What happens in the nursery?
On March 18th, Roxana Escobar de Portillo went into labor. She was scared because it was a month before her due date. She went straight to CHA Cambridge Hospital and had a beautiful baby girl. But there was a problem - her baby was having trouble breathing.
Most newborns never need to visit a maternity nursery, but when they do, CHA’s Continuing Care Nursery (CCN) offers the special attention some babies need to get a healthy start.
“Preterm babies like Roxana’s baby are born before neurological development happens in the womb,” said Kimberlee Chatson, MD, FAAP, a Neonatologist at Beth Israel Deaconess Medical Center and Medical Director of CHA’s Continuing Care Nursery. “Neonatal care environments can add unnecessary stress to newborns. We do everything we can to create a calm, inclusive space, welcoming parents to learn what their newborns need to thrive.”
Survival rates of babies born preterm have improved dramatically, but many of these babies still have complications later in life (high morbidity rates).
“Modifying nursery environments using a Developmental Care model can support important neurological growth in newborns, reducing stress on babies and decreasing morbidity,” explained Dr. Chatson. “Simple changes like reducing noise, dimming lights, preserving sleep and skin-to-skin contact can all improve long term outcomes and allow babies to continue their neurological developmental growth.”
All hospital maternity units are required to have at least a Level I nursery. These nurseries can resuscitate babies, evaluate newborn health (see Hearing from the Beginning article), and stabilize sick newborns if they need higher levels of care. At CHA, our CCN is a Level IB nursery, with specialized nurses to help babies who need tube feeding, isolette/thermoregulation, monitoring for apnea or other common health problems.
As part of the regional Beth Israel Deaconess system, CHA has direct access to Neonatal Intensive Care (NICU) if needed. Level III nurseries, or NICUs, are for newborns with severe health needs like surgical interventions, critical illness and extreme prematurity. Babies born at CHA who have severe health risks are quickly transferred into Boston for care. Many times, these same babies will return to CHA when they need a lower level of care. This provides easier access to parents, allowing them to be closer to their babies until they are ready to go home.
Arielys, Roxana’s newborn, was put on oxygen and transferred to Beth Israel Deaconess. “She was there for about a week before she was transferred back to CHA’s nursery,” said Roxana. “My husband and I came every afternoon to spend time with Arielys. She had lots of wires attached to her, monitoring her breathing and heart rate. The nurses showed me how to hold her and explained all the details about how to take care of her. They were so kind, making it a beautiful experience.”
Babies like Arielys are continually evaluated in the Continuing Care Nursery using key indicators. This allows parents to learn what they can do to help their infant develop and grow. After almost a month at CHA, Arielys was discharged and is doing great living at home with her parents.
“Individualizing the care of each infant allows us to work with parents and babies getting them into the best environments for healthy growth,” explained Dr. Chatson. “Working together, parents are integrated into the team and are supported as they bring their newborns home. These specialized services are what make CHA a safe and nurturing environment for new parents and newborns. It’s why we are one of Newsweek’s best maternity hospitals in the nation.”
Related Article - Hearing from the Beginning