New Findings on Preterm Labor Meds: Mothers Receiving Magnesium Sulfate More Likely to have NICU Babies

A recent study due to be published in July’s "Green Journal" (Obstetrics & Gynecology Journal) found that newborns whose mothers had received magnesium sulfate were more likely to be admitted to the NICU than those whose mothers had received the alternative treatment (nifedipine). At this point, the researchers cautioned that the data did not offer a clear explanation for this finding and more research needs to be done to rule out other causes.

Deirdre Lyell, MD, a specialist in high-risk obstetrics at the Lucile S. Packard Children’s Hospital at Stanford, CA led the investigations that compared the use of magnesium sulfate with nifedipine for acute tocolysis of preterm labor.

Definitions

• Preterm labor – labor before 37 weeks of gestation (completed weeks of pregnancy).
• Preterm birth – a baby born before 37 gestation (completed weeks of pregnancy). Also called premature birth.
• Acute Tocolysis – the use of medications to delay or inhibit or stop contractions experienced during preterm labor. The medications relax overactive uterine muscles.

Main Study Findings
The researchers found magnesium sulfate was more effective in preventing delivery for 48 hours by quieting uterine contractions. But there were no significant differences in the ability of these treatments to delay delivery, in the gestational age of the newborn or in the birth weight of the infants. What was significant were the side effects experienced by each of the groups.

Two-thirds of the women on magnesium sulfate experienced mild to severe side effects including shortness of breath and fluid build-up in the lungs during the treatment. Other side effects reported with magnesium sulfate include vomiting, lethargy and blurry vision. By comparison, only one-third of the women on nifedipine experienced side effects which included headaches.

The side effects of magnesium sulfate are long remembered by the women who are on the medications. According to Dr. Lyell, "Women who have had magnesium sulfate remember it; they don't like it. Those who receive nifedipine don't feel as bad."

Take Home Message from Study
According to Dr. Lyell, there were no significant differences in relevant outcomes between the two groups studied.

What was significant, this study found, was the difference in the side effects experienced by the women, some of these were very serious.

You can read about a first hand account from Dr. Kristie McNealy on being in preterm labor and treated with both magnesium and nifedipine at the NICU 101 Blog.

First Hand Account:
McNealy K. June 29, 2007. More Side Effects with Magnesium Sulfate. NICU 101 Blog.

More Info on Preterm Labor and Preterm Birth:
March of Dimes. February 2006. Preterm Labor. Common Complications of Pregnancy. http://www.marchofdimes.com/pnhec/188_1080.asp
March of Dimes. February 2007. Preterm Birth. Quick Reference and Fact Sheet. http://www.marchofdimes.com/professionals/14332_1157.asp
Weissmiller DG. Preterm Labor. American Family Physician. 1999;59(3).
http://www.aafp.org/afp/990201ap/593.html

Sources:
Lyell DJ, Pullen K, Campbell L, Ching S, et. al. Magnesium Sulfate Compared With Nifedipine for Acute Tocolysis of Preterm Labor. Obstetrics & Gynecology. 2007;110:61-67. Abstract online at: http://www.greenjournal.org/cgi/content/abstract/110/1/61
Lucile Packard Children's Hospital. June 28, 2007. Press Release. Common Preterm Labor Drug Has More Side Effects than Alternative, Finds Study from Packard Children's Hospital and Stanford.
http://www.lpch.org/newsEvents/NewsReleases/2007/pretermLaborDrugs.html

Photo Credit: Adam Ciesielski. IV Drip - Intravenous Drug. Royalty Free Use.

NICU Parent Support Site Recommended on the Mom 4 Life blog

We are pleased to be a Featured site on the Mom 4 Life blog. Heather called the NICU Parent Site and blog a great resource and recommended the site to parents with babies in the NICU.

A special thanks to Heather for helping spread the word about the NICU Parent Support Site.

What can I *say* when a NICU baby dies?

More sad news came on Monday June 25 with the death of the 4th of the Morrison Sextuplets in Minnesota. Cadence Alana, died Saturday morning, she joins her brothers Tryg Brenton, Bennet Ryan and Lincoln Sean who all died earlier this month.

