They say that a little knowledge is a dangerous thing. As a neonatologist, I was terrified when my son developed complications and had to be admitted to the NICU. When you're faced with this situation, the mind can play tricks on you and you tend to think about the worst case scenario. With all of my medical training and background, my mind still raced with questions and concerns. Why did this happen? What could I have done differently to have prevented this from happening?
The fact of the matter is, each year more than 500,000 babies in the U.S are born preterm. That's one in eight babies born too soon. According to the March of Dimes, the good news is that the U.S. preterm birth rate declined for the second straight year in 2008, to 12.3 percent of all live births, down 4 percent from the 2006 rate of 12.8 percent. This means that 21,000 fewer babies are born preterm and spared the serious health risks of an early birth.
As a doctor, I witness firsthand the many common misconceptions about prematurity. From my experience, most families immediately think that most babies die when born prematurely. In fact, the majority survive. However, even with the aforementioned decline in the preterm birth rate, more than a half million babies are still born too soon in the U.S. each year, and premature birth is the leading cause of newborn deaths (March of Dimes).
Leading to the question I often get from moms everywhere: how can I help prevent this from happening to me and my baby?
Risk factors are many and can include the following:
- Maternal age (older and younger moms)
- Pre-existing maternal diseases (hypertension, diabetes, lupus, to name a few)
- development of preeclampsia during gestation
- Infants with congenital anomalies
Sadly, we know that stressful lifestyles where women are involved in relationships where drug abuse and/or emotional or physical abuse are present are also a risk factor for preterm delivery.
Recommendations for a healthy pregnancy seem to change rapidly. Most importantly, women should seek prenatal care early and speak often to their OB-GYN or midwife about the most up-to-date recommendations. Additional known strategies that can lower the risk an early birth include:
- Good nutrition and healthy lifestyle
- Smoking cessation programs
- Progesterone treatments for women with a history of preterm birth
- Avoiding multiples from fertility treatments
- Avoiding unnecessary C-sections and inductions before 39 weeks
If and when you find yourself in the situation of having a pre-term baby, the prognosis is variable, depending on how pre-term the infant was born in addition to what complications he/she had during the NICU course. It is so important to have your infant's medical progress tracked, and equally important to have the child's neuro-developmental progress is also followed. All states have a program called the Infant and Toddler program, which facilitates this follow-up and any necessary therapies, including physical, occupational and speech therapies.
Although some babies are born very ill, and may need intensive care, they generally recover pretty quickly. NICU teams are very cognizant that the whole family is affected. Caring for moms and dads is almost as important as the critical care the babies receive. There can also be long term impacts on the parents after a NICU stay. Many parents are anxious when it comes time for the baby to come home. It is the role of the NICU team to spend time with families at the time of discharge, helping them prepare and feel ready to care for their baby at home. Research has revealed a significant percentage of parents who have had infants in a NICU who in turn experience symptoms similar to those suffering from post-traumatic stress disorder (PTSD). It's very important for families to seek help if this happens to them.
My son has grown up knowing that his mom takes care of babies, some of whom are very sick. I used to tell him that I was working hard to get the babies better -- so that those babies could go home with their moms and dads. Somehow, that made sense to him and gave him a sense of satisfaction -- even if it took me away from him.
Having a baby in the NICU is an incredibly stressful time and everyone reacts and copes differently. So my personal advice to families experiencing this situation: visit as often as you can, ask a lot of questions, and remember to take care of yourself!
Dr. Dulkerian is featured in the new Discovery Health series, "NICU." Airing Thursdays at 10 PM (ET/PT) beginning July 15, NICU is an original 10-episode docu-drama series that goes behind the scenes of top national neonatal intensive care units, showing the day-to-day care required to sustain the smallest of lives.