Saturday, August 27, 2011

Apgar Scores


Apgar Scores

The very first test given to your newborn, the Apgar score, occurs right after your baby's birth in the delivery or birthing room. The test was designed to quickly evaluate a newborn's physical condition after delivery, and to determine any immediate need for extra medical or emergency care. 

Although the Apgar score was developed in 1952 by an anesthesiologist named Virginia Apgar, you may have also heard it referred to as an acronym for: Activity, Pulse, Grimace, Appearance, and Respiration.

The Apgar test is always given to your baby a minimum of 2 times: once at 1 minute after birth, and again at 5 minutes after birth. Rarely - if there are serious problems with the baby's condition and the first two scores are low - the test may be scored for a third time at 10 minutes after birth.  See Kids Health to learn more about this topic

Infant Massage

Infant Massage

happier and healthier baby!Infant massage can help baby sleep better,
advance thier development and may raise IQ!
Infant massage may
relieve colic,
teethingconstipation and 
nasal congestion.The benefits don't stop there.
Providing massage to baby helps to relax the caregiver.
Infant massage gives that special bonding time for
all involved.


How do you feel after a long, relaxing back rub? Pretty good, right? Well,
not only is your touch very soothing to your baby, but giving your baby a
massage can actually make you BOTH feel better! A certified infant massage
instructor joined us recently to tell us about all the benefits of infant
massage. Although infant massage has been an important part of parenting in
other countries, it has only begun to be accepted in the U.S. since the
early 1980s. Studies have shown that systematically touching your baby, skin
to skin, for as little as 12 minutes a day can offer many benefits. Not only
do the babies gain weight faster, but their neurological connections
actually improve and they are able to process input better!

You don't even have to devote a solid twelve minutes each day to massage
you could do it for two minutes six times a day if that is more convenient
for you. The important thing is that you are both relaxed, and that the
touch is skin to skin. In other words, pay attention to your baby's cues to
see if your baby is receptive at that time, and don't try to massage your
baby through a shirt or pajamas.  Also, some babies get really sleepy after
a massage while others become wide awake, so you may want to keep that in
mind before attempting a late night massage for the first time.

While infant massage is beneficial to all babies, it is especially good for
preemies and other children who are hypersensitive. These are the babies who
don't normally like to be touched or held, or don't like dirt on their skin,
or sand between their toes, or who are constantly being irritated by their
clothes. You'll definitely have to be patient and pay close attention to
their reaction to massages, but you are almost assured to see improvement in
their level of hypersensitivity. While doing a massage on these babies, try
to keep other sensory input to a minimum. In other words, don't have the TV
on or music playing, don't talk, and you may even want to avoid direct eye
contact during the massage.

When you're ready to try a massage, the first thing to do is to ask your
baby if he would like a massage. This may sound silly, but once your baby
realizes what a massage is they will usually let you know if they're ready
for one. Pay attention to them! Do they look away? They're probably not
interested. Do they maintain eye contact, or as they get older, maybe even
smile or lift their usual starting leg, you can probably assume that they're
ready to begin!  It is usually better to begin with the legs (one at a
time), then the arms (one at a time), and eventually work your way up to
their trunk and face.. Use a firm, but gentle pressure.

Preemies, or other babies who have spent time in the hospital, may be
especially sensitive to having their feet touched (thanks to all the heel
sticks they've experiences). If so, you can try massaging only the tops of
their feet, or avoid the feet altogether.

Here is a very brief description of what a massage may be like. Remember
if they let you know that they don't like a particular motion, stop doing
that particular motion.

Starting at the thigh, use a whole hand motion to stroke the entire length
of one leg from thigh to ankle.

Next, using a very light "Indian rub" motion (squeeze and twist), massage
the same leg from thigh to ankle

Eventually moving onto the top of their foot and their toes.

After a few minutes, begin massaging the foot and move toward the hip and
back toward the foot.

Finish off the "body part" (in this case, the leg) by lightly stroking the
entire leg with your fingertips. This stroking will signal that you're all
finished with that part of their body.

