pátek 18. listopadu 2011

A Mother's Story




How My Feisty Preemie Came Into the World


It was over four-and-a-half years ago, but it often seems like yesterday that my daughter Aria was born. The way she came into the world, at 32 weeks old, was nothing like the way I’d envisioned. There were no birthing classes, no labor, no excited trip to the hospital.

Several weeks before she was born, I thought I’d gotten food poisoning from some past-its-prime frozen spinach. After what seemed like an obvious bad reaction to the food, I kept feeling intermittently sick and a dull but persistent pain at the top right quadrant of my chest. I went to my OB/GYN and he sent me to my primary care doctor to make sure it wasn’t some kind of tapeworm or parasite. She -- arrogantly -- insisted that it was just food poisoning and didn’t think there was any reason to do bloodwork. In retrospect, I should’ve insisted on it but I trusted her. At 30 weeks pregnant, I’d also gone for a growth scan and it showed that the baby was growth restricted. But I was told that I shouldn’t be too concerned and they’d just keep monitoring me.

The day Aria was born, I had gone for a routine check-up with my husband David. When my doctor took my blood pressure, it was high -- which it hadn’t been before. He said he’d feel better if we went to the hospital nearby for an ultrasound. When we arrived, I got an ultrasound and at the same time they received a call from my doctor that there’d been protein in my urine. They then sent me upstairs to get bloodwork and to be monitored further. We were there several hours doing tests and waiting for the bloodwork results to come back, but nothing seemed urgent. They told me I’d likely go home and do a 24-hour urine test to monitor the protein in my urine.

But things suddenly turned into what felt like an episode of ER. As soon as the blood-test results came back, a nurse bolted into the room and told me that I wouldn’t be going home -- I’d be having an emergency C-section immediately. “How can I be having the baby now -- it’s only 32 weeks old?” I asked, confused and panicked. Suddenly, I was told that I had the HELLP Syndrome, a variant of preeclampsia that involves hemolysis (the breaking down of red blood cells), elevated liver enzymes and low platelet count and that I was at risk for having a stroke or seizures. The baby -- whose sex I didn’t know -- had to be delivered immediately because we were both in danger. I was spiraling into a state of confusion and despair. How could this be?

Because I was considered high-risk, my OB/GYN wouldn’t be able to deliver her. I’d have to be delivered by a maternal-fetal specialist I’d never even met. My husband and I were both reeling from shock. But Dr. Fereshteh Boozarjomehri (it’s no coincidence that her first name means “angel” in Farsi) assured us that I’d be okay. Within minutes of being prepped, I was in the operating room and having a C-section. Aria was born at a tiny 2 lbs. 10 oz., and because of her prematurity and issues with her breathing, she was whisked away to the NICU. In my precarious condition, I wasn’t allowed to leave my bed for 24 hours as they stabilized me. It was horrible and surreal. I’d just had a baby and I saw her for what felt like 1 second. And now she was in the NICU and I had no idea what would happen next.

I couldn’t leave my bed as I recovered, so I asked for a NICU doctor to come to tell me about my new baby’s state. They assured me that though she was tiny, she wasn’t quite as tiny as many of the “peanuts” in the NICU -- she was more like a cashew. Little Cashew soon became her nickname since we hadn’t named her yet. Twenty-four hours later, during which I was convinced that I'd missed the window for bonding with her, I was wheeled up to the NICU to see her. I was shocked. She was tiny and hooked up to tubes. She looked so frail that it broke my heart. I would repeatedly ask if she would survive but no one could tell me anything definitively. I was plunged into fear that I'd lose her.

My feisty little girl -- whom we didn’t name for two weeks -- fought her hardest. There were many scary moments, like when we would do kangaroo care with her, skin-to-skin snuggling that has been proven to have positive health benefits for preemies, and she would suddenly have an apnea episode and stop breathing (which is very common in preemies). The nurse would grab her from me and resuscitate her while I stood by crying. She also had a PDA (patent ductus arteriosus), an open artery in her heart that typically closes in full-term infants but not always with preemies. Luckily, the artery closed with medicine and she was able to avoid getting surgery.

