Monday, 19 December 2011
In the past week, three children from the big nursery were admitted to the NICU for short-term care. The first was17 month old Frantina. She had a pneumonia that did not respond to oral antibiotics. On IV antibiotics, this little lady soon recovered.
The second child was Faland, a two-year-old girl, with chronic digestive problems. She developed severe, watery diarrhoea and wasn't able to tolerate Oral Rehydration Solution. She was on IV fluids for just a day. That was all it took to restore her to health.
Geraldson, also needed an IV to help him recover from gastroenteritis. His recovery was even faster than Faland's!
By Friday, all three children had returned to their nurseries. where they were cheered by their nannies and the 'brothers' and 'sisters' in their groups. 'I'm are so happy!' nanny, Chantalle exclaimed'. Her hand gestures were exaggerated but her facial expressions were very sincere. She told me that one year old Naika, had missed Frantina so much that she wouldn't eat. The other children in Frnatina's group were also out of sorts, Chantalle reported.
As we were caring for these children. an epidemic of cold symptoms, coughing and wheezing developed at the main house. Yesterday, two of the premature babies were struggling with this virus, and showing signs of bronchiolitis, a condition that causes the air sacs in the lungs to fill with fluid and collapse. At mid-day, Louna vomited and aspirated her feed. Her panicked mother responded by hiding Louna under her jacket. We don't know how long she was struggling for breath, but intuition told the day-nurse to check in on Louna. Ginette found the baby pale and gasping.
Although I suctioned her airway, sited an IV and gave preventative antibiotics and started her on oxygen, the damage had been done. She had breathed the milk she vomited into her lungs and Louna had several spells of apnoea over the afternoon, which means that she stopped breathing frequently. We were unable to keep her oxgen levels up, and by dinner time, Louna had to be started on CPAP. She went on to have seizures. It took two hours of intense effort to stabilise this baby, who became so irritable as a result of all the medications she was given that she pulled out two IV lines. Louna is doing much better today, and we hope to get her off of her CPAP in the next day or two.
Rivens, another premature baby boy also had to be started on oxygen yesterday, and today, he was too tired to feed. Bronchiolitis can be very serious for premature babies. He has a feeding tube down and we will be observing him carefully, constantly assessing him to make sure that he is not become exhausted. He will receive IV fluids or CPAP if he needs them.
It is an amazing thing, to be able to offer bubble CPAP to our babies who are struggling the most with bronchiolitis. Even in the developed world, some babies become so sick with this condition that they need to be ventilated. CPAP prevents our babies from getting to that stage. This is extremely important -to all intents and purposes, they are no Paediatric Intensive Care services in this country.
Posted by Susan Westwood at 18:04