After completing steps 1-5 on the first leg, if baby seems receptive you can
move on to the other leg. Repeat the same five steps, and then lightly
stroke both legs with your fingertips to signal "all done with your legs."

If you'd like, you can then move on to do similar motions on first one arm,
then the other, and then onto their trunk and face. That's all there is to
it!  Well, not really, but that is "the Reader's Digest" version of it. To
learn more, look for one of the growing number of how-to books and videos on
the market.
-This article was taken from a certified infant massage therapist. I liked it because of the focus on preemies. We are trying to schedule a certified therapist for our upcoming Houston meeting and will broadcast that Live on our Preemie Prints livestream channel. If you would like to attend this live event please email amber@preemieprints.org.

Tuesday, August 9, 2011

Breathing in the NICU
 
Oxygen Therapy
Description/Purpose
Babies with breathing problems are usually admitted to the NICU. Most times, these breathing problems will require oxygen therapy. Normal air that we breathe is 21% oxygen. When oxygen is given to babies, it is measured in percentages, from 21% up to 100%. There are several different ways to administer oxygen to babies. The first is an oxygen hood (halo). This is used for babies who can breathe on their own but still need extra oxygen. A hood is a plastic dome or box with warmed and humidified oxygen inside. The baby's head is placed under the hood. Oxygen tents are the same set up as hoods, except that they are made of a soft, flexible plastic.
Another way to give oxygen is via nasal cannula (NC). This is made of soft, thin, plastic tubing through which oxygen flows. There are soft prongs that fit into the baby's nose so they can breathe the oxygen. This type of oxygen therapy is usually reserved for babies who are going to need oxygen for some period of time. Some infants will even go home on oxygen with a nasal cannula.
Side Effects and Risks
Prolonged oxygen therapy can be related to retinopathy of prematurity (ROP). This is why oxygen is weaned (decreased) as soon as possible. Sometimes, infants under hoods or tents can get chilled if the temperature of the humidified oxygen is not warm enough. Infants on nasal cannula oxygen can get dry or irritated noses from the cannula prongs.
 
Continuous Positive Airway Pressure (CPAP)
Description/Purpose
Many babies with respiratory conditions require extra oxygen. Some require a ventilator because they cannot breathe well enough on their own. There are also babies that breathe well enough to not need the ventilator, but need a combination of extra oxygen and pressure to help keep their lungs well inflated. CPAP can provide this last group with what they need. To deliver CPAP a tube (or tubes) is placed in the nose and air or extra oxygen is delivered through this tube to the back of the nose. This flow of air produces pressure that goes into the lungs to keep the lungs better inflated. Since the pressure from the CPAP is delivered to the back of the nose it is also called NPCPAP. NPCPAP might be used in conditions such as, Respiratory Distress Syndrome (RDS) when the baby needs more than extra oxygen, to try and prevent the need for a ventilator. Some babies, after they are taken off the ventilator, might be given NPCPAP to keep their lungs inflated. Also NPCPAP might be used on babies who have apnea such as Apnea of Prematurity to decrease the frequency or severity of the apnea. The main benefit of NPCPAP is the ability of delivering both extra oxygen and pressure without the need for the more invasive endotracheal tube and ventilator.

Side Effects and Risks
The main risks of this therapy are nasal irritation (from the tube) and abdominal distention (from pressure in the back of the nose that goes into the stomach instead of the lung). However, just like with the ventilator, babies on NPCPAP might be at risk for pneumothorax
.
 
