Comfort Care a la Carte: New Addition to Labor Support

Oftentimes patients are unsure of what to expect when labor starts. They may decide to try and prepare for the unknown by touring the unit, taking a childbirth class, reading pregnancy and childbirth books, studying birthing options on the internet and writing up a birth plan – all of these are excellent ways to prepare. Some patients know nothing more than they want an epidural or they’re planning on “going natural.” Regardless of preparation, sometimes it’s still a mystery what will happen when you are actually admitted to the hospital. This is when the bedside labor nurse can be a vital resource.

In Labor & Delivery, we strive to help our patients and their families feel comfortable and stay informed throughout, but undeniably our most important goal is to provide the best possible care, utilizing best practice. We are currently working very diligently to reduce our C-section rate.

Several factors come into play when taking a look at the reason for successful vaginal delivery. Delaying admission to the hospital until labor has begun (progressively dilating cervix over 4-5cm and contractions at regular intervals) may significantly increase the laboring woman’s possibility for vaginal delivery. However, there are occasions when a patient may need to be admitted before labor starts. In this case, studies show that having bedside labor support during early labor is incredibly important. At Overlake, we are making strides in improving our bedside care and support – educating staff, seeking out pertinent research, and auditing our own patient records to see what’s working in alignment with our goals and areas for improvement.

Recently, we added a Comfort Care a la Carte menu for patients – a complimentary assortment of “tools” that can be used to get through those tough hours of labor. These tools have been found to significantly improve patient experience, especially for those planning on an epidural, but aren’t quite ready for it. We’ve found that something so small, like a headband to keep your hair back or tea light candles for an ambient setting, can make a world of difference. These items also give the patient and their birth partner a chance to connect. We’ve had excellent feedback from our patients who’ve taken advantage of our Comfort Care menu. Sometimes it’s the little things that count.


Posted in Labor & Delivery, Mother Baby, Women's Services | Leave a comment

Annual Santa Visit to Overlake

On December 13, 2014, Santa and his elf visited the Overlake Medical Center Childbirth Center. First stop was the NICU, where each infant was able to be held by Santa and a photo taken. Some of these photos we later saw as the family holiday card.

From there, Santa went to the Mother Baby Unit for more pictures with newborns. There he was able to include siblings in some of those pictures. The older brothers and sisters were thrilled by Santa’s appearance and some even gave Santa their Christmas wishes.

 

Posted in Mother Baby, Newborns, NICU | Leave a comment

Vitamin K Administration After Birth

It is a growing trend to scrutinize the medications or vaccinations that are offered to our infants and children. As these medications and/or vaccinations become routine we no longer see the adverse effects of foregoing these medications. What is the benefit of a Vitamin K shot to the newborn after delivery? The goal of Vitamin K administration is prevention of hemorrhagic disease of the newborn, also known as vitamin K deficiency bleeding. Although rare, this disorder can result in long-term brain damage and death.  Vitamin K is essential for our body to adequately clot blood and thus prevent excessive bleeding.   Infants have inadequate vitamin K stores at birth and breast milk cannot adequately compensate for deficient endogenous production. Without adequate vitamin K stores the infant is at risk for excessive bleeding. This can be seen as oozing from the umbilical cord, circumcision, oral mucosal bleeding or in severe cases bleeding in the stomach or brain. At Overlake, we follow the current recommendation of the American Academy of Pediatrics that all newborns be given a single intramuscular dose of Vitamin K. 

Posted in Newborns | Leave a comment

Newborn Hearing Screen at Overlake

 

Newborn Hearing Screen is an important part of every baby’s care in the first weeks of life. Most babies can hear normally, but one to three of every 1,000 babies are born with some degree of hearing loss. This loss can be difficult to detect without infant screening. Delayed detection leads to delayed intervention and subsequent delays in speech and language development.  That is why the American Academy of Pediatrics recommends that all infants are screened for hearing loss.

 

What makes detection difficult is that babies may respond to sound but that does not mean they have normal hearing. Most babies with hearing loss; hear some sounds but experience enough loss to impact speech and language.

 

At Overlake, babies are initially screened for hearing loss at the Mom & Baby Care Center. An appointment is made while families are on the Mother Baby Unit and families come back to the Mom & Baby Care Center within a few days of discharge.  If passage is not attained at the initial screening, a follow up screen is performed within one to two weeks.

