November is Prematurity Awareness Month. An infant is considered premature if he or she is born before 37 weeks gestation. A full-term pregnancy is 40 weeks gestation. One in eight infants is born prematurely every year in the United States. The earlier an infant is born, the more likely they are to have health problems; therefore, premature infants require very specialized care as they may spend weeks or sometimes months hospitalized in a Neonatal Intensive Care Unit (NICU). Vermont is proud to have the lowest rate of prematurity in the U.S. with a rate of 8.1 percent as compared to the national average of 11.4 percent.
At the University of Vermont Children’s Hospital we have a NICU that cares for more than 650 children a year from both within Vermont as well as areas of upstate New York. The NICU provides specialized care to infants as young as 23-24 weeks gestation. These infants are very fragile and require specialized temperature-controlled environments as well as respiratory support, intravenous fluids. and nutrition until the point at which they are able to take regular feedings, which includes breast milk. This is often a long journey for baby and families alike and can sometimes feel like a bit of a roller coaster ride.
To support families in this journey, the NICU has a core group of specially trained nurses, providers, respiratory therapists, a social worker and an administrative staff that work collaboratively to provide the best medical care in a timely fashion for the baby as well as provide support and guidance for the families that will someday soon take their special baby home. This includes lactation support for moms to encourage pumping and provision of breast milk, and skin to skin contact for the baby and mom and dad. This close physical bond promotes stability for the baby, encourages brain growth and development, and encourages critical bonding between the baby and his or her family. Studies have supported the importance of this close physical contact. In our NICU every baby, regardless of gestational age, is generally held skin-to-skin within the first 24 hours. We are proud that we are able to offer this as parents play a critical role in family -entered care, particularly in the NICU. We also encourage our families to be present every day at the team rounds and to ask questions and offer feedback regarding the plan of care for their baby that day.
As for the medical care in the NICU we are always striving to be the best we can. The NICU at the University of Vermont Children’s Hospital works very closely with a collaborative called Vermont Oxford Network (VON). VON works to bring together nearly 1,000 centers throughout the United States and around the globe to improve the quality and safety of medical care for newborn infants and their families through a coordinated program of research, education, and quality improvement projects. Our NICU has been and continues to be very active in this ongoing collaborative work and has consistently been in the top quartile with respect to favorable neonatal outcomes when benchmarked against other hospitals in the collaborative. We are pleased with how we care for our babies, yet we are always striving to learn more and do better. We can’t think of any better way to honor Prematurity Awareness Month.
Barbara Henle, BSN, MPS, is assistant nurse manager in the neonatal intensive care unit (NICU) at The University of Vermont Children’s Hospital.