Home from the NICU: how to handle visitors and trips outside

20
Nov
Posted by Lauren

You’ve finally brought your baby home from the NICU and you’re looking forward to taking her out into the world and introducing her to your friends and family. But before you send out a group text telling everyone to come on over, we have some tips to keep in mind.

Since babies who have stayed in the NICU have a greater chance of getting infections than other babies, you want to take steps to keep them healthy. Here are some things you can do:

  • Limit the number of people who come to your home.
  • Ask visitors to wash their hands before touching your baby.
  • Do not let visitors smoke in your home or near your baby.
  • Do not let adults or children who are sick, have a fever or who may have been exposed to an illness near your baby. Any adult who will have contact with your baby should get a pertussis (whooping cough) vaccine.
  • Do not take your newborn to crowded places like shopping malls and grocery stores.

This does not mean that you can’t invite people to your home or that you have to stay in your house for the first months after your baby comes home. It’s fine to take your baby for walks outside in nice weather and go visit friends or family members. Just make sure your baby is going to a smoke-free and illness-free home.

If you have questions about your child’s health or condition, especially if your baby has medical equipment at home, reach out to your baby’s health care provider. She will be the ideal person to advise you.

Life at home after the NICU can be challenging, but you may find that you have new strength. And there is much to celebrate. Share your baby’s birth story and get support from other families on Share Your Story. Your experience and story will resonate with others as well as provide you with encouragement as you create new memories at home.

World Prematurity Day: Why it matters

17
Nov
Posted by Sara

In the United States,

About every eight seconds, a baby is born.

Every hour, about three babies die.

African-American infants are more than two times as likely as white infants to die before their first birthday.

About one in ten infants is born preterm (less than 37 weeks gestation).

About every 1½ minutes, a baby is born with low birthweight (less than 5 pounds 8 ounces).

Prematurity/low birthweight and related conditions account for more infant deaths than any other single cause (about 1 in 3).

Every year, about 4,400 babies are born weighing less than one pound.

Premature birth is birth that happens too soon, before 37 weeks of pregnancy. Each year 15 million babies worldwide are born prematurely and more than a million die as a result. Babies born too early may face life-threatening complications and have lifelong health problems. Today, in honor of World Prematurity Day, we are raising awareness of this serious health crisis.

We don’t always know what causes preterm labor and premature birth. Sometimes labor starts on its own without warning. Even if you do everything right during pregnancy, you can still give birth early. However, there are some things that you can do to reduce your risk for preterm labor and premature birth.

  • Schedule a preconception checkup with your health care provider. A preconception checkup helps your health care provider make sure that your body is ready for pregnancy.
  • Get to a healthy weight before pregnancy and gain the right amount of weight during pregnancy.
  • Wait at least 18 months between giving birth and getting pregnant again. Use birth control until you’re ready to get pregnant again.
  • Get treated for health conditions, like high blood pressure, diabetes, depression and thyroid problems.
  • Protect yourself from infections. Get vaccinated, wash your hands frequently, and don’t eat raw meat, fish or eggs. Have safe sex.
  • Reduce your stress. Eat healthy foods and do something active every day.
  • Don’t smoke, drink alcohol, or use street drugs. Ask your provider about programs that can help you quit. Tell your provider about any medicines you take, with or without a prescription.
  • Go to all your prenatal care checkups, even if you’re feeling fine. Prenatal care helps your provider make sure you and your baby are healthy.
  • Know the signs and symptoms of preterm labor. This won’t reduce your risk of preterm labor but it will allow you to get treatment quickly and that may help stop your labor.

There is no single cause of premature birth and therefore there is no simple solution. The March of Dimes is working towards giving every mom the opportunity to have a healthy pregnancy and every baby the chance to survive and thrive.

What does it mean to have a short cervix?

15
Nov
Posted by Lauren

A short cervix means the length of your cervix is shorter than normal. To be more specific, a short cervix is one that is shorter than 25 millimeters (about 1 inch) before 24 weeks of pregnancy.

Why is the length important?

