Posts
The Risk of Inducing Labor
By Robin Elise Weiss, LCCE, About.com
The induction of labor can be done for many reasons, including many valid medical reasons. However, the rise in the rate of social inductions, or elective inductions is on the rise. As the induction rate rises there are more babies and mothers placed at risk for certain complications. Here are five risks of induction that you may not know about:
1. Increased risk of abnormal fetal heart rate, shoulder dystocia and other problems with the baby in labor.
Labor induction is done by intervening in the body's natural process, typically with powerful drugs to bring on contractions or devices that are used to break the water before labor starts. Both of these types of induction can cause the baby to react in a manner that is called fetal distress as seen by fetal monitoring.
The nature of induction like contractions may also be more forceful than natural labor. This can cause your baby to assume or stay in an unfavorable position for labor making labor longer and more painful for the mother. It can also increase the need for other interventions as well.
2. Increased risk of your baby being admitted to the neonatal intensive care unit (NICU).
Babies who are born via induction have not yet sent signals to the mother to start labor. This means that they simply aren't yet ready to be born. This risk is worth it if the baby or mother's lives are in danger, but simply to take this risk for elective reasons may not be well advised.
When a baby is in the intensive care unit there is less ability for you to be with your baby or to hold your baby. Breastfeeding usually gets off to a rocky start as well. This can usually be avoided by giving birth when your body and baby say it is time.
3. Increased risk of forceps or vacuum extraction used for birth.
When labor is induced babies tend to stay in unfavorable positions, the use of epidural anesthesia is increased and therefore the need to assist the baby's birth via the use of forceps and vacuum extraction is also increased.
4. Increased risk of cesarean section.
Sometimes labor inductions don't take, but it's too late to send you home, the baby must be born. The most common cause of this is that the bags of waters has been broken, either naturally or via an amniotomy. Since the risk of infection is greater, your baby will need to be born via c-section.
A cesarean in an induced labor is also more likely for reasons of malpresentation (posterior, etc.) as well as fetal distress.
5. Increased risks to the baby of prematurity and jaundice.
Induction can be done before your baby is ready to be born, because your due date is off or because your baby simply needed more time in the womb to grow and mature their lungs. Your baby may also be more likely to suffer from jaundice at or near birth because of the induction. This can lead to other medical treatments as well as stays in the hospital for your baby.
Being born even a week or two early can result in your baby being a near term or late preterm infant. This means that your baby is likely to have more trouble breathing, eating and maintaining temperature.
Showing posts with label nicu. Show all posts
Showing posts with label nicu. Show all posts
Thursday, November 12, 2009
Wednesday, October 14, 2009
5 Reasons to Avoid Induction of Labor
Posted by the Denver Doula on Facebook
Written by By Robin Elise Weiss, LCCE, About.com
The induction of labor can be done for many reasons, including many valid medical reasons. However, the rise in the rate of social inductions, or elective inductions is on the rise. As the induction rate rises there are more babies and mothers placed at risk for certain complications. Here are five risks of induction that you may not know about:
1. Increased risk of abnormal fetal heart rate, shoulder dystocia and other problems with the baby in labor.
Labor induction is done by intervening in the body's natural process, typically with powerful drugs to bring on contractions or devices that are used to break the water before labor starts. Both of these types of induction can cause the baby to react in a manner that is called fetal distress as seen by fetal monitoring.
The nature of induction like contractions may also be more forceful than natural labor. This can cause your baby to assume or stay in an unfavorable position for labor making labor longer and more painful for the mother. It can also increase the need for other interventions as well.
2. Increased risk of your baby being admitted to the neonatal intensive care unit (NICU).
Babies who are born via induction have not yet sent signals to the mother to start labor. This means that they simply aren't yet ready to be born. This risk is worth it if the baby or mother's lives are in danger, but simply to take this risk for elective reasons may not be well advised.
When a baby is in the intensive care unit there is less ability for you to be with your baby or to hold your baby. Breastfeeding usually gets off to a rocky start as well. This can usually be avoided by giving birth when your body and baby say it is time.
3. Increased risk of forceps or vacuum extraction used for birth.
When labor is induced babies tend to stay in unfavorable positions, the use of epidural anesthesia is increased and therefore the need to assist the baby's birth via the use of forceps and vacuum extraction is also increased.
4. Increased risk of cesarean section.
Sometimes labor inductions don't take, but it's too late to send you home, the baby must be born. The most common cause of this is that the bags of waters has been broken, either naturally or via an amniotomy. Since the risk of infection is greater, your baby will need to be born via c-section.
A cesarean in an induced labor is also more likely for reasons of malpresentation (posterior, etc.) as well as fetal distress.
5. Increased risks to the baby of prematurity and jaundice.
Induction can be done before your baby is ready to be born, because your due date is off or because your baby simply needed more time in the womb to grow and mature their lungs. Your baby may also be more likely to suffer from jaundice at or near birth because of the induction. This can lead to other medical treatments as well as stays in the hospital for your baby.
Being born even a week or two early can result in your baby being a near term or late preterm infant. This means that your baby is likely to have more trouble breathing, eating and maintaining temperature.
