Neonatal Intensive Care and Breast Feeding

Neonatal Intensive Care and Breast Feeding Course

Introduction

Before the birth of a baby, the baby depends entirely on the mother. Upon leaving the uterus, the baby finds itself in an unfamiliar environment where they have to perform certain functions that include but not limited to:

  • Using lungs to breathe, undertake cardiac and pulmonary functions.
  • The emergence of a fully functional digestive system that processes and excrete waste.
  • Working kidneys as they balance the body fluids and electrolytes as well as waste excretion.
  • The start of the liver and immune system to work (Tubbs-Cooley, et al, 2019).

Adjusting to the changes proves difficult for some babies leading to preterm birth, difficulty during birth, or birth defects. Thus special care known as neonatal intensive care in a special facility known as neonatal intensive care unit is needed (Prouhet, et al, 2018).

Neonatal intensive care unit (NICU)

  • The facility has advanced technology and specialized healthcare professionals who give specialized care for newborn infants.
  • The area also provides care for babies who are not sick but need specialized nursing care

Who needs to be in the Neonatal Care Unit?

  • Babies who are born before their date of delivery usually before 37 weeks of pregnancy, those having low birth weight less than 5.5 pounds, or have special health conditions (Williams, et al, 2018).
  • Studies show that almost half a million babies are born preterm in the US with low birth weights. Also, most of the children born as twins, triplets, and other multiples birth get admission to Neonatal Care Unit (NICU) (Tubbs-Cooley, et al, 2019).
  • Multiple births babies find themselves getting admitted in NICU since they are born earlier and smaller than single birth babies.
  • Also, babies that have breathing and heart problems, birth defects, and possessing infections get admitted to NICU.

What factors contribute to a baby being admitted to Neonatal Care Unit?

Certain factors will place a baby at higher risks of getting admitted to the Neonatal Care Unit. However, the baby should be accessed keenly before being placed in the unit. The factors are grouped into three such as baby factors, maternal factors, and delivery factors (Williams, et al, 2018). It’s upon the nurse in the delivery unit to decide in consultation with other health professionals on the status of the newborn to warrant admission in the NICU.

  • The maternal factors include the mother being younger than 16 or older than 40 years, using drugs or alcohol during pregnancy, being diabetic, suffering from hypertension, and bleeding excessively. Also, if the mother is suffering from sexually transmitted disease, multiple pregnancies, having too little or too much amniotic fluid, and rupture of the amniotic sac (Williams, et al, 2018).
  • The delivery factors include fetal distress or birth asphyxia, breech birth or abnormal position, the baby having passed first stool or meconium in the amniotic fluid, the baby umbilical cord being wrapped around the neck of the baby, and cesarean delivery.
  • Some issues may be inherent in the baby that can contribute to the child being taken to the Neonatal Intensive Care Unit and they include; The baby having been born at an age less than 37 weeks or more than 42 weeks, having a birth weight fewer than 2500 grams or more than 4000 grams, having very small gestational age and birth defects (Tubbs-Cooley, et al, 2019).
  • Other baby-related factors will encompass things like resuscitation in the delivery room, Distress related to respiration such as rapid breathing, grunting or apnea, having herpes, group B streptococcus and chlamydia, and seizures.
  • Further, if the baby needs extra oxygen or monitoring, intravenous therapy, or medication, the baby requires procedures or treatment such as blood transfusion.

The Neonatal Intensive Care Unit Multi-disciplinary Team

  • Due to the varied professional background required to support both the newborn and the mother as well as the close family the leadership potential of the nurse becomes hardy. The ability of the nurse to showcase teamwork together with her training will promote evidence-based care for the parties involved heralding timeless medical interventions that rest with her.
  • Therefore, the team will comprise of the following health care who are guided by the NICU nurse throughout the process of their interventions.
  • Neonatologist as a pediatrician with advanced training in the care of the sick and premature babies as he supervises the pediatric colleagues and resident doctors, the practicing nurse, and those caring for the babies in NICU (Prouhet, et al, 2018).
  • The Neonatal fellow is a pediatrician with extra training for the sick and premature babies as she performs various procedures and guided the nurse on the best way to cater for the baby.
  • The pediatric resident will be involved in assisting in performing procedures as a trained medical doctor as they help to give guidance on the needed care to the NICU nurse.
  • Neonatal nurse practitioner as a trained and registered nurse she got special training in the care of newborns and can perform procedures on the child.
  • Lactation Consultants will prove vital information as they help women to get the children breastfed. Therefore, they help in guiding milk pumping, ensuring regular milk supply, starting and guiding continued breastfeeding of the babies. They are usually nurses with advanced training in lactation (Tubbs-Cooley, et al, 2019).
  • The pharmacists will help the NICU nurse choose the best medicines for their patients, check the dosage form, types, and levels as they give hints on potential side effects and applicable remedies to the nurses.
  • Hospital social worker who through the guidance of the NICU nurse will give emotional support, assist the families to get the right information from the nurses, and facilitate the arrangement of home care.
  • The Hospital Chaplain will give spiritual support as well as counseling to the family to help them cope with NICU stress as guided by the nurse in charge of the patient.

Breast Feeding and Benefits to Newborn

The feeding of a child with her mother’s milk apart from a donor during the time they are in NICU has been found to result in numerous advantages such as;

  • Reduced risk of short-term and long-term morbidities in premature babies.
  • Reduces risks of enteral feed intolerance.
  • Reduces the risks of nosocomial infections
  • Reduces, the risk of chronic lung diseases and enterocolitis.
  • Reduces hospitalization after discharge from a neonatal intensive care unit.
  • The mother’s milk reducers the occurrence of retinopathy of prematurity (ROP), developmental and neurocognitive delay (Lindsay, & Abigail, 2020).
  • Mother’s milk has been found to contain very many components that change throughout lactation and stay in NICU providing nutrition and protection to the infant (Li, et al, 2017).
  • Some of these components include long-chain polyunsaturated fatty acids, digestible proteins, undifferentiated stem cells, and a high number of oligosaccharides.

References

Lindsay, N., & Abigail, C. S. (2020). Factors impacting breastfeeding and milk expression in the neonatal intensive care unitInternational Journal of Caring Sciences13(2), 970-981.

Li, Y. W., Yan, C. Y., Yang, L., & Han, Z. L. (2017). Effect of breastfeeding versus formula milk feeding on preterm infants in the neonatal intensive care unit. Zhongguo dang dai er ke za zhi= Chinese journal of contemporary pediatrics19(5), 572-575.

Prouhet, P. M., Gregory, M. R., Russell, C. L., & Yaeger, L. H. (2018). Fathers’ stress in the neonatal intensive care unit: a systematic review. Advances in Neonatal Care18(2), 105-120.

Tubbs-Cooley, H. L., Mara, C. A., Carle, A. C., Mark, B. A., & Pickler, R. H. (2019). Association of nurse workload with missed nursing care in the neonatal intensive care unit. JAMA pediatrics173(1), 44-51.

Williams, K. G., Patel, K. T., Stausmire, J. M., Bridges, C., Mathis, M. W., & Barkin, J. L. (2018). The neonatal intensive care unit: Environmental stressors and supports. International journal of environmental research and public health15(1), 60.

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