Tiny Blessings

Imagine hands smaller than a quarter, ears no bigger than a dime. Imagine a newborn who struggles daily to keep warm, who struggles, by the hour, working his tiny lungs just to breathe. Imagine a baby weighing just one-and-a-half pounds.

Each year nearly 11 percent of all babies in the United States are born prematurely — before 37 weeks of gestation. Nearly 8 percent of babies born are considered low birth weight — less than 5 lbs. 8 oz. Very low birth weight is considered less than 3 lbs. 5 oz.

My own introduction to my first daughter came from a blurry instant photograph of a purplish baby lying prone amid a tangle of wires and tubes. I had just awoken from an emergency C-section that took place nearly two-and-a-half months before my baby’s due date. My pale husband gently showed me the Polaroid, clutched my hand and whispered softly, “It’s a girl . . . she’s going to be fine.” Only later, when I had shaken off the effects of anesthesia, did I find out she weighed 2 lbs. 14 oz. and could not breathe on her own. It was the beginning of a fierce battle.

Today my daughter today is a healthy, happy — albeit slender — 4th-grader who certainly cares more about fashion, reading and dancing than the trials she endured as a tiny babe.

The good news is that an increasing number of premature babies survive and thrive. A sampling of statistics show that 40 to 70 percent of 24 weekers, 50 percent of 25 weekers, and between 80 to 90 percent of 26 weekers survive their early births. The rates are much higher for babies born above 30 weeks, hovering around 95 percent.

“We have better and more sophisticated ventilators and other technology, and it does mean that more immature babies are surviving,” says Dr. Valya Visser, neonatologist and chairperson of pediatrics at Carolinas Medical Center in Charlotte, adding that she “routinely” sees babies at 26 weeks survive, and many at 24 or 25 weeks gestation, often weighing a mere 1-1/2 lbs.

There are many reasons that a pregnancy can end with premature delivery: pre-term labor, incompetent cervix, premature rupture of membranes, placenta previa and toxemia are among the most common. If you are at an increased risk for a pre-term baby or have had a premature newborn, keep in mind the following tips as you prepare (and wait!) to bring your new bundle home:

Surviving the NICU

When a baby arrives very early, shock, sadness and disappointment are often the first reactions. After all, a parent’s dream of a normal delivery and baby’s arrival did not materialize as expected.

The neonatal intensive care unit (NICU) where your baby stays can be a frightening and overwhelming place where monitors beep nonstop. The pace is often furious for the specially trained nurses who oversee baby’s day-to-day care.

I can smile a bit at my own experience now, but at the time it felt as if the world were crashing down around me. In my layman’s mind, I was disturbed by every complication and setback, unsure about our daughter’s prognosis and what lay ahead. Lack of control was one of the most frustrating emotions I felt as I sat helplessly watching my child endure anemia, a blood infection, a spinal tap, transfusions and frequent spells of apnea (temporary cessation of breathing) and bradycardia (a slower than normal heart rate).

Many parents feel as if they are on an emotional roller coaster caused by the daily ups and downs of baby’s condition. Pre-term infants are susceptible to a number of complications including: jaundice, apnea of prematurity, anemia, retinopathy of prematurity which affects eyesight, infection, hemorrhaging within the brain, low blood pressure, respiratory distress syndrome, necrotizing enterocolitis (an inflammation causing injury to the bowel), reflux and other feeding difficulties, patent ductus arteriosus (open blood vessels connecting the pulmonary artery to the aorta), fast breathing or even bronchopulmonary dysplasia, a form of longer lasting lung disease.

Learning to communicate with the medical personnel and learning the NICU “lingo” is often a big challenge for new parents.

“It’s really hard for parents who aren’t medical to articulate their feelings, their questions, just as sometimes doctors are more comfortable speaking in definite medical terms,” says Visser. “It is a real roller coaster. Some decisions parents will have to make, some I’ll have to make and some we’ll make together.”

Plan to be a frequent visitor in the unit. “The babies who have had lots of contact with both of their parents mature better, organize faster and grow. It’s tremendously important,” adds Visser.