Make the right choice when choosing a NICU

Tanner and Kirah Crane

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Lee Ann Damian, speech therapist, helps Tanner Crane develop his feeding skills as Chris and Crystal watch.

When you’re expecting a baby, it’s easy to get overwhelmed with all the decisions to be made, whether it has to do with breast feeding (or not), safe sleeping arrangements, how to choose the baby’s doctor or what kind of car seat to buy. Add to that the many other things you may not think of until something happens.

One of these is what options are available to you if a baby is born prematurely or with multiple problems. While this is something most expectant parents would rather not think about, it is increasingly important to know where to turn if the unexpected happens.

Crystal and Chris Crane of New Lebanon are researchers—not as professionals, but as parents. And when Crystal found out they were expecting twins, both wanted to be as prepared as possible. They knew there was a chance their twins would come early, so Chris researched area hospitals to determine which were best prepared to care for premature babies if that care was needed.

And the twins did come early—even earlier than expected—arriving November 2, 2011, 14 weeks before their due date. Crystal arrived at Southview Medical Center at 8:20 am; the twins were born at 11:22 am. Tanner, a boy, weighed just 2 pounds, 3 ounces, and Kirah, a girl, weighed 2 pounds, 5 ounces. “I just had an ultrasound the day before and everything was fine. This was completely unexpected,” Crystal  says. 

Doctors soon determined Tanner and Kirah would need a higher level of newborn care. The Cranes chose to have their baby transported to Dayton Children’s Level III B Newborn Intensive Care Unit. “I was given a choice,” Chris says, “but we wanted to be at a hospital that specialized in pediatrics and could provide the highest level of care.”

The area’s only regional neonatal transport unit and specially trained transport team brought Kirah and Tanner to Dayton Children’s on Wednesday. “Our girls—Tori and Amethyst—along with Chris and my parents were with the twins,” Crystal recalls. “Chris and the NICU nurses were in constant contact with me and took lots of photos, so I felt completely informed.” In the meantime, Crystal surfed the web for information on premature babies, the challenges they face and the kind of care they would receive.

One thing neither Chris nor Crystal expected was the involvement of a speech therapist in the twins’ care. At Dayton Children’s, Lee Ann Damian, one of the hospital’s speech therapists, evaluates every premature baby admitted to determine if there are feeding challenges.

“The baby’s ability to feed and gain weight is not only a survival issue, but is one of the main factors in determining how quickly that baby can go home,” Lee Ann explains. “The sooner we can get the baby happy and comfortable with feeding, the better it will be for the entire family.”

With Lee Ann’s help and the Cranes’ involvement, the twins are now feeding and gaining weight.

“Once Lee Ann started working with the twins, we could see the difference,” Chris says. “We’ve been very impressed with Lee Ann’s skill and watching the twins’ progress.” Chris jokes that Tanner is known around the NICU as the “bottle killer” because of his ability to finish his small bottle in record time.

All premature babies at risk for feeding issues

Lee Ann points out that all premature babies are at risk for feeding issues, since it’s not until 38-40 weeks that all the muscles and reflexes needed to feed fully develop. “They use their time in the womb to practice sucking, tasting, smelling and swallowing. When that time is cut short, we need to provide that stimulus outside the womb,” she explains. 

At Dayton Children’s, our team of neonatologists and specially trained nurses realize that the whole family is going to be involved in a child’s care and recovery. They are prepared to not only work closely with the parents, but with grandparents, the baby’s brothers and sisters, and anyone else who is part of the family’s support system.

“The nurses were wonderful with Tory and Amethyst,” Chris says. “They answered all the girls’ questions, taught them about the care the babies were receiving and made every effort to include them.”

David Yohannan, MD, medical director of the NICU, points out that our team of nurses in the NICU have years of clinical experience—16 years on average—and specialized training, such as neonatal resuscitation certification, that make them the best at what they do. But more importantly, their years’ of experience make them highly attuned to subtle changes in a baby’s condition that helps them quickly avert a possible crisis or determine if one of the pediatric specialists needs to examine a baby.

“As the region’s referral center for premature and critically ill newborns, we have all the pediatric specialists these babies need centered in one place,” Dr. Yohannan says. “Any of these specialists are just moments away if they are needed.”

And, because Dayton Children’s is a referral center for the region, our NICU team also cares for a significant number of babies every year. “Research shows that when it comes to medical care, the best care is provided in a setting where the greatest numbers of patients are seen. This enriches our knowledge base and results in a highly experienced staff, which results in the best patient outcomes,” Dr. Yohannan says.

In addition to the neonatologist, pediatric specialists and our nursing staff, other experts are part of every baby’s multidisciplinary care team. In addition to speech therapists such as Lee Ann, pediatric respiratory therapists, a neonatal nutritionist, lactation consultant, physical or occupational therapists, pharmacists and social workers may be part of a baby’s care team. It is the goal of all these specialists that every family leave the NICU feeling prepared to care for the baby at home.

Crystal advises other parents to do their research, but also to ask questions. “The nurses are always ready to answer all our questions. Use this time to participate in your baby’s care and learn from the nurses. We’ve been very happy with the care the twins have gotten as well as the care we’ve gotten.”

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