Our thoughts and prayers go out to the Morrison family who have not only lost one NICU baby, but now have to endure the deaths of four of their children. During a time of loss, such as the death of a newborn, it can be difficult to know what to say.

As mentioned earlier in this month, words can provide a source of solace, hope, comfort and reassurance--emotions much needed during the grieving process, but they need to be words that can provide comfort.

What can I say when a NICU baby dies?
Some of my personal favorites:

• I am sorry for your loss.
• I wish you didn't have to experience this.
• I am sorry that this happened to you.
  
• I am thinking of you during this difficult time. (usually written)
  

These phrases are some of the ones included in the blog on words:

• I'm so sorry.
• I wish you comfort.
• I hope things will be good.
  
• I wish this hadn't happened to you.

The following are suggestions that can be to use when talking with a grieving person or parent from a paper that I wrote in the Neonatal Network Journal:

• I'm sad for you.
• I don't know why it happened.
• What can I do for you?
• How are you doing/coping with all of this?
• How can I help?

This last collection of words to use comes from an article written for physicians about expressing wishes in response to loss, futility and unrealistic hopes. Some of the phrases suggested (or variants) included:

• I wish things had turned out better for you.
• I wish the news had been different.
• This has been a terrible loss for you. I wish it hadn't turned out this way.
• This is so hard for you. Just when our hopes were so high, for this to happen. I wish it had been otherwise.
• I will work with you to find a way through this.

Say Something to Show You're Support
People often fear so much saying the wrong thing that they often don't say anything at all. A grieving parent would like to know that family and friends are there to support them during this difficult time of loss.

Pick one of these various suggestions, or modify one so it feels more like something you would say, then let the person know verbally or in writing that you are there for them.

Sources:
CBS Broadcasting Inc. June 25, 2007. 4th Sextuplet Born To Minn. Couple Dies. Available at: http://wcco.com/topstories/local_story_176160040.html
Dyer KA. Comforting Moment - It's Only Words... June 2007. Available at:
http://nicuparentsupport.blogspot.com/2007/06/611-comforting-moment-its-only-words.html
Dyer KA. Identifying, Understanding, and Working with Grieving Parents in the NICU, Part II: Strategies. Neonatal Network. June/July 2005; 24: 27-40. Abstract at: http://www.neonatalnetwork.com/nn3/Abstracts/nnja05.htm
Quill TE. Arnold RM. Platt F. "I Wish Things Were Different": Expressing Wishes in Response to Loss, Futility, and Unrealistic Hopes. Ann Intern Med, Oct 2001; 135: 551 - 555. Available at: http://www.annals.org/cgi/content/full/135/7/551

6/25 - Comforting Message - Living on in the Hearts

During times of loss, often a simple message can be the most meaningful and comforting.

This week's comforting message is one of the simple quotes that I have found to be very meaningful and comforting over the years during times of loss.

To live in the hearts we leave behind is not to die. Thomas Campbell

To realize the impact of this quote, take a moment to think about

How many people have you known in your life that still live on in your own heart and in your memories?

Photo Credit: Janet Goulden. Two Hearts. Royalty Free Use.

6/24 - Encouraging Message - Keeping the Faith

Faith is the bird that sings when the dawn is still dark. Rabindranath Tagore

Have Faith
"Have Faith" was an acronym that I developed for the paper that I wrote on "Identifying, Understanding, and Working with Grieving Parents in the NICU" as a way to encourage parents to have faith, in their child, themselves, the NICU professionals and the healing process.

"Have Faith" stands for

Hope.
Accept life changes.
Verbalize questions, emotions, and concerns.
Engage with supportive friends and family.
Empathize with other parents.

Fortitude to endure the experience.
Adaptability. Being able to roll with the waves.
Incredible courage to survive day to day.
Trust in your baby yourself, physicians, and the team.
Healing in whatever forms it may take.

Another Interesting Perspective on Faith

I stumbled upon another view of Faith in the NICU setting, this one from Shoshana Greenspan. In her article from May 2007, she writes of the challenges she faced in coping with her son's NICU admission and then with his eventual diagnosis with Cerebral Palsy.

