Tranell Johnson-Suarez was 24 weeks pregnant with her first child when she started to feel pain and cramping. She called her doctor as a precaution. Within minutes, she and her wife, Liana, were on their way to Lehigh Valley Hospital–Cedar Crest where they learned Tranell was 3 centimeters dilated.
Tranell got medication for pain and to stop the contractions. She also received a steroid injection to develop her baby’s lungs. At 6 a.m., the baby’s heart rate dropped, and doctors began preparing for an emergency cesarean section. At 7:06 a.m., baby Sydney was born.
Sydney was born a micro preemie (1 pound, 9 ounces and 13 ½ inches long). While every baby’s journey is different, all preemies benefit from specialized care in a neonatal intensive care unit (NICU). Recently, the NICU at Lehigh Valley Reilly Children’s Hospital was designated Level IV – the highest level of care for fragile babies.
Here’s what happened next when Sydney went to the NICU.
A specialty-trained physician examined Sydney. Neonatologists, like Nachammai Chinnakaruppan, MD, with Lehigh Valley Reilly Children’s Hospital, looked for common problems of prematurity including immature lungs, brain, eyes and other systems. Neonatologists are fellowship-trained physicians who specialize in care of premature or ill newborns.
Sydney was intubated and placed on a ventilator for breathing assistance. When she wasn’t improving in mid-December, doctors put her on a stronger ventilator and eventually recommended a nine-day course of steroids to reduce inflammation.
“Dr. Chinnakaruppan wanted to see if steroids would help,” Liana says. “She broke down all the benefits and said it may take 48-72 hours to see improvement.” Within 12 hours Sydney was starting to improve. She came off the ventilator on Christmas Eve, the same day a hospital chaplain held an emotional baptism in the NICU.
An incubator stabilized her temperature. Sydney couldn’t regulate her temperature on her own. Nurses adjusted the heat until she was slowly weaned off the incubator.
She was closely monitored for signs of infection. Sydney was born before infection-fighting antibodies could develop during the third trimester. Her care team watched for early signs of infection and gave antibiotics as needed.
Sydney developed retinopathy. Babies born before 31 weeks and weighing less than 2 pounds, 12 ounces, are at high risk. Bleeding and scarring can cause the retina to detach and lead to blindness.
She was fed breast milk. Tranell pumped breast milk every three hours to establish her milk supply. Sydney received breast milk through a nose tube while also receiving IV fluids that contained liquid protein, fats, minerals and vitamins.
“A preterm baby’s gut can’t process food properly,” Chinnakaruppan says. “Breast milk is best because it offers antibodies and easy-to-digest protein. It also protects against necrotizing enterocolitis, which causes inflammation of the intestines.”
Sydney got help from a speech therapist. After eight weeks in the NICU, she was strong enough to work with a speech therapist who taught her the suck/swallow reflex and introduced bottle-feeding. Later, a nurse helped Sydney latch on so breastfeeding could begin.
“She was so excited at her first taste of breast milk dropped on top of a pacifier,” Tranell says. “It took some time, but Sydney eventually latched on to the breast for feedings.”
After 98 days in the NICU, Sydney went home. The retinopathy and breathing issues she experienced in her first several months are now gone. Her only lingering problem is acid reflux — common in preemies — which is being managed with a special infant formula.
“She is doing amazing,” Liana says. “Our care team was unbelievably caring. They explained everything so we always knew what to expect. When we finally went home, our nurse Vicky (Vicky Fellenz, RN) said, ‘Call me, text me with questions, I’m here for you.’ She was part of our support system then and still is now.”