Small Baby Unit Before and After

In observance of Prematurity Awareness Month, meet a few graduates of the Small Baby Unit (SBU) at CHOC Children’s. The only of its kind in Orange County, the SBU focuses on caring for the unique needs of the smallest and sickest babies. This special unit is designed for babies born at less than 28 weeks gestation or who weigh less than 1,000 grams.

moanalani

Moanalani Solomon
Current age: 1
Birthday: July 14, 2015
Gestational age at birth: 28 weeks
Birth weight: 2 pounds, 13 ounces
Personality now: “Moanalani is an extremely happy baby who loves to chat with anyone who will listen.  She can roll over and wants to show that trick off as soon as she’s on the floor. She is feisty and absolutely full of life,” says Noelani, Moanalani’s mother.
Reflections on the journey: “We got to know every family in the unit. We really became such a support group for each other. We exchanged phone numbers and birth dates of all the other babies, and asked ‘How did you get here?’ and ‘What’s your story?’ You become family. You’re here for the same purpose. That’s what we really clung to,” Noelani says.

small baby unit

Lucas Zaragoza
Current age: 1
Birthday: June 16, 2015
Gestational age at birth: 24 weeks
Birth weight: 1 pound, 8 ounce
Personality now: “Lucas is always happy, loveable, mischievous, very alert, and curious,” says Heather, Lucas’ mother.
Reflections on the journey: “The nurses told us we’d be very hands on, take his temperature, change his diaper, hold him. They said, ‘It’s OK, we’ll walk you through it.’ They’re part of our family now. We don’t know we would be without CHOC and the nurses and doctors and everyone who had a hand in Lucas’ care,” Heather says.

small baby unit
Jeremiah Zazueta
Current age: 6
Birthday: March 22, 2010
Gestational age at birth: 25 weeks
Birth weight: 2 pounds, 4 ounces
Personality now: “Jeremiah, known as J.J., is a kindergartner full of life and personality. He is very outgoing and friendly. He enjoys playing T-ball, singing, reading, and playing with Hot Wheels. In other words, he’s a typical active boy,” says Maria, Jeremiah’s mother.
Reflections on the journey: “At that moment, you just want them breathing. The doctor said if he cries when he’s born, that’s a good thing. I heard a whimper like a kitten and that gave me peace. The doctor said he’s a feisty one – he was moving his arms. This one’s a feisty one,” Maria says.

small baby unit

Parker Evans
Current age
: 4
Birthday: Sept. 29, 2012
Gestational age at birth: 23 weeks
Birth weight: 1 pound, 1 ounce
Personality now: “Parker’s battle to survive despite the odds seems to have established a bold defiance of the day-to-day challenges that life presents. Every task, no matter how simple or complex, is something that she routinely and emphatically proclaims, ‘I want to do it all by myself!’ The smallest of her peers and behind in her physical development, Parker seems to be the only one not to notice. She has a zest for life and is intent on taking full advantage of the chance she has been given,” says Kristina, Parker’s mother.
Reflections on the journey: “We ended up falling in love with the Small Baby Unit, the nurses and the consistency. Everyone in that unit made a huge difference,” Kristina says.

small baby unit

Faith and Brayden Kohrs
Current age
: 3
Birthday: Nov. 26, 2012
Gestational age at birth: 24 weeks
Birth weight: Both 1 pound, 10 ounces
Personality now:  “We love their amazing hearts, helpful spirits and beautiful souls. They are truly our two little blessings. The kiddos love to travel. They do really well on road trips. Going out with Grandpa Kohrs on his boat in Lake Havasu is always a blast. Faith loves to dance. Brayden loves blocks and Legos. They both love Mickey Mouse Club House, music and books,” says Marydith, the twins’ mother.
Reflections on the journey: “We love the wonderful, wonderful Small Baby Unit staff. They are the reasons we have our babies today. They are just amazing,” Marydith says.