If you have a short cervix, you have a 1-in-2 chance (50 percent) of having a premature birth, before 37 weeks of pregnancy. So if you have a short cervix and you’re pregnant with just one baby, your health care provider may recommend these treatments to help you stay pregnant longer:

  • Cerclage
  • Vaginal progesterone. Progesterone is a hormone that helps prepare your body for pregnancy. It may help prevent premature birth if you have a short cervix and you’re pregnant with just one baby. You insert it in your vagina every day starting before or up to 24 weeks of pregnancy, and you stop taking it just before 37 weeks.

If your provider thinks you have a short cervix, she may check you regularly with ultrasound.

How do you know if you have a short cervix?

Checking for a short cervix is not a routine prenatal test. Your provider probably doesn’t check your cervical length unless:

  • She has a reason to think it may be short.
  • You have signs of preterm labor. This is labor that begins too soon, before 37 weeks of pregnancy.
  • You have risk factors for premature birth, like you had a premature birth in the past or you have a family history of premature birth (premature birth runs in your family).

What makes a cervix short?

Many things can affect the length of your cervix, including:

  • Having an overdistended (stretched or enlarged) uterus
  • Problems caused by bleeding during pregnancy or inflammation (irritation) of the uterus
  • Infection
  • Cervical insufficiency

Read about our own Health Education Specialist Juviza’s personal experience being pregnant with a short cervix and her new connection to the March of Dimes’ mission.

Have questions? Text or email us at AskUs@marchofdimes.org.

Premature birth and the NICU: a personal experience

13
Nov
Posted by Juviza Rodriguez

Every day I read and answer lots of questions on topics like pre-conception care, prenatal care, and how to have a healthy pregnancy. I also answer many questions about complications in pregnancy, like premature birth. So when I found out I was pregnant last year, I felt pretty well-prepared and knowledgeable. However, like many first time moms, I had a little anxiety those first few weeks.

The first half of my pregnancy was completely healthy and free of problems. However, at 23 weeks during my prenatal check-up, my doctor told me that there was a problem with my cervix. She told me that the ultrasound was showing I had a short cervix and explained I would need to go on bed rest and be treated with progesterone in order to help me stay pregnant longer. Unfortunately, having a short cervix is ​​a risk factor for preterm labor.

I had been on bed rest for 11 weeks, when during a routine prenatal check-up, the doctors told me that they would need to induce labor. My amniotic fluid was very low and they suspected that I had preterm premature rupture of membranes (PPROM) I was 34 weeks and 1 day. My son, Theodore (Theo), was born the next day, November 22nd, weighing 4 pounds and 14 ounces.

Although I was able to hold him in my arms for about 10 minutes after delivery, while in the recovery room, he was quickly taken to the neonatal intensive care unit (NICU) for testing and put in the incubator. Theo was born with very high levels of bilirubin (jaundice) and had problems controlling his body temperature. Despite knowing that he was in good hands and receiving the necessary treatment, it was such a hard moment.

When I saw my son in the NICU for the first time I felt so many emotions. He was in the incubator, with the special blue lights for jaundice, and a small IV that was supplying his first nutrients. A few days after, they inserted a tube through his nose to feed him my breast milk because he didn’t have enough strength to suck and swallow on his own properly. The good news is that he had no breathing problems.

Despite these challenges, I was determined to practice kangaroo care (skin-to-skin contact) and feed him breastmilk. Since Theo was still learning to suck and swallow, he couldn’t latch, so I pumped my breast milk for his feedings. Kangaroo care is especially good for preemies because it helps them stay warm, helps them sleep better, and helps with bonding.

Having to leave our son in the hospital was a very difficult experience for my husband and me. Every day we headed out to the NICU early and came back home to eat dinner and sleep. I pumped every 2 to 3 hours and stored the milk to bring to the NICU for the next day. Theo stayed in the NICU a total of 10 days from birth until being discharged. The day we took him home was one of the happiest days of our lives.

The month of November will always be special month for me. In exactly 9 days, we will be celebrating Theo’s first birthday. He is a healthy, curious, independent, and sweet boy who can make anyone’s heart melt with his sweet smiles and giggles. It’s amazing how time flies.