Written by By Robin Elise Weiss, LCCE, About.com
The induction of labor can be done for many reasons, including many valid medical reasons. However, the rise in the rate of social inductions, or elective inductions is on the rise. As the induction rate rises there are more babies and mothers placed at risk for certain complications. Here are five risks of induction that you may not know about:
1. Increased risk of abnormal fetal heart rate, shoulder dystocia and other problems with the baby in labor.
Labor induction is done by intervening in the body's natural process, typically with powerful drugs to bring on contractions or devices that are used to break the water before labor starts. Both of these types of induction can cause the baby to react in a manner that is called fetal distress as seen by fetal monitoring.
The nature of induction like contractions may also be more forceful than natural labor. This can cause your baby to assume or stay in an unfavorable position for labor making labor longer and more painful for the mother. It can also increase the need for other interventions as well.
2. Increased risk of your baby being admitted to the neonatal intensive care unit (NICU).
Babies who are born via induction have not yet sent signals to the mother to start labor. This means that they simply aren't yet ready to be born. This risk is worth it if the baby or mother's lives are in danger, but simply to take this risk for elective reasons may not be well advised.
When a baby is in the intensive care unit there is less ability for you to be with your baby or to hold your baby. Breastfeeding usually gets off to a rocky start as well. This can usually be avoided by giving birth when your body and baby say it is time.
3. Increased risk of forceps or vacuum extraction used for birth.
When labor is induced babies tend to stay in unfavorable positions, the use of epidural anesthesia is increased and therefore the need to assist the baby's birth via the use of forceps and vacuum extraction is also increased.
4. Increased risk of cesarean section.
Sometimes labor inductions don't take, but it's too late to send you home, the baby must be born. The most common cause of this is that the bags of waters has been broken, either naturally or via an amniotomy. Since the risk of infection is greater, your baby will need to be born via c-section.
A cesarean in an induced labor is also more likely for reasons of malpresentation (posterior, etc.) as well as fetal distress.
5. Increased risks to the baby of prematurity and jaundice.
Induction can be done before your baby is ready to be born, because your due date is off or because your baby simply needed more time in the womb to grow and mature their lungs. Your baby may also be more likely to suffer from jaundice at or near birth because of the induction. This can lead to other medical treatments as well as stays in the hospital for your baby.
Being born even a week or two early can result in your baby being a near term or late preterm infant. This means that your baby is likely to have more trouble breathing, eating and maintaining temperature.
Thursday, February 19, 2009
A NICU Story Part II
Posted by Kim:
A continuation of yesterday's post, here are some more letters we wrote to Connor while he remained in the NICU. While our stint in the hospital was about to get worse, it was also the beginning of the answers to Connor's problems. Thank goodness for Denver's Children's Hospital!
Written by Kim
October 28, 2002
Dear Connor,
Today was a day filled with joy and concern. I was so excited to come to the hospital and see you today because I knew you would not need the bililights, which meant that I could hold you all day long. When I called Karen in the nursery last night she told me you had gained 16 grams. Dad and I were both VERY excited about that. When I came into the hospital this morning you took 23ccs from a bottle. I just knew it was going to be a good day. You laid in my arms all morning long, I couldn't bare to put you down. I just love it when you snuggle your head into my neck. You are the most beautiful and loving baby. Sometimes I can't believe you are mine. I often wonder how my life can be any more perfect. I have the greatest husband and the most wonderful son. We sat on the couch and read stories all day. We read about Old Yeller, Paul Bunyan, and Pecos Bill and of course we read your favorite book "Guess How Much I Love You." Later in the afternoon we had a wonderful visit with Aunt Kathy and your little friend Adrian. We had lunch on the floor and Adrian just stared at you. He can't wait until you start going over to his house to play. You two are going to have the greatest time growing up together.
When Mom and Grandma came back to the hospital to feed you at 5pm you weren't feeling very good. Dr Rosquist came to visit and we decided to go for a trip to Denver. You were the greatest little thing and got to ride in the ambulance with the nice nurses. I am sure it was very exciting. We are at Children's Hospital now and the nice doctors are looking you over. I knew we are going to figure out what is going on . They are going to fix it and you will soon be home with Mom and dad. We love you so much. Can you guess how much?
We love you all the way to the moon and back.
After a trip home to pick up Grandma Sarah and Paul we arrived at the hospital to find things spiraling down for Connor quite rapidly. It was kind of like watching a car accident. Everyone was rushing around quickly taking care of Connor and another critical baby that had just been born, but at the same time everything seemed to be moving in slow motion and the sound was drowned out by my mind wondering what was happening. The nurses were amazing,
truly like Mothers to me rather than clinical medical nurses. I will never forget seeing Connor's limp little body laying in the crib with the oxygen tent over his head. I just wanted to hold him, he needed to be held by his Mom! The sweetest nurse just stood by his side singing Amazing Grace and rubbing his little fingers. The Flight for Life team came to take the other baby to Denver and we were waiting for Connor's team to arrive. The LUH nurses kept taking Polaroid pictures of Connor and giving them to me. I didn't understand what was going on and I kept screaming inside of my head saying "Stop taking his picture" because I was thinking that they thought these might be his last pictures alive. In retrospect however, I wonder if they took the pictures so when we arrived at the hospital we would be able to identify Connor, because there was not room in the ambulance for us ride along with him. Everything was so scary and all I could think of was the worse case scenario. I kept praying and praying that Connor would be ok. Life couldn't be that cruel, God wouldn't separate me from my baby, he was going to live! I'll never forget the long drive to Denver Children's Hospital, following the ambulance wishing I could be in the ambulance with Connor.