Shoshana initially believed that when her son was in the NICU if she could remain in control of every factor that affected his life, that somehow she might be able to cure him. Her outlook shifted after remembering an encounter with a Hasidic family during her time in the NICU. For her these grandparents "demonstrated a profound understanding of the principles of faith by recognizing that control is not in our hands."

Instead of wanting to control every aspect of their granddaughter's treatment and care, this family wanted to understand her condition, but made no attempt to remain in control. Instead, with their faith they believed that God was in full control of their granddaughter’s fate. They realized that "Grilling the nurses would not change the fact that neither the parents, nurses nor even the doctors were in charge."

After remembering this family and their perspective on faith, Shoshana's own perspective changed as she writes below:

I no longer pray for all his difficulties to disappear overnight. I pray that he receive the appropriate therapy and treatment that will enable him to lead a full and meaningful life. I pray that God lead us to the doctors who will accurately diagnose and treat his various medical issues. Above all, I pray that God give me the strength to accept my son for who he is, with his unique strengths and weaknesses, just as I accept the strengths and weaknesses of my other children.

Shoshana Greenspan

Shoshana's sentiments are very similar to the ones echoed in the post last week in Asking Why and Finding Hope. In order to cope with the challenges parents find an internal core of strength and learn to accept their NICU baby to support their child in leading a meaningful life.

Source:

Dyer KA. Identifying, Understanding, and Working with Grieving Parents in the NICU, Part II: Strategies. Neonatal Network. June/July 2005; 24: 27-40.
Shoshana Greenspan. May 2007. Faith in the NICU. http://www.aish.com/family/heart/Faith_in_the_NICU.asp

Photo Source: Danny de Bruyne. Boring Winter. Royalty Free Use.

Water Blessing Labels Turn Water (or Medicine) into Liquid Prayers

When I stumbled upon this website, I immediately loved the concept of using words as a simple way to enhance healing especially in the hospital setting and turn water or medicine into a liquid blessing for the patient and also for the family members.

Their motto seemed to resonate with me also:


Transform your water into Liquid Prayers.

The concept is simple. The Spirit of Water company has created crystal clear static-cling labels that be placed on containers of water or other fluids.

The idea that I liked the most was using these labels was one of the testimonials that I saw by a Chemotherapy nurse. She used the labels in the hospital setting, placing words of encouragement "courage" and "love" for her patient on I.V. fluids.

The wheels started turning as to how these labels could be used in the NICU setting to support NICU Parents and NICU Babies.


Empowering Parents to Participate in the Healing Process
My greatest frustration in being a NICU Parent was the helplessness and the feeling that I was not able to contribute anything to my daughter's care.

The inability to do anything, to contribute to my daughter’s care medically as a physician or emotionally to hold her hand and pacify her as a mother was indescribably frustrating. How was I supposed to "turn off" my years of training as a physician—being in the hospital, caring for patients and providing them comfort during a tormenting time? It was impossible.

We used several different additional modalities--music, blessings and touch--when my daughter was in the NICU. These were things that I thought to bring in as part of a more Integrative Approach to care, a way that I could participate in her care and enhance her treatment. It was my hope that these additional treatments would bolster her inherent strength and inner healing abilities.

Many of these ways of helping a NICU baby that we used have since been shown in research studies to have some positive benefits with NICU babies. If nothing else, as long as the treatment is not harming the baby, I think letting parents 'do something' to actively participate in their child's care is very important.

Using Water Blessing Labels in the NICU setting
If the water blessing labels had been available at the time, I would have asked the NICU staff put them on her I.V. fluids. (e.g. love, healing, trust, courage, guidance).

I also would have used them on any bottled water we were drinking (e.g. love, healing energy, manifesting miracles) as another way to feel that we were doing something by holding her in our foremost thoughts and using the power of words and positive thoughts even if we weren't with her.

Favorite Words or Combinations
This is a list of my favorite words or word combinations from their various collections. Maybe with enough interest, the company will eventually develop a line for the hospital setting.