 

Overlake was recently recognized as the “Hospital of the Quarter” by the Washington State Early Hearing-loss Detection, Diagnosis and Intervention (EHDDI) program for improving hearing detection processes which promote early detection, diagnosis and intervention.

 

If a possible hearing loss is detected after the two screenings performed at Overlake, further testing will be done to confirm the results with an audiologist. When hearing loss is confirmed, early intervention should begin as soon as possible.  Timing is important; babies have the best chance for normal language development if intervention begins before six months of age. The earlier – the better!

 

Posted in Mother Baby, Newborns | Leave a comment

Eastside mothers give 95 gallons of milk to help premature babies (Bellevue Reporter)

In the six months since Overlake Hospital opened its Milk Donation Center, Eastside mothers have given more than 95 gallons of life-saving, nutritious donated human milk to the hospital.

The donations assure that Overlake Medical Center has priority access to the milk to support fragile, premature infants in the hospital’s Neonatal Intensive Care Unit.

“We have been amazed at the generosity demonstrated by the caring donor moms of our community,” said Sandy Salmon, RN, who manages Overlake Medical Center’s Mom & Baby Care Center.

Salmon’s message to all the mothers who donated: “We recognize the time and energy taken to collect and donate this milk for babies in need. Your actions are inspirational and deeply appreciated both by the babies and families who receive your gift and by the staff at Overlake who are lucky enough to assist you in this process.”

Overlake is one of just a few hospitals in Western Washington to offer a local donation location to mothers in the greater Seattle area. After taking care of Overlake’s needs, any additional breast milk collected will help support 120 hospitals in 24 different states.

The milk is shared with other hospitals through Overlake’s partnership with Mothers’ Milk Bank in Colorado, which provides the screening and blood testing needed to become a donating mom at no cost.

“We are always in need of donors and milk,” said Laraine Lockhart Borman, outreach director at Mothers’ Milk Bank in Colorado. “We frequently have more need for milk from hospitals than there is supply.”

Borman and Salmon are hoping Eastside moms continue to give the gift of human milk. The 95 gallons – roughly 12,248 ounces – were donated by 36 moms.

“One special donor gave 3,698 ounces so far,” Borman said. “Some gave the minimum of 150 ounces. To us it doesn’t matter because every drop is precious. An ounce will feed a micro preemie for a day. A little goes a long way toward protecting their health and ensuring their survival.”

Mothers who have been screened and accepted as prospective donors can come to Overlake’s Mom & Baby Care Center to drop off their frozen donated human milk and have blood work done at the medical center’s outpatient lab. The milk is temporarily stored in a deep freezer before being shipped for processing along with the blood samples.

The mailed blood samples are tested to assure donors meet the proper criteria (much like testing for blood donation). Milk that is safe for use is then pasteurized and cultured to assure there is no contamination from the processing. The milk is then frozen in 2 to 4 ounce bottles for shipment to hospital neonatal intensive care units.

A milk donation center is a controlled collection point where healthy, lactating women can donate their surplus milk for premature babies. The milk collection, shipping, processing and distribution are overseen by the Human Milk Banking Association of North America (HMBANA), an organization consisting of multiple banks and collection depots throughout the United States and Canada.

Studies showing strong clinical benefits combined with recommendations from many health organizations have prompted a growing number of hospitals to provide donated, pasteurized human milk to premature infants when their mother’s own milk is not available.

Donated human milk provides life-saving nutrition and immune support to fragile, premature babies. In the United States, there is a critical shortage of donated human milk. According to the HMBANA, there are 60,000 low birth weight infants (weighing 3.5 pounds or less) born every year who need donated human milk.

Milk banks depend on “drop off” milk depots to meet the growing demand for donated human milk. Only milk from a HMBANA milk bank can safely be given to preterm infants in the hospital.

For more information about Overlake Medical Center’s new mother’s milk depot and to learn about how to donate, call 425-635-6150.

