Hope for Preemies

Bonding With Your Baby

"Prematurity is a crisis for the whole family," says Jay Greenspan, M.D., who co-chairs Pennsylvania's Prematurity Campaign for the March of Dimes. "Premature babies often can't be held by their mothers or fathers and bond in the way you would expect. They are in an environment where lights go on and off and monitors beep constantly. Ideally, they should be in nurseries with plenty of space so parents can be with their infants, go on rounds with the doctors who treat them, and be intimately involved in decisions about their babies' care."

Recognizing the need for family involvement, the March of Dimes' Neonatal Intensive Care Unit (NICU) Family Support project has been working with the Children's Hospital in Denver, Akron Children's Hospital in Ohio, and the Greenville Hospital System Children's Hospital in South Carolina to make the NICU experience more comfortable for parents, sibings, and grandparents. Videos, information sheets, and a March of Dimes staff member at each site help family members cope while the infant is in the hospital, during the transition home, and in the event of a newborn death. The program will be expanded to 50 additional hospitals by 2007.

While there's no denying the serious risks of prematurity, other developments in the last decade are improving the survival rate and quality of life for these tiny, fragile infants. They include:

Reducing the Risk of Death

• Warming preemies in flatbeds with a heater above them or in incubators with humidity regulators to maintain optimum body temperatures
• Hooking them up to finely tuned, computerized neonatal ventilators that monitor and aid their breathing, reduce their risk of death, and help prevent lingering lung problems
• Using less-potent antibiotics and stopping them as quickly as possible to avoid side effects, such as organ damage and compromised immune systems that would make the infants more susceptible to infection later
• Monitoring babies for signs of pain and providing relief through simple strategies -- such as shifting their position, swaddling them, giving them a pacifier -- or, if necessary, by administering opiate medication, such as morphine

• Coating preemies' lungs with surfactant, a soap-like substance that makes breathing easier
• Introducing pumped breast milk, along with a nutritional supplement, within the first few days
• Encouraging kangaroo (skin-to-skin) care with mothers (and occasionally fathers), who hold their infants on their breast to soothe them and help them maintain body temperature
• Fostering bonding by encouraging parents to visit their babies often -- to sing to them, tell them stories, and comfort them with the familiar sound of their voices

Three recent cutting-edge studies provide additional hope for the future. Research at the University of Chicago has found that giving nitric oxide as an inhalant to premature babies with breathing problems can reduce the incidence of chronic lung disease. Early data from an Australian study indicates that magnesium sulfate given intravenously to women about to give birth prematurely can help reduce both death and cerebral palsy in infants. And a study conducted at Yale University suggests that preemies who are exposed to cycling lights that mimic day and night in the NICU are more likely to develop healthier sleeping habits sooner.

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