtan and I invite you to visit my social media. See you there!