On December 30, 2021, Kelsey Schleppy gave birth to her baby girl, Maleila. Within days of taking her home, Kelsey’s intuition told her something wasn’t right. Her family practice doctor assured her Maleila’s shallow breathing and lack of appetite wasn’t anything out of the ordinary, but Kelsey kept a watchful eye, nevertheless. One morning, Kelsey noticed Maleila deteriorating rapidly and made the decision to call 911.
By the time they arrived at their local hospital in Skagit Valley, Maleila no longer had a pulse. She was rushed into Emergency Department (ED) where the team performed chest compressions to resuscitate her. The team also needed to give her epinephrine, but the standard method of inserting an IV in a vein in her arm or leg wasn’t working.
At the same time, many miles away, Dr. Rachel Umoren, Medical Director of Inpatient Telehealth at Seattle Children’s and Associate Professor & Associate Division Head for Research, Neonatology at UW, was the scheduled on-call doctor for Seattle Children’s Telehealth Services. She received a call from Skagit Valley Hospital and dialed into the portable device positioned facing Maleila’s bed.
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Dr. Rebecca Stark
Seattle Children’s and University of Washington Medicine launched a new program in October 2021 to provide the next generation of fetal care for families around the Northwest and beyond. The two hospitals offer the only fetal intervention and surgery program in the Pacific Northwest. Care will be provided at Seattle Children’s Fetal Care and Treatment Center and UW Medical Center. Dr. Rebecca Stark, co-directs the Maternal Fetal Intervention and Surgery Program with Dr. Martin Walker, and Dr. Bettina Paek.
Dr. Stark, who is also the director of the Congenital Diaphragmatic Hernia program, spoke with On the Pulse about the new Fetal Care and Treatment Center and exciting additions to the center’s services. Read full post »
The low-cost bCPAP device combines room air with oxygen and delivers it to the baby’s nose. The tubing carrying the oxygen ends submerged in water, which creates the pressures in the system and makes bubbles when the air comes out. The bubbles create a vibration that helps to keep the lungs open and working better. (Photo: PATH)
Each year, hundreds of thousands of babies born prematurely in low- and middle-income countries die because medical facilities there cannot afford the equipment that could help babies survive those crucial first few weeks after birth.
Many of these deaths are caused by respiratory distress syndrome.
In sub-Saharan Africa alone, some 6 million preterm babies are born every year with immature lungs. Their lungs aren’t fully developed, and they have trouble staying inflated, so they collapse. While medical institutions in high-income countries have bubble continuous positive airway pressure machines to help them breathe, those bCPAP units cost thousands of dollars—making them prohibitively expensive for many low-income nations. Of those 6 million babies, 800,000 of them are born at mid-level facilities that require bCPAP devices but likely don’t have them.
The bCPAP devices keep the lungs from deflating and also deliver blended oxygen into them—a critical step because breathing 100% oxygen can cause blindness in premature babies.
Medical providers in some low-resource countries use improvised bCPAP kits assembled from parts they already have in their clinics and use them to help preterm babies survive. However, these kits do not have the ability to provide blended oxygen for babies.
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Dr. Maneesh Batra’s experience with babies in low-resource countries fed his passion to focus on neonatal care and public health.
Dr. Maneesh Batra, the new interim chief of neonatology at Seattle Children’s, first became interested in neonatology when he was working as a resident in Ugandan hospitals in 2002. He witnessed the incredible sorrow on the faces of mothers whose babies were failing to thrive.
“It was striking to me how much the providers and the families wanted to give those babies hope,” Batra said. “The moms were bringing their babies there to give them a chance at survival, and most of them were dying. It felt really wrong and unfair.”
When Batra returned to the U.S., he found it hard to shake those images from his mind. It ultimately led him to converge two of his interests — neonatal care and global health — with the mission of helping improve access to care for all babies everywhere.
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At 10 months old, Amelia and Calvin Phillips have proven they are fighters, overcoming multiple obstacles to get to where they are today. The twins were born as micro preemies, a term used for babies born before 26 weeks gestation, or who weigh less than 1 pound, 12 ounces.
Throughout their time in Seattle Children’s Neonatal Intensive Care Unit (NICU), their parents, Amanda Littleman and Nathan Phillips, have been by their side. In time for Mother’s Day, Littleman shares her story and advice to mothers in a similar situation.