Mechanical Ventilator
Description / Purpose
Babies who are too small or sick to breathe on their own might be intubated with an endotracheal tube and placed on a conventional mechanical ventilator. Another word for ventilator is respirator. The ventilator delivers oxygen to the baby with each breath. It also gives pressure at regular, timed intervals to act as breaths for the baby. Another setting on the ventilator is the constant pressure to keep the lungs open. These settings on the ventilator are increased or decreased based on blood gases. Sometimes the support of a conventional ventilator is not enough for some babies. These babies might need to be placed on a high-frequency ventilator.
Side Effects and Risks
One of the risks to babies on ventilators is a collapsed lung, or pneumothorax. When a lung collapses, the air around it inside the chest needs to be removed in order for the lung to expand. This is done with a chest tube. Babies who are very premature when they are born might need the support of a ventilator for some time. The longer the babies require this support, the higher risk they have for scarring /damage in the developing lungs, called bronchopulmonary dysplasia.
 
High-Frequency Ventilator (HFV)
Description / Purpose
A high-frequency ventilator is a special ventilator that uses very high rates (often 480 to 840 breaths/minute) and very small opening pressures for each breath. These ventilators are especially useful for very tiny babies or babies with air leak.

Side Effects and Risks
Same as above.
 
Extra-Corporeal Membrane Oxygenation (ECMO)
Description / Purpose
The use of ECMO peaked in 1992 when over 1,500 infants in the United States were treated. Due to many improvements in care, currently fewer than 500 infants each year require treatment with ECMO. The most common conditions resulting in the need for ECMO are:
  • Congenital Diaphragmatic Hernia (CDH)
  • Meconium Aspiration Syndrome (MAS)
  • Severe Pulmonary Hypertension
  • Cardiac Malformations
  • Severe Air Leak problems
The purpose of ECMO is to provide oxygen to the body when the lungs and/or heart are too sick to do the job. ECMO allows us to "rest" the lung and/or heart. Recovery of the lung and/or heart function usually occurs in 3–7 days, but might require 2–4 weeks

Side Effects and Risks
ECMO is the highest risk therapy used in the NICU. Due to this risk there are certain conditions that might prevent the use of ECMO.
  • Significant bleeding that has occurred in the brain (intracranial hemorrhage)
  • Prematurity with estimated gestation less than 34 weeks
  • Congenital malformations that are known to produce death, regardless of support
  • Severe pulmonary disease that has persisted for more than 14 days
  • Severe Air Leak problems
Several important risks that can occur with ECMO include:
  • Rupture of the ECMO circuit tubing
  • Formation of blood clots (thrombosis/clots) in the tubing and the baby
  • Due to the use of "blood thinners", bleeding can occur in any part of the body
  • ECMO requires the use of many blood transfusions; reactions and risks are possible
  • Infection is always a risk factor with ECMO
  • Death can occur due to the underlying lung/heart problems or from complications of ECMO; infants who require treatment with ECMO are at risk for long-term lung, neurologic, and developmental problems

 

Tracheostomy

A tracheostomy is a surgical procedure to create an opening through the neck into the trachea (windpipe). A tube is usually placed through this opening to provide an airway and to remove secretions from the lungs. This tube is called a tracheostomy tube or trach tube.  General anesthesia is used. The neck is cleaned and draped. Surgical cuts are made to expose the tough cartilage rings that make up the outer wall of the trachea. The surgeon then creates an opening into the trachea and inserts a tracheostomy tube.
 
Why the Procedure Is Performed:
A tracheostomy may be done if you have:
  • A large object blocking the airway
  • An inherited abnormality of the larynx or trachea
  • Breathed in harmful material such as smoke, steam, or other toxic gases
  • Cancer of the neck, which can affect breathing
  • Breathed in harmful material such as smoke or steam
  • Paralysis of the muscles that affect swallowing
  • Severe neck or mouth injuries
  • When you can't breathe on your own
 
Risks:
The risks for any anesthesia are:
  • Problems breathing
  • Reactions to medications
The risks for any surgery are:
  • Bleeding
  • Infection
  • Erosion of the trachea (rare)
  • Nerve damage
  • Scar tissue in the trachea
After the Procedure:
If the tracheostomy is temporary, the tube will eventually be removed. Healing will occur quickly, leaving a minimal scar.
 