• From the Healing Medicine Collection - energy, courage, healing, wholeness, breakthrough, nurturance, body wisdom, healing + energy
• From the Personal Growth Collection - love, health, trust, strength, success, vitality, gratitude
  
• From the Prosperity Collection - focus, trust, success, miracles, manifest + miracles, gratitude
  

Source:
The Spirit of Water Website - http://www.thespiritofwater.com/
Testimonials - http://www.thespiritofwater.com/Miracles.htm
Observing Mother's Day with Renewed Appreciation - http://www.journeyofhearts.org/resources/momday.html

Music Used for NICU Newborns in Studies & Other Selections

Something that parents can do for their NICU newborn is to share music with them. Many studies have shown that music has the ability to soothe and nurture the NICU baby.

This Music Used for NICU Newborns list on Amazon of carefully selected CD titles are ones that have been used in NICU music studies on newborns or are other favorite music selections for NICU newborns. A few additional titles were added from our list of favorites.

The list of musical selections are also included below.

• Lullaby Favorites: Music for Little People - This CD comes from one of my favorite companies, Music for Little People this is a soothing collection of many of the classic lullabies for babies. Includes many of the classics: All the Pretty Little Horses, Twinkle, Twinkle Little Star, Somewhere Over the Rainbow and
  Brahm's Lullaby.

• Transitions: Soothing Music for Crying Infants(Transitions Music) - One of a series of CD's developed under the guidance of Dr. Fred Schwartz. Digital samples of womb sounds, barely discernible female vocals and the soft wash of other atmospheric sounds are combined to create music to reduce the stress of infant children and their parents.

• Transitions 2: Music to Help Baby Sleep(Transitions Music) - One of a series of CD's developed under the guidance of Dr. Fred Schwartz. Soothing instrumental and vocal music are blended with womb sounds and the rhythm and sound of mother's breathing to create a relaxing musical environment for infants and their parents.

• Dream A Little Dream (Transitions Music) - Another musical collection developed under the guidance of Dr. Fred Schwartz.
  
  This CD is a series of relaxing and soothing recognizable lullabies that include Dream a Little Dream, Journey, Sweetest Song, Rock into the Night, Sleep, Sleep, Sleep and Dreamin'.

• Baby Sleep - A collection of classical selections perfectly chosen to soothe babies and start them on an early appreciation of music.
  

  This CD includes selections such as: Adante, Dance of the Sugar Plum Fairy, Moderato, Nocturne No. 7, Cradlesong, Lullaby, Allegretto piacevole, Minuets Nos. 4 and 5 and Morning Prayer.

• Music for Babies - From one of my favorite musical composers, Steven Halpern, Music for Babies surrounds babies (and their parents) with soothing music-- a warm blanket of sound to help babies relax and fall asleep more easily. Includes the classics Brahm's Lullaby (Cradle Song), Twinkle, Twinkle Little Star, Frere Jaques, My Bonnie and Beautiful Dreamer.

• The Snow Faires: Newborn Snow Christmas Music - A collection of Christmas Music perfect for the Newborn that is hospitalized over the holiday season. This collection includes Christmas Classics such as What Child is This?, The First Noel, Silent Night, O Christmas Tree, Angels We Have Heard on High and Jingle Bells.

  Some of these songs may not be as soothing to NICU newborns, so might be better if used when your baby is a bit more stable.

Note: Before using any of these with your newborn, be sure to listen to the music yourself first. Excerpts of the musical selections can be found on the Amazon Pages by following the 'Listen to samples' or following the links."

Coping Strategies Used by Parents to Deal with their Child's Death

They had a camera and they had pictures...
they had already taken his hand and feet prints...

Looking back we have not only our memories,
but some of the things...
those things are very important.

Parents of a NICU Baby Who Died

Coping with the end of a NICU infant's life is a very difficult situation for most parents; each family learns how to cope in their own way. The end-of-life experience with their infant can be made easier with support from family, friends and the hospital care providers.

In a study published in April 2007 in the Journal of Perinatology researchers surveyed parents and identify factors that were important to them in caring for their infant at the end of life. These were presented in a prior blog on "Factors Important to Parents at the End of their Infant's Life."

This study also identified various coping strategies that helped parents deal with their child's death. The strategies identified included:

• Family Support
• Keeping the Child's Memory Alive
• Spirituality & Faith
• Altruism - wanting to 'give back' to the hospital
  
• Refocusing on Life - often on the other children
  
• Validation of their Decision
• Bereavement Support Groups

Additional Recommendations
The Parents who were interviewed were asked what would have made their end-of-life experience better with their infant. Their recommendations included:

• Parents should always ask questions and stay informed.
• Parents need to be vocal and stand by their decisions.
• Be sure to keep siblings included.
• Participate in the child's care as much as possible.
  

