Having healthy babies in Leeds, Grenville and Lanark is a partnership

Posted Jan 17, 2013 By Doreen Barnes

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Doreen Barnes, St. Lawrence EMC

Upon entering the MacLean Maternal Child Unit at the Brockville General Hospital, families are treated with the standard level of care. Some mom and babies require more monitoring than others. This can come about due to the mother having a dependency, the baby being pre-term or any number of issues which the hospital handles. The MacLean Maternal Child Unit, the Brockville General Hospital and the Leeds, Grenville and Lanark District Health Unit are all there to help with children's growth and development.

EMC News - The following is part two in a series of articles on the partnership between the Brockville General Hospital and Leeds, Grenville and Lanark District Health Unit regarding the best practices for newborn baby, mom and dad.

There's a standard level of care that every single person receives upon entering the hospital, regardless of their age.

If a mother-to-be enters the hospital and has been known to have a dependency, whatever it may be - alcohol, drugs, depression - the baby and mother will be monitored a little more closely.

"Knowing this, we may monitor the baby more," said Jennifer Torode, director, acute medical-surgical inpatient services, maternal-child program and interprofessional practice.

"Depending on when those dependencies occurred, whether they were in the past or present, whether they are involved in any programs now, in terms of recovery from addictions, we see all those as positive signs," indicated Torode. "If we have concerns that that person has continued to use throughout the pregnancy, or coming into the hospital using, then we are obligated to contact children's aid services."

To treat any newborns whose mothers have dependencies, namely substances, heroin or crack with withdrawal symptoms, the MacLean Maternal Child Unit will watch the infants very carefully.

"We have a special scoring system," said Torode. "We may keep them in the hospital for additional days."

Non-pharmaceutical measures will be used to help the infant along with putting the newborn into a low stimulating environment, handling the baby only when necessary.

"There are things that they will exhibit that they have difficulty with, they will often projectile vomit, shake, have tremors and are terrible feeders exerting a lot of energy doing it," added Torode. "Sometimes they will be on a higher calorie count. They are also usually hot to touch and run a temperature while going through withdrawals."

In come cases, if the score indicates there's a need, the infant will also be given medication or they may be transferred to a higher level centre where specific programs are available.

Infant

Development Program

Any child identified as having developmental delays has a wide range of services and support through various community agencies. Occupational therapy or physiotherapy are examples of programs that are available in this area.

"For example if an infant with a clubfoot may get their surgery in CHEO, we would continue to follow them here for their physiotherapy," said Torode. "We do provide an out patient (program) and for a community this size, we have a really robust program."

Skin hydration

With an infant, skin hydration is of great concern.

"If the mucous membranes are dry looking with peelable skin or it feels like an older person's skin where there is too much skin and not enough underneath," said Torode. "If the fontanelle feels like it is flush with the top of the head or sunken. This is another place where you can see dehydration."

Postpartum depression

Symptoms of an individual who may be exhibiting signs of depression may have a lack of interest in the newborn, lack of attachment to the infant and not wanting to feed or change the baby.

Currently the MacLean Maternal Child Unit will inform the physician of the mother's state. Or there may be a psychiatric referral. Depression is treatable.

"We do utilize the Leeds, Grenville and Lanark District Health Unit," said Torode, "But they only have so many resources. We will utilize whatever measures we can. If they are part of the Upper Canada Health Team, they have a social worker within the team. Then we know that there are opportunities of a follow up in the community. If she has a previous diagnosis or she is displaying symptoms and we are concerned, we will do a psychiatric referral. It's not the same as a social worker and it may take an extra day as a result of that."

Torode feels there's a significant proportion of women and families in this community she considers as high risk.

"They need more referrals and follow-up," explained Torode, "especially the young parents, who are not in the best living circumstances or are financially dependent on their family. They are or trying to get by on very little income. There are significant drug and alcohol addictions that go on here and we see that."

The MacLean Maternal Child Unit can provide a list to the young families or individuals regarding services or programs available through various local agencies, Interval House, food banks, Leeds, Grenville and Lanark District Health Unit.

Pre-term

There have been instances at the BGH wherein women have arrived thinking they had an ailment when in fact they were in labour, giving birth and didn't know it.

"A pre-term baby depending on the gestation, 35 weeks or up, we will often keep them, meaning that the baby will be monitored for awhile after the mother has left the hospital," stated Torode.

Skin-to-skin practices

"Skin-to-skin practices are extremely important," said Torode. "It affects a lot of different things, so when the baby is first born to put them skin-to-skin helps them to transition into the world in the most comfortable and less stressful way."

According to Torode, there is a provincial initiative to have more babies when born to be placed on the mother's chest. The program is called Mother-Baby Dyad.

"By being there it also promotes breast feeding as well," stressed Torode, "the latching and what not."

Discharge information

Upon leaving the hospital, mom and baby receive packets with a couple of diapers, skin lotion, Huggies wipes, Today's Parent and Parents Canada magazines, advertising flyers and coupons, information on the newborn registration service, Leeds, Grenville and Lanark District Health Unit hand-outs on tooth decay prevention, newborn screening tests, Vitamin D and breastfeeding sheets along with a release information sheet.

The MacLean Maternal Child Unit will also give the new family any agency contact information that is required.

Plus data on a provincial infant hearing program, cord care, fever management, bathing, jaundice, never shake a baby pamphlet, grandparents, baby's communication check list, home safety and much more.

From Welcome Wagon, a yellow packet containing moisturizer, lotion and other information is contained.

In addition, the May Court Club of Brockville and the Brockville General Volunteer Association (BGVA) provide 'We Care Baskets' for those moms in need of sleepers, clothing and blankets as well as baby toiletries.

To continue this tradition, BGVA is accepting donations of new baby toiletries, namely shampoo, lotion, wipes or diapers. Contact Cheryl Marshall, coordinator of Volunteer Services for more information 613-345-5649, extension 1254.