If babies being born in the UAE in 2009 could choose, they’d all want to be born in the ‘City’. But especially so premature babies. Find out why.
The new City Hospital in Dubai Healthcare City doesn’t just dazzle the eye with glorious modern architecture and pretty patient rooms, it offers seriously high-tech equipment and facilities too. But the greatest benefits of all will come to the UAE’s tiniest population – premature and ill newborn babies – and their mothers.
Nobody ever plans to have a premature baby but with the rates of diabetes and preeclampsia being so high in the UAE, it’s best to play safe. And Martie Clayton, a qualified midwife and the nursing manager in charge of City Hospital’s maternity ward, is the safest bet a new mother could make.
We do kangaroo care for all our newborns, but it’s especially important for our premature babies. – Martie Clayton.
Her warm, caring personality is coupled with a firm grasp of all the intricacies of childbirth – and all the wisdom of having handled hundreds of complicated cases, in the UAE and overseas.
Previously based at The Corniche Hospital in Abu Dhabi, Clayton was handpicked to head the new maternity ward at City Hospital. Having witnessed firsthand the prevalence of preeclamptic births, she says, “Postpartum haemorrhages and preeclampsia are very prevalent in the UAE.”
She explains that the key to helping preeclamptic patients is identifying and treating the problem early on, and educating the patient about the treatment, to empower her, build trust and reduce stress for the family.
David Hadley, the patient-focused hospital director, is another reason City Hospital is destined to become the hospital of choice for discerning mums and dads-to-be. He clearly understands the tiniest patients’ needs.
When asked about neonatal care at City Hospital he first provides a fount of information on the extreme vulnerabilities of premature infants, such as: “For instance, in a tiny prem, if there is a loud bang, it can cause them to startle, their blood pressure shoots up and they can have a brain bleed (stroke). The same thing can happen with too much or improper handling.”
It’s little wonder then that the Giraffe OmniBed incubator system was a priority for the hospital’s neonatal ICU.
The nurturing Giraffe system
Used by the top paediatric hospitals in the US and UK, the Giraffe minimises the need to move or touch premature babies, so they remain temperature- and noise-protected, which is critical to their survival.
Hadley says, “The Giraffe incubator system is the most advanced in the world. It was designed by nurses, who understand that we need to try to create the most beneficial environment possible for the sick or premature infant.” So how exactly does the Giraffe system protect fragile, premature babies?
• It’s a two-in-one The Giraffe OmniBed converts from an overhead warmer to a closed incubator at the touch of a button. Many hospitals use open incubators and radiant warmers because it lets the nurses intervene quickly if there is a change in the baby’s condition. The problem then is that the baby is left exposed to high noise levels, unstable temperature control and excessive touching or handling
• Protection When the omnibed is closed, the baby is protected from the environment. The doors are double-walled to insulate against noise, and maintain a stable, neutral, thermal environment
• No need to move The omnibed has a built-in digital scale so the baby doesn’t need to be moved out of the warmth in order to be weighed
• Built-in humidifier Hadley says, “A humidifier is very important, especially in premature babies. Because their skin is underdeveloped they lose fluid through their skin, which causes all the electrolytes to become unstable and can cause them to become very ill. We nurse them in high levels of humidity (up to 80%). The humidity prevents them from ‘drying out'”
• Constant temperature control This ensures the baby is kept warm, even when the lid is lifted up
• Great for surgery The mattress can swivel 360° which is convenient for surgery and the heater warms a wider area so that the baby is not exposed to cold during surgery
• The bed lifts, lowers and rotates – the baby doesn’t When one of the doors is down, a mother can almost sit with her entire upper body in the incubator, and when the bed lifts it enables easy access for surgeons. Babies can be viewed from all angles without being picked up.
Preeclampsia usually starts after the 20th week of pregnancy and is related to increased blood pressure and protein in the mother’s urine. It affects the placenta, and can affect the mother’s kidney, liver, and brain. It can also cause seizures and is the second leading cause of maternal death in the US. Preeclampsia is a leading cause of low birth weight, premature birth, and stillbirth.
