Setting Families Up for Breastfeeding Success

Every day, at 9 am and 9 pm, the nurses on the mother/baby unit at the University of Maryland Medical Center (UMMC) huddle for what they call the “Milk Minute.” They gather to exchange breastfeeding tips and other helpful information. This quick, daily training encourages communication between day and night shift staff, and keeps breastfeeding best practices top of mind.

Why the emphasis on breastfeeding? It can significantly reduce infant mortality rates, as well as childhood obesity and related chronic diseases in adulthood.

Based on research, staff has worked to modify practices in order to change the breastfeeding culture.  Why? Clinical practices and processes have evolved to promote success in infant/mom bonding and breastfeeding. This includes skin-to-skin contact, rooming in, and educating moms on baby’s feeding cues.

Here are some changes you may notice:

OLD WAY BABY-FRIENDLY WAY
Historically, it had been standard practice for newborns to receive a lot of their care in the nursery – away from their mothers. This practice unintentionally created a barrier to breastfeeding and newborn care education. Babies spend as much time as possible with their mothers. In fact, within five minutes of delivery, the infant is placed on the mother’s chest. After delivery, mom and baby are transferred to the mother-baby unit and room in together. Almost all of baby’s tests and procedures happen at the mother’s bedside.
OLD WAY BABY-FRIENDLY WAY
During daily rounds, the mother-baby care team used to bring all the babies into the nursery (away from their mothers) for assessment. If the babies cried, they would be given pacifiers. The care team visits each mother and baby in their hospital room and exams take place there with mom and other family members present. This process takes longer, but allows for better dialogue and education.
OLD WAY BABY-FRIENDLY WAY
All staff members had basic breastfeeding training. Lactation consultants were called in to visit breastfeeding mothers while in the hospital. All staff members have received additional education and are considered breastfeeding experts. They are equipped to provide moms with 24/7 breastfeeding education and support. Lactation consultants are still available for moms who need more intensive support.

New parents are often worried about whether their babies are getting enough to eat during breastfeeding. Staff use the picture chart below to help parents understand that newborns have tiny stomachs and that breastfeeding allows them to naturally stop eating when satisfied.

 

 

 

 

 

 

 

 

Breastfeeding success starts even before baby is born. Doctors discuss infant-feeding choices with moms-to-be during their prenatal care appointments. UMMC offers free breastfeeding classes for women receiving prenatal care at University of Maryland Redwood office, Penn St. office, Edmonson office, or Family Medicine. Once at the hospital for delivery, mothers continue learning about the benefits of breastfeeding from nurses.

A breastfeeding support group is also available so women have the opportunity to discuss any challenges they’re having with a breastfeeding expert. The support group meets every Thursday from noon to 1 pm at 29 S. Paca St. Moms can also get breastfeeding help by calling the UMMC Warmline at 410-328-3512 or emailing their questions to lactationsupport@umm.edu.

The Stork’s Nest, sponsored by the March of Dimes and Zeta Phi Beta, is a program that provides education to moms living in West Baltimore. Mothers are awarded points when they attend classes, attend prenatal care appointments and adopt healthy behaviors like breastfeeding. The points can be used toward baby items such as diapers, a playpen, a breast pump, and more.

Learn more about breastfeeding.

Birthday Surprise Lifts Spirits of Long-Term Cardiovascular Patient

Team members celebrate with Mr. Boyd

When a hospital stay extends past six months, it can be hard to keep a patient thinking positively. Especially so on special days like birthdays. So, when Mr. Boyd, who has been in University of Maryland Medical Center’s in-patient Cardiac Progressive Care Unit for more than 250 days, had a birthday coming up, the unit staff knew they wanted to do something special.

The team planned a surprise birthday party for weeks, raising money amongst themselves for decorations, food, and of course, a birthday cake. They also invited Mr. Boyd’s friends and family to join in the party.