Breastfeeding Resources for Moms in the NICU

By Crystal Deming, RN, lactation consultant at CHOC Children’s

Surgery, ventilators, central lines with IV nutrition, and medications are just some of the tools that can save and improve lives of babies in the CHOC Children’s neonatal intensive care unit (NICU). Yet some parents may overlook a mother’s own breast milk as lifesaving or as a medication as well. In the NICU, our mantra to new moms is “Your Milk is Medicine.” From the moment our families are admitted to our care, we begin the process of helping moms understand the value of their breast milk for their infant, giving them helpful information, necessary equipment and continual support from our multidisciplinary team, to help them produce and express breast milk for their own infant and to support breastfeeding when it becomes appropriate.

breastfeeding

Kangaroo Care

Our goal is to lessen the strain of separation by including families in the care team, by collaborating with parents and promoting their participation in the care of their infant. We initiate skin to skin contact, or Kangaroo Care, as soon as possible and have protocols to do this safely with even the smallest infants. Families later comment that this first experience holding their infant was a time of healing and bonding. This intimate interaction provides a break from the stress that can come with not being able to take your baby home from the hospital right away. Moms, babies and family members secrete oxytocin with this skin to skin touch and that gives them a sense of relaxation, wellbeing and promotes bonding. Skin to skin care often increases a mom’s milk supply, and we consider this holding the first step toward breastfeeding.

Assistance in Obtaining Breastfeeding Supplies

We can assist moms in obtaining a breast pump for home or connect them with a free pump to borrow, or help her submit a prescription to her insurance until she can obtain one of her own to keep. From hour one, we help teach hand expression and techniques to improve milk removal. Later we help moms maintain their milk supply, while supporting hydration and nutrition with our meal program, where some meals are provided free of charge when moms are in the hospital with their baby. We can also help with breast and nipple issues that can develop with prolonged pumping, as well as assist with storage when moms have a full milk supply but are waiting for their little one to grow into full size feedings.

Team Support

With developmental specialists, lactation consultants and specialty trained nurses, our team helps moms to adapt positioning and use tools to assist latching. We help moms learn the special behaviors of a premature or healing infant and to pace their feeding accordingly. Each mother/infant relationship is unique and our goal is to help families to have a fruitful and satisfying experience together. For some this can become exclusive breastfeeding and for others, partial breastfeeding that is neither stressful nor overwhelming. And for some we support their difficulty in producing milk while continuing to support skin to skin care and parental involvement in decision making and for the care of their infant in other ways.

World Breastfeeding Week

World Breastfeeding Week is an annual health observance recognized by more than 170 countries around the world, being celebrated this year from August 1-7. One of its goals is to show the importance of, “Good Health & Wellbeing,” and how incorporating breastfeeding has been shown to improve the lives of infants and children. Breastfeeding supports a baby’s health, development and even survival, but we also recognize there are health benefits for their mothers as well.

Learn more about the benefits of breast milk.

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Pediatrics Article Highlights Big Outcomes in CHOC’s Small Baby Unit

CHOC Children’s Small Baby Unit (SBU) is improving quality and outcomes in extremely low birth weight (ELBW) infants (babies born at 28 weeks gestation or less and weighing less than 1,000 grams), according to results of an article CHOC physicians and staff published in a recent issue of Pediatrics.

“In recent years, the survival rates for ELBW infants have improved with the latest advances in neonatal intensive care, but many are still released from the hospital with significant challenges, including neurodevelopmental delays and/or chronic medical problems,” said Mindy Morris, DNP, the SBU program coordinator and the article’s co-author. “Our goal was to improve these outcomes by utilizing a dedicated team with expertise in the care of these patients.”

The objective of the CHOC neonatology team was to care for ELBW infants in a single location physically separated from the main Neonatal Intensive Care Unit (NICU). This space became the 12-bed SBU, which consisted of four individual patient rooms, two of which are surgical suites, and three four-bed pods. Different from a traditional NICU, this smaller unit allows for a darker, quieter environment that encourages developmentally supportive care. The goal is to create an environment that respects and supports the physiologic needs of the baby to grow and develop after being born so prematurely. Grouping this population also provides parents an opportunity to form strong bonds with other families sharing similar experiences.

Outcomes from the two years before and four years after the SBU’s opening in March 2010 include:

• Reduction in chronic lung disease from 47.5 percent to 35.4 percent. A common condition for premature babies, chronic lung disease can have long-lasting ramifications including re-hospitalization and poor neurodevelopment.

• Rate of hospital-acquired infection decreased from 39.3 percent to 19.4 percent.

• Infants being discharged with growth restriction (combined weight and head circumference, < 10th percentile) decreased from 62.3 percent to 37.3 percent. (These factors are linked to cognitive and physical disabilities.)

• Reduction in laboratory tests (from 224 to 82) and X-rays (from 45 to 22).

Additionally, there was a reduction in illness and complications among infants after leaving the SBU.

Moving forward, the SBU’s goal is to continue to improve patient outcomes, as well as family and staff satisfaction, while also becoming a destination for the care of extremely preterm infants.