November is also Prematurity Awareness Month. As overwhelming as the experience of having a premature delivery and birth was, I feel even more connected to March of Dimes’ mission, to all the women and families who share their story with us, and to all those who fight to give babies a happy and healthy tomorrow.

What is reflux?

10
Nov
Posted by Sara

All babies spit up at times. But if your baby spits up more than usual, she may have gastroesophageal reflux or simply reflux. Reflux is common among premature babies. Most babies outgrow it after a few months.

What happens when your baby has reflux?

  1. Food first passes through the mouth and the esophagus into the stomach. The esophagus is the tube that connects the mouth and the stomach.
  2. Once the food is in the stomach, it comes back up the esophagus and out of the mouth.
  3. Most babies with reflux are less bothered by it than their parents. They grow and develop normally.

What can you do?

With time, reflux usually goes away on its own. However, there are some changes you can make to how you feed and position your baby that may help:

  • Hold your baby upright during feeding.
  • Try smaller, more frequent feedings.
  • Burp your baby often, especially if you are feeding her with a bottle.
  • Try a different nipple on your baby’s bottle so she swallows less air.
  • Ask your baby’s provider if you can thicken expressed breast milk or formula with a small amount of rice cereal.
  • Keep your baby still after feeding.
  • Raise the head of your baby’s bed 30 degrees or so.

If changes to how you feed and position your baby don’t seem to help, talk to your baby’s provider to see if medication may be an option.

When should you call your baby’s health care provider?

Some babies may have other problems digesting food. Call your baby’s health care provider if she has any of these symptoms:

  • The spit-up is bright yellow or green.
  • There is a large amount of spit-up.
  • Your baby arches his back or cries during feeding.
  • Your baby vomits with great force (projectile vomiting).
  • Your baby refuses to eat or is irritable after feeding.

Have questions? Text or email AskUs@marchofdimes.org.

Thinking about pregnancy after premature birth

08
Nov
Posted by Sara

Even if you do everything right, you can still have a premature birth. We don’t always know what causes premature birth, but we do know that if you’ve had a premature baby in the past, you’re at increased risk of having a premature birth in another pregnancy. If you have given birth early, here are some ways you may be able to reduce the chances of premature birth in another pregnancy:

Wait 18 months between giving birth and getting pregnant again

Waiting at least 18 months between pregnancies gives your body time to recover from one pregnancy so that is it ready for the next one. Use birth control so you don’t get pregnant again too soon. Talk to your provider about the best birth control option for you.

Schedule a preconception checkup

Being as healthy as possible when you get pregnant can help you have a healthy, full-term pregnancy. At your preconception checkup you and your provider can talk about:

Talk to your provider about progesterone shots

Progesterone is a hormone that helps your uterus grow and keeps it from having contractions. Progesterone shots may help prevent you from giving birth early again if:

  • You’re pregnant with just one baby.
  • You were pregnant before with just one baby and had spontaneous premature birth.

Get treatment for short cervix

Your cervix is the opening to the uterus that sits at the top of the vagina. The cervix opens, shortens and gets thinner and softer so your baby can pass through the birth canal during labor and birth. Having a short cervix increases your risk for giving birth early. Talk to your provider about cerclage and vaginal progesterone.

Take low dose aspirin to help prevent preeclampsia

Preeclampsia is a kind of high blood pressure some women get after the 20th week of pregnancy or after giving birth. If not treated, it can cause serious problems during pregnancy, including premature birth. If you have risk factors for preeclampsia, like you’ve had it before or you have high blood pressure or other health conditions, your provider may want you to take low-dose aspirin during pregnancy.

Quit smoking, drinking alcohol, using street drugs and misusing prescription drugs.

All of these can put your health and your baby’s health at risk and make you more likely to give birth early. Quitting or getting help to quit is the best thing you can do. Talk to your provider about programs that can help.

Learn the signs of preterm labor

Learning the signs and symptoms of preterm labor doesn’t reduce your risk of premature birth. But if you know them and know what to do if you have them, you can get treatment quickly that may help stop your labor. If you have any signs or symptoms of preterm labor, call your provider right away or go to the hospital.

Have questions? Text or email AskUs@marchofdimes.org.