How a person gets through a difficult experience, such as the death of a child, depends a lot on what happened and how the experience was handled at the time by the hospital staff and by family.

Parents who utilize these coping strategies that were identified, although they live through an excruciatingly difficult experience, are generally able to cope with the death of a child.

Researchers' Conclusions:
Results of this study suggest that most parents are able to effectively cope with the death of their infant. These results are in contrast to other studies that have shown a higher rater of depression and PTSD in parents who had a child die.

Related Blog
Factors Important to Parents at the End of their Infant's Life.

Source:
Brosig CL, Pierucci RL, Kupst MJ, Leuthner SR. Infant end-of-life care: the parents' perspective. Journal of Perinatology. Online Publication 19 April 2007. http://www.nature.com/jp/journal/vaop/ncurrent/abs/7211755a.html

6/18 - Comforting Moment - All that You Deeply Love

A simple comforting thought:

What we once enjoyed and deeply loved we can never lose, for all that we deeply love becomes a part of us. Helen Keller

Photo Source: Soňa Psotová. Intimate. . Royalty Free Use.

6/17 - Weekly Encouraging Message - Asking Why and Finding Hope

Former President of the Czech Republic, Writer and Dramatist, Václav Havel once wrote:

Hope ... is not the conviction that something will turn out well, but the certainty that something makes sense, regardless of how it turns out.

Václav Havel (1936 - )

Asking Why?
For Parents having their newborn admitted to the Neonatal Intensive Care can leave them struggling to make sense of it all, wondering "Why?" and "What did I do to make this happen?" and to try and find some hope in what may appear to be a hopeless situation.

When coping with our NICU adventure, my husband and I purposefully did not spent much time dwelling on the "Why?" especially when it became apparent that there would be no definitive medical answer. Instead we chose to focus on "How do we go on living as meaningful a life as possible, now that our life has been forever changed?"

We realized that asking "Why" may be disruptive and even counter-productive. Letting go of the "Why’s" can be extremely beneficial to the integrating the loss into our lives and restoring peace after a crisis.

Finding Hope
Over time NICU parents adjust to the disruption of their initial dreams for their child. Many discover an internal core of strength as they make sense of or find personal meaning in the loss.

It has taken many years to get to the point where we can now see the hope that we had at the time, that she would be "healthy and strong" and things would turn out alright has come into play. We can now see in hindsight how our lives have shifted and things now make sense after our daughter's NICU experience.

Our lives would be very different had we not gone through the experience, but even more so, had she not survived.

Here is hoping that your experience will make sense...regardless of how it turns out.

Books for NICU Babies Program

Books for Babies is a wonderful idea to let NICU parents at the University of Missouri's Children's Hospital do something with their baby that lets them feel like a normal parent--read their newborn a book.

The program is the brainchild of neonatologist and former Health Sciences Center fellow Colleen Rose, MD. Books for Babies provides parents with free storybooks to read to their hospitalized infants. The cost is a mere $3 book for the ability to help NICU parents give their babies the love they need to thrive and grow.

Babies recognize their parents voices. These voices can be a great source of comfort. Reading to NICU babies has been show to have a positive effect--improving oxygen uptake and making the heartbeat more regular.

A Chance to Focus on Being a Parent
Judy Bildner, NICU case manager and a coordinator of the Books for Babies Program at Children's Hospital talks about the unique benefits of the program:

This is a program helps parents bond with their babies and helps them focus on something else besides drugs, monitors and ventilators.

An Opportunity to Improve Development
Elizabeth James, MD, chief of neonatology at the Health Sciences Center, praises for the program developed by Dr. Rose's friend and former teacher.

It involves parents in doing something for their children that is helpful. And we know from the literature that kids who are read to develop better.

For More Information:
Neonatal Intensive Care Unit Adopts Book Program. University of Missouri Health Care. See Books for Babies at the University of Missouri Health System website.