October 29, 2002
Dear Connor,
Again today was filled with joy and concern. We woke up in our little parent sleep room somewhat refreshed and immediately rushed downstairs to see you. You are just so cute I can't take my eyes off of you.
Around lunch time Auntie Amy brought Grandma Sarah down to the hospital to see you. We were all staring at you and saying how you are the most beautiful baby we have ever seen.
Soon after lunch Dr Mitchel came to see us to tell us about a heart procedure they were going to do. You have a duct in your heart (PDA Duct) that should have closed soon after you were born, but it didn't. So Dr Mitchel will go into your chest and tie off the duct so that all the blood flows where it should. We are also hoping that once this is complete it will help your intestines do the job they should do.
You went in for surgery around 4:20pm and Mom and Dad were VERY worried, but luckily Auntie Amy and Grandma were here to keep us company. We were also talking to Grandma Vonnie and Grandpa Roger every hour or so to keep them updated.
Not an hour later the nurse and the doctor came in to see us all and they said you were a perfectly behaved boy and the surgery was a great success. You even pooped while on the surgery table. You are just so cute.
We all hated to leave the hospital tonight, but we knew you were in good hands and boy did Mommy need a shower! Daddy too! But we knew we would be down to see you first thing tomorrow morning. We love you so much!
Even though being transferred to Children's Hospital was the scariest night of my life, it proved
to be the best thing that could have happened to us. We had spent the last week in limbo in the Longmont NICU having no idea what was going on or how to make things better. We finally arrived at Children's around midnight, they gave us a parent sleep room that consisted of a bed, sheets and a phone for $1 rental, but at least we had somewhere to sleep. By the time we were at Connor's bedside at 8am the next day Drs Karrer and Hendrickson had already identified the need for a PDA duct ligation and the possibility that Connor had Hirschsprung's Disease. We had hoped after the PDA Duct ligation that the new blood flow would correct Connor's bowel problems, but things remained the same so the doctors took a tissue sample from Connor's colon and when the test results arrived they discovered that Connor did in fact have Hirschsprung's disease, a rare disease of the large intestine where the ganglion cells, or nerve cells that make the intestine push stool down to be excreted, are absent in some or all of the intestine. The stool then backs up in the intestine causing an infection in the belly and would eventually cause death. This disease is more often found in children with Down's Syndrome and has varying degrees of severity.
Thankfully after several days of observation and an enema, the doctor discovered that only the lower sigmoid region of Connor's colon was effected and at 3 months he would be eligible for a Pull Through Surgery. So they kept Connor in the hospital for observation for one week after we arrived to make sure he was stable and to educate us on how to care for Connor's bowels until the surgery.
Each day we would go down to the hospital and sit by Connor's side in the one chair that was there. Every three hours I would go to the breast pump room (which was about the size of a phone booth) and pump enough milk to feed the entire NICU! I was just glad they continued to feed Connor the breast milk and the my milk stayed so that I was able to nurse Connor until he was a year old. These pumping breaks were literally the longest 20 minutes of my life. I am not sure what the new hospital has, but hopefully there is a little tv or something in the pumping room!
Eventually on November 5th after they had deemed Connor stable and taught us how to irrigate his bowels with a tube and saline solution (which we had to do for 3 months) we were released from the hospital and ready to go home. It was so funny because I had been praying for so long for Connor to come home with us, but when they actually said we could leave I started to panic a little and worried if I would be able to take care of this precious little baby. Until now I had hardly even changed his diaper or dressed him in clothes. Luckily love overcame fear and I knew that Paul and I would be wonderful parents. As you can imagine once we arrived home we could hardly put Connor down. He rarely if ever slept in the crib or pack and play and eventually we just adopted the family bed and we haven't changed since!
Connor looked so tiny in his car seat it seemed like it really wasn't very protective.
At 3 months old Connor had his pull through surgery, they removed the lower sigmoid region and he began popping right away and hasn't stopped since! I was very impressed with the care we received at Denver Children's Hospital and I was particularly impressed with our doctors Dr Karrer and Dr Hendrickson. While I never imagined this situation happening I was so thankful to have such a great hospital close by!
A continuation of yesterday's post, here are some more letters we wrote to Connor while he remained in the NICU. While our stint in the hospital was about to get worse, it was also the beginning of the answers to Connor's problems. Thank goodness for Denver's Children's Hospital!
