Cradle of Life

Cradle of Life

The smallest patients at Yale New Haven Children’s Hospital weigh as little as one pound. Brand new to the world, they’re especially vulnerable. Now a state-of-the-art neonatal intensive care unit, opened in January, aims to lower the stress of these needier newborns and their parents with more privacy, more daylight and more family time.

The entrance to the new unit is colorful and inviting. A giant, pale blue seashell adorns the huge glass doors that admitted me and my tour guides: Dr. Matthew Bizzarro, medical director of the unit and a professor of pediatrics at Yale University School of Medicine, and Dr. Mark Mercurio, chief of neonatal-perinatal medicine at the hospital and director of the medical school’s program for biomedical ethics. About 6,000 babies are born every year at Yale, including the Saint Raphael campus, and about 900 of them are sent to the intensive care unit, which can care for up to 68 babies at once, for stays of a few days to nearly a year.

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The unit was nearly full on the afternoon of my visit, but you wouldn’t have guessed it. The halls were quiet and calm. A few nurses could be seen at the team work areas or through the interior windows of patient rooms. One looked up from feeding a baby to smile at us. From another incubator in the same room, the baby’s twin wailed a hardy newborn cry. A two-year-old big sister stood in one doorway and gazed at us with big eyes as if she might be guarding her baby brother’s space. Later, I was invited in to say hello to her family, the Sanseverinos, whose infant son had been in the unit for 63 days. He has since gone home and is reported to be doing well.

Mom Kristina Sanseverino appreciated the amenities of the new setup. “It’s just nice because we can come up with our families, we can bring in here, we can have alone time,” she said. “It’s hard enough leaving your child here. So coming here and being able to have this time alone… just makes it a little more comforting, like home.” A large, bright window in the baby’s room looked out over the city. Beneath it was a couch with a built-in table that converts to a bed for parents to stay overnight.

It’s a far cry from the old neonatal intensive care unit Bizzarro describes. Built in 1992 and at that time “the standard of care,” it had five large rooms with 12 bays each. There were no doors or even privacy curtains and no windows. There was barely room to squeeze in equipment when it was needed. When one baby was in crisis, every family suffered. “They basically had this giant shared experience of fear,” Mercurio says. However, the old model worked for nurses, who could keep an eye on all of their tiny patients at once.

Mercurio says the nurses worried at first about the new setup: semicircular clusters, most with 10 rooms, around central work stations. But new technology, including a central monitor displaying every baby’s vital signs and an app on every caregiver’s cell phone to notify them immediately of emergencies, allayed their fears. The system, Mercurio says,provides “safety nets below safety nets, and safety nets below those.”

“A lot of us actually really are enjoying having the privacy for the families,” nurse Kristen Fulton told me on my visit. The new setting makes it possible, she said, for families to “have more personalized care.” And seeing the light of day is good for staff as well as families. For the first couple of weeks, Fulton said, the nurses were drawn to the windows every morning because their old unit had never given them a view outside.

One reason the previous unit outgrew its space, Bizzarro says, is an improved survival rate for babies born earlier. Care of those infants is more complex, and they tend to stay longer as a result. Meanwhile, as “the babies got smaller, the equipment around the bedside got bigger,” he says.

Doctors visited other neonatal units around the country in order to learn from their experiences, Bizzarro says. Yale’s includes its own procedure room and pharmacy and will soon have its own custom-designed MRI for infants. A milk room logs and labels the breast milk mothers bring in, fortifies it if necessary and delivers it daily to patient rooms. There are 10 double rooms to accommodate twins and four isolation rooms for babies with respiratory illnesses. In addition to the spacious private suites, families can gather in a small community room with a kitchen and laundry.

Perhaps the most innovative addition is eight “couplet care” rooms, where low-risk mothers can be admitted postpartum with babies expected to need intensive care for just a short period. That means some mothers with babies needing intensive care don’t have to be separated from them. No other Level 3/4, or highest-level, unit in the country currently has such a setup.

For all its bells and whistles, both literal and figurative, it may be that what Yale’s new neonatal intensive care unit does best is the most basic thing of all: putting newborn babies in their parents’ arms.

Neonatal Intensive Care Unit
Yale New Haven Children’s Hospital – 1 Park St, New Haven (map)
(203) 688-4242…

Written by Kathy Leonard Czepiel. Image 1 photographed by Kathy Leonard Czepiel. Images 2 and 3 provided courtesy of Yale New Haven Children’s Hospital.

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