My Goals:
"The Capstone Project engages students in personalized learning experiences wherein students apply critical thinking skills while investigating a specialized area of interest. Students synthesize the teaching and learning from core courses and STEM elective pathways to solve real-world problems related to their chosen fields. The Capstone Project serves as a culminating demonstration of what a student has learned in his or her career pathway.” In our STEM Capstone project we plan to research breathing patterns and treatment processes on premature babies. We also plan to look at the long-term effects this has on babies through their adulthood. We also want to look at the effect this has on parents. To achieve these goals visiting Dartmouth-Hitchcock Medical Center will greatly assist us.
Some questions I have are:
Some questions I have are:
- What types of procedures do doctors use?
- What is the criteria for making decisions in the treatment of premature babies?
- What are the most common long-term health issues seen from prematurity?
- Explanation of the growing process of babies and why the lungs take such a long time to develop?
- How much are parents or guardians involved in the decision-making?
- What kind of effect does this experience have on parents?
- How much does it cost to run these procedures and have a baby in the NICU
- Help us to better-understand the decision making process and treatment process
- Allow us to see what actually goes on in the NICU
- Watch the treatments take place
- Understand what the equipment does and why it is such a necessity for premature babies to be in a NICU.
- Detailed sources of information that you would suggest
- Possibility to become involved with events (ie. March of Dimes)
- Other contact information such as doctors, parents, and organizations
My Findings
A premature birth is a birth that takes place more than three weeks before the baby is due. In other words, a premature birth is one that occurs before the start of the 37th week of pregnancy. Normally, a pregnancy lasts about 40 weeks. Premature birth gives the baby less time to develop in the womb. Those born earlier, often have complicated medical problems.
Complications in Premature Babies
Premature babies have many severe complications that are very serious to their undeveloped bodies. Twin to Twin Transfusion is a serious disorder that occurs in identical twins and higher order multiples who share a placenta. This occurs when there is a connection in the two babies’ blood vessels of their shared placenta. This results in one baby (this twin is referred to as the recipient) receiving more blood flow, while the other baby (this twin is referred to as the donor) receives too little (Hoecker, 29 Dec. 2011). Infant jaundice is a yellow discoloration in a newborn baby's skin and eyes. Infant jaundice occurs because the baby's blood contains an excess of bilirubin (bil-ih-ROO-bin), a yellow-colored pigment of red blood cells. Feeding troubles in a preterm infant consists of inability to coordinate breathing, sucking and swallowing. Breathing problems most of the time have symptoms that appear within minutes of birth. However, they may not be seen for several hours. Symptoms may include:
Age of Mother Effecting Premature Labor
Mothers 16 and younger, or 35 and older are more likely to have premature babies (Ekwo, 06 November 2013). This is due to the younger girls getting pregnant have undeveloped uteruses making it harder for babies to grow to full development because there is not enough space in the placenta. Mothers over 35 are more at risk because they have an older uterus not giving the baby enough nutrients to grow to full development (Macdonald 23 October 2014).
Personal Parent Story
Parents that have premature babies deal with an extreme amount of stress. These parents have to spend a lot of time in the hospital keeping them out of work. Being in the hospital this long and not working puts parents in debt. Also every 1 out of 8 babies are born premature in the United States each year(March of Dimes, 23 October 2014) and feel responsible for their death feeling as if there is something they could have done. I was able to talk to a mother who had a premature baby and she told me about the way she felt during her time in the NICU. She had to deliver her child at 25 weeks gestation in Dartmouth Hitchcock Hospital. Going into labor she said all she could think of is do I save this child who i've had a name picked out for, for so long and I have her room all set up or do I let her go and not suffer to try and stay alive. She explained that you don't know that real feeling until you have a child of your own and that although she was thinking it, she could not say it out loud because she didn't want to feel responsible for making the wrong decision. They delivered her child and began to resuscitate her. The mother told us how comfortable she felt in the NICU and how she always knew her child was getting the best care she could get. Unfortunately she lost her daughter 16 days after her birth, however she is able to tell about her time there and what she went through as a parent and the decisions she had to make concerning her daughter.
Decision Making
Many parents have to make a decision if they do everything they can do to save their child or if they arrest (a stoppage or sudden cessation of motion) if they should stop and not try to revive them. Many parents have to make this decision knowing that if they revive their child, their child will grow up with many physical problems and will most likely not be capable of walking, talking, or eating on their own. Choosing that lifestyle for your child includes a lot of money because parents have to hire a nurse to come in and take care of the child and equipment, they would also have to pay for the machines that the child will be on for their whole life.
