Care of premature infants has seen many changes

By LAURIE M. FISHER
VINDICATOR CORRESPONDENT
YOUNGSTOWN -- Care for premature infants has changed significantly over the past decade.
Dr. Elena Rossi, director of neonatology and chairwoman of pediatrics at St. Elizabeth Health Center, estimates that the staff cares for 350 to 400 babies per year. Most children are hospitalized under two weeks, though a few are in the unit for more than two months.
"The medical changes include ... high-frequency oscillator ventilators, maternal steroids prior to delivery to mature the baby's lungs, and steroids for the baby's lungs after birth, if needed, to help them mature," she explained.
Nutrition changes: In addition to new medications, better nutrition including intravenous feedings and a focus on breast milk has helped premature infants, she said.
The neonatal special care unit is more family-centered, she noted. Babies can be held at two pounds rather than waiting until they reach four pounds.
"There is 24-hour-a-day visiting for parents and their adult family members and friends. In the past, visiting was limited to 12 to 8 p.m. and parents had to be present if there were adult visitors. We recognize that family and friends are a huge support to parents during this difficult time, and we welcome them to visit," Dr. Rossi said.
Siblings have also become an important part of the healing process.
Visiting siblings: Three years ago a program began that allows visitation for sisters and brothers age 3 to 13 years on Thursdays and Sundays. Children under 3 are not permitted to visit because of the risk of contagious diseases.
The sibling activity program, established in memory of one of the babies from the unit, offers a structured program in which trained volunteers lead children in crafts, stories and play. "This gives the parents time to visit with their baby together and not worry about the other children," Dr. Rossi said.
Twins and triplets are co-bedded during every shift, she added. When they are out of the isolettes, they stay together 24 hours a day in a larger bassinet called a cribette. For the past three years, the isolettes are covered with material to prevent light and sound from overstimulating the baby.
"It took a while for the staff to get used to not being able to see every movement the baby makes, but to rely on the monitors to alert them of the change," she said.
Skin to skin: For the past three years, parents have been encouraged to "Kangaroo Care." Parents place the baby, with just a diaper, skin to skin, on their chest, Dr. Rossi said.
"This has been shown to decrease crying, improve weight gain, decrease apnea and bradycardia [slow heart rate], improve bonding and earlier discharge," she explained.
Adults help in the cuddle program, in which volunteers hold babies who are more stable but not ready for discharge. "Nearly every day a volunteer comes in to hold babies for an hour. Many of the babies are from Pennsylvania, Columbiana and Trumbull counties, and some families have a hardship in visiting daily. The cuddlers provide extra holding time for the babies," she said.
Out-of-town families can keep up on loved ones' progress through an e-mail program. Babies are photographed and relatives are updated on growth, feeding and plans for discharge.