When a pregnant woman goes into labor too soon, medical staff can usually stop it, at least for a while. But babies are born prematurely all the time — and parents seldom know what to expect when that happens.
The role of the newborn intensive care unit is to support a newborn's fragile system, some of it, like the lungs, woefully underdeveloped. And to help the families get through it, as well.
"Our job is to support those (physical) systems in any way the baby lets us know it needs it," said Kandee Jones, a registered nurse at LDS Hospital's newborn intensive care unit.
Initially, that usually means respiratory support, nutritional support, intravenous fluids and whatever else.
Jones and Tracy Karp, neonatal nurse practitioner at both Primary Children's Medical Center and LDS Hospital, will be featured during today's Deseret News/Intermountain Health Care Hotline. They'll answer questions about premature babies, new treatments and all things prenatal and neonatal from 10 a.m. to noon.
Babies who are born premature typically stay in the hospital until close to the date they were expected to be born, she said. "We want the baby stable in the open crib for five days and to be able to take all their feedings by bottle, gaining weight on that and able to breathe so they won't have problems when they go home," said Jones.
The going home part is what's important to families, but they often have to learn how to care for babies who are frail because of their prematurity or other medical conditions.
Some of the biggest advances, which make it possible for babies born very early in their development to survive, have come in the area of respiratory care. Special ventilators have been created "to treat those very teeny lungs," Jones said. So have warmers and incubators that maintain the infant's heat. Other advancements have come in the area of nutrition and medication development.
Doctors who expect mom to deliver a premature baby now give mothers a drug within 48 hours of the expected delivery that helps mature the lungs faster so the baby can tolerate living outside the womb and without the umbilical cord. It's given as an injection. Another drug provides an enzyme that's missing in the premature baby's lung that makes the inside of the lungs more pliable so the little air sacs will open more easily.
Specialized hospital staff have learned to watch the premature babies for "stress cues" and "support them to develop in an organized, comfortable way," Jones said. Physical therapists may work on positioning and movements. Everything has a developmental component.
Keeping a premature infant's stress level under control is important, Jones said.
Parent support has become another key issue for hospitals. Any new baby places some stress on a family; it's much harder when the baby is in the hospital for an extended period of time. So support people in hospitals are now teaching stress-busters like infant massage, scrapbooks and CPR — anything to make parents more comfortable in their new role.
Local hospitals also often take the expectant parents on a tour in cases where the infant is quite likely to be premature, so the parents can see beforehand some of the equipment and the setting. That seems to reduce the overall stress as well, Jones said.
E-mail: lois@desnews.com