Thursday, November 30, 2023

Premature babies and the lonely terror of an NICU pandemic

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At first, Ruscica and D’Ambra brought their relatives and friends to the NICU to see their son. D’Ambra worked part-time and took a bus and then a train from their home in New Jersey to Morgan Stanley Children’s Hospital in upper Manhattan every day. But every day, it seemed, the bus and train were emptying. Mars was like a narrowing tunnel, the light at the back fading too quickly. Soon only Ruscica and D’Ambra were allowed to enter the room. And then, one day in mid-March, the couple were told they had to choose which of them would be allowed to visit Caelan from there.

“We got it,” D’Ambra says. “It’s a pandemic. We want Caelan to be safe, and how many other babies are there in there? New York was becoming a global coronavirus hotspot. But D’Ambra still found it overwhelming to leave the hospital that day, not knowing when he would see her son again, leaving Ruscica to face the terrors and boredom of the NICU alone.

The hospital was already working on a pilot project to enable virtual visits to the NICU, a two-way HIPAA-compliant video feed that allows parents to sing, pray or read to their children, or even engage with the hospital. medical team during their daily rounds. . Prompted by a measles epidemic in New York in 2019, which had forced the NICU to resume visits, the program was launched, tentatively, in January, but the pandemic has caused a rapid expansion. D’Ambra was able to beam daily and know that Caelan would at least hear his voice. For nearly a month, until her son was released on April 14, food was their only form of contact.

Connecting parents and babies was just a complication for hospitals; manage another principle of premature care – provide as much breastmilk as possible – also became tense. Many premature babies are born without the ability to latch on, suckle and swallow, so many birth mothers end up pumping their breast milk, either to feed it through a nasogastric tube that sends the milk directly into the stomach. baby, or to be kept for later use. when they are able to swallow.

Often times, it is not as simple as it may seem. Prematurity can complicate lactation, reduce milk production, and while the ability to provide milk to your baby may seem like a gift, it is a heavy burden when things aren’t going well. “I realized that my daughter was less likely to die if I could… get off milk,” writes author Sarah DiGregorio in “What We Made,” an essay on pumping at the NICU. During the pandemic, hospitals had to write multi-page protocols for collecting milk. Both in the hospital and at home, mothers had to work very hard to keep their milk and equipment sterile, as did the hospital workers who then deliver their milk.

Spending days and weeks alone with her son in the NICU, Ruscica was almost constantly restless, and the pumping added to the stress. She tried to follow pandemic sanitation protocol while pumping, but the crises kept coming. Sometimes her face would turn blue from the lack of oxygen and her monitor alarms would go off and she would jump in terror, scared that her child was dying, and spill the milk she had carefully collected. After each of her emergencies had passed and her pounding heart slowed down, there was nothing else to do but clean up and start over.

Even in normal times times, the rules of the NICU are not that different from those governing life in a pandemic. Parents here are too often stripped of the little intimacies that most others take for granted, and they endure the kind of small losses we have all suffered in the past year. Lindsey Pervinich couldn’t feel the warmth of her baby against her chest immediately after giving birth, and a moment that might normally be filled with joy and relief was filled with fear instead.


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