This post was written by Cara Jo Swetsky of Jefferson Corporate Communications.
The Intensive Care Nursery (ICN) at Jefferson is a Level III Neonatal Intensive Care Unit that provides advanced care and treatment for babies born with a variety of conditions every day. Due to complications at birth and extended hospitalizations which can negatively influence the developing brain, many infants in the ICN are at-risk for developmental delays following their discharge home.
In order to prevent the short and long-term developmental delays/disabilities often associated with premature and medically fragile infants, developmental supportive care is the standard of care for all infants in the Jefferson ICN. Developmental care is a family-centered, evidence-based approach to the care of high-risk infants that supports neurodevelopment by minimizing infant stress and providing an environment that supports the optimal development of each infant.
This particular type of care requires the effort of a multidisciplinary team of professionals, speech-language pathologists, neonatologists, nurse practitioners, residents, neonatal nurses, respiratory therapists, pharmacists, social workers, case managers, child-life specialists, physical and occupational therapists, along with experts from Nemours duPont Pediatrics.
With the knowledge that developmental care can decrease the length of hospital stay and improve long-term developmental outcomes of premature and critically ill infants, William’s medical team recognized the importance of collaborating with neonatal occupational and physical therapists to provide supportive care to reduce infant stress. Earlier this year, the team took care of an incredibly vulnerable, tiny patient, named William. Born via an emergency C-section at 23 weeks premature and weighing only 1 lb. 4.9oz in order to save both mom and baby due to a placental abruption, the clinical team provided life-saving resuscitation to William. For 85 days, he survived with the support of a ventilator in the womb-like atmosphere of a highly technical incubator with the help of countless IV fluids and breastmilk through a feeding tube. He endured numerous tests, blood transfusions, laser eye surgery to save his eyesight, hernia surgery, amongst other examinations and treatments.
Thankfully, William responded beautifully to the therapy. As he grew, he was able to tolerate increased handling and movement for motor and sensory-based interventions designed to promote achievement of typical developmental skills and motor patterns. His parents embraced the development care approach and participated in his care and therapy sessions on regular bases, allowing them to remain a part of the process, while being able to touch, hold, and care for William.
Another challenge William faced was learning to feed by the mouth, which can be a great challenge for infants born extremely premature. Once he was stable enough, his medical team consulted speech and feeding therapists to have William started on a cue-based feeding protocol in which the parent or nurse follows the communication and behaviors of the infant to guide the feeding, overall supporting and protecting the child’s neurodevelopment while learning to eat.
While William was very interested in feeding, he began to experience episodes in which his heart rate and oxygen saturation would drop while he ate. He was then referred for a Videofluoroscopic Swallow Study, which revealed aspiration (inhalation of food/drink into the lungs) with traditional feeding methods. With a slower flow bottle and specific compensatory strategies in place, William was able to protect his airway while swallowing and feed safely. His medical team took the time to educate and train William’s parents on feeding strategies and have been feeding him safely ever since.
Despite all of the obstacles that William had to overcome since birth, he has not only survived, but thrived. After six months in the ICN, it was time for William to go home. He is currently leading the life of a happy newborn — breathing on his own, feeding his food from a bottle, and smiling at the sound of his parents and sibling’s voices.
The commitment of all team members and their developmental care measures was the contributing factor to the survival of William and his positive outcome. Thank you to our dedicated staff members in the ICN. See a short video on our Jefferson Health Facebook page featuring William’s success story.