“Everyone tells you that the NICU will be a rollercoaster ride, and it really is. But it does get better,” Littleman said. “Just seeing Calvin and Amelia today makes all the ups and downs and scary conversations worth it. I can’t believe how far they have come since the day they were born.” Read full post »
Trainees in Africa participate in a pilot study of a virtual reality simulation that teaches care providers how to care for a newborn unable to breathe on their own.
Wanting to do something different to address the alarmingly high number of newborn deaths in low income countries, Dr. Rachel Umoren, a neonatologist at Seattle Children’s, turned to virtual reality (VR).
As mobile phone-based VR programs became increasingly accessible, Umoren thought the emerging technology could offer a better way to equip health care providers with the skills necessary to save babies’ lives in low- and middle-income countries with high neonatal mortality rates.
Her case was compelling: with mobile VR training, providers could learn and easily maintain new skills at their own convenience, on their own smartphone, and with game-based automated feedback that is ideal for learning. With its on-demand availability, she believed mobile phone-based VR training could effectively translate into clinical practice better than current training methods.
“Mobile technologies are ubiquitous in low and middle income countries, yet they are relatively untested at disseminating health care information or training in these settings,” Umoren said. “I wanted to see how we could apply innovations in virtual reality to address the pressing issue of neonatal mortality.” Read full post »
Amani Jackson and her identical twin sister, Amira, possess a rare bond that began in their mother’s womb.
Up until the moment they were born, grasping on to one another, their bond remained unbroken.
It wasn’t until surgeons noticed one of them wasn’t quite like the other, that they needed to part ways.
“Although they were both premature, Amira came out healthy as can be,” said their mother, Stranje Pittman. “However, as soon as the doctor saw Amani, they knew something was wrong. Before I knew it, she was rushed out of the operating room and immediately taken to Seattle Children’s.”
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When Cassie Fannin and her husband arrived at her 19-week ultrasound, the newly married couple was excited to learn more about their child. However, the first-time parents’ joy quickly turned to uncertainty when the ultrasound showed their baby’s stomach in her chest due to a life-threatening condition.
Fannin learned that her daughter, Summer, would be born with a congenital diaphragmatic hernia (CDH). Summer had a hole in the left side of her diaphragm that allowed her stomach, intestines and a portion of her liver to slip through into her chest cavity. This prevented her left lung from developing normally.
“To say it was a shock is an understatement,” said Fannin. “We went from being ecstatic about finding out we were having a girl to absolutely devastated in a matter of seconds. I left that day a completely different person. My sadness slowly turned into anger and resentment as I thought, ‘Why us? Why our baby?’”
Doctors referred the family to Seattle Children’s Prenatal Diagnosis and Treatment Program since Fannin’s baby would need surgery after birth, if she survived. The couple met Dr. Kimberly Riehle, an attending surgeon at Seattle Children’s, when Fannin was about 22 weeks along.
“My husband and I were completely lost and overwhelmed,” said Fannin. “Dr. Riehle helped ease our troubled minds during a really uncertain time. My feelings of bitterness and sorrow slowly started to melt away as I came to terms with the diagnosis and the realization that we were no different than anyone else getting a life-changing diagnosis, and I just focused on my excitement to meet her.” Read full post »
Garrett Smith survived six weeks on life support in Seattle Children’s neonatal intensive care unit (NICU). Photo courtesy of Arlene Chambers Photography.
From the moment he made his entrance into the world, Garrett Smith struggled to breathe.
“We longed for that first cry as he was placed upon his momma’s chest,” said Kevin Smith, Garrett’s dad. “Unfortunately, we didn’t get to hear that cry. Instead, we saw Garrett gasping for air and making quiet whimpers.”
As doctors raced to get Garrett the air he desperately needed, they first transferred him to the neonatal intensive care unit (NICU) at the hospital where he was born. When his condition continued to deteriorate, they transferred him to a higher level of care at Swedish First Hill. Less than 24 hours later, the Smiths learned he would need yet another transfer, and faced the scariest decision they ever had to make as parents. Read full post »
In 2009, during Laurina Barker’s 20-week ultrasound, she and her husband Ryan received news that no expecting parents want to hear.
“The technician turned to me and said something looked different and that they would have my doctor call me,” said Barker.
A couple of days later, the Barkers would learn their baby had congenital diaphragmatic hernia (CDH), a rare birth defect where a baby’s diaphragm does not form completely. This leaves a hole between the abdomen and chest allowing their organs, most often their intestines and liver, to slip through the hole and up into the chest.
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