Written by Kim
October 28, 2002
Dear Connor,
Today was a day filled with joy and concern. I was so excited to come to the hospital and see you today because I knew you would not need the bililights, which meant that I could hold you all day long. When I called Karen in the nursery last night she told me you had gained 16 grams. Dad and I were both VERY excited about that. When I came into the hospital this morning you took 23ccs from a bottle. I just knew it was going to be a good day. You laid in my arms all morning long, I couldn't bare to put you down. I just love it when you snuggle your head into my neck. You are the most beautiful and loving baby. Sometimes I can't believe you are mine. I often wonder how my life can be any more perfect. I have the greatest husband and the most wonderful son. We sat on the couch and read stories all day. We read about Old Yeller, Paul Bunyan, and Pecos Bill and of course we read your favorite book "Guess How Much I Love You." Later in the afternoon we had a wonderful visit with Aunt Kathy and your little friend Adrian. We had lunch on the floor and Adrian just stared at you. He can't wait until you start going over to his house to play. You two are going to have the greatest time growing up together.
When Mom and Grandma came back to the hospital to feed you at 5pm you weren't feeling very good. Dr Rosquist came to visit and we decided to go for a trip to Denver. You were the greatest little thing and got to ride in the ambulance with the nice nurses. I am sure it was very exciting. We are at Children's Hospital now and the nice doctors are looking you over. I knew we are going to figure out what is going on . They are going to fix it and you will soon be home with Mom and dad. We love you so much. Can you guess how much?
We love you all the way to the moon and back.
After a trip home to pick up Grandma Sarah and Paul we arrived at the hospital to find things spiraling down for Connor quite rapidly. It was kind of like watching a car accident. Everyone was rushing around quickly taking care of Connor and another critical baby that had just been born, but at the same time everything seemed to be moving in slow motion and the sound was drowned out by my mind wondering what was happening. The nurses were amazing,
truly like Mothers to me rather than clinical medical nurses. I will never forget seeing Connor's limp little body laying in the crib with the oxygen tent over his head. I just wanted to hold him, he needed to be held by his Mom! The sweetest nurse just stood by his side singing Amazing Grace and rubbing his little fingers. The Flight for Life team came to take the other baby to Denver and we were waiting for Connor's team to arrive. The LUH nurses kept taking Polaroid pictures of Connor and giving them to me. I didn't understand what was going on and I kept screaming inside of my head saying "Stop taking his picture" because I was thinking that they thought these might be his last pictures alive. In retrospect however, I wonder if they took the pictures so when we arrived at the hospital we would be able to identify Connor, because there was not room in the ambulance for us ride along with him. Everything was so scary and all I could think of was the worse case scenario. I kept praying and praying that Connor would be ok. Life couldn't be that cruel, God wouldn't separate me from my baby, he was going to live! I'll never forget the long drive to Denver Children's Hospital, following the ambulance wishing I could be in the ambulance with Connor.October 29, 2002
Dear Connor,
Again today was filled with joy and concern. We woke up in our little parent sleep room somewhat refreshed and immediately rushed downstairs to see you. You are just so cute I can't take my eyes off of you.
Around lunch time Auntie Amy brought Grandma Sarah down to the hospital to see you. We were all staring at you and saying how you are the most beautiful baby we have ever seen.Soon after lunch Dr Mitchel came to see us to tell us about a heart procedure they were going to do. You have a duct in your heart (PDA Duct) that should have closed soon after you were born, but it didn't. So Dr Mitchel will go into your chest and tie off the duct so that all the blood flows where it should. We are also hoping that once this is complete it will help your intestines do the job they should do.
You went in for surgery around 4:20pm and Mom and Dad were VERY worried, but luckily Auntie Amy and Grandma were here to keep us company. We were also talking to Grandma Vonnie and Grandpa Roger every hour or so to keep them updated.
Not an hour later the nurse and the doctor came in to see us all and they said you were a perfectly behaved boy and the surgery was a great success. You even pooped while on the surgery table. You are just so cute.
We all hated to leave the hospital tonight, but we knew you were in good hands and boy did Mommy need a shower! Daddy too! But we knew we would be down to see you first thing tomorrow morning. We love you so much!
Even though being transferred to Children's Hospital was the scariest night of my life, it proved
to be the best thing that could have happened to us. We had spent the last week in limbo in the Longmont NICU having no idea what was going on or how to make things better. We finally arrived at Children's around midnight, they gave us a parent sleep room that consisted of a bed, sheets and a phone for $1 rental, but at least we had somewhere to sleep. By the time we were at Connor's bedside at 8am the next day Drs Karrer and Hendrickson had already identified the need for a PDA duct ligation and the possibility that Connor had Hirschsprung's Disease. We had hoped after the PDA Duct ligation that the new blood flow would correct Connor's bowel problems, but things remained the same so the doctors took a tissue sample from Connor's colon and when the test results arrived they discovered that Connor did in fact have Hirschsprung's disease, a rare disease of the large intestine where the ganglion cells, or nerve cells that make the intestine push stool down to be excreted, are absent in some or all of the intestine. The stool then backs up in the intestine causing an infection in the belly and would eventually cause death. This disease is more often found in children with Down's Syndrome and has varying degrees of severity.Thankfully after several days of observation and an enema, the doctor discovered that only the lower sigmoid region of Connor's colon was effected and at 3 months he would be eligible for a Pull Through Surgery. So they kept Connor in the hospital for observation for one week after we arrived to make sure he was stable and to educate us on how to care for Connor's bowels until the surgery.
