Newborns Can Experience PTSD Following Hospitalization

Ruchi Kaushik, MD, MPH, Medical Director, ComP-CaN (Comprehensive Peds for Complex Needs); Medical Director, The Children’s Hospital of San Antonio Blog; Assistant Professor, Pediatrics, Baylor College of Medicine

June 27 is Post-traumatic Stress Disorder Awareness Day; PTSD is a mental health diagnosis that you have likely heard, particularly among the men and women who have served in the armed services. But did you know that premature babies can have a form of post-traumatic stress after staying in the neonatal intensive care unit (NICU)?  The trauma, or “early adverse experiences,” from a NICU stay can affect your premature baby’s health, development, and behavior.

Why is a NICU stay traumatic? NICU stays can be traumatic for a variety of reasons:

Stimulation  Babies do not tolerate being overstimulated. Flashing lights, beeping monitors, constant alarms sounds in the NICU can cause a premature baby to suddenly pause in breathing and also result in frequent increases and decreases in heart rate, blood pressure, and oxygen levels.

Procedures  The procedures performed in the NICU are life-saving, but they do have consequences.  In addition to having a tube placed in the airway to help a baby breathe, there are many procedures that cause pain such as placing an IV or undergoing surgery.  These “skin-breaking” procedures can affect a baby’s normal development.

Separation from Mom  Although necessary, separating a premature baby from mom interferes with bonding and can affect the baby’s normal stress responses.  This means that a premature baby’s response to stress may be excessive (prolonged crying, more severe separation anxiety, etc.) compared to that of a baby who was not premature and in the NICU.

What can I do to lessen the effects of this trauma?

The best studied technique to improve the impact of trauma on a premature baby in the NICU is skin-to-skin (or kangaroo) care.  To perform skin-to-skin care, the baby is wearing only a diaper and is held upright on her belly against mom’s chest.  Indeed, in animals, being sensitively touched soon after having been born results in less production of the body’s stress hormones (steroids).

Other methods to decrease stimulation include covering incubators with blankets to reduce light exposure, removing noisy equipment from the area if not necessary, and using sound-absorbing panels if they are available.

Although the  NICU experience is necessary to help save a premature baby’s life, as a parent, you can do their part to lessen the effects of this trauma by being aware that this is a problem, providing skin-to-skin care as often as possible, and always responding quickly to your baby’s needs so your baby feels safe and secure with you once you go home.

Beating the Summer Slide

By Tiffany Ponzio, M.D., Resident, Baylor College of Medicine, PGY3

When you hear “summer slide” you may think of water slides, slip ‘n slides, or slides into second base, but there’s a far more dangerous slide you should know about. “The summer slide,” otherwise known as summer learning loss, can happen to children while they are off during the summer months.

Some facts about the summer slide:

• Children lose two to three months of reading development over the summer if they do not read.
• Most students lose two months of math skills every summer.
• Students from low-income households, who often have less access to books, are most likely to fall behind their peers.
• A three-month gap in reading achievement exists between low-income and middle-income children following the summer break.
• Over time, these months turn to years. By the time children enter middle school, a two-year gap in reading skills develops between kids who read during the summer and those who do not.
• On average, teachers will spend the first four to six weeks of a new school year re-teaching lessons in an attempt to get children caught up.

How to beat the summer slide:

• Visit your local library. Many local libraries offer free summer reading programs for kids that include not only access to lots of books but arts and crafts and other fun activities to encourage reading.
• Make learning fun. Find books that your kids really love (topics that interest them such as comic books, dinosaurs, fantasy, etc.), or offer rewards when they complete at least 20-30 minutes of reading each day.
• Look for math opportunities. Math is all around us. At the grocery store, children can count items in the shopping cart and add up the prices.
• Cook together. Spending time in the kitchen involves both reading and math skills. Children can help out by reading recipes and measuring ingredients. Find healthy delicious recipes on The Children’s Hospital of San Antonio CHEF website.
• Lead by example! If a child sees you reading for fun, they will likely want to do the same.

If you are concerned about your child’s summer slide, talk to your pediatrician for more tips. If you need a pediatrician, check out our online referral: www.chofsa.org/findadoc.