Other than going home to sleep, I lived at the NICU every day and night with Aria. During her six weeks there, I was grateful for the incredible hospital staff (who sometimes had to tough-love me through my fearful moments) and the parents who became my support group -- and who I still count as friends over four years later. We were in it together, celebrating the tiny milestones of our tiny babies as we waited -- during what felt like an eternity -- for them to be able to leave the hospital.

Six weeks after she was born, Aria was finally discharged. Weighing a little over 4 lbs., she came home on an apnea machine to monitor her breathing (which she was constantly connected to for two months other than during bath time). Having her home was surreal: The first night, I honestly didn’t know if I could handle being on my own without the nurses’ guidance. It was overwhelming.

It took us a while, but she learned to nurse, which she hadn’t been strong enough to do until she was five weeks old (before that, I pumped and she was fed through a feeding tube or tiny bottles). And as time went on, we were assured that she didn’t have any developmental delays. Though small in size, which she still is to this day, she was a feisty little fighter. The joy I felt in having her home -- and not having to visit her in the hospital -- was immeasurable. My baby was with finally me.

On World Prematurity Day today, I am grateful that I was given the gift of my teeny-tiny Little Cashew, who is now an incredibly funny, joyful, curious little dancing machine. It doesn’t feel like it’s over four years ago that Aria first came into the world in a way that was anything but ideal. But that experience has made us both stronger.


Serena Kappes is iVillage’s Entertainment Editorial Director.

http://www.ivillage.com







Prematurity Awareness Month


http://www.youtube.com/watch?v=hqxVRnk1H90

Does A Bigger Brain Make For A Smarter Child In Babies Born Prematurely?


New research suggests the growth rate of the brain's cerebral cortex in babies born prematurely may predict how well they are able to think, speak, plan and pay attention later in childhood. The research is published in the October 12, 2011, online issue of Neurology®, the medical journal of the American Academy of Neurology. The cerebral cortex is the outer layer of the brain covering the cerebrum, and is responsible for cognitive functions, such as language, memory, attention and thought.

"In babies born preterm, the more the cerebral cortex grows early in life the better children perform complex tasks when they reach six years old," said study author A. David Edwards, DSc, of Imperial College in London. "The period before a full-term birth is critical for brain development. Problems occurring at this time have long-term consequences, and it appears that preterm birth affects brain growth."

The study looked at brain growth rates of 82 infants who were born before 30 weeks gestational age using MRI scans of their brain between 24-44 weeks. Brain scans were collected repeatedly from immediately after the babies were born until their full-term due date. Their cognitive abilities were tested at two years old and again at six years old.

The study found that the faster the rate of cerebral cortex growth in infancy, the higher their scores were on the developmental and intelligence tests as children. A five to 10 percent reduction in the surface area of the cerebral cortex at full-term age predicted approximately one standard deviation lower score on the intelligence tests in later childhood. Motor skills were not correlated with the rate of cerebral cortex growth, and the overall brain size was not related to general cognitive ability.

"These findings show we should focus on the growth of specific regions of the brain like the cortex when trying to understand or diagnose potential problems in babies and fetuses," said Edwards.

The study was supported by the Health Foundation, the Garfield Weston Foundation, Wellbeing of Women and the NIHR Imperial College Healthcare Comprehensive Biomedical Research
Center.


http://www.medicalnewstoday.com

pátek 27. května 2011


Necrotizing Enterocolitis (NEC) and Preemies


Necrotizing enterorcolitis is a gastrointestinal illness that mostly affects premature babies. Enterocolitis refers to the small and large intestines and necrotizing means tissue death. Because NEC results in the death of gastrointestinal tissue, it is a very serious concern for a premature baby. It is more common in preemies that weigh 1,500 grams or less, but it can also affect other high risk infants.

What causes necrotizing enterocolitis?

Although it is not entirely clear what causes necrotizing enterocolitis, there are some theories about what could cause NEC. We do know that it generally occurs once milk feeding is started. Since preemies gastrointestinal systems are immature, one theory is that the preemies intestinal tissues are weakened by not having enough oxygen or blood flow. As a result, when the baby’s system is introduced to milk feedings and food is moved through the weakened area of the intestines, bacteria from the food enters into the intestinal tract which damages the intestinal tissues. Even with treatment, NEC is a serious complication for a preemie. If the bacteria continues to spread, the intestinal tissues may become severely damaged and tissue death may occur. In severe cases, tissue death may create a hole in the intestine. When the intestine is perforated, bacteria from the intestines can leak into the abdomen causing a life threatening infection.

