Prematurity Awareness Month: Mind/Body Medicine in the NICU

November is Prematurity Awareness Month and I’m pleased to have a guest post from OB/GYN and author, Dr. Jennifer Gunter, about prematurity and “mind-body medicine in the NICU.”

Mind-Body Connection

The mind-body connection is the idea that our thoughts and emotions impact our health. When we are stressed, anxious, or depressed our brain releases different combinations of chemicals and hormones that affect every organ system. Because mom and baby share a physical bond before birth as well as close emotional bond after birth, the mind-body connection is very important both during pregnancy and after delivery.

Studies show depression, stress, and anxiety during pregnancy increase the risk of preeclampsia (high-blood pressure) and premature delivery and can also lead to smaller babies. The American Congress of Obstetricians and Gynecologists recommends routine screening for depression as 14-23% of pregnant women are affected. There are many treatment options and getting help can improve your baby’s health. Remember, if you feel better it will benefit your baby.

It is intuitive that a mother’s emotional health can affect her pregnancy. After all, there is an intimate and prolonged physical connection. But how can this be the case after delivery? Have you ever been in a room with an anxious person or someone who is very depressed and felt your mood change? Our moods are influenced by the emotions of others and this is especially true with a mother and her newborn. When a mom is stressed, her baby is more likely to have abnormal levels of stress hormones. Some of the physical effects of mom’s (and dad’s too) stress on baby include increased colic, disturbed sleep patterns, feeding problems, and developmental concerns.

While reducing stress is important for everyone, premature babies appear to be especially vulnerable to the negative effects. This is because premature babies are not only exposed to physical stress from illness, the physical effects of a premature birth, and the intense medical care in the neonatal intensive care unit (NICU), but because their nervous system is immature they’re less able to mount any kind of protective responses.

Fortunately, this mind-body connection can be harnessed to facilitate wellness, even for a baby in the NICU. Positive thoughts, taming the stress response, and working towards emotional wellbeing promotes the best chemical and hormonal responses, which can positively impact your premature baby’s health.

The first thing is to work on your own emotional health, because up to 40% of mothers with a premature baby develop post partum depression and up to 75% develop post-traumatic stress disorder (PTSD). Make sure you are screened for post partum depression and if you are feeling stressed, anxious or are having flashbacks, ask for help from the social worker, your OB/GYN, or therapist if you already have one.

Don’t neglect your physical health. While you may be deconditioned from bed rest and/or the physical recovery from your delivery, try to get outside two or three times a day for fresh air and as you get stronger, think about some short walks or other physical activity. Make sure you do your best to eat right (it’s hard when your baby is in the hospital, but processed foots and skipping meals will make you feel worse) and get enough sleep. It is better be well rested and in control for 5 hours in the neonatal intensive care unit than be exhausted and nonfunctional for ten hours. Remember, taking care of yourself is taking care of your baby.

Try one or two techniques to reduce stress every day, and then gradually add in others as your mood and emotions dictate.

  • Breath from your diaphragm. When we are stressed we breathe with our chest muscles instead of breathing from the diaphragm (also called belly breathing). Takes some time several times a day to practice deep, cleansing belly breaths for a few minutes. Put your hand on your belly and focus on taking deep, natural breaths—if your belly is moving up and down you are doing it right.
  • Practice pausing. When you find your stress level rising, stop what you’re doing and shift your focus away from what you cannot change, such as oxygen levels and infection, and focus on what you can influence, such as positive interactions with your baby or learning more about her condition.
  • Say affirmations, which are positive statements that when repeated help combat negative thoughts and feelings by reprogramming the unconscious mind. Podcasts and CDs are available. Affirmations can be found in books, on preprinted cards, and even services that will text affirmations to your cell phone. Another option is to buy a pack of 3 x 5 note cards and create your own. Some examples include, “I am strong and courageous,” and “I will share my spirit with my baby.”
  • Journal, because some thoughts are too hard to say out loud, but still need to be released. Write everything down on paper.
  • Keep your hands busy. Celebrate your baby with pictures and mementoes in a baby book. Knitting, crocheting, and sewing are also excellent stress relievers.

To maximize positive interaction and minimize stress on the nervous system it is also very important for a preemie parents to learn their baby’s stress cues.

  • Ask if your baby is stable enough for kangaroo care (holding your baby skin to skin). Your rhythms and warmth are soothing and healing (for both of you!).
  • Make eye contact, smile, and interact with your baby if your baby is ready to accept that kind of stimulation (your baby’s nurse will help you learn to read her cures so you can tell when she is physically receptive). Babies absorb every interaction (it actually helps program the nervous system), because of physical challenges many premature babies have fewer opportunities.
  • Offer a pacifier at regular intervals and any time your baby appears stressed. Sucking a pacifier is comforting for a premature baby and helps the developing nervous system form positive connections.

ABOUT THE AUTHOR:

Jennifer Gunter, MD, is an internationally renowned ob/gyn and leading expert in the field of women’s pain medicine.  She lives in Mill Valley, California. To see videos of Dr. Gunter and her preemie sons, Victor and Oliver, in action visit: www.preemieprimer.com.

From the press release for the book:

12.3 percent of babies are born prematurely every year in United States (March of Dimes), while in many northern European countries that rate is 5 percent — representing an alarming statistic as prematurity is the leading cause of death and disability for newborns. Not only that, but neonatal intensive care unit costs alone for premature babies are $6 billion a year, representing 47 percent of costs for all infant hospitalizations and 27 percent of all pediatric stays in hospital (Pediatrics, Oct 2010).

After rounds of fertilization treatments, Dr. Jennifer Gunter, ob/gyn, became pregnant with triplets. Twenty-two and a half weeks into her pregnancy she suddenly went into labor and delivered her first son, Aidan, who died just three minutes later.  Then something unexpectedhappened-she stopped delivering.  Nearly four weeks later, at week twenty-six, Jennifer delivered her sons, Oliver and Victor-weighing one pound eleven ounces and one pound thirteen ounces, respectively-and became a parent of preemies.

Approximately five hundred thousand babies are born prematurely every year in the United States. In fact, prematurity is the leading cause of death and disability for newborns. In The Preemie Primer: A Complete Guide for Parents of Premature Babies-from Birth through the Toddler Years and Beyond, Dr. Gunter provides a comprehensive resource that covers everything from delivery and hospitalization in the NICU to preemie development and parenting multiples-even discussing specific topics like finding a car seat for your preemie, setting special needs preemies up in school, and understanding insurance plans and medical billing.

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