When less blood is delivered to the mother’s uterus, it can mean problems for the baby, such as poor growth, too little amniotic fluid, and the placenta separating from the uterine wall before delivery. There is no known way to prevent preeclampsia but diabetes patients are at higher risk. The only way to “cure” preeclampsia is to safely deliver the baby.
Kangaroo care for newborns
But giraffes aren’t the only wildlife making an impact on neonatal care worldwide. Studies have shown that newborns receive immense benefit from being cradled on their mother’s chests, skin-to-skin.
And this kind of mothering has been called “kangaroo care”, because it resembles how a mother kangaroo holds her child in her tummy, keeping it snug and warm. To Clayton’s knowledge, City Hospital is the only facility in the UAE to offer this valuable kind of care programme.
She says, “We encourage mothers and fathers to take part in our kangaroo care programme. We do kangaroo care for all our newborns, but it’s especially important for our premature babies – to assist with their development and promote breastfeeding. It’s also the most natural form of bonding between mother, father and newborn.
“We have had special wrappers made for our kangaroo programme in the unit. The newborn is placed securely on their parent’s chest and can suckle and feed on demand. From then on their body temperature is controlled, they are really comfortable and can listen to their parent’s heartbeat and breathing. In this ‘kangaroo’ position, they get food, security, warmth and love, all at the same time.”
Dedicated to childbirth
With all the special care given to newborns it’s not surprising that, as Hadley says, “One of the hospital’s main focus areas is maternity.” Indeed, City Hospital is one of the largest private maternity facilities in the UAE, with six labour and delivery rooms, 12 postnatal beds, a caesarean theatre, 12 neonatal ICU beds and a nursery – all on the same floor. A laboratory and radiology department are also on-site for added convenience.
The neonatal unit is located right next to the caesar theatres and delivery rooms, ensuring immediate care for newborns. And it’s the first neonatal ICU in the UAE to be accredited for level 3 babies, which means that it can accept babies from 28 weeks.
Hadley adds, “We have on-site lactation consultants and a dedicated midwife available 24/7 for breastfeeding and other, related ‘new mom’ problems. Paediatricians are also available around the clock, seven days a week, as are many other associated specialists, such as a diabetic nurse educator.”
Naturally, all the doctors and nursing staff in the maternity, paediatric and neonatal units have been accredited according to Dubai Healthcare City’s worldclass standards.
Apart from the peace of mind that comes from knowing emergency care is of the highest standard, expectant mums can expect a great deal of comfort when they deliver at City Hospital. The maternity unit décor is attractive and more reminiscent of a hotel than a hospital, while the luxury suites are beyond compare in the UAE.
Hadley says, “All new mums receive baby bags, start-up packs and various other goodies, but most of all good clinical service. All our wards have rooming-in facilities – for the dads. We also have luxury suites available, that are able to take maternity cases.”
With all these obvious assets, one would imagine that City Hospital will soon become so popular for childbirth that parents will be queuing up. So how many deliveries can City Hospital manage?
Hadley replies: “We can take in excess of 200 deliveries per month. We also have access to other floors if the existing 12 beds are full.”
Which is just as well, because my guess is that the queue is already forming.
• Very little body fat Premature babies have very little body fat so they can’t maintain their own temperature. If they are not kept warm by an incubator, they use valuable energy to keep warm – energy that should be used to convert food into fat and help them put on valuable weight.
• Low body temperature If premature babies have a low body temperature it can affect other vital organ functions – even slowing down their breathing.
• Prone to bleeding Premature babies are so fragile that they are prone to bleeding just from being moved.
• Very underdeveloped sensory and nervous systems. These babies can’t cope with too many stimuli. They can’t multitask and when overwhelmed by stimuli they shut down and become unstable. If they receive too much negative stimuli, such as from having prolonged high noise levels around them or too much bright light, it can cause them to stop breathing, breathe too fast or vomit, among other things.
• Can’t handle bright light Babies born before 36 weeks can’t constrict their pupils. So prolonged periods of bright or fluorescent light will cause pain and can cause blindness.
• Noise can be deadly as it disturbs premature babies’ sleep cycles, metabolism and vital signs. A loud noise can cause them to startle, their blood pressure will shoot up and they can have a stroke. The same thing can occur with incorrect handling.
• Their skins are underdeveloped which means that even the lightest touch can cause them pain.
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