Breathe, Just Breathe - An Effective Strategy for Coping with a Challenge

No one can find the rewind button now, So cradle your head in your hands, And breathe, Just breathe, Oh breathe, Just breathe Modification of Lyrics by Anna Nalick, Breathe

Just Breathe

The lyrics to this song, "Breathe, Just Breathe" have been my new mantra when things start getting difficult. It is a reminder that when I feel stressed, I need to breathe to relieve the tension.

Breathing - An Effective Strategy for Coping
There are several different breathing techniques that can be used to help in calming the frazzled nerves that NICU Parents may frequently experience. I'll include several over the next few weeks.

Calming your own nerves helps you to keep your baby calm when you interact with him or her.

Slow, Deep Breaths
This technique is one that can be easily done in just a few minutes. If you are feeling nervous, you may want to take a minute before you walk into the hospital or onto the NICU and again while you are scrubbing your hands to calm yourself down.

1. Stop what you are doing and focus on your breathing.
2. Breathe deeply.
3. Exhale slowly.
4. Feel your body relaxing.
5. Repeat 3-5 times.

Mini Break - 30 seconds to Relax.
Another quick technique that can be used.

1. Find a quiet place.
2. Close your eyes.
3. Count backwards from 10 to 0.
4. As you count, imagine that your worries are shrinking in importance, until you reach 0 and they have diminished in size.
5. Open your eyes and feel refreshed.

Photo Credit: Julia Freeman-Woolpert. Sorrow and Worry. Used with Permission.

Music's Ability to Soothe and Nurture the NICU Baby

One of my few happy memories of our NICU experience is watching my daughter sleeping under the special bilirubin treatment lamps with her “shades” on and listening to “tunes” with her mini headphones. I could almost imagine her lying on the beach in the sun as a teenager listening to music.

A recent article this week on using music therapy with preemies brought back this memory. It was good to read that something I had intuitively done for my own daughter, bringing in music for her to listen to while in the NICU, is now being used as a therapy in more NICU settings.

Research is showing that Music therapy may be another way for caregivers to positively alter the environment of NICU premature babies and sick newborns.

Desirable Impact of Music on NICU Babies

• Aids in brain and language development
• Conveys security to babies.
• Improves Oxygen saturation levels.
• Helps babies to sleep.
• Decreases pain.
• Increases weight gain.
• Shortens duration of hospital stay.

According to an article published in JAMA in 2000, playing music in the neonatal intensive care unts can also play a role in holding down the noise level in the NICU's.

Guidelines for Using NICU Music
These guidelines come from Dr. Fred J. Schwartz, anesthesiologist and one of the leading authorities on using music with newborns:

• Try not to disrupt the baby’s normal sleep state.
• Consider the baby’s mood or behavioral state when music is played.
• Use music to help change or transition the baby’s behavioral state e.g. an agitated or fussy baby can go to sleep or become more quietly alert.
• Adjust volume and amount of time music is played if needed.

Suggestions for Music to Play for Your NICU Baby
I have included some of the music CD's most commonly used in the NICU Music studies on the My Baby's in the NICU: Now What? lens that are readily available on Amazon.

Sources (Alphabetically) :
Collins SK, Kuck K. Music therapy in the neonatal intensive care unit. Neonatal Netw. 1991 Mar;9(6):23-6.
Marwick C. Music hath charms for care of preemies. JAMA. 2000 Jan 26;283(4):468-9.
Sagario D. Technology, music therapy give preemies an edge: Neonatal Intensive Care Unit. June 11, 2007. Des Moines Register.com
Schwartz FJ. Ritchie R. Music Listening in Neonatal Intensive Care Units. Previously available at Transitions Music.
Schwartz F. Perinatal Stress Reduction, Music and Medical Cost Savings. Previously available at Transitions Music.

Photo Credits: Sanja Gjenero. Pure Music. Royalty Free Use.

A Self Care Strategy for NICU Parents - Remember to HALT

During times of stress it can be difficult to remember to stop what you are doing and take care of yourself; this is especially important when your newborn is hospitalized in the NICU.

NICU parents need to be sure to take care of themselves...in order to have the energy and the reserves to be available to support your baby.

