When Sarah Priestley-Akhtar gave delivery to twins — a boy, Zayn Priestley Akhtar, and a lady, Sophie Priestley Akhtar — she skilled the outpouring of affection from neonatal intensive care unit (NICU) nurses.
“I had a perfect due date for twins,” stated Priestly-Akhtar, 36, of Palmetto Bay. “It was 2/22/22.”
Her infants, nonetheless, have been born three months prematurely, on Nov. 24, 2021.
Sophie, who weighed simply 2 kilos, 1 ounce, needed to be airlifted by helicopter to Nicklaus Children’s Hospital about an hour after she was born. Her brother, Zayn, was airlifted to Nicklaus the identical day. He weighed 2 kilos, 10 ounces.
Though Priestley-Akhtar gave delivery to them at Mercy Hospital in Coconut Grove, they wanted Level 3 care within the neo-natal intensive care unit (NICU), which Nicklaus gives.
“The NICU nurses really cared for them as if they were their own children,” stated Priestley-Akhtar. “They went above and beyond. The specialists and the doctors and the lactation consultants there were phenomenal. We’ll always be forever grateful for the nurses and the care that they gave them.”
Sophie stayed within the NICU at Nicklaus for 4 months and Zayn for 3 and a half months. Now almost 5 months previous, Sophie weighs almost 11 kilos and Zayn weighs almost 12 kilos.
“Their team was very expansive,” stated Priestley-Akhtar. “They had cardiology, neurology. … Every specialist they needed they saw in the NICU.”
Support from hospital to house
Two years in the past, Nicklaus Children’s Hospital launched the Baby Steps Program to offer help from hospital to house for infants who obtained NICU providers at Nicklaus. Premature infants are at larger threat of growing well being problems that may lead them again to the hospital.
“The program offers a nurse-led telehealth transition of care intervention for infants cared for in the NICU and their caregivers,” stated Danielle Altares Sarik, Ph.D., a pediatric nurse scientist and a pediatric nurse practitioner at Nicklaus.
From April 2020, when it began, to March 2021, there have been 158 telehealth visits and 90 cellphone calls among the many 229 households enrolled in Baby Steps. During that interval, solely three infants needed to be readmitted to the NICU.
So far, round 300 moms have used this system, funded by a $300,000 grant from Florida Blue Foundation and out there to all infants who obtain care within the Nicklaus NICU and are discharged to a house setting. Caregivers should reside in Florida. A telehealth go to is scheduled inside 24-48 hours after discharge.
“The work grew from the clinical gaps that were noticed by team members,” stated Altares Sarik, who additionally serves as principal investigator of this system.
“The transition of care period represents a critical time during which caregivers need support,” stated Altares Sarik. “While discharge planning begins long in advance and parents learn from the clinical team how to provide care, inevitably there are questions and concerns once the family is home. The Baby Steps Program was created to fill this need.”
In the United States, near 1 in each 10 infants receives care within the NICU inside the first month of life.
Getting solutions from a trusted supply
Verquisha Blige of Miami labored with Baby Steps after her son Johnny’s nine-month keep within the Nicklaus neonatal unit following his delivery.
“The ability to speak to someone by telehealth after going home was extremely helpful,” stated Blige, who had three consults by way of telehealth within the weeks after Johnny was discharged from the hospital in March. “It saved me going to Google for answers. Instead, I could get them from a caregiver I trusted.”
On-demand calls to a NICU nurse will also be made for pressing points that come up inside the first two weeks of discharge.
“During the telehealth encounters, the NICU nurse has the ability to see the infant and the caregiver, and to visually assess the home environment,” says Altares Sarik.
She provides that if the toddler has been discharged with any expertise wants, corresponding to supplemental oxygen, feeding tubes or different units, the telehealth platform additionally facilitates visible inspection of those programs.
The grant is supplied by an academic-clinical partnership between Nicklaus and the University of Miami School of Nursing and Health Studies. Altares Sarik serves because the principal investigator and Yui Matsuda, Ph.D., a nurse scientist specialised in public well being nursing on the University of Miami School of Nursing and Health Studies, serves because the co-principal investigator.