Posted in Uncategorized | Leave a comment

March of Dimes: Nurse of the Year Awards

On November 20, 12 of Overlake’s outstanding nurses were recognized and  attended the March of Dimes:  Nurse of the Year award ceremony at the Meydenbauer Conference Center in Bellevue. This awards event  brings together the health care community to recognize nursing excellence and achievement throughout the state of Washington in areas of research, education, quality patient care, innovation and leadership. Awards were presented to the most outstanding nurse within several categories.  One new category was for a non-nurse who has advanced the nursing profession.

Eight of the nominees were nurses  who have had a direct and positive impact on the Childbirth Center.  We are extremely proud and recognize that our patients benefit from the staff that consistently go above and beyond!

Posted in Mother Baby, Women's Services | Leave a comment

Second Annual NICU Reunion

The Second Annual NICU Reunion was held on Sept. 7, 2014 with more than 125  participants.  We welcomed approximately 75 adults and 50 children.  The graduates ranged in age from 3 months to 12 years of age.  Infact, one of the volunteers was an Overlake NICU graduate 17 years ago!  This turnout was double what we had last year.  Most of the graduates attending were under a year which gave more time for staff and parent interaction.  Many activities were scheduled for graduates and their siblings including such things as making a cereal necklace; a Bouncy House and cupcake decorating.  It was so much fun for both family and staff to see each other again.  Parents beamed beings able to “show off” their graduate!!  As we begin planning for next year’s reunion, we already envision the activity level with all these one year olds now running around full steam ahead!

For a look at more photos, check out our Facebook page at www.facebook.com/OverlakeHospital.

Posted in NICU | Leave a comment

Breastfeeding: Natural, but not always easy

Breastfeeding is natural but not always easy. Many moms find that breastfeeding is not as instinctual as they anticipated, but find that with a little help they can quickly gain confidence and increase their comfort. Positioning baby at the breast may feel quite awkward during the first several days but there are techniques that may help reduce mom’s pain and increase baby’s milk intake.

* Remember to call baby’s provider or outpatient lactation for immediate follow up if weight gain,      wet /soiled diaper count is not adequate, baby is not settling after feedings, or baby is not waking to feed at least 8 times every 24 hours. Your baby should gain 6-7 ounces of weight each week, after initial minimal weight loss, for the first 3 months of life.

  • Use a supportive pillow so that the pillow is holding the weight of baby to breast level. A pillow will free mom’s hands to position her instead of lift her.
  • Hold baby tummy to tummy with mom. Sucking and swallowing is more effective and comfortable when his head is not turned to the side.
  • Support breasts, keeping thumb and index finger parallel (lined up) with baby’s lips. Many newborns are unable to feed and keep the breast in place.
  • Line baby’s nose up to the nipple. If latch-on starts too high, it is usually painful for mom.
  • Tickle baby’s upper lip with nipple and as he opens his mouth wide. Advance his lower jaw deeply by applying pressure to his shoulders.
  • Relax and be patient. Rookies need time to learn and help is a phone call away.

If you need help with breastfeeding please call the Overlake Women’s Clinic at 425-688-5389.

Our nurses are expertly trained and experienced in assisting mothers with latching, teaching new breastfeeding positions, monitoring baby’s growth and answering parents’ ongoing feeding questions as baby grows.

Posted in Mother Baby, Newborns, Women's Services | Leave a comment

When can I take my preemie home?

When your premature baby was born you understood that there would be medical issues that needed to be resolved before you could take him or her home.  As your baby progressed in the NICU, he or she became more stable and did well, and now you wonder, “When can I take my preemie home?”

A premature baby has some basic tasks to master before he or she can go home.  Your baby must:

  • Breathe all the time
  • Stay warm in a regular crib
  • Feed well

These may sound like simple tasks, but for a preemie these are complex activities they are not ready to do until they have completed developmental stages usually accomplished by full term babies before they are born.

Breathing is one of the most fundamental tasks of living, but before a baby is born he or she does not need to breathe regularly; the task of getting enough oxygen to the body is accomplished through the placenta.  The parts of a baby’s brain that control breathing are not fully developed before about 34-35 weeks gestation (where 40 weeks is the expected full term “due date” in a normal pregnancy).  Before this time babies may experience apnea of prematurity, pauses in breathing.  There is tremendous variability in how much apnea of prematurity a premature baby may experience.  In the neonatal ICU cardio-respiratory monitors watch heart rate and breathing patterns and pulse oximeters monitor oxygen levels to catch these pauses in breathing, apnea events.  If the heart rate goes too low or oxygen level goes down for too long an alarm will sound and a care provider will intervene to stimulate the baby, or give some added oxygen or manual breaths, if needed.  These events typically decrease with increased maturity and stop by full term.  The care team will monitor the frequency and severity of these apnea events and will not send a baby home until the baby has matured enough to be discharged home without monitors.  This usually means observing until a baby has not had an apneic event severe enough to require intervention while sleeping or alone for 5 days or more.

