Working with Parents with Premature Infants
Dr. Dawn-Elise Snipes, PhD, LPC-MHSP, LMHC
Executive Director: AllCEUs.com
Podcast Host: Counselor Toolbox and Happiness Isn’t Brain Surgery
Objectives
~ Review medical issues for preemies
~ Discuss life in the NICU
~ Explore the range of feelings in NICU families
~ Identify strategies to help bond with baby
~ Explore parenting under the microscope (in the NICU)
~ Identify methods for easing discharge anxieties
Health Problems That May Affect Preemies
~ Intraventricular hemorrhage (IVH). This is bleeding in the brain. It usually happens near the ventricles in the center of the brain. A ventricles is a space in the brain that’s filled with fluid.
~ Patent ductus arteriosis (PDA). This is a heart problem that happens in the connection (called the ductus ateriosus) between two major blood vessels which can c ause breathing problems or heart failure.
~ Necrotizing enterocolitis (NEC). This is a problem with a baby’s intestines that can cause feeding problems, a swollen belly and diarrhea. It sometimes happens 2 to 3 weeks after a premature birth.
~ Retinopathy of prematurity (ROP). This is an abnormal growth of blood vessels in the eye. ROP can lead to vision loss.
~ Anemia. This is when a baby doesn’t have enough healthy red blood cells to carry oxygen to the rest of the body.
Health Problems That May Affect Preemies
~ Jaundice. This is when a baby's eyes and skin look yellow. A baby has jaundice when his liver isn't fully developed or isn't working well.
~ Most preemies become jaundiced at some point and need to bask in the billi-lights (light therapy)
Health Problems That May Affect Preemies
~ Apnea caused by immaturity in the area of the brain that controls the drive to breathe (the brain doesn't “remember” to take a breath).
~ These breathing abnormalities may begin after 2 days of life and last for up to 2 to 3 months after the birth
~ The first line of treatment for apnea is simply stimulating the baby to help him or her remember to breathe. This can mean rubbing the baby's back or tapping the feet
~ May limit interaction time with baby (overstimulation)
~ Apnea of prematurity usually ends on its own with time.
~ Healthy infants who have had AOP usually do not go on to have more health or developmental problems than other babies.
~ AOP does not cause brain damage, and a healthy baby who is apnea free for a week will probably never have AOP again.
Health Problems That May Affect Preemies
~ Respiratory distress syndrome (RDS). This is a breathing problem because the baby doesn’t have a surfactant that keeps small air sacs in the lungs from collapsing.
~ Bronchopulmonary dysplasia (BPD). This is a lung condition that can develop in premature babies as well as babies who have treatment with a breathing machine. Babies with BPD sometimes develop fluid in the lungs, scarring and lung damage.
~ Infections. Premature babies often have trouble fighting off germs because their immune systems are not fully formed. Infections that may affect a premature baby include pneumonia, a lung infection; sepsis, a blood infection; and meningitis, an infection in the fluid around the brain and spinal cord.
~ Other diagnoses can be found here: https://kidshealth.org/en/parents/nicu-diagnoses.html
NICU Life
Life in the NICU
~ The NICU is a wealth of sensory input.
~ Machines have unique operating noises and alarms that may frighten you or make you feel something is not right with your baby.
~ The NICU staff will explain what they mean.
~ As you spend more time in the NICU, you too will begin to distinguish among various alarm sounds.
~ Depending on the time of day, the unit may be a flurry of activity.
~ Many different health care providers involved