 
 

NICU GIFT BAG FUNDRAISER


Time
Monday, August 8 at 4:00am - September 30 at 7:00am

Location
National Drive

Created By

More Info
Preemie Prints is holding a drive for our NICU gift bags. We would like to collect at least 500 individual items during the month of August-September.

NICU families face a difficult journey when their baby is born early or with serious health concerns. One of our missions is to share hope through the distribution of gift bags while families are in the NICU!

As of now we have been able to provide gift bags to families in the Brazos Valley, Houston, and Temple areas. We would like to continue our mission of delivering these gift bags in person and expand their distribution to our online private national NICU family group members!

Anytime we have a current NICU family in our group we would like to send them a wonderful care package to bring a smile to their face and give a little comfort during this scary time.

We cannot expand this part of mission without donations from our preemie community, family, and friends. So we ask that you donate at least 1 item or make a monetary donation of $2 so that we can donate 1 item in your name! On behalf of NICU families across the US thank you so much for being a part of Preemie Prints!

What are examples of items that may be in a NICU gift bag?
Information and books on premature babies and life in a NICU
Brand new or handmade (new please) preemie clothes
Preemie hats
Preemie diapers
Blankets
Gift cards for food delivery, restaurants, & grocery stores
Hand sanitizer
Kleenex
Journals
Nutritious snacks (non perishable)
Scented hand lotion
Books to read to baby
Soothing music cd
Reusable water bottles
Teas, relaxing bath items for mom, etc.

You can send your item to

Preemie Prints
2306 Kendal Green Cir.
College Station, TX 77845



If you live in the Houston area and would like to arrange for a pick up of your items please contact our Houston chapter assistant director allison@preemieprints.org

If you live in the Brazos Valley you can drop your item off at our local donation drop off location -- Burger Boy! 

Burger Boy is located at:
4337 Wellborn Rd
Bryan, TX 77801
(979) 846-2146

If you would like us to donate a gift item in your name, you can donate $2.00 to our Paypal account https://www.paypal.com/cgi​-bin/webscr?cmd=_s-xclick&​hosted_button_id=W2GDV6YZB​MFBU. For a $25 donation, a NICU care bag will be donated in your name or in memory/honor of a loved one and you will receive a free copy of our e-cookbook with recipes and entries from our NICU member families! Donate $25 dollars herehttp://preemieprints.blogs​pot.com/p/donate.html

Monday, August 8, 2011

Developmental Care 4 months - 1 year of age

Download the 4 page information PDF here

The informational document focuses on developmental care for ages 4 months - 1 year. It includes information on tummy time, sitting, standing, and other developmental activities.


Thursday, August 4, 2011

Jewelry Winner!

Here are the answers to the awareness quiz and the winner of the beautiful 3 piece jewelry set donated by Sarah Doyle! Thank you all for participating!!

About how many babies on average are born prematurely each year in the US?*:
500,000
Which problem/health condition is not a cause of prematurity?*:
All of the above are causes
What is the primary difference between a level II and level III neonatal intensive care unit?*:
A level III cares for babies that require interventions like ventilators and pediatric surgery
Are the risks for postpartum depression and post traumatic stress disorder increased for NICU parents? 
Yes, NICU parents are at an increased risk for both

1st place WINNER: Susan D'Alesandro Wilder


Here is the random.org link to verify results if you are interested 

Sunday, July 24, 2011

Kangaroo Mother Care: Essential for your life and for your baby's health

History of KMC
  • Kangaroo Mother Care was invented in Bogota, Colombia, in 1978 and inspired by a grandmother 
Kangaroo Care began in 1979 in Bogota, Columbia. Due to a shortage of isolettes and staff, doctors hoped that skin-to-skin contact between mother and baby would provide the warmth and stimulation needed by newborns to survive. The results were so encouraging that the “kangaroo” method was introduced into various hospitals in Western Europe during the 1980s. Kangaroo Care came to the United States around 1990.
  • The method was approved by WHO, and UNICEF 
  • Helps in reducing the infant mortality in 3rd world countries
4 basic needs of every baby
  • Warmth
  • Nutrition
  • Breathing/Oxygen
  • Protection
What is KMC/KC