Babies at risk for necrotizing enterocolitis

Some babies are at higher risk for developing necrotizing enterocolotis. Some risk factors include:

  • Preemies that weigh 1,500 grams
  • High risk babies taking milk by mouth. NEC typically is not seen until babies begin taking milk. Breast milk may be easier on a preemie’s digestive system than formula. Some experts believe the make-up of infant formula may be a factor in the development of NEC. Preemies that are breast fed are at lower risk of developing NEC, but they are not immune from it.
  • Difficult delivery or low oxygen levels at birth
  • Babies with too many red blood cells in circulation
  • Babies with other gastrointestinal issues or infections

Symptoms of necrotizing enterocolitis

  • Abdominal bloating or swelling
  • Baby not tolerating feedings well
  • Decreased bowel sounds
  • Feedings stay in stomach
  • Greenish colored vomit (indicating bile in vomit)
  • Redness of the abdomen
  • Bloody stools
  • Lack of bowel movements
  • Other signs of infection

Diagnosis and treatment of necrotizing enterocolitis

NEC is usually diagnosed by taking an x-ray of the abdomen. NEC may be diagnosed if there is an abnormal bubbly appearance in the intestines. They will also look to see if there are signs of air in the large veins of the liver or in the abdomen. Air is produced by the bacteria found in the bowel. If air is seen outside of the intestines, it may indicate that the bowel is perforated. A needle may be inserted into the abdominal cavity to aspirate fluid from the abdomen. Withdrawing intestinal fluid from the abdomen is another indicator that the intestines have been perforated.

Most of the time NEC can be treated without surgery. Stopping feedings is generally the first step in treatment. A nasogastric tube may be inserted through the nose and into the stomach to keep baby’s stomach empty. IV fluids may be given for nutrition and to keep baby hydrated. Baby may be given antibiotics to treat the infection as well. Baby will then be monitored and x-rayed frequently to make sure the infection isn’t spreading. If the NEC is severe, surgery may be necessary to remove the diseased intestine or bowel.

Feedings may be withheld for a week or longer to treat baby with antibiotics and give the intestines time to recover and mature. When feedings are resumed, baby will be monitored closely.

German baby survives record-equalling premature birth

A German baby born after only 21 weeks and five days in the womb has equalled a world record for surviving premature infants, the hospital said Saturday.

When Frieda was born on November 7 she measured 11 inches (28 centimetres) and weighed only one pound (460 grammes).

"In the specialist literature, other premature babies have been lighter than her at birth, some even less than 300 grammes, but there is no mention of a premature baby even younger than Frieda," the clinic in western Fulda said in a communique.

A baby was born in Ottawa in 1987 at exactly the same stage of its mother's pregnancy, the statement said.

Frieda was discharged on Wednesday weighing 7.7 pounds (3.5 kilos) and measuring 50 centimetres (nearly 20 inches), the clinic said.

Her twin brother Kilian died a few days after being born.

Professor Reinald Repp, director of the paediatric clinic, could not be reached on Saturday, but a doctor on duty told AFP that "there is no foreseeable risk of after-effects for the moment" and that the little girl "should develop normally like any other child."

Generally babies born before 22 weeks have no chance of surviving because their lungs, heart and brain are not sufficiently developed.

"Frieda was kept in a completely sterile environment, with her breathing assisted and fed through her navel," Repp told the mass circulation Bild newspaper.

Any baby born before eight months of pregnancy is considered premature.

Very premature babies (less than 32 weeks) are considered at high risk of suffering developmental problems.

Click here to find out more!


A baby at a maternity ward. A German baby born after only 21 weeks and five days in the womb has equalled a world record for surviving premature infants, the hospital said Saturday.
A baby at a maternity ward. A German baby born after only 21 weeks and five days in the womb has equalled a world record for surviving premature infants, the hospital said Saturday.


http://health.yahoo.net/news