It’s all the stuff that makes a great party – balloons and streamers, clowns, cake and ice cream, and the joyful squeals of young children having a good time. But what made this celebration extra special for many of the children is the “Once upon a time” – the story that begins in El Camino Hospital’s Neonatal Intensive Care Unit.
Mountain View resident Carolyn Cutler was just 26 weeks pregnant with her second child when she went into labor and delivered Drew, a 2-pound, 1-ounce baby boy 14 weeks shy of reaching full-term. Drew spent his first three months of life in El Camino’s NICU, attached to machines that helped him live as his little body fought off the complications common to premature newborns – a lung infection, problems with digestion and sepsis.
“We just really didn’t know in our heart of hearts what was going to happen,” Cutler said of her son. “These little guys – when they’re born this early, it’s critical.”
Cutler and her family went through a roller-coaster ride of emotions over the next few weeks after the birth – elated that Drew was here, but worried about the challenges he faced.
At a time when most families are bonding with their babies – feeding, changing, holding and cooing at their budding bundles of joy – Drew rested behind the walls of his isolette, barely visible among the numerous wires attached to his little body. Cutler said she couldn’t touch or hold Drew in those first few weeks as his weight dipped to 1 pound, 7 ounces.
“At that point, he belonged to the machines,” she said.
Cutler said she knew Drew was improving with each machine that disappeared from his side.
“His hurdles were measured by the equipment,” Cutler said. “It gave us milestones along the way.”
Cutler couldn’t say enough about the professionalism, care and attention Drew received in the NICU nursery – or about the emotional support she received from the nurses.
“The nurses kept our spirits up,” she said.
So, a week shy of his 9-month birthday, Drew and his family returned to El Camino Hospital June 27 for the NICU’s yearly reunion of Level III babies, a celebration for the graduates, their families and medical staff.
“It’s great – we really look forward to seeing them annually,” said Yvonne Chu, a nurse in the neonatal unit.
And with the technological advances Chu has seen in the 17 years she’s been a NICU nurse, outcomes for premature babies are improving all the time.
“This is what we work for,” she said. “I would have to say that 99.5 percent of our babies go home.”
Normal gestation for infants is 40 weeks – births between 37 and 42 weeks are considered full-term, and births before 37 weeks are considered premature. Approximately 12.8 percent of all births in the United States are premature – more than half a million yearly – according to information from the March of Dimes.
Neonatologist Dharshi Sivakumar, M.D., said El Camino’s NICU treats 450-500 premature babies each year and has witnessed vast technological improvements for the infants in the past 10 years.
“You want to have the right level of care,” Sivakumar said. “I’m so proud of what we have done here.”
Treating premature infants doesn’t start at birth, she said. Mothers at risk for premature delivery are given steroids to help babies’ lungs mature.
“That makes a big difference how they do respirator-wise,” Chu said.
Drug therapies keep the lungs from collapsing while oscillators pump tiny puffs of air into undeveloped lungs to keep them inflated, a high-frequency ventilating system introduced in 2002.
“It ventilates without the pressure and prevents lung disease,” Sivakumar said. “In the last six to seven years, we have come a long way.”
Two decades ago, a child born at 28 weeks would have had a higher mortality risk than a child born today and treated in a neonatal unit.
“At 28 weeks, we really have hardly any problem,” Sivakumar said. “Between 24 and 27 (weeks), we really have to work very hard.”
Premature births have increased 36 percent since the early 1980s, according to March of Dimes statistics, although there is no one specific explanation for the jump.
Many mothers with no obvious risk factors give birth prematurely, Sivakumar said.
“Nobody knows why,” she said.
What is important to know or understand is the level of intervention a premature baby will require. Infants with immediate surgical needs should be born at a hospital with a Level IV neonatal unit, such as Stanford Hospital. Sivakumar said transporting premature infants is difficult and should be avoided.
“You want to have the right level of care from the start,” she said.
Kristine Festa of San Jose knew her baby needed extra help from almost the beginning. Festa was carrying twins when she discovered one of them would be stillborn. Festa gave birth to son Ian five weeks early, at 4 pounds, 5 ounces. She and Ian returned June 27 for the second year to visit with their doctor, Sivakumar.
“We’re close to Good Samaritan,” Festa said, “but all of our doctors and nurses are here.”
Despite the medical advances for the country’s youngest patients, not all stories that begin “Once upon a time” have a happy ending.
“We all cry with the parents,” Chu said of fellow nurses. “It’s absolutely OK to cry with them.”
Nurses also work extensively with their tiny patients’ families, teaching them skills to care for their babies and instilling the confidence they need to trust themselves once they get home.
Cutler said she worried about bringing Drew home after three months in the NICU, but as he continues to grow and thrive, his earlier problems fade into distant memories.
“My child is happy – he’s eating, he’s healthy,” Cutler said. “You just remember you have a little, little baby you love and adore.”
For more information, visit www.elcaminohospital.org.