…especially tiny sick babies.

They are strange fragile lifeforms that struggle against all odds. They are not held together by bones, instead they hold the bones, which float inside as individual pieces. Picking up the baby is scary enough, but it is simply terrifying if you need to intubate or resuscitate them. It is really a heavy responsibility.

The baby I checked on was 3 weeks old, born premature with bronchopulmonary dysplasia, impairing his ability to get enough oxygen through normal lung gas exchange. He needed intensive surfactant therapy, steroids, beta agonists, and high frequency nasal ventilation with oxygen supplementation. Without these supportive therapies, infants with BPD experience necrotizing bronchiolitis and alveolar septal fibrosis, ie. scarring in the lungs.

As I examined his x-rays, it was evident that he had gotten better, then a bit worse as he was weaned off of the ventilator. However, this meant he was learning to breathe on his own, and would be able to go home with his parents in two weeks.

As Zach and I observed in the neonatology ward, we got a pleasant surprise as the parents of the infant came in to spend time with their baby. We watched as the nurse trained them to massage his body. Below you can see the young father using the back of a vibrating toothbrush to stimulate the baby.

We also watched as they changed his diaper and administered a puff of medication. The nurse said, “Don’t be afraid of your baby!” as they awkwardly handled the infant, such as the way of first time parents.

In the other room was a baby who had hyperbilirubinemia and was undergoing phototherapy. In this condition, the infant has high levels of unconjugated bilirubin (UCB), which is fat soluble and can deposit in the basal ganglia leading to kernicterus, retardation, and death. However, phototherapy is an effective treatment by making UCB water soluble, allowing it to be excreted into the urine and eliminated from the body.