Each day we would go down to the hospital and sit by Connor's side in the one chair that was there. Every three hours I would go to the breast pump room (which was about the size of a phone booth) and pump enough milk to feed the entire NICU! I was just glad they continued to feed Connor the breast milk and the my milk stayed so that I was able to nurse Connor until he was a year old. These pumping breaks were literally the longest 20 minutes of my life. I am not sure what the new hospital has, but hopefully there is a little tv or something in the pumping room!Eventually on November 5th after they had deemed Connor stable and taught us how to irrigate his bowels with a tube and saline solution (which we had to do for 3 months) we were released from the hospital and ready to go home. It was so funny because I had been praying for so long for Connor to come home with us, but when they actually said we could leave I started to panic a little and worried if I would be able to take care of this precious little baby. Until now I had hardly even changed his diaper or dressed him in clothes. Luckily love overcame fear and I knew that Paul and I would be wonderful parents. As you can imagine once we arrived home we could hardly put Connor down. He rarely if ever slept in the crib or pack and play and eventually we just adopted the family bed and we haven't changed since!
Connor looked so tiny in his car seat it seemed like it really wasn't very protective.
At 3 months old Connor had his pull through surgery, they removed the lower sigmoid region and he began popping right away and hasn't stopped since! I was very impressed with the care we received at Denver Children's Hospital and I was particularly impressed with our doctors Dr Karrer and Dr Hendrickson. While I never imagined this situation happening I was so thankful to have such a great hospital close by!
Wednesday, February 18, 2009
A NICU story Part I
Posted by Kim:
Connor's birth went smoothly and for some reason Paul and I were under the misconception that we would have a baby that was 5 weeks premature, a little small, but healthy and ready to go home. Unfortunately that was not what happened. Connor ended up spending 2 weeks in the hospital after I was discharged. He was at Longmont United Hospital for one week and then at Denver Children's Hospital for one week. The following are letters I wrote to Connor while he was in Longmont United Hospital.
Written by Kim
October 23, 2002
Dear Connor,
Today has been a very difficult day for Dad and me, but somehow you knew just what to do to make us feel better. Last night was heartbreaking for us because we did not want you to leave our room. Dad was so sad when he had to put you down in your crib so the nurse could roll you to the nursery, but we knew it was the best thing to do and all we want is for you to be healthy.
Together Dad, the doctor and I decided we would
start your tube feedings (gavage) last night and I think we made the right decision because you seem to have a lot more energy. I just never want to leave your side.
Unfortunately Mommy is feeling good physically and there are too many patients in the hospital so I must be discharged. I hate the thought of being without you, but I will be here with or without a room.
After your 4:30 feeding Dad and I went to dinner with Aunt Amy and Uncle Jeff and then we all came back to see you. Auntie Amy could hardly wait! She loves you so much. She says that you are the cutest baby she has ever seen and I know it is true.
After Auntie Amy and Uncle Jeff had a chance to cuddle and snuggle with you it was time for dinner. It turned out to be a great feeding. You breast fed at 7:30 and 10:30. It was just the encouragement Dad and I needed. We love you so much and just can't wait to take you home. This was definitely what we needed. Thank you Connor, we love you!
October 24, 2002
Dear Connor,
Today is going to be a tough day. Dad and I were very encouraged by your eating last night, but today you have to spend time under the bililights. You just look so vulnerable. I hate having to put you back down when you are done eating. Luckily Pooh has been by your side the whole time to keep you company. We'll have to thank Aunt Lisa for that.
You are so special to us and we love you so much. We are going to have the greatest times together.
October 25, 2002
Dear Connor,
Today was such a wonderful day! I guess you decided it was time to go home. When I came to the hospital this morning the nurse, Robyn, told me you no longer had the tube in your belly and you had taken both of your late night meals by bottle. I was so surprised I could hardly believe it. I had wondered why the nurse decided to take out the tube when Robyn said it was you who decided to pull out the tube. Apparently you pulled the tube out yourself and the rest is history. You breast fed and bottle fed breast milk all day long.
We also had a fabulous visit with the pediatrician Dr Rosquist. She said she is very excited about your progress and if all goes well the rest of the day you may be able to go home with us tomorrow. That would be the most wonderful thing. I can hardly wait for tomorrow.
Hopefully we will all be together at home. It will be a great surprise for Grandma Sarah too, because she will be arriving tomorrow night and will be so excited to meet you.
I know I keep telling you this, but I can't help it, Mom and Dad love you with all of our hearts. You are my special little guy!
October 26, 2002
Dear Connor,
Today was a very diffi
cult day. I stayed overnight at the hospital so I could be with you every single minute and make sure you had some really good feedings. Unfortunately when we weighed you, you only gained one gram and I knew that was not a good sign but I still kept hope that you could come home. When Dr Rosquist came in she was a little concerned because you really hadn't gained any weight and you looked a little yellow. We looked at your bilirubin test results and they decided you needed to head to the tropics again (light therapy). Hopefully this trip will be the last.