On the day of the surprise party, the interdisciplinary team decked out the conference room with tropical-themed décor. They even put together a photo booth area. Social worker Sarah Downs explains, “We put together a photo booth with props and a background. I brought a Polaroid camera to take instant photos so we can put together a scrapbook for Mr. Boyd with pages from each of the team members.”

The team came together to purchase more gifts for Mr. Boyd, including a foot pedal exercise bike and a tablet; items that will keep him busy and active while in the hospital.

Mr. Boyd enters the party completely surprised!

After all the planning, the only thing left was to get Mr. Boyd to the conference room without ruining the surprise. Under the ruse that they were taking him on a walk outside, unit nurses brought Mr. Boyd to the conference room. Upon seeing everyone gathered in the room decorated for his birthday, he was truly blown away, repeating, “They got me good, they all got me!”

After the initial surprise, Mr. Boyd took pictures with the care team and his friends and family. He remarked, “Thank you to the team. They are all really special to me.”

Then, he began to list and point to the team members that he feels close to, but it became clear that he would end up listing everyone in the room. The surprise was filled with emotion, but the scene quickly became that of a party with excited chatter, laughter, and friends enjoying each other’s company.

By throwing this surprise party, the Cardiac Progressive Care Unit far surpassed expectations for a patient they have formed a special bond with. As interim nurse manager Julie Landon puts it, “He has really become a part of the family.”

A Gift of Thanks – 3 Years (and 43 Surgeries) Later

Grant (second from right) with part of the STC team and his parents

Three years ago, Grant Harrison was in a horrific motorcycle crash.  It was a bright sunny day on the Eastern Shore when a large deer struck the motorcycle Grant was riding.  He was airlifted to UMMC’s R Adams Cowley Shock Trauma Center with multiple life threating injuries.

The fact that he is alive today is nothing short of astonishing. Grant had a fractured skull, severe traumatic brain injury, bleeding of the brain and severe injuries to his limbs.

Grant spent 58 days on the Neurotrauma Critical Care Unit, and has had 43 surgeries on his road to recovery.

Grant is a now a walking, talking (and hilarious) miracle.

Exactly three years after the accident, June 6, 2017, Grant, along with his mother and father, wanted to give thanks to the nurses and doctors at Shock Trauma who showed them extraordinary compassion and care throughout this life-altering experience.

They brought the Shock Trauma team a framed thank you letter, along with photos documenting Grant’s journey to recovery.  The gift is now hung along the walls of the Neurotrauma Critical Care Unit, right outside the Patient Family Waiting Area.

The Harrison Family hopes that families pacing those halls (like they did many times 3 years ago), will read the testimony and find hope and encouragement.

Read a portion of the family’s letter below:

“The doctors and nurses here not only care for the patient, but for you, the family as well. They will always hold a special place in our hearts for their kindness and compassion. We encourage you to listen well to them, as they will educate and guide you through this unexpected journey. The Trauma Survivor’s Network, a resource offered through the hospital, was also most helpful to us.”

Grant with TRU Nurse Christopher Wentker

 

Ear, Nose & Throat Team Returns from Medical Mission after Cyclone Winston Rocks Fiji


A 12-person team of nurses, surgeons, residents and anesthesiologists from the University of Maryland Medical Center have returned from their medical mission in Fiji.   Team members performed 15 surgeries and saw 150 patients before Tropical Cyclone Winston rocked the islands.   Watch the video above to hear about the mission from the team themselves.

 

March of Dimes Thanks UMMC During Day of Gratitude

The March of Dimes recognized the University of Maryland Medical Center during their Day of Gratitude, Wednesday, Jan. 6. Staff at the UMMC Neonatal Intensive Care Unit (NICU) received a plaque to commemorate their efforts to support the March of Dimes mission to improve the health of babies.