It’s time to get your flu shot

06
Nov
Posted by Lauren

The flu is more than just a runny nose and sore throat, it can make you very sick. And since the flu shot is safe during pregnancy, now is the time to get yours.

Why is the flu dangerous during pregnancy?

Health complications from the flu, such as pneumonia, can be serious and even deadly, especially if you’re pregnant. If you get the flu during pregnancy, you’re more likely than other adults to have serious complications.

Pregnant women who get the flu are more likely than women who don’t get it to have preterm labor (labor that happens before 37 weeks of pregnancy) and premature birth (birth that happens before 37 weeks of pregnancy).

Fever from the flu early in pregnancy may be linked to birth defects, like neural tube defects, and other problems in your baby. A birth defect is a health condition that is present at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, how the body develops, or in how the body works. Neural tube defects are birth defects of the brain and spinal cord.

Protect yourself

The flu shot contains a vaccine that helps prevent you from getting the flu. The flu shot can’t cause the flu and it’s safe to get a flu shot any trimester during pregnancy. As the flu season is during the fall and winter, it’s best to get it now. Tell your health care provider if you have any severe allergies or if you’ve ever had a severe allergic reaction to a flu shot. Severe allergic reactions to flu shots are rare, but if you have a life-threatening allergy to any flu vaccine ingredient, like egg protein, don’t get the flu shot.

Not pregnant?

You should still get your flu shot. Everyone 6 months and older should get an annual flu shot. It takes about two weeks after vaccination for your body to develop full protection against the flu. Getting the flu vaccine is especially important for children 6 months and older, children with special needs, pregnant women and other high-risk groups.

Need more reasons to get your flu shot? We have 10 right here.

Premature birth rate in U.S. increases for second year

03
Nov
Posted by Sara

For the second year in a row, the rate of preterm birth in the United States has increased. The premature birth rate went up from 9.6 percent of births in 2015 to 9.8 percent in 2016, giving the U.S. a “C” on the March of Dimes 2017 Premature Birth Report Card. The report card also shows that across the U.S., black women are 49 percent more likely to deliver preterm compared to white women. American Indian/Alaska Native women are 18 percent more likely to deliver preterm compared to white women.

More than 380,000 babies are born prematurely in the U.S. each year. An additional 8,000 babies were born prematurely in 2016 due to the increase in the preterm birth rate. Premature babies may have more health problems or need to stay in the hospital longer than babies born on time. Some of these babies also face long-term health effects, like problems that affect the brain, lungs, hearing or vision.

The Premature Birth Report Card provides rates and grades for all 50 states, plus the District of Columbia and Puerto Rico. Preterm birth rates worsened in 43 states, the District of Columbia and Puerto Rico. The rates stayed the same in three states (AL, AZ, WA), and improved in only four states (NE, NH, PA, WY).

  • Four states earned an “A” on the 2017 Premature Birth Report Card;
  • 13 states received a “B”;
  • 18 states got a “C”;
  • 11 states and the District of Columbia got a “D”;
  • 4 states and Puerto Rico received an “F.”

Among the 100 cities in the U.S. with the greatest number of births (latest data is for 2015), Irvine, California had the lowest rate of preterm birth (5.8 percent), and Cleveland, Ohio had the highest preterm birth rate (14.9 percent).

This year’s Report Card also includes a preterm birth disparity ratio. This measures the disparities in preterm birth rates across racial/ethnic groups in a geographic area. The disparity ratio shows that the differences in preterm birth rates among racial/ethnic groups are getting worse nationally and no state has shown improvement since the measurements started being recorded in 2010-2012.

There is no single cause of premature birth and therefore there is no simple solution. However, things like expanding research, increasing education, strengthening advocacy, and improving clinical care and community programs can all help. The March of Dimes continues to work towards giving every mom the opportunity to have a healthy pregnancy and every baby the chance to survive and thrive.

If you want to learn how you can help increase awareness of the serious problem of premature birth throughout November, check out our blog post.

Have questions? Text or email AskUs@marchofdimes.org.