The good thing about today is that you have started to eat more. It is
usually a combination of tube and bottle feeding, but we'll take it. Our goal is to get you to consistently eat 30-35 ccs of breast milk at each feeding. Even though I was upset that you could not come home, I know it is for the best. The worst thing in the world would be for us to take you home and have to bring you back to the hospital.
Daddy has been working so hard on your little bedroom and it looks so great! He painted the wall and assembled your crib. You are going to look so adorable in the room. I think we picked the perfect theme (Americana). Now that we know our baby is a boy Daddy wants to add some Buffalo Bills memorabilia to your room. With their new colors the Bills stuff will match perfect. So, I am sure you will be a big Bills fan.
As the day wound down it began to get better. The most wonderful thing happened. You got to meet your Grandma Sarah for the very first time. Daddy picked her up from the airport at midnight and they came straight to the hospital to meet you. Grandma Sarah thought you were the most handsome little
boy she has ever seen. I have to say that I agree. I just can't wait to bring you home so I can hold you whenever I want to. You are going to be the most spoiled little boy because Mom and Dad are going to make sure you have everything you could possibly want or need. We love you!
October 27, 2008
Dear Connor,
Today was a nice quiet day. We spent the day together feeding and reading stories whenever possible. But mostly you had to spend time in the tropical bilisunshine. I am looking forward to holding you all day tomorrow.
Grandma also visited you today and held you for a while. she loves you so much. We are all looking forward to the day you can come home.
Throughout the week Connor had many ups and downs, but I never suspected that things were about to get worse. Everyday I would go to the hospital thinking this is going to be the day we are going to go home, but because of his rising bilirubin count he had to spend every second of each day under the bililights. Apparently if his bilirubin count got too high it could have caused brain damage This increased bilirubin count was due to the fact that Connor was not pooping and no one seemed to be able to figure out why he wasn't having bowel movements. The only times that he was not under the lights was during feedings. Connor ate via a tube that went in through his nose and down into his stomach (gavage feeding). The great thing about the feedings was that I was able to hold Connor while he ate through the tube because they thought this would help him to associate feeding with Mom as I planned to nurse him whenever he was ready. Unfortunately many times he would eat and then spit up the majority of the breast milk. I was so thankful that I was able to pump enough milk that he never had to have any formula to supplement his feedings. I was with Connor everyday from 7am until 1am, missing only one feeding a day. While exhausted when I went home being away from Connor was absolute torture and I was so frustrated not knowing what was causing the rise in his bilirubin count. Every time we took one step forward it seemed like we would take 2 steps back. Until October 28th when things got much worse, but at least was the beginning of the end of your NICU stay.
To be continued........
Connor's birth went smoothly and for some reason Paul and I were under the misconception that we would have a baby that was 5 weeks premature, a little small, but healthy and ready to go home. Unfortunately that was not what happened. Connor ended up spending 2 weeks in the hospital after I was discharged. He was at Longmont United Hospital for one week and then at Denver Children's Hospital for one week. The following are letters I wrote to Connor while he was in Longmont United Hospital.
Written by Kim
October 23, 2002
Dear Connor,
Today has been a very difficult day for Dad and me, but somehow you knew just what to do to make us feel better. Last night was heartbreaking for us because we did not want you to leave our room. Dad was so sad when he had to put you down in your crib so the nurse could roll you to the nursery, but we knew it was the best thing to do and all we want is for you to be healthy.
Together Dad, the doctor and I decided we would
start your tube feedings (gavage) last night and I think we made the right decision because you seem to have a lot more energy. I just never want to leave your side.Unfortunately Mommy is feeling good physically and there are too many patients in the hospital so I must be discharged. I hate the thought of being without you, but I will be here with or without a room.
After your 4:30 feeding Dad and I went to dinner with Aunt Amy and Uncle Jeff and then we all came back to see you. Auntie Amy could hardly wait! She loves you so much. She says that you are the cutest baby she has ever seen and I know it is true.
After Auntie Amy and Uncle Jeff had a chance to cuddle and snuggle with you it was time for dinner. It turned out to be a great feeding. You breast fed at 7:30 and 10:30. It was just the encouragement Dad and I needed. We love you so much and just can't wait to take you home. This was definitely what we needed. Thank you Connor, we love you!
October 24, 2002
Dear Connor,
Today is going to be a tough day. Dad and I were very encouraged by your eating last night, but today you have to spend time under the bililights. You just look so vulnerable. I hate having to put you back down when you are done eating. Luckily Pooh has been by your side the whole time to keep you company. We'll have to thank Aunt Lisa for that.You are so special to us and we love you so much. We are going to have the greatest times together.
October 25, 2002
Dear Connor,
Today was such a wonderful day! I guess you decided it was time to go home. When I came to the hospital this morning the nurse, Robyn, told me you no longer had the tube in your belly and you had taken both of your late night meals by bottle. I was so surprised I could hardly believe it. I had wondered why the nurse decided to take out the tube when Robyn said it was you who decided to pull out the tube. Apparently you pulled the tube out yourself and the rest is history. You breast fed and bottle fed breast milk all day long.
