Sunday, April 27, 2008

Article - Phoenix Children's has new way to treat premature babies

My mom gave me this front page article from last Sunday's Arizona Republic newspaper. I thought I would share it with all of you. It talks about the NICU that the girls have been in. It's an awesome NICU!

Phoenix Children's has new way to treat premature babies
John Faherty
The Arizona Republic
Apr. 20, 2008 01:05 AM

Mayra Murillo walks into the dark, quiet room and lifts the blanket covering her daughter's crib. She smiles at the sight of Jocelynn.

The infant, born in March weighing less than 2 pounds, is sound asleep.

Mayra whispers to her daughter and holds her hand. She tells her that she loves her and that she is her mother.

The baby, still remarkably small, grabs hold of her mother's finger and does not let go.

This quiet moment between mother and child takes place at Phoenix Children's Hospital's new Newborn Intensive Care Unit.

The facility, which has been opening in phases and is now the largest in the country, represents a fundamental change in how premature babies are cared for.
The new place feels like a nursery.

Its predecessor was often described as a casino.

It was one large room lined with bassinets and bright surgical lights and fueled by coffee and desperation.

In the new model each of the 76 rooms is private, meaning the babies can grow strong and the parents can act like parents.

Next door to Jocelynn's room, a father is feeding his son.

Across the hall, another mother holds her child in a room so quiet the air can be heard pushing from the vents.

Doctors now know that a pre-term baby such as Jocelynn, who was due in mid-June, has the best chance to develop normally in a calm, serene environment.
She should be a fetus, so her frontal lobe - which will determine how she talks, behaves and feels - is still under construction.

Overloading the brain during this critical state with noises and lights could mean emotional and neurological problems in later years, even a lower IQ, research suggests.

The frontal lobe "is the most vulnerable part of pre-term development, and it is the most exquisitely human part of the brain that makes us uniquely human," said Heidelise Als, the director of neurobehavioral infant and child studies at Children's Hospital in Boston and a professor of psychiatry at Harvard University.

For Phoenix Children's Hospital, the goal was clear: Create a place that affords the best medical care for pre-term children while providing an atmosphere of womb-like tranquility.

"These babies should not be born. They should be in their mother's womb," said Dr. Mark Shwer, medical director at the care unit.

"This is part of a very strong movement to look at the quality of a child's survival."

Keeping babies alive
The changes in the newborn intensive care unit reflect how far the care of pre-term children has come.

Previous facilities were designed with the sole purpose of keeping children alive.

Children were lined up in rows of basinets and attached to monitors that buzzed with alarms.

What the facilities lacked in charm, they made up for with utilitarian efficiency.

"It was very, very efficient," Shwer said. "I could stand on a stool and look at 64 babies at once."

At Phoenix Children's newborn intensive care unit, where 80 percent of the babies were premature and half were considered "extremely pre-term," the staff was always busy.

Doctors and nurses hovered over children. Machines beeped and tubes stretched. The lights were bright because there were no windows. Parents tried to figure out where to stand.

"It was very much like a casino, except that it had clocks," said Deb Green, a nurse with 30 years of experience who now manages the care unit.

Over the past 25 years, improved training, equipment and pre-natal care pushed up the survival rate for babies born too soon.

The mortality rate for intensive-care newborns at Phoenix Children's is now down to 3 percent, Shwer said.

When Green became a nurse 30 years ago, a baby born three months prematurely had very little chance for survival.

"When I first started, a 28-weeker would just be left with the mother," Green said. "Now a 28-weeker is nothing. That's an easy baby."

As hospitals became better at keeping babies alive, some in the medical community began looking for ways to make sure that a baby did more than just survive.

Closing the 'casino'
Als, 67, has spent a lifetime advocating for pre-term children.

In 2004, the Harvard professor published a landmark study in Pediatrics that became the guiding principle for much of the design at Phoenix Children's new care unit.

In her study, she measured the brain functions of children who had been cared for as preemies in the old "casino" environment and compared them to children who had been cared for in the more serene setting she advocates.

The research, she wrote, "demonstrates that quality of experience before term may influence brain development significantly."

A premature child cared for in this type of environment will be less at risk of attention deficit disorder, could have a higher IQ, and may have better control over his or her emotions.

Hospitals, doctors and nurses already had been taking steps to improve the care for the pre-term patients in newborn intensive care units, but Als' study created a sense of urgency.

Her research also indicated the new environment will help the children grow stronger faster.

The data suggested that they will spend less time on supplemental oxygen, will gain weight faster and will spend fewer days in the hospi- tal.

Als' work urged the medical community to reconsider how they consider their smallest patients.

"These are fetuses, displaced into a different environment while trying to continue on their developmental trajectory," Als said.

Bonding with child
The new facility that Phoenix Children's Hospital runs at Banner Good Samaritan Medical Center is growing from 8,000 square feet to 38,000 square feet. The renovation cost $31 million, nearly half of which was raised through private donations.

It looks like a hospital, it even smells like a hospital. But the sounds of a hospital are missing.

It feels like watching television with the sound turned down.

There are tiles in the ceiling to absorb noises, and the floors also were built to remain quiet. The countless machines attached to the babies are vigilant but muted.

People speak in hushed tones. There are no phones in the rooms.

In addition to helping the children develop, this atmosphere also helps their families.

"It's so lovely when a parent gets to bond with their child," said DeAnn Huft, a speech pathologist who works at the NICU. "It's such a gift for the child."

Ava Jackson was born on March 6. The first child of Leland Jackson, 23, and Charm Daniel, 24, stayed in the womb for only 29 of the 40 weeks needed to be full term.

Daniel and Jackson have been at the hospital almost constantly to be with their daughter.

"It feels very good," Jackson said, holding Ava. "I love coming here to see my baby."

Unlike most babies at the care unit, Mark and Sonnie Linebarger's son Joshua was born at 38 weeks, the early side of full-term.

But Joshua was experiencing respiratory distress when he was born April 8, so he went to the care unit.

In the previous facility, the Linebargers would have a hard time holding their baby or even standing over him for long periods of time.

There wasn't enough room. Parents would back away when nurses or doctors would approach their child.

"A parent shouldn't have to be a visitor, shouldn't feel in the way," Green said. "A parent should be a parent."

In the new setting, the parents can.

"It's amazing," said Mark as he gave Joshua a bottle. "We've been here going on three and a half days, and I haven't left once."

Helping them grow
Mayra Murillo wears her orange identification bracelet all the time.

When she is home, it reminds her of her daughter.

Jocelynn is doing well, but things were dicey when doctors realized the child was not thriving in Murillo's womb.

They performed a Caesarean section on Murillo even though she was only 27 weeks along.

"It's hard to have a baby this way," Murillo said. "I was so worried. I'm a mom for the first time."

The quiet of the care unit has helped her forge a relationship with her baby. She can sit and watch her sleep. Or rub her head. Or just hold her.

At a time when she feels more helpless then any other, those small acts help her feel like she can actually help her baby grow.

"It's a good feeling just being able to hold her close," Murillo said, staring at her child. "It makes me feel good to know I'm helping."

Sometimes Murillo and her husband, Jairo Carrera, come to the hospital together. Sometimes they take shifts. But one of them is there nearly all the time.

"You worry about these babies," Murillo said. "You worry about all babies, I guess. But if this place helps her grow, helps her mind grow, that's incredible."


baby boy said...

it sound very promising.

Anonymous said...

Way cool God directed you guys there to tend to your little chicks. Medicine with love. Medicine with treating the whole baby and family as a home. Nursing at it's finest. Love Grandma C.

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