How to hold in Kangaroo Care
















Kangaroo Care is a special way of holding your baby (wearing only a diaper) upright between the mother’s breasts or in the center of the father’s chest, with skin-to-skin contact. The parent’s shirt can be buttoned around the baby, and a blanket placed over the baby’s back or a kangaroo zak can be used. Nurses will be nearby to help you hold the baby and make sure you both feel comfortable. In this position, you may be able to feel your baby’s movements and your baby may be able to hear your heartbeat. Kangaroo Care enables you to hold your baby sooner, helping to strengthen the emotional bond between parents and baby. You should Kangaroo for no less than 1 hr so the baby receives all benefits from 1 sleep cycle. If your going to Kangaroo, make it worth it for baby!! 

Sensorial Stimulation
The stimulations that a baby is exposed to during KMC are:
  • Vestibular stimulation-by the movement of the chest of the parent when breathing
  • Tactile stimulation-by the sink-to-skin contact and the warmth of the mother
  • Olfactory stimulation-by the scent of the parent and maternal breast milk
  • Auditory stimulation-by the parent's voice and the heartbeat
Brain Development


a baby's brain at 35 weeks weighs only 2/3 of what it will weigh at 39 to 40 weeks. So much time is needed for the baby to sleep so that they can grow. KMC provides time for that to happen while naturally regulating temperature and heart rate. 

Benefits for babies
  • Normalized temperature, heart rate, and respiratory rate (Ludington-Hoe et al., 2005)
  • Breast milk is readily available and accessible, and strengthens the infant's immune system
  • The maternal contact causes a calming effect with decreased stress and rapid quiescence (McCain, Ludington-Hoe, Swinth, & Hadeed, 2005; Charpak et al., 2005)
  • Reduced physiological and behavioral pain responses (Ludington-Hoe, Hosseini & Torowicz, 2005; Johnston et al, 2003)
  • Increased weight gain (Charpak, Ruiz-Pelaez, & Figueroa, 2005)
Benefits for babies
  • Enhanced mother-infant bonding (Dodd, 2005)
  • Positive effects on infant's cognitive development
  • Less noscomial infection, severe illness, or lower respiratory tract disease
  • Restful sleep
  • Earlier discharge
  • Possible reduced risk of sudden infant death 
  • Normalized infant growth of premature infants
  • May be a good intervention for colic
  • Possible positive effects in motor development of infants
Benefits for mothers and all the family
  • Enhanced attachment and bonding
  • Increased milk volume, doubled rates of successful breastfeeding
  • Physiologically her breasts respond to her infant's thermal needs
  • Resilience and feelings of confidence, competence, and satisfaction regarding baby care
Benefits for medical staff and hospital
  • Baby's less dissaturations, apnea, and bradycardia therefore monitors go off less and the noise level of the unit decreases
  • Moms that are kangarooing are calmer, more confident, and therefore require less nursing time and communication 
  • Kangaroo moms produce more milk therefore there is less need to supplement feeding formulas
  • Babies that get consistent kangaroo, sleep better so there is less need for unscheduled nursing intervention 
  • Kangaroo babies go home faster, grow and develop better
Faqs
  • Who can hold in KC? Mom, dad, or anyone you allow to 
  • Why the nurse doesn't allow me to Kangaroo? 
    • How stable your baby’s condition is
    • How much heat your baby requires to stay warm
    • The types of IV lines your baby has
  • How do I approach the nurse about KMC?
    • Open a up a discussion about your wish to Kangaroo, communicate your desire, and if necessary visit with your neonatologist
  • Who makes the decision to KMC?
    • The parent along with the advice from your Doctor and nurses

Adapted from a presentation by Yamile C. Jackson, PDH, PE, PMP at our June Preemie Prints meeting. Please feel free to contact Yamile at yamile@nurturedbydesign.com with questions or comments or visit http://blog.nurturebydesign.com for more information on purchasing the Zaky or Kangaroo Zak.