We also had a fabulous visit with the pediatrician Dr Rosquist. She said she is very excited about your progress and if all goes well the rest of the day you may be able to go home with us tomorrow. That would be the most wonderful thing. I can hardly wait for tomorrow.
Hopefully we will all be together at home. It will be a great surprise for Grandma Sarah too, because she will be arriving tomorrow night and will be so excited to meet you.
I know I keep telling you this, but I can't help it, Mom and Dad love you with all of our hearts. You are my special little guy!
October 26, 2002
Dear Connor,
Today was a very diffi
cult day. I stayed overnight at the hospital so I could be with you every single minute and make sure you had some really good feedings. Unfortunately when we weighed you, you only gained one gram and I knew that was not a good sign but I still kept hope that you could come home. When Dr Rosquist came in she was a little concerned because you really hadn't gained any weight and you looked a little yellow. We looked at your bilirubin test results and they decided you needed to head to the tropics again (light therapy). Hopefully this trip will be the last.The good thing about today is that you have started to eat more. It is
usually a combination of tube and bottle feeding, but we'll take it. Our goal is to get you to consistently eat 30-35 ccs of breast milk at each feeding. Even though I was upset that you could not come home, I know it is for the best. The worst thing in the world would be for us to take you home and have to bring you back to the hospital.Daddy has been working so hard on your little bedroom and it looks so great! He painted the wall and assembled your crib. You are going to look so adorable in the room. I think we picked the perfect theme (Americana). Now that we know our baby is a boy Daddy wants to add some Buffalo Bills memorabilia to your room. With their new colors the Bills stuff will match perfect. So, I am sure you will be a big Bills fan.
As the day wound down it began to get better. The most wonderful thing happened. You got to meet your Grandma Sarah for the very first time. Daddy picked her up from the airport at midnight and they came straight to the hospital to meet you. Grandma Sarah thought you were the most handsome little
boy she has ever seen. I have to say that I agree. I just can't wait to bring you home so I can hold you whenever I want to. You are going to be the most spoiled little boy because Mom and Dad are going to make sure you have everything you could possibly want or need. We love you!October 27, 2008
Dear Connor,
Today was a nice quiet day. We spent the day together feeding and reading stories whenever possible. But mostly you had to spend time in the tropical bilisunshine. I am looking forward to holding you all day tomorrow.
Grandma also visited you today and held you for a while. she loves you so much. We are all looking forward to the day you can come home.
Throughout the week Connor had many ups and downs, but I never suspected that things were about to get worse. Everyday I would go to the hospital thinking this is going to be the day we are going to go home, but because of his rising bilirubin count he had to spend every second of each day under the bililights. Apparently if his bilirubin count got too high it could have caused brain damage This increased bilirubin count was due to the fact that Connor was not pooping and no one seemed to be able to figure out why he wasn't having bowel movements. The only times that he was not under the lights was during feedings. Connor ate via a tube that went in through his nose and down into his stomach (gavage feeding). The great thing about the feedings was that I was able to hold Connor while he ate through the tube because they thought this would help him to associate feeding with Mom as I planned to nurse him whenever he was ready. Unfortunately many times he would eat and then spit up the majority of the breast milk. I was so thankful that I was able to pump enough milk that he never had to have any formula to supplement his feedings. I was with Connor everyday from 7am until 1am, missing only one feeding a day. While exhausted when I went home being away from Connor was absolute torture and I was so frustrated not knowing what was causing the rise in his bilirubin count. Every time we took one step forward it seemed like we would take 2 steps back. Until October 28th when things got much worse, but at least was the beginning of the end of your NICU stay.
To be continued........
Wednesday, January 14, 2009
The Late Preterm Infant & Getting to Know Your Baby
Posted by Kim:
I am the Coordinator of a non-profit group called Exceptional Families and we provide parent to parent support to families who have children with special needs. Part of my responsibility as the Coordinator is to attend the Boulder County Health Department's monthly cross-disciplinary meeting for children birth to 3 years old. This month we had a therapist from the Tiny Tim Center present the following information to us. It is shocking and eye opening considering our current birth environment and the prevalence of preterm induction and cesarean birth.
I am making no judgments here because I am all the things that I would now preach against (unfortunately I have learned more about birth since my children were born). My first son was an induced preterm labor due to fetal distress. While there was nothing I could do about this induction the statistics below are still frightening to me and make me cringe that I never once doubted my doctor or sought a second opinion. This being said, I do believe we did right by Connor inducing his birth and providing him with a better chance of survival outside the womb (I will post Connor's birth story soon). Griffin however is a different story. His induction was the typical convenience birth at 40 weeks. It has taken me several years to process his birth and I will always regret the induction (birth story also to follow).
Please read over the following information and consider it carefully. Share it with friends, family and clients. While it is particularly focused on late preterm births (and sometimes this can not be avoided), I think the "Get To Know Your Baby" section can also be applied to full term children in some situations. Every baby is different, but if you can read their signals you can better respond to their needs.
