- Ryan McAdams, a neonatologist in Madison, Wisconsin, had a complex case to handle: A tiny newborn with a heart defect needed surgery.
- The baby’s mother was around all the time to care for the infant until she tested positive for COVID-19 and wasn’t allowed to be in the hospital.
- All of that has changed with the recent Omicron surge.
A neonatologist in Madison, Wisconsin, Ryan McAdams, had a difficult case on his hands: a tiny newborn with a heart abnormality needing surgery as reported by The Atlantic.
Mother’s isolation
The baby had been struggling to feed, so doctors planned to insert a gastrostomy tube directly into the stomach to assist in supplementary feeding.
The baby wasn’t feeding as well without the mom there, McAdams says.
When the mom’s isolation period officially ended, at midnight before the scheduled procedure, she rushed back to the hospital.
She told McAdams the agony she had experienced at home, sobbing as she watched the crib side camera set up to see her baby.
She just kept saying, ‘I wanted to be there,” he says.“It was heartbreaking.”
Breathing problem
As a part of the hospital where babies are sent when they are very sick—perhaps because they have trouble breathing after birth, or because they were born far earlier than expected—the NICU has a special role.
Patients sometimes stay for months, cared for by nurses and parents who must inevitably take breaks, coming and going from this isolated world.
And in that shuffle, Omicron found openings.
No one ever plans on spending time in a NICU, but one in 10 babies ends up there, says Rachel Fleishman, a neonatologist in Philadelphia.
The babies are attached to a maze of machines and wires, and tubes in their mouths.
But now they have become even more overwhelming and controlled.
Stringent restrictions
She says the project is still hearing stories of parents who are not permitted to remove their masks or gloves when holding their babies; restrictions, in some hospitals, are still so stringent that grandparents have never been permitted to see their grandchildren.
Parents might live like this for months—some babies stay in the NICU that long.
“We have these fragile little babies who are like these little warriors, you know, fighting for their lives and have all these struggles against them.”
Until recently, COVID was not usually one of those struggles.
That situation sometimes made him feel guilty—he was caring for all these babies, while his colleagues were managing an onslaught of death and serious illness in adults in the next wing over.
The mood could grow ominous, Fleishman says, hearing alarms and codes go off several times a day in the adult ICU.
Omicron surge
All of that has changed with the recent Omicron surge.
Now the NICU where McAdams works is seeing more babies testing positive, more symptomatic babies, and many more parents with COVID.
“We’re back to wearing not only surgical masks but N95 masks and eye protection.”
But none of that makes up for not being there, for the mother or the baby.
But during the pandemic, infection prevention has taken over.
Incredibly challenging
Shuman has been studying families with babies in the NICU during the pandemic, and the biggest way that the NICU has changed, he says, is a shifting ground of visitation policies.
That makes caring for a sick baby incredibly challenging.
Shuman’s research found that the parents of NICU babies were experiencing unusual levels of distress, on top of their decreasing likelihood of breastfeeding.
Some NICUs keep multiple patients in the same room; others have single-patient rooms, which allow more protection.
“There are a lot of question marks I think that will need to be studied,” he said.
In other words, the separation itself could be its own risk.
Silver lining
One strange silver lining that Shuman found in his research: Although having a baby during COVID increased the odds that a mother would be diagnosed with postpartum PTSD, having a baby in the NICU was sometimes protective against this type of stress, paradoxically.
That support can, in some ways, extend to a parent’s COVID diagnosis.
Fortunately, the baby was not symptomatic.
McAdams called the mom back and arranged for her to stay isolated in the NICU with the baby so that they could be together and she could breastfeed.
“It’s not the adult ICU, so if mom gets sick, we really can’t take care of her—she’s not our patient.”
Ultimately, their job is to do whatever is best for the baby.
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Source: The Atlantic
