Tuesday, May 29, 2007

Taking care of the tiniest of babies ...

NYTimes's Christine Hauser has a very interesting article about the latest developments in neonatal care for babies born well before they are ready to face the world. [The article also taught me a new phrase and a beautiful concept: "kangaroo care".]

This is how it used to be (and how it is, probably, in India):

In the six months that Mrs. Johnson sat by Ellie’s isolette, she began to understand firsthand the jarring discrepancy between the aquatic nest that her daughter had left too early and the new environment into which she had been thrust and was now expected to grow.

Parents of other babies stopped and gawked. Alarms went off at adjacent isolettes. Monitors beeped, instruments clattered and lights glared. Sometimes, a wail of grief from parents learning of the death of their fragile baby added to the cacophony.

And this is the direction in which it's going:

... [P]rivate rooms in neonatal intensive care units, or NICUs, ... strive to replicate the qualities of the womb: its darkness, relative quiet and full entanglement with the mother’s biological rhythms.

The spaces, called “womb rooms” by some researchers, are predicated on the obvious notion that the best place for a premature baby would be the exquisitely complex environment where, in the last three months of gestation, the neural connections in the baby’s brain grow exponentially as it curls up in amniotic fluid, listening to the mother’s heartbeat, breathing, intestinal gurgling and pitch of her voice.

In premature births, however, the second-best place is one where the infant develops in a cocoonlike environment that mimics as many of the womb’s qualities as possible, with uninterrupted sleep, indirect light, skin-to-skin contact and the assuring sound of parents’ voices.

“We are trying to approximate to decrease the discrepancy of the natural womb environment in the intensive care unit,” said Dr. Heidelise Als, the director of neurobehavioral infant and child studies at Children’s Hospital Boston.

Hospitals are overhauling their neonatal intensive care units to transform open wards into private spaces that, in essence, restore the intimate relationship between the mother and child and allow the fragile infants to develop.