Cover_Jan 05 (Page 2) - The Parklander Magazine

Newborns Receive
Special Treatment
The birth of a child is one of the most exciting
times of parents’ lives. While most parents do
everything they can to ensure their child is
born healthy, problems sometimes arise that
require a newborn to remain hospitalized
longer than expected.
When complications occur, infants are
often sent to an intensive care unit that
specializes in treating sick newborns, often
called a neonatal intensive care unit or NICU.
Babies are often admitted into NICUs within
24 hours after birth, before they have been sent
home. The illnesses vary, but some of the
reasons an infant might enter a NICU is if he is
born prematurely, if difficulties arise during
delivery or if signs of a problem show up within
the first few days of life. Common NICU diagnoses
include:
Anemia—a low red blood cell count
Apnea—slowed breathing; the baby’s brain does
not remember to take a breath
Hydrocephalus—the buildup of fluid around the brain
and spinal cord; also called “water on the brain.”
Jaundice—a high level of bilirubin (a byproduct of the
natural breakdown of blood cells) in the blood.
Sepsis— an infection caused by bacteria growing in
the blood.
Once an infant enters a NICU, he will receive care tailored
to his specific needs. Equipment used in NICUs, such as
incubators and ventilators, are made especially for premature
infants and their special needs. Most babies in NICUs are
on special feeding schedules, depending on their level of
development or any problems they have. For example, some
infants cannot eat on their own and must have a feeding tube
that runs through the mouth and into the stomach. Others
need high-calorie diets to help them grow.
The doctors and nurses who work in NICUs specialize in
caring for newborns and the illnesses that afflict them. Infants
will often have multiple doctors assisting with care. A neonatalogist,
a doctor who specializes in newborn intensive care,
usually heads up the medical team. Specialists, such as
neurologists, cardiologists and surgeons, often care for the
babies as well, depending on the illness.
Having a child in a NICU can be very overwhelming for
parents. Nurses are often a great resource because they see the
baby every day. Nurses can give parents frequent updates on
the baby’s condition and explain what the monitors, tubes and
machines do. However, it is important to remember that nurses
do not make diagnoses. Parents should discuss a diagnosis or
their baby’s overall plan of care with the neonatologist.
Most parents want to bond immediately with their
newborn and they can still do it in a NICU. Doctors will tell
parents how much contact they can have with their newborn,
but parents are almost always allowed to visit and spend time
bonding with their child. Depending on how sick the baby is,
parents may be allowed to hold him, even if he is on a ventilator
or has an IV. Sometimes holding might be too much for
the baby, but parents will be allowed to hold his hands or
stroke his head. If a doctor thinks touching would be too
stressful on the baby, parents may still be encouraged to
talk and sing to him.
While complications during or after childbirth
are often unexpected, it is important for parents to
know their options for care before labor begins.
Not all hospitals have NICUs and their
capabilities differ. NICUs are rated I, II
or III, with a level III NICU being
equipped to handle difficult neonatal
emergencies while a lower rating
might require a baby to be transported
to another nursery in a different
hospital. West Boca Medical Center is
the only level III NICU from northern
Broward County to Boca Raton. It also has
a neonatal transport team that cares for newborns
in critical condition as they are transported
to WBMC from other facilities.
Knowing what type of nursery your hospital
or birth center offers before labor starts will
allow you to concentrate on your health and
the health of your baby instead of making lastminute
decisions. ● P
Photos by Steve Shires
Continued from page 16
Fighting Lung Disease
Since the FDA approval of surfactant, neonatologists
have been able to dramatically improve the survival of very
immature infants with lung disease. They also can reduce
lung injury from prolonged use of the ventilator. Prior to the
use of surfactant these premature infants would need to be on
ventilators for 2-3 weeks. Now these infants are usually taken
off the ventilator within 3-4 days.
Since RDS usually occurs as a result of prematurity, every
effort is usually made to help the mother carry the baby to
term. This begins with the first prenatal visit, which should
be scheduled as soon as the mother discovers that she is
pregnant. Statistics clearly show that good prenatal care
results in healthier babies. If a mother does go into labor
prematurely, every effort is made to stop the labor and allow
the pregnancy to continue to full term. A lab test called the
L/S ratio (a measurement of the fetus’ lung maturity) is made
and labor is usually halted with medication until the L/S ratio
shows the lungs have matured.
The infant has a decreased risk of RDS, but may still need
support in a neonatal intensive care unit. When it appears that
premature delivery is unavoidable, administration of corticosteroids
to the mother 2-3 days prior to delivery may help the
fetal lung tissue mature in certain cases.
Many breakthroughs are expected for premature infants
in the next 10 years. The use of surfactant as well as newer
ventilators, which provide a gentler form of ventilation for
these fragile infants, remain encouraging. Organizations
such as the March of Dimes and academic research
continue to increase the chances of intact survival for the
premature infant. ● P
Dr. Brenker is medical director of Neonatal Intensive Care & Newborn
Services at Boca Raton Community Hospital. E-mail him at
brenker@theparklander.com.
the PARKLANDER 17