Lactation assist for brand spanking new mothers
Carey Acosta has been an RN at Baptist Health Homestead Hospital for 12 years. For the previous 9 years, she has been the hospital’s lactation coordinator.
She helps new moms breastfeed, facilitates child care preparation for brand spanking new mothers earlier than discharge and provides free lactation follow-up consultations on the hospital for mothers who gave delivery there and wish breastfeeding assist after being discharged.
“If they need help breastfeeding, they can come back to me for free,” she stated.
Acosta stated there are lots of advantages of infants who drink breast milk, particularly with the specter of COVID-19 infections.
“If you had COVID or if you’re vaccinated, you’re going to pass the antibodies to your newborn, especially since there isn’t a vaccine available for babies,” she stated.
Acosta additionally usually leads donation drives for brand spanking new moms who lack monetary assets. Her drives present child garments, diapers, bassinets and different necessities.
Safe sleep practices for infants
One of Acosta’s greatest efforts is educating mother and father and caregivers in regards to the significance of secure sleeping to cut back the danger of sudden toddler demise syndrome (SIDS).
Each 12 months within the United States, 3,400 infants beneath the age of 1 die from SIDS, in keeping with the CDC. Nearly 30% of these deaths have been as a consequence of unintentional suffocation and strangulation within the toddler’s mattress/crib.
“The best thing for a caregiver to use on their baby is a swaddle blanket or long-sleeve pajamas,” says Acosta, who heads the hospital’s Safe Sleep Task Force.
Among her suggestions:
▪ Always place an toddler on their again to sleep, by no means their abdomen.
▪ Do not put blankets, pillows or bunkers within the crib, as a child may simply suffocate from these.
▪ Do not wrap infants in too many blankets, inflicting them to overheat.
Since 2019, Homestead Hospital has given out 2,000 sleep-sacks, freed from cost, for moms who gave delivery there.
“We started the task force because we noticed that we had an increase of babies in our community that were dying from SIDS,” stated Acosta.
In 2018, eight unresponsive infants have been rushed to the emergency room at Baptist Health Homestead Hospital. All eight died from sleep-related deaths.
In 2019, the 12 months the Safe Sleep Task Force was established, 4 unresponsive infants have been rushed to the emergency room at Homestead Hospital. All 4 died from sleep points.
In 2020, there have been no SIDS circumstances at Homestead Hospital.
“That really became our big passion — to teach moms how to safely put their newborns to sleep.”
Help for postpartum despair
Acosta stated that it’s regular for mothers to have the infant blues after giving delivery. Feelings of tension, despair and being upset can final a number of days or a number of weeks after childbirth earlier than subsiding.
“It’s concerning when you’re crying all day, when you don’t want to get out of bed, when you’re not interested in eating,” she says of indicators of postpartum despair.
The American College of Obstetricians and Gynecologists (ACOG) defines postpartum despair as intense emotions of disappointment, nervousness, or despair that forestall ladies from having the ability to do their every day duties.
“Postpartum depression can turn into postpartum psychosis,” stated Acosta, “when you think of harming yourself or hurting your baby. That’s when it turns really dangerous. We always try and catch that early on.”
Nurses at Homestead Hospital name all moms one week after discharge and once more at 14 days, which is when postpartum despair normally peaks.
“We’ve actually had several moms that we’ve identified,” Acosta stated.
“We usually refer them to Healthy Start Coalition of Miami-Dade, which has a program called Moving Beyond Depression.”
In that program, licensed psychological well being clinicians present 15 weekly therapy periods to moms utilizing In-Home Cognitive Behavioral Therapy (IH-CBT), which focuses on the mom’s psychological well being. They are also referred to their physician if treatment was wanted.
Acosta and one among her co-workers led a PBS well being phase on postpartum despair and have been stunned by how many individuals referred to as in saying they’d skilled it.
“I think that so many people are afraid to talk about it, so we definitely need to normalize it and not have that stigma that’s attached to it, because it is hormone-driven,” she stated.
CDC analysis reveals that nationally, about 1 in 8 ladies experiences signs of postpartum despair. And since postpartum despair estimates range by state, the speed could be as excessive as 1 in 5 ladies.