UMMC is one of 33 Maryland hospitals to earn banner recognition from the March of Dimes as part of its “Healthy Babies are Worth the Wait” campaign, which aims to reduce the number of elective births before a full term of 39 weeks. The March of Dimes partners with the Maryland State Department of Health and Mental Hygiene and the Maryland Patient Safety Center to award banners.

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Left to right: Katie Stover (MoD), Jennifer Tarr (MoD),  Treza James, Joan Treacy, Caroline McGinnis, Danielle Luers, Dr. El-Metwally, Jane Munoz, Dr. Bearer, Sara Bielecki (MoD), Penelope Shields

Thanks to our staff for all you do to keep babies healthy!

Learn more about the NICU at the University of Maryland Children’s Hospital or visit the Maryland March of Dimes website.

 

Governor Larry Hogan Visits the Neonatal Intensive Care Unit

“Heading to my fifth round of five-day, 24-hour chemo this morning at the University of Maryland Medical System in Baltimore. As always thank you to everyone for your prayers and support during this journey!

Before my treatment I took some time to visit the brand-new, world-class Drs. Rouben and Violet Jiji Neonatal Intensive Care Unit at UMMS which officially opened on Tuesday. There I met families with children being treated at the NICU and listened to the stories of Baby Rebecca, Baby Ilyanna, and Baby Javion who are on the road to recovery following bouts with a range of health challenges such as infections, cardiac abnormalities, and abdominal complications. They are carefully cared for, with a balance of compassion and unparalleled clinical excellence!

The work these incredible doctors and nurses at the NICU do is amazing and they are saving lives every day! Please keep these families in your thoughts and prayers!”

-Governor Larry Hogan

Gov. Hogan NICU 1Gov. Hogan NICU 2Gov. Hogan NICU 3Gov. Hogan NICU 5Gov. Hogan NICU 6

 

Walkthrough of the New NICU


NICU_Signage

The new Drs. Rouben and Violet Jiji Neonatal Intensive Care Unit (NICU) has that new hospital look and feel. Everything in the space is new, from the lightbulbs to the intercoms, and smells like it just came out of the box.

NICU_huddleThe Jiji NICU is almost ready to welcome its first tiny patients, but with the lengthy checklist of pre-opening touchups, the nurses haven’t been allowed much time to see their new workspace. The agenda for today: familiarizing the nursing team with the new unit. Across a 48-hour span, every two hours, each of the unit’s 125 nurses will attend an orientation session like this one to get to know the Jiji NICU from the inside.

After a morning huddle in the spacious and bright team room, the nurses continue on for a physical orientation of the rooms. As everyone files into one side of an adjoining twin room, you can only hear the voices in the room itself. Noise absorbing windows, ceilings and floors blanket the unit and offer a respite from the outside Greene Street bustle. With the door closed, it is nearly impossible to hear voices from the hallway.

Twin_Room_AEach of the 52 rooms is thoughtfully designed, featuring fold-down couches for overnight guests and a designated breastmilk refrigerator. A grey provider zone and a white family zone are demarcated on the floor. These soft boundaries are representative of the team effort that will undoubtedly go into each patient’s care. Knowing that infants at the NICU may not see the outside world for some time, each room is equipped with circadian lighting to acclimate each baby to a standard sleep-wake cycle.

Concern for patient safety is also apparent in the design plans. Situated near each quad of rooms is a nursing station, at which patient vitals will be displayed and carefully monitored. Each nurse has been assigned to one of five neighborhoods, color-coded regions of the NICU that correspond to each of the five wings. Each neighborhood was also assigned a facilitator, a person in charge of monitoring the alarm system and making sure help goes to where it is needed.

The nurses then start training on the escalation alarm system. Colored lights sit above each door and throughout the hallways of each neighborhood. Each alarm has a different protocol. The three flashing orange lights for an urgent call are accompanied by a persistent “ding-dong” and are sent to all neighborhoods, whereas the single white light for a nurse call remains in one neighborhood. By the time the first patients come through the doors, nurses will know how to respond to each of the alarms.

