A Family Affair: The neonatal intensive care unit staff provides special babies their first home

December 29, 2014
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Just over three years ago, Tami and Fred Schmitt of Westwood were experiencing the perfect pregnancy. “We were happily preparing for our first baby. Everything was going great,” says Tami, who was working as a property manager at the time.

Though the nursery wasn’t quite ready and the baby wasn’t due for several months, they went ahead and toured Saint John’s Health Center’s maternity floor. Tami felt so good, the couple decided to proceed with a planned trip to Costa Rica.

Two weeks after they got back, however, Tami began to feel ill. She immediately went to the doctor and was admitted to the hospital. Within four hours, on June 18, 2011, their daughter Hanna was born. She was just 23 weeks gestation.

“To this day we still don’t know why, but for some reason the baby wanted to come out. By the time I was admitted to the hospital, I was so far dilated that the only option was to proceed with delivery,” explains Tami.

Cecilia Lev, MD, a board-certified neonatologist and medical director of the Irene Dunne Guild Neonatal Intensive Care Unit at Saint John’s Health Center, was realistic with the couple. “Dr. Lev told us that there was something like a 5% chance that Hanna would survive,” says Tami. “We heard that, but we didn’t accept it; we told the medical team to do everything in their power to save her.”

And they did. Hanna, now 3½ years old and a thriving preschooler, became the youngest baby ever delivered at Saint John’s Health Center.

During her six months in the neonatal intensive care unit (NICU), Hanna had seven surgeries including heart, bowel and eye surgeries. She had several blood transfusions with a specially matched donor, whom the family had the opportunity to meet and thank. Hanna also had to be assisted with breathing, feedings, and taught how to suck and swallow.

Essentially the NICU doctors, nurses and therapists had to step in and manually direct all the steps that Mother Nature usually takes to ensure a human can survive outside the womb.

“These babies depend on us to do everything for them,” says Evelyn Tintoc, MD, a neonatologist who has worked in the Saint John’s NICU for 16 years. “We keep them warm; we help them breathe; we insert little tubings into their stomach to feed them, and we calculate fluids and calories so they can grow. We follow them closely for signs of infections so we can treat them promptly. We provide a comprehensive care package for our babies to thrive in their first home.”

Saint John’s NICU is an 18-bed, Level III facility, equipped with the latest technology and experienced specialists. The unit provides a wide range of services for extremely premature neonates and newborn infants requiring medical or surgical intervention.

Care is provided in a warm, supportive, family-like environment by a multidisciplinary team of neonatologists, nurses, respiratory therapists, physical therapists, pharmacists and many other specialists working in close collaboration with obstetricians, perinatologists, pediatricians and surgeons. A baby’s care starts in the delivery room, where a certified neonatal resuscitation team initiates gentle ventilation, oxygen delivery and temperature control to assure a smooth transition to the NICU.

“Dr. Lev told us that there was something like a 5% chance that Hanna would survive. We heard that, but we didn’t accept it; we told the medical team to do everything in their power to save her.” – Tami Schmitt

Some babies at the Health Center’s NICU stay as little as a few hours during the transition from the intrauterine to the extrauterine environment. But many require stays as long as three to four months. The NICU is essentially many babies’ first home, a responsibility the staff doesn’t take lightly.

“The NICU is a pretty special place to work,” says Irena Zuanic, RN, administrative director of women’s health. “The entire staff is focused on getting babies well enough to go home with their parents. We do this by providing clinically competent and compassionate care, and encouraging bonding and interaction between parents and babies. We are all aware of how much the babies depend on the NICU team’s care and just how much parents and babies depend and thrive on touch and connection.”

Zuanic says beyond the clinical need, the goal is to create a calming and caring environment. Ask Tami Schmitt, and she’ll say most of the miracles happen because of this dedication to old-fashioned, tender-loving care.

Doctors are constantly available, and the babies are held as much as possible. A few NICU staff members even hand-knit each baby a blanket to be used over their incubator as a light shield.

“They are the most compassionate bunch I’ve ever met,” Tami says. “They held Hanna all the time, they took pictures of her, they recorded every single cubic centimeter she ate, every single thing that happened, and if we weren’t there, they communicated constantly with us.”

NICUteam_2015
From left: Kathy Chayet, RN; Pari Ghaffari, RN; Jessica Ford, RN; Dr. Evelyn Tintoc and Letty Garcia

Of course the medical issues babies like Hanna experience are the primary challenge of the NICU, says Dr. Lev. But the next task is nearly as important: taking care of the whole family.

“If you haven’t been through this, you can’t imagine the shock and stress of having your newborn admitted to the NICU,” says Dr. Lev. “That’s why it’s essential to have this sort of family-centered care. We view it as our mission to form a bond with the whole family, to make sure we address the parents’ concerns and respect their choices and beliefs.”

Encouraging the parents to be present in the NICU and involved in the baby’s care is a trend that has swept the nation. But that philosophy was always at the heart of Saint John’s NICU, Dr. Tintoc observes.

“Initially, families were not as involved in care as they have been in the last few years,” she explains. “But at Saint John’s, it has always been family-focused. We’re family-focused from the first day the baby comes in until the day of discharge. We want the parents to feel they have a role in the care of the baby. It’s about teaching them and making them feel secure. When it’s time for them to take the baby home they feel prepared to care for their child.”

Dr. Lev says her team—all specialty-trained in neonatal intensive care—is comprised of curious, compassionate professionals who are guided by evidence-based medicine and are always willing to make changes to improve outcomes. They are assisted with equally incredible improvements in technology and medical knowledge.

The Giraffe Incubator, for example, helps reduce stress on babies by keeping them in an ideal temperature and humidity and in a sound-proof environment that facilitates development and growth.

The Giraffe also makes it possible to weigh the baby, gingerly manipulate the baby for changing and feeding and even perform bedside surgeries without changing the baby's environment.

The incubator was a gift to the NICU from several generous donors including: Janice and Ken Ruck, NexGen, the Martha and David Ho Family, Cynthia L. and William E. Simon, Jr. Foundation, and Frances and Terry Flanagan.

The NeoRay portable neonatal digital X-ray imaging system has reduced the time it takes to process an X-ray from an hour to sometimes just minutes, significantly decreasing radiation exposure. The system was generously donated by Su-Z Schneider, a founding Irene Dunne Guild member, and Ted Schneider, a Saint John’s Health Center Foundation trustee.

“Our NICU now focuses on gentle, non-invasive ventilation techniques because those have been found to reduce risk of chronic lung disease for the children,” explains Dr. Lev, who says she enjoys the constant challenge of the neonatal intensive care unit.

Tami Schmitt can attest to Dr. Lev and her staff’s dedication. “Right now so many people talk about how you have to do your research and really be your own advocate. When you’re in the type of situation we were in, though, you discover pretty quickly that you also have to trust at some point. We made the decision early on to fully trust the staff, and they delivered perfectly. We’ve made lifelong friends because of it.”

Happily, the Schmitts recently welcomed new baby sister Hazel, who at 8 months already weighs as much as Hanna. But Tami says Hanna’s small stature is balanced by her larger-than-life personality.

“It’s almost like she knows she beat the odds,” Tami notes. “She’s so full of life.”

She boasts about the NICU, "The experience has changed us. We are a much stronger, more faithful family now. We have Hanna because someone more powerful than any of us was looking out for her and because of the entire NICU staff. I don’t think we can ever repay the NICU team for what they did for us.”

To learn more about supporting the Irene Dunne Guild Neonatal Intensive Care Unit, please call Cookie Galanti at 310-829-8423.