Including Parents in the Care of Premature Babies

We are lucky to live in age of constant discovery and innovation to advance the care for babies and expectant mothers. Still, one out of 10 babies born in the U.S. is born prematurely.

We know some of the causes of high-risk pregnancies and preterm births and we work hard to impact these risk factors before a baby arrives. But in the large majority of cases, we never know why babies come too early. As a neonatologist and researcher, it is my job to expect preterm babies and be ready with our team of experts to treat them with the best possible care, and to hopefully help them survive and thrive.

Advances in medicine, technology and research means that at places like Lucile Packard Children’s Hospital Stanford, where I work, many babies who wouldn’t have survived 20 to 30 years ago are eventually able to go home to their families. Our neonatal intensive care unit is a Level IV NICU, taking care of the smallest and sickest of newborns, many needing complex therapies due to arriving a bit too early.

But what about the parents? If you are like most parents, a premature birth quickly turns what was supposed to be one of the happiest days of your life into a traumatic experience. One of the first things I tell the parents, especially the mom, is not to blame themselves.

Giving birth to a preemie, especially when it is unexpected, leaves many parents feeling unprepared and helpless. But we make it clear very early. “You, the parent, are a critical part of our medical team.” That’s right. Even in the heart of Silicon Valley where we are located, two of our biggest assets are decidedly low-tech workers: the baby’s parents.

Including parents in the care of preemies is a standard that was unheard of in the early days of neonatology, but is now used in leading NICUs for one critical reason: it works.

Here’s an example of how parents contribute. Studies have shown that skin-to-skin care, also known as kangaroo care, can have beneficial effects on preterm neonates, including improved temperature and heart rate stability. In many NICUs, you will see babies—clad only in a diaper and covered by a blanket—placed prone position on the chest of either the mother or the father. This intimate method of care provides a preterm baby a natural environment for rest, growth and healing.

Another key ingredient of parental involvement and a quicker recovery is mother’s milk. The research is clear. Breast milk is the best source of nutrition for all babies and it is especially beneficial for babies in the NICU. Preterm babies are at risk for serious health problems, and breast milk carries special nutrients and antibodies to help these very vulnerable babies fight off infection and illnesses. So, even though your baby may not be able to breastfeed during the first few weeks, your expressed milk, fed by feeding tube to your baby, can carry all the important nutrients to make it the best food you can offer your baby.

But what about the experience itself? Who better to know what a parent is going through, seeing their tiny, fragile baby in a NICU, than another parent who has been through the same thing?

At many leading NICUs, families who also have been through the experience of having a preemie will help guide and support you. This is extraordinarily valuable, and it’s a type of care that doctors cannot provide. At our hospital, we have a group of veteran preemie parents who provide peer-to-peer and group counseling to help answer parent questions and allay many of the fears associated with such a life-changing experience.

In the end, we know that each baby forges their own path, so there is no one guide to what happens to a preterm baby during and after its stay in a NICU. Some will develop normally and have regular checkups with pediatricians; others will need extra follow-up with specialists for individual concerns. We encourage parents to develop their own set of partnerships with medical staff based on what an individual child and family needs.

No matter when a baby is born, term or preterm, families know their children best. A parent’s contribution is critical to treating these most vulnerable of newborns. Neonatologists, NICU nurses, and the many other healthcare professionals who dedicate their lives to caring for newborns believe that a partnership with parents is one of the keys to extraordinary care, and provides a direct value in helping a baby born too early survive and thrive.

By Henry C. Lee, MD, MS, a neonatologist at Lucile Packard Children’s Hospital Stanford and Stanford Medicine Children’s Health. He is also an assistant professor of pediatrics at the Stanford University School of Medicine, and is director of research for the California Perinatal Quality Care Collaborative. This blog first appeared in U.S. News & World Report.

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