Bringing your Child Home
Bringing a premature baby home is a lot of work for parents they have to make sure they have an outpatient nurse coming to check on the baby and the equipment being used on the child such as oxygen and cardiac monitors. They also have to bring the baby to many doctors appointments and child growth development programs to insure that these babies grow up to have no problems with their development. Equipment that parents have to have in order to bring their child home includes:
Complications in Premature Babies
Premature babies have many severe complications that are very serious to their undeveloped bodies. Twin to Twin Transfusion is a serious disorder that occurs in identical twins and higher order multiples who share a placenta. This occurs when there is a connection in the two babies’ blood vessels of their shared placenta. This results in one baby (this twin is referred to as the recipient) receiving more blood flow, while the other baby (this twin is referred to as the donor) receives too little (Hoecker, 29 Dec. 2011). Infant jaundice is a yellow discoloration in a newborn baby's skin and eyes. Infant jaundice occurs because the baby's blood contains an excess of bilirubin (bil-ih-ROO-bin), a yellow-colored pigment of red blood cells. Feeding troubles in a preterm infant consists of inability to coordinate breathing, sucking and swallowing. Breathing problems most of the time have symptoms that appear within minutes of birth. However, they may not be seen for several hours. Symptoms may include:
- Bluish color of the skin and mucus membranes (cyanosis)
- Brief stop in breathing (apnea)
- Decreased urine output
- Grunting
- Nasal flaring
- Rapid breathing
- Shallow breathing
- Shortness of breath and grunting sounds while breathing
- Unusual breathing movement (such as drawing back of the chest muscles with breathing)
Age of Mother Effecting Premature Labor
Mothers 16 and younger, or 35 and older are more likely to have premature babies (Ekwo, 06 November 2013). This is due to the younger girls getting pregnant have undeveloped uteruses making it harder for babies to grow to full development because there is not enough space in the placenta. Mothers over 35 are more at risk because they have an older uterus not giving the baby enough nutrients to grow to full development (Macdonald 23 October 2014).
Personal Parent Story
Parents that have premature babies deal with an extreme amount of stress. These parents have to spend a lot of time in the hospital keeping them out of work. Being in the hospital this long and not working puts parents in debt. Also every 1 out of 8 babies are born premature in the United States each year(March of Dimes, 23 October 2014) and feel responsible for their death feeling as if there is something they could have done. I was able to talk to a mother who had a premature baby and she told me about the way she felt during her time in the NICU. She had to deliver her child at 25 weeks gestation in Dartmouth Hitchcock Hospital. Going into labor she said all she could think of is do I save this child who i've had a name picked out for, for so long and I have her room all set up or do I let her go and not suffer to try and stay alive. She explained that you don't know that real feeling until you have a child of your own and that although she was thinking it, she could not say it out loud because she didn't want to feel responsible for making the wrong decision. They delivered her child and began to resuscitate her. The mother told us how comfortable she felt in the NICU and how she always knew her child was getting the best care she could get. Unfortunately she lost her daughter 16 days after her birth, however she is able to tell about her time there and what she went through as a parent and the decisions she had to make concerning her daughter.
Decision Making
Many parents have to make a decision if they do everything they can do to save their child or if they arrest (a stoppage or sudden cessation of motion) if they should stop and not try to revive them. Many parents have to make this decision knowing that if they revive their child, their child will grow up with many physical problems and will most likely not be capable of walking, talking, or eating on their own. Choosing that lifestyle for your child includes a lot of money because parents have to hire a nurse to come in and take care of the child and equipment, they would also have to pay for the machines that the child will be on for their whole life.
Bringing your Child Home
Bringing a premature baby home is a lot of work for parents they have to make sure they have an outpatient nurse coming to check on the baby and the equipment being used on the child such as oxygen and cardiac monitors. They also have to bring the baby to many doctors appointments and child growth development programs to insure that these babies grow up to have no problems with their development. Equipment that parents have to have in order to bring their child home includes:
- Endotracheal tube – This is a tube that is placed down the newborn’s windpipe in order to deliver warm, humidified air and oxygen.
- Ventilator – This machine is sometimes referred to as a respirator. It is the breathing machine connected to the endotracheal tube that can monitor the amount of oxygen, air pressure and number of breaths.
- Continuous Positive Airway Pressure (C-PAP) – This method is used for babies who can breathe on their own but need help getting air to their lungs.
- Oxygen hood – This a clear plastic box that is placed over the baby’s head and is attached to a tube that pumps oxygen to the baby.
- Intravenous lines – These lines carry nutrition directly into the baby’s blood stream. They are used for premature babies who have immature digestive systems and are unable to suck, swallow and breathe normally. This method is sometimes used when treatment for other health complications is being implemented. This approach utilizes an IV that may be placed in the scalp, arm or leg.
- Umbilical catheter – This painless method involves a tube that is surgically placed into a vessel of the umbilical cord. However, there are risks associated with this method that include infection and blood clots. Therefore, the method is normally used only in the most critical cases and where the baby might need this type of feeding for several weeks. For these babies, it is the safest and most effective way to receive nutrients.
- Oral and nasal feeding – This method utilizes a narrow flexible tube that is threaded through their nose (nasogastric tube) or mouth (orogastric tube). It is a solution for babies who are ready to digest breast milk or formula but not yet able to suck, swallow and breathe in a coordinated manner.
- Central line (sometimes referred to as a PICC line) – This is an intravenous line that is inserted into a vein, often in the arm, that allows the use of a larger vein. This is a method of delivering nutrients and medicines that might otherwise irritate smaller veins
- Incubator – Incubators are clear plastic cribs that keep babies warm and help protect them from germs and noise.