It is very important for NICU parents to follow the acronym coined by A.A. (Alcoholics Anonymous) and be sure to H.A.L.T.

You should never let yourself get too

Hungry
Angry
Lonlely
Tired

This simple self care strategy will help you out greatly to decrease your stress and distress during your time in the NICU.

Photo Source: Daniel Battiston. Stop! Royalty Free Use.

NICU Parent Support Lens on Squidoo

The NICU Parent Support Site now has a series of lenses relating to NICU Parents on Squidoo. These lenses benefit the March of Dimes NICU Family Support Program.

The lenses include:

• NICU Parent Support Site Lens - The overall organizing lens
• My Baby's in the NICU: Now What?
• Surviving Your NICU Experience - Advice for NICU Parents and Families
  
• CarePages - Connecting Friends and Family During Times of Challenge

We have also created two lenses that we hope no NICU parent needs to use, but with nearly 30,000 infants dying each year, many in the NICU or ICN, these are lenses with beneficial information for those facing the end of their baby's life and then what to do once that life is over.

• My NICU Baby is Dying: Now What?
• My NICU Baby has Died: Now What?
  

Questions about Squidoo

• What is Squidoo? - The world's most popular site for people who want to build a page about their passions.
• What is a Squidoo Lens? - A lens is one person's view on a topic that matters to him or her. It's an amazingly easy-to-build, single web page that can point to blogs, favorite links, RSS feeds, Flickr photos, Google maps, eBay auctions, CafePress designs, Amazon books or music, and more. A Squidoo Lens can help someone is looking for recommended information, to get them started in the right direction.
• What is this about earning royalties and donating to charity? Lensmasters can earn a royalty on the lenses that they create. You can choose to keep the royalty or to donate to one of the 80+ non-profit charity partners.
• Sounds good - How do I get started? - If you are interested in creating your own Squidoo Lens, on your favorite topic, follow this link and get started.
  

6/11 - Comforting Moment - It's Only Words...

It's only words and words are all I have to take your ache away. The Bee Gees (modified)

I'm so sorry. I wish you comfort. I hope things will be good. I wish this hadn't happened to you.

Words can provide a source of solace, hope, comfort and reassurance--emotions much needed during the grieving process. Words that are written or spoken, help us to realize that we are not alone in our feelings of grief or desolation.

Writing down words is a powerful way of dealing with grief that has been utilized since ancient times. Often the written words can often be more effective than spoken condolences at touching the part of a person's heart which is grieving.

6/10 - Weekly Encouraging Message - Laughter

My daughters are both big fans of Peter Pan, Tinker Bell and all of her fairy friends.

This week's EM (Encouraging Message) comes from the author and creator of Peter Pan:

When the first baby laughed for the first time, the laugh broke into a thousand pieces and they all went skipping about, and that was the beginning of fairies.

James Matthew Barrie (1860-1937)

Scottish Dramatist and Novelist

Wishing you magical moments of mirth and merriment with your newborn.

Photo Credit: Becky Szmutko. Laughing Fairy. Used with Permission.

Inspirational Website - Pitter Patter: A Message of Hope from a Former Preemie

I found the most inspiring website today for NICU parents. It is the story of a former NICU preemie, created by the former NICU baby, herself to spread a message of hope to NICU Parents.

About the Site
PitterPatter.info is a website created by a former preemie with a message of hope for parents of preemies. To spread her message of hope, the author created and distributed business cards about the site to NICUs (Neonatal Intensive Care Units) and March of Dimes offices.

The image above compares her actual birth footprints are near actual size (approximately 1 1/2 inches) compared to the letter tiles (3/4 inches).

Her site was also Girl Scout Gold Award Project.

For more information visit the website: http://www.pitterpatter.info/

The Latest in NICU and Neonatal News

We've added a link to the blog, so it will be updated with the latest NICU and Neonatal news.

I will also try to highlight some of the major news stories that are breaking in the NICU and neonatal world.

News feed Locations
Side Bar - You can view the news feeds on the side bar and toggle between NICU news feeds and neonatal news feeds.

Bottom Bar - You can also view a scrolling news feed for NICU or Neonatal at the bottom of the page. Only one feed will display at a time. To get to the other option refresh your browser.

