As many of you are putting away holiday decorations and enjoying the unseasonably warm temperatures this week, don't let this warm Texas winter weather fool you...RSV and Flu season is still here!

Unfortunately, I heard from several NICU graduate families over the holidays who were fighting off various "bugs" this year.  So, please be sure to take precautions with your little one.  What can you do?

1. Be sure to get your baby's Synagis shot on-time (if he/she is receiving them).

2. Lots...and lots...and lots...of handwashing!

3. Avoid large crowds (as much as possible).

4. Clean surface areas around your home with disinfectants frequently.

5.  Do not allow anyone with cold or flu symptoms around your high-risk baby.

Check out these links for symptom information and recent RSV stats:

http://www.cdc.gov/rsv/about/symptoms.html

http://txpeds.org/sites/txpeds.org/files/documents/RSV-and-Flu-11262011.pdf

Stay Healthy!

Julie Hudson, MSN, RN

NCBH NICU

Flu season is here again.....and flu shots are available! 

According the the CDC website, flu seasons are unpredictable but begin as early as October. The vaccine is already available in San Antonio, so that means it is time for everyone to get his/her shot!  "It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza virus infection" (CDC, 2011).

All of our NICU nurses and staff receive the vaccination each year, in order to protect our high risk population of patients.  For NICU parents and families this is an important step that may prevent your infant from getting sick.  The national recommendation is that anyone over the age of 6 months get a flu vaccination.  "It’s especially important that certain people get vaccinated either because they are at high risk of having serious flu–related complications or because they live with or care for people at high risk for developing flu–related complications.

• Pregnant women
• Children younger than 5, but especially children younger than 2 years old
• People 50 years of age and older
• People of any age with certain chronic medical conditions
• People who live in nursing homes and other long–term care facilities
• People who live with or care for those at high risk for complications from flu, including:
  • Health care workers
  • Household contacts of persons at high risk for complications from the flu
  • Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated) (CDC, 2011)."

Most physician offices, medical clinics, and even pharmacies are offering flu shots right now.  Some insurance companies and Medicare plans will also cover the expense of a vaccine.

If you are a NICU family member, please consider getting your flu shot right away.

Have a comment or story to share?  Email me or leave a comment for us all (using the comment link below).

Julie Hudson, MSN, RN
NCBH NICU

Reference
CDC. (2011). 2011-12 Influenza and vaccine and vaccination information.  From www.cdc.gov/flu/flu_vaccine_updates.htm

This week I received a photo of one of our NICU grads on his way to his first day in daycare.  It was a big day for the whole family.  For many of our graduates, the first day of "school" is a long-time coming.  For those of you who do not know this, many premature infants (and some term ones too) have long-term respiratory issues.  This makes them more susceptible to all kinds of respiratory illnesses.  For this reason (and others), it is usually recommended that NICU infants not be exposed to large crowds, sick people, small children, or daycare centers until their systems are more mature.

Why are they more susceptible?  Scientists and researchers have been asking that for years.  They also want to find out just how long this increased susceptibility lasts.  One study found that premature infants (30-34 weeks) had decreased lung capacity up to two years after birth compared to term infants and that premature infants' lung growth does not "catch-up" (Friedrich, et al., 2007).  A 2010 study on infants born at 25 weeks or less found:
"At 11 years of age, 56% of children born before 25⁺⁶ weeks of gestation had abnormal baseline spirometry,27% had a positive bronchodilator response, and 25% had a diagnosis of asthma (twice that observed in classmates). Among the 65% of extremely preterm children who had been asymptomatic over the previous 12 months, 48% had abnormal baseline spirometry, of whom 81% had prior bronchopulmonary dysplasia, emphasizing the need for continued monitoring of these children" (Fawke, et al., 2010).

This means that parents of preemies need to be vigilant about infection control (such as handwashing and exposure to others) and monitoring of their baby's respiratory status.  Immunizations and RSV prophylaxis (for those that qualify) are important things to discuss with your pediatrician.  

Little is known about more recent NICU grads' long-term respiratory function.  As Fawke, et al. (2010) pointed out, recent graduates are typically more immature, but have been exposed to "less agressive ventilatory support". 
We have come a long way in neonatology practice and we still have more to learn.  It is hoped that in years to come these statistics will be very different.....we'll have to watch and see.

Julie Hudson, MSN, RN
NCBH NICU

References

Fawke, J., Lum, S. Kirkby, J. Hennessy, E., Marlow, N., Rowell, V., Thomas, S. and Stocks, J. (2010).  Lung function and respiratory symptoms at 11 years in children born extremely premature:  The EPICure program.  American Journal of Respiratory and Critical Care Medicine, 182, 237-245.

Friedrich, L., Pitrez, P.M., Stein, R.T., Goldani, M., Tepper, R. and Jones, M.H.  Growth rate of lung function in healthy preterm infants.  American Journal of Respiratory and Critical Care Medicine, 176, 1269-1273.

We get many admissions to the hospital during the holiday season due to safety pitfalls.  The toddler’s environment at home may be safe and child-proofed, but what is the environment like when he/she visits Grandma or Aunt Sue?  The following are a few types of cases I can remember off the top of my head:

·        Young children taking older relative’s medicines

Many older relatives have their meds in baggies, or easy to open pill dispensers.  The meds may be in a purse, in the refrigerator, or dropped on the floor.  If a little one gets a hold of a strong heart medication, pain pill, or even certain kinds of vitamins, it can lead to tragic results.

·        Young children staying at homes that are not child-proofed 

When I worked in Arizona, we had so many cases of grandchildren drowning during visits.  The families would all say the same thing, “I only turned my back for a minute…”or, “We never thought he could open the door…”

·        Not using Sudden Infant Death precautions when traveling

I have seen where parents or grandparents make an “infant bed” by putting the baby in the middle of an adult bed and place pillows around the baby so she/he does not roll off.  Not every single baby will die if placed in that kind of environment, only a certain percentage will.  Are you willing to take that chance?  Invest in a portable crib like a Pack-n-Play and use it at home from time to time so your baby will be accustomed to it when you travel.

·        New environments causing new triggers for your child’s asthma

Smoke scented sofas, dusty old pillows/bedding, new cats/dogs, or even different regional trees/pollen may cause an asthma attack.  Keeping your child well controlled with their prescribed asthma controller medications is a big part of avoiding an asthma attack.  Bring and follow the doctor’s asthma action plan for your child.  Don’t forget to bring the asthma emergency medication and spacer with you on the trip.

When you think about it, how long did it take you to child-proof your home?  So, when you visit this holiday, take some time to secure your child’s environment.

I wish you and your family a safe and peaceful holiday season,

Cindy, RN