Next up on the agenda: trips to different places in the hospital, including walking the most efficient route to labor and delivery. Floor plans and detailed way-finding maps line the hallway for reference, but everything is different in practice. Little details like time spent going to and from the elevator add up, and if the nurses know the best way to get from place to place, they can provide the most effective and attentive care for babies.

Scavenger_HuntThe final activity for this session is a scavenger hunt. To make sure the nurses know where to find things in their units and throughout the NICU as a whole, they divide up into groups and tick off items like the circadian light switches, EKG machines, bathrooms, stairwells and supply closets. As everyone finds their way around the unit and cross items off their lists, the confidence begins to build—within no time these professionals will be in the best shape to take care of the NICU’s most in-need patients. Pretty soon this place will be put to good use.

Watch Dr. Cynthia Bearer, division head of Pediatric Neonatology, give a virtual tour of the Jiji NICU:

 

The 52-room unit, specially designed by clinical staff, will open September 15th.

Nurses Run for their ‘Heart Kids’

By Jen Arrington, MS, RN, CPN, and Kristen Fantel, BSN, RN, CEN

On Oct. 12, 17 nurses and friends of the Pediatric Intensive Care Unit (PICU) will be running in the Baltimore Running Festival to raise money for the UMMC Children’s Heart Program. When people ask us why we run, there’s one easy answer. We run for patients like Brandon Kerrigan and all of the heart kids that we care for everyday.

When Brandon celebrated his 15th birthday on Aug. 16, no one had any idea that two days later he would be fighting for his life. Brandon was diagnosed with dilated cardiomyopathy, and went into cardiac arrest while being flown from Easton to the University of Maryland Children’s Hospital. Once Brandon was stabilized, his family was told that he would need a heart transplant. Since his arrival to the PICU, Brandon has been determined to get strong while he waits for his heart. He charms the nurses and staff with his bright smile and Nerf guns, just trying to be a normal 15-year-old, while cooped up in the hospital. You can see how charming he is in this picture of us with him at the bottom of our team page.

Brandon is only one example of a patient we are running for. We care for many cardiac patients in collaboration with the Children’s Heart Program. This program provides comprehensive cardiac care for children with a wide range of conditions — from rhythm abnormalities to childhood hypertension, from heart murmurs to serious birth defects requiring complicated heart surgery. While we care for these complex patients, they quickly become a part of our unit – we offer an encouraging smile to their parents in the hallway, we say our silent prayers. And on good days – we dodge Nerf guns as we enter the patient’s room.

The strength and resilience of these children, who battle against all odds, is simply inspiring. As nurses, we are often left with the feeling of wanting to do more. We carefully assess these patients for any changes in condition, we give medications, we advocate for their every need, and we attempt to play and create normalcy whenever we can. But we want to do more.

This is why we decided to run as part of the Children’s Heart Team. We don’t have a miracle drug and we can’t take away the heartache in the eyes of the parents of these patients. But we can run.

As with all of the patients we care for, the teamwork involved in the care of these patients is also inspiring. The team includes Nurses, Doctors, Child Life Specialists, Respiratory Therapists, OR and Cath Lab Staff, Rehabilitation Services – and many, many other people who deserve to be celebrated.

This strong team work was the inspiration for our fundraising efforts. We created a T-shirt that recognizes this team effort, and we are selling the T-shirt around the hospital in order to raise money for the Children’s Heart Program.

In addition to the shirt, we are also hosting a fundraiser at a local restaurant. Join us on Wednesday, Oct. 2, at Blue Hill Tavern in Canton. The restaurant will be donating 20% of its proceeds from the day to our cause. Schedule a lunch with your co-workers, dinner with your family, or join the PICU nurses for Happy Hour – and help an important cause.

Want to join us in our effort to do more? Contact us! Maybe today we can give back a little bit of the inspiration that we have received from these amazing children.

To make a donation: http://www.ummsfoundation.org/picuheart