Prematurity Awareness Month has arrived and here’s how you can help

01
Nov
Posted by Lauren

Here at the March of Dimes November means Prematurity Awareness Month. Although we work all year round to fight preterm birth, this month we are working especially hard to get the word out about the serious problems of preterm birth and how you can help us end prematurity.

Each year in the U.S., 1 in 10 babies is born prematurely. And being born too soon is not only the leading cause of death for children under the age of five, but it can also lead to long-term disabilities. This is a heartbreaking reality for too many families. That is why we are hard at work funding groundbreaking research, education, advocacy and community programs to help give every mom the opportunity to have a healthy pregnancy and every baby the chance to survive and thrive.

Here’s how you can help:

  • Join our Twitter chat with Show Your Love on November 16th at 12pm ET. Just use #PreemieChat
  • November 17th is World Prematurity Day. Share/Retweet/Repost March of Dimes social messages with your friends and followers on Facebook, Twitter, and Instagram.
  • Change your profile picture on Facebook with our branded World Prematurity Day frame.
  • Add a #worldprematurityday profile picture to your Twitter account with the WPD Twibbon.
  • Add your voice and sign-up to automatically post a message of support and awareness of prematurity on your personal Facebook and Twitter accounts on World Prematurity Day.
  • Participate virtually in our Imagine a World event! Make a short video sharing what you imagine for future generations. Post your video on social media using #MODImagines. Together, we’re imagining a world where every baby has the chance to thrive!

Create a purple movement!

  • Wear your March of Dimes gear and share photos using #prematurityawarenessmonth and/or #worldprematurityday and @marchofdimes.
  • Light your front porch/home/office lobby/building. Purchase purple lights through Amazon Smile! For every light purchased Amazon will donate 0.5 percent of the price of your purchase to the March of Dimes. Go to smile.amazon.com, select March of Dimes and use the search term “purple lights.”
  • Host an information booth in a prominent spot, such as outside your cafeteria, to promote November as Prematurity Awareness Month to your employees or coworkers.
  • Spread your gratitude by celebrating, thanking and remembering anyone who has helped you and/or the people you care about who have been affected by our mission.

We have much more in store this month, so stay tuned as we work to spread the word about World Prematurity Month.

What is a respiratory therapist?

30
Oct
Posted by Sara

If your baby is in the NICU, you know that there are a lot of people caring for her and helping her to get stronger each day. One of those NICU team members may be a respiratory therapist. A respiratory therapist (or RT) cares for babies with breathing problems.

When your baby first arrives in the NICU, a respiratory therapist evaluates her breathing. The RT looks to see if your baby is breathing too fast, if the breaths are shallow, or if she’s struggling to breathe. Then, together with the rest of the NICU team, the RT develops a treatment plan to help care for your baby.

Here are some common conditions that a respiratory therapist may see in the NICU:

Breathing problems: Premature babies often have breathing problems because their lungs are not fully developed. Full-term babies also can develop breathing problems due to complications of labor and delivery, birth defects and infections.

Apnea: Premature babies sometimes do not breathe regularly. A baby may take a long breath, then a short one, then pause for 5 to 10 seconds before starting to breathe normally. This is called periodic breathing. Apnea is when a baby stops breathing for more than 15 seconds. Apnea may be accompanied by a slow heart rate called bradycardia. Babies in the NICU are constantly monitored for apnea and bradycardia (often called “A’s and B’s”).

Respiratory distress syndrome (RDS): Babies born before 34 weeks of pregnancy often develop RDS. Babies with RDS do not have enough surfactant, which keeps the small air sacs in the lungs from collapsing.

Pneumonia: This lung infection is common in premature and other sick newborns. A baby’s doctors may suspect pneumonia if the baby has difficulty breathing, if her rate of breathing changes, or if the baby has an increased number of apnea episodes.

Many babies who need treatment for breathing problems benefit from respiratory therapy. In fact, neonatal respiratory therapy has become its own medical sub-specialty. A neonatal-pediatric RT is trained to use complex medical equipment to care for the smallest babies with mild to severe breathing challenges. They visit their patients daily or as often as needed and are an important part of your baby’s NICU team.

Have questions? Text or email AskUs@marchofdimes.org.