What are the NICU Levels of Care?

It is likely if my youngest daughter had been born even 10 years earlier than she was, or born in a more rural setting that she would not be with us here today because she may not have gotten the treatment that she needed to support her heart and lungs (cardio-respiratory system) during the first few critical hours of life.

In our case, she was born at a hospital with a Level 3 standing for their Neonatal Intensive Care unit. In order to get from basic newborn care (Level 1) to the more highly skilled care unit they moved her from one room in the hospital to another.

Ultimately she ended up needing even more specialized care and was transferred to the regional Level 4 NICU that had the potential to deliver the highest level of sick newborn care.

Levels of Neonatal Care Units
The levels of care are used as a method of designating the care provided by hospitals for newborn infants. It is based according to the complexity of care provided, ranging from basic care or level one to the most complex care

• Level I - Basic Neonatal Care The minimum required for any facility that provides inpatient maternity care. The hospital must have the necessary personnel and equipment to

• Perform neonatal resuscitation
• Evaluate healthy newborn infants
• Provide postnatal care
• Stabilize ill newborn infants until transfer to a facility that provides intensive care.

• Level II - Specialty Care Nurseries In addition to providing all of the basic care listed above, Special Care Nurseries can

• Provide care to infants who are moderately ill with problems that are expected to resolve rapidly
• Provide care to infants who are recovering from serious illness treated in a level III (subspecialty) NICU.

• Level III - Subspecialty NICU's Care for newborn infants with extreme prematurity or who are critically ill or require surgical intervention.

• Level IV - Regional Subspecialty NICU's (Level IV is a designation about the Level II, only found in a limited number of the states).The Level IV NICU's are often found in regional academic medical centers and can provide the most complex level of neonatal care including
  
• Advance diagnoses
• Treatment of fetuses, preemies and newborns with complicated conditions.
  

Source:
Committee on Fetus and Newborn. Levels of Neonatal Care. Pediatrics. 2004. 114;5:1341-1347. Available online at: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;114/5/1341

6/4 - Comforting Moment - Information Helps During Times of Loss

For many parents the loss of a baby is among the highest levels of loss, if not the highest.

While little can assuage the difficult and forgotten grief surrounding stillbirth and neonatal death, information can be helpful regarding the normal feelings and experiences which leave parents in an emotional and spiritual wilderness.

Dr. Elizabeth K. Best

While information cannot take away the intense pain and sorrow you are feeling, getting informed and reading useful resources can help parents to understand the physical and emotional responses and find ways of managing these responses.

Information can also help parents find suggestions and resources that others who have been in similar situations have found to be helpful during their own time of loss.

6/3 - Weekly Encouraging Message - Coping with Life

This week's Encouraging Message is a reminder of just how much we learn about life from our children.

Parents learn a lot
from their children
about coping with life.

Muriel Spark (1918-2006)
Scottish Novelist

I thought I was an expert on being in the hospital and dealing with crises, but my daughter's unexpected NICU admission taught me many new things and gave me invaluable insights about being in the hospital--from the family's perspective.

You can read some of these "Lessons Learned from Crisis" that I learned in the article that written soon after my experiences.

May you enjoy learning from your children.

Image: Stef Komen. Flower in Hand. Royalty Free Use.

What's in a Name? NICU, NNICU, ICN, SNCN, SBCU, SCN, PICU

NICU, NNICU, ICN, SNCN, SBCU, SCN, PICU - What term do I use?

There are a variety of different terms used to describe the hospital care for newborns, sick newborns and premature infants (preemies).

Which term is used often depends on the age of the newborn or child, country of origin and the level of care provided being.

The following list is a list of the various different abbreviations I was able to find.

• ICN - Intensive Care Nursery, (neonatal) Intermediate Care Nursery
  

• NICU - Neonatal Intensive Care Unit
  


• NNICU - Neonatal Intensive Care Unit (UK)
  

• NNU - Neonatal Unit (UK)
  

• PICU - Pediatric Intensive Care Unit
  

• SBCU - Special Care Baby Unit (UK)
  

• SCN - Special Care Nursery (Canada)
  

• SNCN - Sick Newborn Care Unit (India)
  

If you know of others, let us know.




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