As many of you are putting away holiday decorations and enjoying the unseasonably warm temperatures this week, don't let this warm Texas winter weather fool you...RSV and Flu season is still here!

Unfortunately, I heard from several NICU graduate families over the holidays who were fighting off various "bugs" this year.  So, please be sure to take precautions with your little one.  What can you do?

1. Be sure to get your baby's Synagis shot on-time (if he/she is receiving them).

2. Lots...and lots...and lots...of handwashing!

3. Avoid large crowds (as much as possible).

4. Clean surface areas around your home with disinfectants frequently.

5.  Do not allow anyone with cold or flu symptoms around your high-risk baby.

Check out these links for symptom information and recent RSV stats:

http://www.cdc.gov/rsv/about/symptoms.html

http://txpeds.org/sites/txpeds.org/files/documents/RSV-and-Flu-11262011.pdf

Stay Healthy!

Julie Hudson, MSN, RN

NCBH NICU

Flu season is here again.....and flu shots are available! 

According the the CDC website, flu seasons are unpredictable but begin as early as October. The vaccine is already available in San Antonio, so that means it is time for everyone to get his/her shot!  "It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza virus infection" (CDC, 2011).

All of our NICU nurses and staff receive the vaccination each year, in order to protect our high risk population of patients.  For NICU parents and families this is an important step that may prevent your infant from getting sick.  The national recommendation is that anyone over the age of 6 months get a flu vaccination.  "It’s especially important that certain people get vaccinated either because they are at high risk of having serious flu–related complications or because they live with or care for people at high risk for developing flu–related complications.

• Pregnant women
• Children younger than 5, but especially children younger than 2 years old
• People 50 years of age and older
• People of any age with certain chronic medical conditions
• People who live in nursing homes and other long–term care facilities
• People who live with or care for those at high risk for complications from flu, including:
  • Health care workers
  • Household contacts of persons at high risk for complications from the flu
  • Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated) (CDC, 2011)."

Most physician offices, medical clinics, and even pharmacies are offering flu shots right now.  Some insurance companies and Medicare plans will also cover the expense of a vaccine.

If you are a NICU family member, please consider getting your flu shot right away.

Have a comment or story to share?  Email me or leave a comment for us all (using the comment link below).

Julie Hudson, MSN, RN
NCBH NICU

Reference
CDC. (2011). 2011-12 Influenza and vaccine and vaccination information.  From www.cdc.gov/flu/flu_vaccine_updates.htm

This week I received a photo of one of our NICU grads on his way to his first day in daycare.  It was a big day for the whole family.  For many of our graduates, the first day of "school" is a long-time coming.  For those of you who do not know this, many premature infants (and some term ones too) have long-term respiratory issues.  This makes them more susceptible to all kinds of respiratory illnesses.  For this reason (and others), it is usually recommended that NICU infants not be exposed to large crowds, sick people, small children, or daycare centers until their systems are more mature.

Why are they more susceptible?  Scientists and researchers have been asking that for years.  They also want to find out just how long this increased susceptibility lasts.  One study found that premature infants (30-34 weeks) had decreased lung capacity up to two years after birth compared to term infants and that premature infants' lung growth does not "catch-up" (Friedrich, et al., 2007).  A 2010 study on infants born at 25 weeks or less found:
"At 11 years of age, 56% of children born before 25⁺⁶ weeks of gestation had abnormal baseline spirometry,27% had a positive bronchodilator response, and 25% had a diagnosis of asthma (twice that observed in classmates). Among the 65% of extremely preterm children who had been asymptomatic over the previous 12 months, 48% had abnormal baseline spirometry, of whom 81% had prior bronchopulmonary dysplasia, emphasizing the need for continued monitoring of these children" (Fawke, et al., 2010).

This means that parents of preemies need to be vigilant about infection control (such as handwashing and exposure to others) and monitoring of their baby's respiratory status.  Immunizations and RSV prophylaxis (for those that qualify) are important things to discuss with your pediatrician.  

Little is known about more recent NICU grads' long-term respiratory function.  As Fawke, et al. (2010) pointed out, recent graduates are typically more immature, but have been exposed to "less agressive ventilatory support". 
We have come a long way in neonatology practice and we still have more to learn.  It is hoped that in years to come these statistics will be very different.....we'll have to watch and see.

Julie Hudson, MSN, RN
NCBH NICU

References

Fawke, J., Lum, S. Kirkby, J. Hennessy, E., Marlow, N., Rowell, V., Thomas, S. and Stocks, J. (2010).  Lung function and respiratory symptoms at 11 years in children born extremely premature:  The EPICure program.  American Journal of Respiratory and Critical Care Medicine, 182, 237-245.

Friedrich, L., Pitrez, P.M., Stein, R.T., Goldani, M., Tepper, R. and Jones, M.H.  Growth rate of lung function in healthy preterm infants.  American Journal of Respiratory and Critical Care Medicine, 176, 1269-1273.

Was that a sneeze?...the sniffles?....a cough?

“It’s the Most Wonderful Time of the Year” , but “Baby, It’s Cold Outside”!   As mentioned in one of the October blogs, tis the season for RSV and the flu.  Because infants are still trying to build an immune system, they are especially vulnerable to infection.  Premature infants and those with chronic lung disease are even more at risk.  A cold or the flu can have devastating effects on your babies, so it is very important that we take extra care during this season.

If you have visited the NICU lately, you may have noticed that we are now screening all visitors for cold/flu-like symptoms.  It is very important for your baby (as well as all of our NICU babies) that you do not come into the NICU (or allow visitors to) if you have any signs of illness.

How do you know if it is “Jack Frost nipping at your nose” or “The Holly and the Ivy” that is making it twitch?  We all know how difficult it sometimes is to distinguish between allergies and a cold….please err on the side of caution and do not take the chance of exposing your baby (or others).  We will be happy to keep you updated on your baby via the telephone while you recover. 

We want you to have “That Holiday Feeling” and not that icky feeling of a cold or flu.  Please ensure that you are washing your hands frequently, getting plenty of vitamins, and healthy foods and drinks.  If you are sick or have been, please remember to bring in a copy of your doctor’s note that clears you to visit the NICU again. 

“It’s Christmas Time All Over the World”, so “Have Yourself a Merry Little Christmas” and be well.

Please drop me a line if you have questions or comments.  I would love to hear from you.

Julie Hudson, BSN, RN
NCBH NICU

**For more Christmas song titles, see: http://en.wikipedia.org/wiki/List_of_Christmas_hit_singles