Premature babies are small.  Their small size makes it difficult for them to keep warm.  A premature baby needs to stay warm to grow.  If they are exposed to the world without adequate support to remain warm they will burn too many calories and will not grow.  To help babies remain warm they are usually kept in an incubator.  After they reach about 4 pounds (1800 grams) the team caring for your baby will consider weaning him or her from the incubator to a crib.  This is usually not done until your baby’s temperature is stable in an incubator with temperature of 28 degrees Celsius, or less.

Finally, the ability to feed well is also critical for a baby to thrive and grow at home.  The process of coordinating sucking, swallowing and breathing is fairly complex and premature babies initially do not do this well.  It is common for babies not to be able start taking feeds by mouth until about 34 weeks gestation.  After they start showing some interest in sucking and swallowing it can take weeks before they are able to take all of their milk from the bottle or breast.  The usual standard in the NICU is for a baby to take all of his or her feedings by mouth (by bottle or from the breast) before they are sent home.  This is usually the last piece to come into place before a baby is able to safely go home.

All of these tasks represent normal developmental stages for a premature baby and each baby progresses through these stages at different rates.  The time to attain the abilities to feed well, maintain temperature and breathe regularly, without apnea, can vary considerable from baby to baby.  The Neonatal ICU team caring for your baby will help explain how your baby is progressing and give your baby the support he or she needs.  They will not be able to give you a good idea about when your baby will be able to come home until you are within a couple days of the big event.  Each baby sets its own pace, and this makes predictions difficult.  In this case, like many others, your baby is in charge!

Posted in Newborns, NICU, Women's Services | Leave a comment

Overlake Opens Donated Breast Milk Depot (KING 5 HealthLink)

Breast milk is best and that’s especially true for fragile premature babies who are more at risk for infection. Overlake Hospital has just opened a Mother Milk Depot, where moms can donate their surplus milk to infants in need.

Little Leif was not scheduled to make his debut until late September. He had other plans.

“He was born at 28 weeks gestation so about 3 months early. Very early,” said Robin Ballard, Leif’s mother.

Seven-and-a-half month Brecken on the other hand was right on schedule. Brecken’s mom, Madeline Williams, and Robin met for the first time Tuesday.

Two different stories with a common thread: Madeleine is a breast milk donor. And Robin is a grateful mom. Her baby is one of many to benefit.

“We have 12 patients today and I’m thinking 10 of those at some point have had some partial parts of donor breast milk,” said Overlake NICU Manager Lynne Saunders.

Saunders says premature babies are especially vulnerable to dangerous infections of the gut, and breast milk provides protection. Supply is always an issue, though.

“We always need new donors as moms wean their babies an can no longer donate unlike donating blood so we’re always looking for new donors,” said Sandy Salmon, Overlake Women’s Clinic.

Donated milk from Overlake is shipped to a milk bank in Denver where it is screened and pasteurized before being distributed.

“And there’s an upside to having the depot is that we have first access to the milk in Denver for our babies,” said Sunders. “Before we got it as it was available.”

Robin had never heard of the donated breast milk before Leif’s early arrival.

“I think I was asked about it within just a couple hours of him being born someone came in and said we have this program,” said Robin. “It was a little hazy for me at that point, but that sounds great thank you. Do it.”

The idea is to provide a much needed bridge until the mom can supply her own breast milk or to supplement if she’s not able to produce enough for her baby to thrive.

There are now three Breast Milk Depots in the Puget Sound area. The others are in Everett and Tacoma. For more information on how to become a donor, go to the Mothers’ Milk Bank – Rocky Mountain Children’s Health Foundation website.

http://www.king5.com/health/Overlake-Hospital-opens-donated-breast-milk-depot-270085041.html

Posted in Uncategorized | Leave a comment