Every mother longs to hold her baby in her arms after she gives birth. But following a pre-term delivery, the baby is immediately taken away to be properly cared for, until both are well enough to be taken back home. But within the NPICU, one can rest assured that their child is being loved and pampered. Therese Bonnici writes.
The Neonatal Paediatric Intensive Care Unit (NPICU) hosts babies and children aged three and under, who require demanding treatment and constant monitoring. The patients are admitted to this ward from the Emergency Department, from Paediatric Wards, from Obstetric Wards and from Operating Theatres. The NPICU does not only cater for premature babies but also for the little ones who require medical attention or who are victims of accidents. The Malta Independent spoke with a number of parents who needed the service of the NPICU, as well as members of the medical team about the challenges of working in an intensive care ward.
Parents’ perspective
Natasha is a mother of triplets, born in April 2011. 35 weeks pregnant, Natasha had to undergo an emergency caesarean, and following delivery, her three boys were kept at the NPICU until they gained enough weight. Each of the three boys spent a different time period in the ward, with the longest stay lasting seven weeks.
“I had become aware of the existence of the NPICU during pregnancy classes; but you’re never really prepared until you’ve experienced being here yourself. Following birth, you are hoping to take you babies back home with you, but because my triplets were born 35 week into the pregnancy, they were kept in the intensive ward for a while. It was not easy taking one baby home, and leaving the other two here. It’s hard for a mother to let go, and to trust her babies into someone else’s care; particularly right after birth. But the medical team truly cared for them as if they were their own. Although shocking at first, things gradually fell into place, until all three boys were healthy enough to be taken home.”
In situations like these, the mother is urged to express breast milk, which is fed to the babies still being kept at the NPICU. The nurses also help mothers by teaching them to feed, change nappies and follow a certain routine.
Natasha is all praise for the medical team at the NPICU. “Members of the team are willing to explain everything you need to know in simplified terms. You become well aware why the baby requires so many tubes and wires, “she says, smiling. “ I used to call at the ward even mid night to check if everything was as need be. They are ready to help anytime you need them.”
Inevitably, bringing up triplets is very challenging; however Natasha admits that the situation gets easier the older they get.
For years, Sharon worked at the NPICU herself; but later on in her life she required the service of her former colleagues. 30 weeks pregnant with twins, one of the babies stopped growing, and she was admitted to hospital. In this case, the mother is given an injection to help the baby’s lungs to develop more quickly, to be able to sustain the respiratory system should it be born earlier. Sharon gave birth to her two children at 33 weeks pregnant, and the twins were admitted to the NPICU right away.
Sharon confesses that the saddest part of undergoing a pre-term caesarean was not being able to be with her children following birth, and only see them the following day. “That one day seemed like eternity,” she says. “Because those taking care of my babies were former colleagues, I was certain they were being well taken care of, but parents who experience it for the first time must be shocked, and I can understand that.”
Today Sharon works at Parent Craft, a free standing unit, which offers courses to expectant parents. She is also leading the NPICU awareness campaign – aimed at providing knowledge for prospective parents, just in case their baby needs medical attention following birth. The NPICU registers a high success rate, but inevitably, sometimes things may get out of hand. However, most parents walk out of the intensive care unit holding their healthy children in their arms.
Mariella is mother of one-year- old Leah, who suffers from a very unusual disease. Mariella had a full-term healthy pregnancy and delivery, but one hour after birth, her daughter was admitted to the NPICU. Leah started getting better; however at just a few months old, she had to undergo treatment in the United Kingdom.
“Prior to evolving situations, you mentally prepare yourself to deliver your baby and head home a few days after. But that was not the case for my family. Thankfully, the medical team is very approachable, and have guided us through the whole procedures. “
“Family is not only blood related, and the employees NPICU are members of our family. A simple hug or smile can go a long way. They are truly human beings,” Mariella says.
The Medical Team’s perspective
Winnie worked as a nurse in the NPICU for 32 years. Today, she works in the Paediatric Ward, and unfortunately, at times she meets patients she knew previously from the NPICU. Parents recognize her, and immediately feel more at ease. Of course, some NPICU patients are successful, however others, develop medical issues later on in life.
“Taking care of the parents is the biggest challenge and perhaps the most important. Parents would always remember the time spent at the ward. These parents, especially during the first 24 hours, need to be approached cautiously, we need to be welcoming. Parents are expecting the delivery of a healthy child. Some are not even aware that there is a ward that serves as an ITU for babies. Of course we need to focus on the patients, but attention on the parents is extremely important.”
Mr Muhammad Shaur Choudhry is a paediatric surgeon from India. He moved to Malta in April this year, and performed the first keyhole surgery in Malta. Keyhole surgery is a method of carrying out an operation without having to make a large incision. This reduces the length of time the patient needs to remain at the hospital, and also prevents scarring. Children tend to recover more quickly after keyhole surgery.
“Working on little babies is always challenging, especially if they are premature. We get babies with very serious conditions. Their organs are not mature enough, so every surgery is a major surgery in that case. It is not only what I do, but how the NPICU manages the baby afterward. Each member at the ward has his or her own role. If we do not work as a team, it simply doesn’t work out.”
The aim of the NPICU campaign is to create awareness amongst the general public about the invaluable work done by the very professional, caring and dedicated team at the Neonatal Paediatric Intensive Care Unit, which was formerly known as the Special Care Baby Unit (SCBU) at Mater Dei Hospital, Malta.
It will hopefully bring light upon the struggles and needs of babies in intensive care and the physical and emotional experiences of parents and families whose babies need special care. The campaign will also hopefully serve to give sufficient knowledge and courage to parents who may be in need of the NPICU services in the future.
The campaign will come to an end with "The Broken Heart - A Musical Evening", music composed by Maurizio Schembri, as the Official Closing Concert on Saturday 10th January at Palazzo de La Salle, Valletta at 19:30hrs. The entrance for this concert will be free of charge. Donations in aid of Qalb it-Tfal will be collected. For further details kindly visit: www.maurizioschembri.com.