Baby ICU mimics womb

The head of the New York City Health and Hospitals Corporation (HHC) came to Queens Hospital Center in Jamaica recently, to officially unveil the first Neonatal Intensive Care Unit (NICU) in the city designed to “mimic the nurturing environment of the mother’s womb.”
HHC President Alan Aviles was joined with two mothers and their premature babies in the atrium of the year-old Ambulatory Care Pavilion of the hospital, located on 164th Street, just north of the Grand Central Parkway, for the announcement.
“We want to improve the quality of care and health outcomes of the littlest New Yorkers by dramatically reducing stressful external stimulation and nurturing them as if they never left their mother’s womb prematurely,” Aviles said.
Shireen Kamael and Juwanda Husbands sat holding their four-month-old daughters, Sofiya Rahib and Toni Simone, who drew all the attention away from the dignitaries, with every grasp-at-air or yawn.
Sofiya was born at 31 weeks, according to Kamael, while Husbands said she was “completely surprised” when she went into labor at 24 weeks. Both credit the hospital and staff for their baby’s good health.
The latest science shows that the bright lighting and noise levels common in most hospital floors are bad for the premature infant’s development, explained Leah Smith, Associate Executive Director of Nursing/Patient Care Services at the hospital.
“I was at a developmental care conference with my head nurse about seven years ago, when these ideas were first being discussed,” Smith recalled. “We started implementing whatever we could, and requesting funds from the administration,” she said, adding, “They did a great job.”
Smith happily conceded that because their unit was new to begin with, updating to the latest practice was a lot easier. “Once HHC picked up on the idea, it just rocketed off,” she said.
Simply put, babies that ought to be floating inside the womb for weeks before being born are at great risk when not so protected. The slightest disturbance can damage their senses and organs.
Going through the doors of the NICU is like entering another world. The lighting is subdued throughout - inside the patient rooms it’s positively dark, because the shades are drawn.
Each bed is a self-contained environment, able to convert from an incubator to a warmer at the touch of a button. All the clinical care facilities are clustered around the beds, so the babies don’t have to be unnecessarily moved.
The other great risk, noise, is also greatly reduced. Each room has a noise sensor, which flashes red whenever the sound levels are higher than recommended. That’s about 45 decibels, (barely above a whisper) according to Dr. Ivan Hand, the director of Queens Hospital Center’s neonatal unit.
“The number of at-risk pregnancies continues to climb, especially pregnancies affected by obesity, diabetes and high blood pressure,” he said, adding, “These factors increase the risk of premature birth.”
Hand outlined some of the other strategies employed. “We feed with fortified mother’s milk,” he said, explaining that although it was “the best,” by adding some protein and calcium, for example, they could make up for a mother’s dietary deficiencies, and foster development. “It’s amazing how quickly they are able to leave the ICU,” he remarked.
Another technique is skin-to-skin contact between mother and child along with breast feeding, called “kangaroo care.”
The marsupials give birth to the tiniest of babies that would never survive, except that they climb into their mother’s pouch, where they feed and complete their development, outside the womb but still protected.
One ancient practice is also employed in a new way - swaddling. In many cultures, babies were wrapped up to allow their bodies to grow straight. Under the new regimen, premature babies are wrapped in the posture they would have in the womb.
“We use a variety of therapies and practices tailored to the individual case,” said Dr. Zenaida Banzon, the Assistant Director of the ICU.
“The sound sensor is important to keep the staff aware of how quiet they have to be,” she observed. Indeed, a staff person pressed the soap dispenser a little too forcefully, and the lights flashed red. “See what I mean?” she said, pointing out that they replaced that standard hospital waste container with a soft plastic one.
Banzon recounted that “preemies” leave the ICU earlier, and have better outcomes, with the new techniques.
“Our earliest patient was delivered at 23 weeks and only weighed 490 grams,” she said. That’s less than six months, and slightly more than one pound, one ounce, for the metrically challenged. “It was amazing that after just a few weeks the baby could be moved from intensive care.”
“Without this unit the possibility of brain or other injury would be very high,” she observed. Searching for just the right words, she said, “Without this care, the long-term outcome for a baby that premature would almost certainly be … not good.”