If you’re an Inner West Mum, the chances are you gave birth at Sydney’s Royal Prince Alfred Hospital (RPA). In fact, more than 5000 babies are born each year at RPA, making it the largest maternity hospital in New South Wales. RPA Newborn Care is the hospital’s newborn intensive care unit (NICU), which looks after sick babies born at the hospital, as well as those who are transferred from other hospitals within the state. Some of the babies in the unit are premature; others are suffering from illness or birth complications.
Each year RPA Newborn Care treats more than 900 babies, and in the unit’s 38 years of service, it has treated more than 31,000 babies. The unit provides one of the highest levels (level three) of neonatal intensive care in the country. In addition to intensive care, the unit offers other vital services, including consultation to at-risk mothers during pregnancy, doctors at all caesarean deliveries, resuscitation of babies at all deliveries, care of well babies at the hospital including the Well Baby check before discharge, and parent education and information.
To bring to life the important work of RPA Newborn Care, I decided to share the stories of Katie and Chloe*, two Inner West Mums whose babies stayed at the unit. Katie’s son, who was delivered staggeringly early – at just 25 weeks, weighing 800 grams at birth – spent three months at the RPA unit. It was an experience that was all too familiar for the mum of four, who in fact has had three premature babies. Meanwhile Chloe’s daughter was born at 37.5 weeks; however, she became seriously unwell just days after birth and with the added complication of a chronic kidney problem.
Katie understood she was at risk of complications with this pregnancy, having given birth to two previous premature babies (at other hospitals) – one born at 31 weeks, and another at 28 weeks. Katie’s third son was due in March. When she began bleeding in December, just 24 weeks into the pregnancy, her heart sank. ‘It was not a surprise,’ she says, ‘but I was so scared. I knew it was way too soon for this to be a good outcome.’
Katie was transported by ambulance to RPA, where she was put on a magnesium drip, which can help prevent micro premmies from suffering brain damage. She also received steroid injections to support his lung development. Katie did not go into labour, but a week later she became very unwell and was taken for an emergency C-section.
When Katie recovered, she was told her son had been taken to NICU: her bub was tiny but well. She also learned she had contracted a rare and serious infection and spent the next two weeks in the intensive care unit before she could meet her son. Over at NICU, her son was immediately put in isolation, as he carried the same infection that Katie had. He had his own dedicated nurse, who had to wear a gown and gloves each time they attended to him and everything was sterilised. The staff also made provisions so Katie could pump breastmilk by her son’s crib. ‘Not once did they ever mention the extra work involved in his care.’
It was an incredibly difficult time for the whole family. Her partner Marc had to care for her three other children at home, including a toddler with a disability (as a result of a cord injury at birth), and also go back and forth between the ICU to visit Katie and the NICU to visit their son. ‘I don’t know how he did it,’ she says. ‘Thankfully he had the help of his mother, and I had my sister by my side.’ And there were even further setbacks to follow, with Marc’s redundancy and Katie’s diagnosis of postnatal depression. Remarkably, though, their baby was released from hospital three months after his birth without any complications.
Katie and Marc’s miracle bub is nine months old. Reflecting on that time, Katie says: ‘I don’t know how we got through it, but we did. And I can’t help but think that if we could get through that, we can do anything in this life. We are now chaotically better than ever.’
Of RPA’s Newborn Care unit, Katie says: ‘The staff assisted in so many ways. They helped to connect us with numerous services both within and outside the hospital. Their donor milk bank provided breastmilk in the very early weeks of our baby’s life when I was so sick. I have no doubt this helped him to survive until I could help. A social worker from the unit was a godsend. She helped us apply for emergency care for our other children so I could spend each day at the hospital. After our son was discharged from hospital, we had a lovely nurse from the RPA Newborn Care team come to our home for two months to check him and also provide support for Marc and me. We return to the hospital monthly for physio and continue to see an NICU paediatrician. I could never repay the staff for all they have done for us. They are amazing.’
At 37 weeks pregnant Chloe was induced following a hind leak, and her third baby girl was born. A few days after the birth, while preparing to take her daughter home, Chloe developed a fever, migraine and body aches. She and her daughter remained in hospital that night, during which she noticed the baby started to cry whenever Chloe put her on her side to breastfeed. By the morning, she had detected a change in her baby’s breathing. Chloe expressed her concerns to the midwives and after a visit from one of the head consultants at NICU her daughter was taken to the unit for observation. That night she also spiked a fever.
The NICU staff were initially unsure whether her baby had a virus or a urinary tract infection related to a chronic kidney issue that had been detected in utero. Chloe’s daughter was given a broad-range IV antibiotic. Chloe explains: ‘We knew our baby girl had an issue with her kidneys – we had learned this at the mid-term scan. I had had fortnightly scans from then on, through which it was suspected that our daughter’s left kidney was damaged beyond repair. Her right kidney, although also damaged, had adequate function. We were connected with a nephrologist at Westmead Children’s Hospital who told us that our daughter would require surgery and long-term management.’
Over the next few days Chloe’s baby’s condition worsened. ‘She was in a terrible state,’ says Chloe. ‘She was hot and bothered and too weak to breastfeed, so they inserted a feeding tube for expressed milk. She was pinpricked constantly to work out what was happening. They soon discovered the baby had viral meningitis. The doctors explained that meningitis would be treated as bacterial, because she had a significant number of white blood cells in her spinal fluid. It was super scary.’
Chloe’s daughter was isolated within NICU to prevent the spread of the virus. Chloe’s baby had her own dedicated nurse, and everything had to be disinfected or thrown away before leaving the isolation area. She improved rapidly after the specific antibiotics were administered for bacterial meningitis.
A few days later Chloe was discharged from the hospital. ‘I had absolute confidence in the NICU staff but really struggled with the act of leaving my baby there. In fact, it was one of the hardest things I have ever had to do. Another thing I struggled with – besides the unknown – was calling the unit each morning to ask how my baby was. Each day I would try to go there for two feeds but with two other kids at home who needed me, I had to find an impossible balance. When I was at home, I yearned for that baby like I have never yearned for anything in my life.’
The staff at RPA Newborn Care collaborated closely with their nephrologist at Westmead Children’s Hospital. ‘Every marker was micromanaged,’ says Chloe. ‘For example, they compared the weight of her nappies with how many millilitres she drank, as well as analysing her potassium, vitamin D, and other mineral levels. She was transported out for specific kidney testing while still in the NICU and a midwife travelled with us for that. It was confirmed that she has no function in her left kidney and that her right kidney needed an operation as soon as possible.’ Chloe’s daughter was discharged by the NICU after three weeks. ‘She was home for ten glorious days before she was admitted to Westmead for her operation, which, thankfully, was a success. Five days later she came home for good.’
Chloe gushes about the support her family received at RPA Newborn Care. ‘The level of care, information and kindness provided by the staff was incredible. Their dedication to those babies is undeniable and palpable. I have an enormous respect and fondness for the RPA NICU, which is still there with me every day. I believe you have to be a certain person to work in the NICU, to dedicate your life to tiny little babies, and I call them baby warriors. I’ll be eternally grateful they listened to me when I sensed that something wasn’t right with my baby.’
*Name changed for privacy reasons.
Photo credit: Katie
Inner West Mums is hosting a movie fundraiser for RPA Newborn Care on 1 June. You can purchase your ticket to Wonder Woman here.
There are some amazing door prizes to be won on the night.