Tending The Tiniest Babies



BY PEGGY O’FARRELL

The first time the monitor started beeping, Marla Peyton was terrified, not knowing what was wrong with her newborn.

The nurses at Cincinnati Children’s Hospital Medical Center had to explain it to her: Jamey’s blood oxygen levels had dropped too low.

He was born about four months premature, and his little body can’t always regulate functions that should be automatic.

Now, when the beeping starts, she holds Jamey a little closer, strokes his head and croons, “It’s all right, sweetheart. Mommy’s here.”

A second later, the monitor falls silent as Jamey’s oxygen level returns to normal.“It was scary the first time,” Peyton said. “The first time it happened, it brought tears to my eyes.”

All first-time parents have a lot to learn. Peyton is a first-time mom who has to learn to manage a host of tubes and wires and monitors that keep her baby properly fed and breathing.

A team of health-care professionals are teaching her the ins and outs of taking care of a fragile newborn.

Jamey was airlifted to the Regional Center for Newborn Intensive Care at Children’s Hospital shortly after his birth Nov. 19 in West Virginia. He was born about four months’ premature.

In addition to the usual problems premature babies have, he faces an additional hurdle. He was born with an open abdominal wall, and his intestines are on the outside of his body.

He will undergo surgery next month to fix the problem.

Children’s was recently designated a special center to train health-care providers and parents how to best care for babies in newborn intensive care units, one of just 17 hospitals worldwide to earn the designation, which is awarded by the NIDCAP Federation International, a non-profit organization. NIDCAP stands for Newborn Individual Developmental Care and Assessment Program.

For now, a team of nurses, speech, respiratory and occupational therapists and other health professionals are concentrating on training staff within Children’s, as well as parents of babies in the newborn intensive care unit, said Patti Bondurant, a registered nurse and the unit’s senior clinical director. Eventually, they’ll train staff at other hospitals in the region.

The team uses a special observational tool, called a “NIDCAP,” to gauge premature infants’ behavior and figure out their individual needs.

Using a checklist, team members like registered nurse Linda Lacina and occupational therapist Noelle Nageleisen watch babies eat, sleep, breathe, fuss and interact with parents, doctors and nurses in the nursery.

The babies’ behavior helps the team figure out how to best care for them, and they pass that knowledge on to the parents.

When Jamey lifts his hands to his face, he’s soothing himself, Lacina said.

When his blood pressure drops, it’s often a response to a stressful environment. Premature babies’ nervous systems are immature, and they’re easily hyper stimulated, said Beth Haberman, a neonatologist and medical director of Regional Center for Newborn Intensive Care.

Lacina and her team help nurses in the center and parents learn how to soothe their littlest patients with gentle touches, a change in position or lullaby. They also help parents learn how to manage their babies’ breathing and feeding tubes.“Parents see their children with all these nurses and all the monitors and all these tubes and wires, and they’re afraid to touch their babies,” Lacina said.

But babies like Jamey need their mothers’ touch just as much as they need all those tubes and wires, she said.

Peyton said it was overwhelming at first to see her son surrounded by medical equipment and see nurses come running whenever a monitor a beeped.But the drama didn’t keep him out of her arms for long.

Now, when Jamey’s oxygen monitor starts beeping, she said, “I just let it do its thing and talk to him until he calms down.”