Question from the NICU

2,455 Views | 13 Replies | Last: 5 yr ago by itsyourboypookie
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Not exactly a question on Covid but on the ramifications that Covid may have on the situation, and I'm thinking it would be useful if some of the medical professionals on this board could share their opinion.

Daughter in law was induced this past Monday. She only pushed 7 minutes and in her words "she popped right out". The doctor then admitted the beautiful baby to the NICU and put her on a CPAP to "clear her lungs". The doctor said that usually the lungs clear as a result of the labor process but with a short period of intense pushing her lungs didn't clear. But here's where it gets strange. They soon diagnosed her with apnea, i.e. short periods where she stopped breathing. So she was seen by a respiratory therapist and there was talk that she may need a brain scan. Scared my son and his wife to death. Then, after a couple of days, they say that it's not apnea and that she stopped breathing because of the CPAP, like when a baby is crying intensely but you hear nothing because she is actually holding her breath. Okay, fine, better safe than sorry. So they begin weaning her off the CPAP, and cannulas for feeding and oxygen. My daughter in law of course says, thank God my baby is healthy, I need skin time, and we're going home. But wait - the hospital says that they have a procedure to wait 48 hours after removing the tubes before they will discharge. DIL is furious - because of Covid, the time she can spend with the baby is limited, both parents can't go in together, and mother time with a newborn is limited. So a perfectly healthy baby is not expected to go home until six days after delivery.

The doctors/nurses have not or will not provide a logical explanation why an arbitrary 48 hour "rule" applies to this healthy baby. Again, nobody finds fault with the decision to put her on a CPAP. But the after-care is raising serious concerns. My conspiracy theory mind says that this is simply a desire to keep insurance money flowing to the NICU. This is where I need help from you medical professionals - can there be a valid medical reason to hold a baby who is breathing on her own and who was, and I'm not sure if this is the correct word, "misdiagnosed"? That she is in the NICU for a condition that didn't exist stands out to me.
KidDoc
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AG
If they discharge early and the child goes apneic and dies at home guess who gets sued? It is not the parents.

This is standard of care because it has been proven that if an infant goes 48 hours without an apneic spell they are very unlikely to have one at home.
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aggiebrad94
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AG
KidDoc said:

If they discharge early and the child goes apneic and dies at home guess who gets sued? It is not the parents.

That's what lawyers and forms are for. They had to sign a bunch of disclosures to have the baby in the hospital, just sign one more.
KidDoc
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AG
aggiebrad94 said:

KidDoc said:

If they discharge early and the child goes apneic and dies at home guess who gets sued? It is not the parents.

That's what lawyers and forms are for. They had to sign a bunch of disclosures to have the baby in the hospital, just sign one more.
True but that form is usually the AMA (Against Medical Advice) form which also usually means insurance will deny the claim.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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KidDoc said:

If they discharge early and the child goes apneic and dies at home guess who gets sued? It is not the parents.

This is standard of care because it has been proven that if an infant goes 48 hours without an apneic spell they are very unlikely to have one at home.
What medical condition would cause her to go apneic when she wasn't apneic in the first place? By the rationale you expressed every baby should go to the NICU. Not a challenge - I'm just trying to understand why the rules apply to a healthy baby. If there is a risk I"m with you 100%.
Knucklesammich
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A form isn't going to protect the hospital and there is a medical guideline as listed by a doctor.

That reason is why the form won't protect the dr or hospital.
KidDoc
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AG
Shagga said:

KidDoc said:

If they discharge early and the child goes apneic and dies at home guess who gets sued? It is not the parents.

This is standard of care because it has been proven that if an infant goes 48 hours without an apneic spell they are very unlikely to have one at home.
What medical condition would cause her to go apneic when she wasn't apneic in the first place? By the rationale you expressed every baby should go to the NICU. Not a challenge - I'm just trying to understand why the rules apply to a healthy baby. If there is a risk I"m with you 100%.
Apnea is still on the chart, there is just disagreement on the medical team about whether she was apneic or "breath holding" which is not a real NICU diagnosis anyway. They are erring on the side of caution and the risk of early discharge is greater than the risk of the 48 hour hold.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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That's fair. Thank you. The one caveat is that they are telling my DIL that it definitely was not apnea. I do recognize that there are emotions involved and she may not be the best historian at the moment. (I'm not there talking to the doctors myself, because of Covid). But I will use your explanation to calm her down.
culdeus
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AG
My wife is T1 and they stuck our 2nd baby and she came back with a 65, 2hrs later she was 80. That 65 landed her in NICU for 48hrs.

I asked to have them stick her with a different meter and they looked at me like I was nuts.

The rules are basically unbreakable.
Windy City Ag
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AG
Quote:


The doctors/nurses have not or will not provide a logical explanation why an arbitrary 48 hour "rule" applies to this healthy baby.
jopatura
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AG
My daughter had a seizure the day she was born. They kept her for five days seizure free once the medication stabilized. I understood it but it sucked. It's bulky as hell but see they can push for an at home apnea monitor. We did it for five months.
UpstateAg
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My wife had the same situation with our daughter.Straight to the nicu. It scared us (first born) but she proceeded to scream healthily at 2 am weeks later. We waited 36 hours before being discharged, and had doctors appointments for the foreseeable future
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Great outcome. They moved the baby to a regular hospital room so the kids can spend the night with her in the room. Then they will discharge to home tomorrow. I don't know if this is normal procedure to accomplish this 48 hour hold thing but everyone is happy.
buffalo chip
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itsyourboypookie
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My son, born June 29th, did the same thing. Spent 2 days in NiCU and two days with us in the room.

Mom spent unlimited time with him in NICU. I got to go in when she wasn't there.

They had a rona positive baby up there. But said it was of no concern for us or baby. But the Rona babies parents weren't allowed up.
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