Center Delivers ‘Little Miracles’ Neonatal Unit Makes Big Strides In Saving Premature Babies
In this artificial womb bristling with beeping, heatsensing machines, they are called “little miracles.”
Here, premature babies live in double-walled incubators. Parents hold vigil, viewing their Lilliputian sons and daughters through a tapestry of wires and tubes.
Today, in the heart of Sacred Heart Medical Center’s neonatal intensive care unit, lies a fragile girl weighing 1 1/2 pounds.
If she could stand, she’d look Barbie in the eye. Her head is the size of a tennis ball, her heart as big as a thumbnail. Since April 4, she has clung to life.
Her mother stands at bedside, praying and singing softly. “Hello, sweetheart,” she soothes.
That baby was the unit’s tiniest survivor until Wednesday night, when doctors delivered a 1-pound girl by emergency caesarean section, ending a troubled, five-month pregnancy.
A knot of experienced nurses gathered around the palm-sized infant and marveled at the sight.
“Tiny, tiny, tiny.”
“She weighs absolutely nothing.”
“Can you believe it?”
To prevent the preemie from losing precious calories due to evaporative heat loss, Dr. Priscilla Hancock blanketed her in Saran wrap. So far, vital signs are good - the right amount of oxygen in the brain, surprisingly mature lungs.
“She’s little,” the doctor says, “but she’s mighty.”
Ten years ago, neither child could have been saved. But neonatology, the care of sick newborns, is changing with incredible speed. Today, babies born two, three or even four months early have a fighting chance.
Preemies tipping the scales at more than 2 pounds have a 90 percent survival rate, most growing up with normal health or only minor disabilities.
“If they make it past the first 10 days, they’re home-free,” says Dr. Hrair Garabedian, who helped create Spokane’s neonatal nursery about 20 years ago.
Garabedian can’t conceal his awe. He looks back at 1963, when John F. Kennedy’s premature son Patrick died, despite all that medical science could offer. That baby weighed more than 5 pounds.
“Even being the president’s son, it wasn’t enough,” Garabedian says, shaking his head.
“Things have really changed a lot. We didn’t know how to treat these kids, so anybody’s guess was good enough. We never appreciated how much time and the one-to-one constant care that is required. All we had was plenty of time to sit with these children and learn.”
As medical knowledge evolved, so did the hardware, including more sensitive ventilators, monitors and probes. A milky medicine, surfactant, came along to prevent immature lungs from collapsing.
Last year, the nursery and a similar one at nearby Deaconess Medical Center treated more than 1,000 babies from Spokane and remote corners of Eastern Washington, North Idaho, Western Montana and northern Oregon. Only a small number died.
That kind of success is why doctors, nurses and technicians stick around so long. In most intensive care units, burnout is common within 18 months, like troops in combat. But Sacred Heart’s neonatal nursery, which can handle 34 babies at a time, boasts a long list of nurses who have been treating sick infants for a decade or more.
Mary Grassi has been caring for “teeny weenies” for 18 years. She carries with her a bright smile and a gold angel pinned to her nurse’s jacket. Part of her job involves comforting stunned parents, whose dreams of perfect childbirth dissolved into catastrophe.
“It’s a real hard time for them. They go into a grief cycle,” she says.
Most are unable to hold their babies for hours or days after birth. When they do, they are often shocked at what they see.
“These aren’t round Gerber babies,” says Karen Harmitz, nurse manager. “These babies don’t give parents the normal cues. They don’t smile, curl up with you and coo.”
Moms often carry massive loads of guilt, blaming the premature birth on the glass of wine at Aunt Betsy’s wedding, or the afternoon spent rearranging the furniture.
About a third are teenage girls, who tried to hide their pregnancy or deny its existence, leading to poor prenatal care.
Because of that, the neonatal team places a strong emphasis on teaching and counseling teen moms who want to keep their babies. Most do, but they must be taught how to bond and nurture sick infants. Before leaving the hospital with their child, they are connected to support groups and social workers.
Therapists work with the babies to teach them the complex art of “nippling” - sucking, swallowing and breathing. When babies gain weight, the good news is quickly relayed to parents.
Within a week or two, new arrivals are weaned from ventilators and moved to a quieter, dimmer intermediate-care room next door.
As medical care for preemies improves, the average hospital stay has been sliced in half: from four months to two.
The cost of the specialized care, however, is soaring. In ordinary cases, parents of preemies face $250,000 in medical bills. Milliondollar babies are no longer rare.
While success stories far outweigh tragedies, the loss of a baby who stubbornly fought to stay alive for days or weeks always cuts deep. Nurses and parents cry in each other’s arms.
The 100-employee unit was staggered a couple of months ago by coverage of the Baby Ryan saga. Doctors and nurses complain the decision not to make heroic efforts to save the severely disabled infant, now living in Vancouver, Wash., was sensationalized by the media, making the baby-saving staff look like babykillers.
But such cases are rare, and the job has its rewards. One of the biggest is the letters from moms and pictures of smiling kids who spent their first days on life support.
Each Christmas, hundreds of thank-you cards pour in. In turn, the hospital throws anniversary parties.
“You become like extended family,” says Dr. Wes Allen, one of the unit’s five neonatologists.
“It’s neat knowing how they are growing up. People go into this kind of work because of an interest in children, and nothing is as satisfying as getting a baby out of here that wouldn’t survive otherwise.”
How far can medical science go? Doctors are capable of keeping alive babies that weigh as little as 10 ounces, and promised advances - such as liquid ventilation now being tested on animals - may push boundaries even further.
Some nurses admit to being troubled at the prospect of caring for half-pound, fetus-like babies who may wind up blind, deaf or retarded.
“Ethically,” says Grassi, “we do a lot of soul-searching. You wonder, are we doing the right thing?”
Tammi Pratt, like most mothers of preemies, is merely thankful.
“It is so wonderful that they can do this for babies. It’s a miracle,” the 27-year-old north Spokane woman says.
Her odyssey should end this week, when she is expected to leave the unit with 4-pound Catie Lee.
Pratt, a mother of two, began experiencing bleeding and contractions two months before her due date. Attempts to stall the birth didn’t work. The baby “came out screaming” - a sign of healthy lungs.
“They told me that, but I still felt scared. I was worried about her health. It was so early,” she says.
The hard part was leaving the maternity ward empty-handed. Twice that first night she called before dawn to check on Catie’s progress. That was 12 days ago. Today, she breastfeeds her baby in a private room. She smiles, but the shock hasn’t worn off.
“I was feeling my stomach the other day and I thought, ‘I should still be pregnant,”’ she says.
Baby Samuel also surprised his parents. On April 7, he was an early arrival at 3 pounds, 15 ounces. He was active during the pregnancy, always kicking. Now he rests all day in an incubator, rarely stirring.
“I can’t believe he’s so mellow,” says his father, Ben Mazzuca of Coeur d’Alene.
The 45-year-old carpenter and his wife, Meaghan, tried to have a baby for four years. He dreamed about the magic moment when he would cut the cord. Now, he spends hours every day consoling his wife.
“Your son’s doing excellent,” he says to her, as she stands in front of the incubator. “A lot to be proud of there, Meaghan.”
She nods, stroking the red-faced baby.
“My little man,” she whispers.