Children need their 40 weeks!
The late preterm infant is:
Respiratory Control
Jaundice
Motor Challenges
State Organizational Challenges
Organized Physiological Behaviors
Disorganized Physiological Behaviors
Organized Motor Behaviors
Organized State Behaviors
organized State Behaviors
Behaviors that help baby become organized/Helpful self regulation behaviors
http://www.uchsc.edu/cfii/Documents/Getting%20to%20Know%20Your%20Baby.pdf
I am the Coordinator of a non-profit group called Exceptional Families and we provide parent to parent support to families who have children with special needs. Part of my responsibility as the Coordinator is to attend the Boulder County Health Department's monthly cross-disciplinary meeting for children birth to 3 years old. This month we had a therapist from the Tiny Tim Center present the following information to us. It is shocking and eye opening considering our current birth environment and the prevalence of preterm induction and cesarean birth.
I am making no judgments here because I am all the things that I would now preach against (unfortunately I have learned more about birth since my children were born). My first son was an induced preterm labor due to fetal distress. While there was nothing I could do about this induction the statistics below are still frightening to me and make me cringe that I never once doubted my doctor or sought a second opinion. This being said, I do believe we did right by Connor inducing his birth and providing him with a better chance of survival outside the womb (I will post Connor's birth story soon). Griffin however is a different story. His induction was the typical convenience birth at 40 weeks. It has taken me several years to process his birth and I will always regret the induction (birth story also to follow).
Please read over the following information and consider it carefully. Share it with friends, family and clients. While it is particularly focused on late preterm births (and sometimes this can not be avoided), I think the "Get To Know Your Baby" section can also be applied to full term children in some situations. Every baby is different, but if you can read their signals you can better respond to their needs.
Children need their 40 weeks!
The late preterm infant is:
- born 34 - 37 weeks
- 75% of all preterm births are in this category
- Many are from induced deliveries or C-sections
- Studies have shown an increase in morbidity rate, as well as long term outcomes showing developmental delays, special education for pre-k and behavior problems that persisted to 8 years of more.
- At 34 weeks the brain has fewer sulci
- During the last 4 weeks of gestation there is an increase in the development of axons, dendrites, synapses etc
- The is the most active phase of synaptogensis (40,000 new synapses per second)
- At 34 weeks the brain only weighs 65% of term brain weight
- Frontal lobes are last to develop
- Late preterm babies are more vulnerable for bilirubin induced brain injury and neurological injuries
Respiratory Control
- 33-38 weeks there are changes in lung compliance, they are still developing how to
- breathe, they may have apnea and bradycardia
- Increase incidences of SIDS
- Less body weight, decreased ability to regulate body temperature
Jaundice
Motor Challenges
- Mild hypotonia, decreased stamina & endurance
- Difficult feedings secondary to tone issues
- May hear respiratory sounds due to decreased muscle activity in intercostals and upper airway
State Organizational Challenges
- Decreased arousal and alertness (can affect attachment between baby and parents)
- Sensitivity to environment (light, noise, activity) therefore may have problems getting to deep and active sleep (brain development occurs when in active REM sleep)
- Less effective suck and swallow
- Breastfeeding may be difficult because they are sleepier, have difficulty stabilizing their temperatures and they are unable to coordinate suck/swallow/breathe
- Education and support for parents
- Scheduling babies activities for when they are in arousal states
- Kangaroo mother care (skin to skin)
- Infant Massage
- Knowing awake/sleep states and stressor signs that baby is communicating to you
- Using environmental modifications keep lights, noise and activity down preserve active REM sleep
Organized Physiological Behaviors
- Skin is pink and stable throughout
- Breathing is regular and smooth
- Gastrointestinal is stable and there are regular elimination patterns
Disorganized Physiological Behaviors- Cough, breathing intervals are variable (too fast or too slow)
- Gasp, Startle, Twitch, Sneeze, Tremor
Organized Motor Behaviors
- Tone is balanced
- Posture is flexed and relaxed
- Movements are smooth and close to the body
- Tone is hypertonic or hypotonic
- Posture: arms salute, sitting on air, toe or finger splay, fisting, high arm position
- Movements: squirm, jerky, gape face, tongue extension, arching
Organized State Behaviors
- Awake States are calm alert, alert and focused, and may be fussy and crying
- Sleep States are deep sleep, active sleep and drowsy sleep
organized State Behaviors- Hypoalert, hyperalert, gaze averting, uncontrollable fussing and crying, upward gaze, staring, grimace
Behaviors that help baby become organized/Helpful self regulation behaviors
- Hands to mouth/face
- Hand & Foot clasping
- Leg/foot bracing
- Sucking and suck search
- Tucking
- Grasping and holding
- Looking and attending
- Light reduction
- Noise reduction
- Positioning
- Comforting
- Look for signs of stressors indicating need for a rest
http://www.uchsc.edu/cfii/Documents/Getting%20to%20Know%20Your%20Baby.pdf
Subscribe to:
Posts (Atom)
