"What's happening to me? Is my baby going to be okay?" Maybe you're reading this guide because you've been told you're at high risk for having a premature baby. Or perhaps you're reading it after your baby's unexpectedly early birth, and you're wondering what the future holds for this incredibly tiny person. You'll find all the answers you need in this comprehensive guide for parents, the first book to fully discuss both coping with high-risk pregnancy and caring for your premature baby. Topics include: Managing the High-Risk Pregnancy: Stalling preterm labor, coping with bed rest, medications to help the baby The First Twenty-four Hours after Delivery: What to expect right after the baby's born, coping with insurance, and more Your Preemie's Growth and Maturation: What to expect in terms of physical appearance and development for 24-, 28-, and 32-week preemies The NICU: What the neonatal intensive care unit looks like, equipment and staff, and how to be a good NICU parent Bringing Your Preemie Home: Getting your home ready, managing anxiety, feeding your preemie, keeping Dad involved Later-Life Development: Health, growth, and cognitive and psychological development as your baby matures Prematurity and the Special Needs Child: How to help your child lead a full life Featuring the most up-to-date medical information available and filled with the voices of dozens of parents who've been in your shoes, this reassuring guide will help you make the best choices for yourself and your baby.

JOSEPH A. GARCIA-PRATS, M.D., has been a practicing neonatologist at Baylor College of Medicine for more than twenty-five years and is medical director of the neonatal intensive care unit at Ben Taub General Hospital in Houston. He is the father of ten sons. <br><br>SHARON SIMMONS HORNFISCHER, R.N., B.S.N., a pediatric and emergency room nurse for more than twelve years, is the mother of three children, including a boy born eight weeks prematurely

Acknowledgments

xi

Introduction

xviii

``What's Happening to Me?'' The Causes of High-Risk Pregnancy

3

(54)

Confronting and coping with the shock of a high-risk pregnancy

3

(7)

Causes of High-Risk Pregnancy---An Overview

10

(1)

Preexisting (chronic) conditions that can lead to high-risk pregnancy or premature delivery

10

(8)

Other conditions that can cause prematurity

18

(5)

Pregnancy-induced conditions that can lead to high-risk pregnancy or premature delivery

23

(24)

Other causes of high-risk pregnancy

47

(10)

Managing the High-Risk Pregnancy

57

(44)

High-risk pregnancy: A numbers game

59

(1)

Determining the length of pregnancy

60

(2)

Some terminology

62

(1)

Identifying preterm labor

63

(5)

Managing premature labor

68

(9)

Homeward bound

77

(1)

Bed rest

78

(15)

Special procedures

93

(4)

Medications to promote maturation of the fetus

97

(1)

Choosing a medical facility

98

(3)

Labor and Delivery

101

(16)

Planning the unplannable

102

(1)

Childbirth class: ``Should I even have bothered?''

103

(1)

It's time: When to go to the hospital

104

(1)

Entering the home stretch

105

(1)

Cesarean delivery

106

(3)

The labor and delivery area

109

(2)

Choices and childbirth

111

(1)

Getting ready for delivery

111

(1)

Induction medication

112

(1)

Deciding about anesthesia

112

(3)

The moment after birth

115

(2)

The First Twenty-Four Hours after Delivery

117

(32)

The first few minutes after birth

118

(6)

The first few hours after birth

124

(15)

Other things to take care of when your baby is transferred to the NICU

139

(10)

Your Preemie's Growth and Maturation

149

(22)

Very premature infants: Twenty-four to twenty-eight weeks' gestation

153

(7)

Premature infants: Twenty-eight to thirty-two weeks' gestation

160

(5)

Moderately premature infants: Thirty-two to thirty-seven weeks' gestation

165

(6)

The Rhythms of the NICU

171

(34)

Common medical procedures in the NICU

174

(6)

Parenting in the NICU

180

(18)

Keeping the home fires burning

198

(4)

Parent support groups and other useful resources

202

(3)

Special Concerns in the NICU

205

(22)

The Eight Most Common Conditions of Prematurity

205

(3)

Infection (early and late onset)

208

(5)

Intraventricular hemorrhage (IVH)

213

(2)

Patent ductus arteriosus (PDA)

215

(1)

Apnea of prematurity

216

(1)

Necrotizing enterocolitis (NEC)

217

(1)

Bronchopulmonary dysplasia (BPD)

218

(2)

Retinopathy of prematurity (ROP)

220

(2)

Other Medical Concerns in the First Year

222

(1)

Anemia

222

(1)

Blood sugar instability

223

(1)

Jaundice

224

(1)

Respiratory Distress Syndrome (RDS)

225

(1)

Temperature regulation

226

(1)

The Intermediate Care Nursery: Your Baby's First Step Home

227

(14)

Life in the step-down unit

228

(1)

Guidelines for discharge: Your baby's ticket home

229

(1)

Medical concerns to deal with before your baby comes home

230

(3)

Medical treatments that may continue in the intermediate care nursery

233

(1)

Developmental care in the intermediate care nursery

234

(1)

Discharge planning

235

(4)

Rooming in before discharge: Dress rehearsal for life on your own

239

(1)

Your discharge debriefing

240

(1)

Bringing Your Preemie Home

241

(18)

Good-bye to the NICU

243

(1)

The home environment

243

(6)

Breast-feeding vs. bottle-feeding

249

(4)

Life at home with multiples

253

(2)

Meeting the pediatrician: The first-year checkups

255

(1)

Dressing your preemie

256

(1)

Preemie support groups

257

(1)

Keeping dad involved

258

(1)

Taking Care of Yourself

259

(12)

Rest

260

(1)

Exercise

261

(2)

Eating well

263

(3)

Lifestyle issues

266

(3)

If you are thinking about becoming pregnant again

269

(2)

Later-Life Development of the Premature Infant

271

(14)

Health

274

(1)

Growth

275

(1)

Neurological disorders

275

(1)

Cognitive and psychological development

276

(2)

Behavior and social competence

278

(1)

School performance

279

(1)

A caveat for the concerned parent

280

(1)

What a parent can do

280

(5)

Prematurity and the Special Needs Child

285

(6)

``Will my child be able to live a full life?''

286

(2)

Another baby?

288

(1)

Parenting the special needs child

288

(3)

When Things Go Wrong

291

(14)

What you should expect from your hospital

295

(2)

The stages of grieving

297

(1)

Common emotions felt by bereaved parents

297

(3)

Accepting and integrating your loss

300

(2)

Bereavement and your relationships with friends, neighbors, and co-workers

302

(1)

The grieving child

302

(3)

Hard Questions, Tough Decisions-Resolving Ethical Issues in Neonatal Care

305

(12)

A historical perspective

306

(1)

Good information: The foundation of ethical decision making

307

(2)

When your doctor must say ``no''

309

(1)

Mediating your dilemma: The hospital biomedical ethics committee

310

(1)

Common ethical issues in the neonatal ICU

311

(6)

Glossary

317

(8)

Appendix A. Developmental Milestones

325

(8)

Appendix B. Conversion Charts

333

(2)

Appendix C. Helpful Resources on Prematurity and High-Risk Pregnancy

335

(6)

Index

341

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What to Do When Your Baby Is Premature A Parent's Handbook for Coping with High-Risk Pregnancy and Caring for the Preterm Infant

9780812931099

0812931092

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