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NICU: A Place of Comfort Healing and Support



Nine-month-old Aira Amiotte shrieks with glee every time her big brother comes near.

The bright-eyed baby with delightfully chubby cheeks and thighs loves three-year-old Eli, reaching out to touch him as he comes near. She’s all smiles, content to play with her brother or snuggle with her mom and dad.

“She’s the most easygoing baby. She just loves to talk,” says mother Robyn, holding Aira close. “After everything she’s been through, we are amazed by how happy she is.”

Aira and her twin sister Breleigh, were born prematurely, delivered at 27 weeks and two days of gestation. Sanford Health specialists helped the girls from day one: from identifying the earliest signs of illness, to supporting the family’s efforts to help surviving twin Aira thrive through her mother’s milk and skin-to-skin care.

Certified Lactation Consultant Lori Johnson says nursing is great for all babies, but the benefits of breastmilk are even more important for pre-term babies, like Aira. A lactation team consisting of 17 NICU nurses with special training helps provide assistance, education and support for breastfeeding moms.

In Sanford’s Neonatal Intensive Care Unit, where Aira lived for the first 109 days of her life, nurses do everything they can to support mothers’ efforts to provide breastmilk for these most vulnerable infants. Increasing numbers of new moms in the NICU are choosing to breastfeed and it’s better for their babies, she says.

“All the research shows that you cannot dispute the benefit of breastmilk,” says Johnson. “We treat it like liquid gold, like medicine.”

During Robyn’s first ultrasound at 16 weeks, the family not only learned that they would be having twins, but also that the two little girls had a very serious condition. “Baby A” (Aira Lael) and “Baby B” (Breleigh Hope) were showing signs of twin to twin transfusion syndrome, a condition where blood flow between the two growing babies is unbalanced. Left untreated, the disease is often fatal to both twins.

On the advice of obstetrician Dr. Jeffrey Boyle, Robyn flew to Cincinnati Children’s Hospital to undergo surgical procedures at 18 weeks to drain excess amniotic fluid and block some of the blood vessels between the two twins. Over the next few weeks, doctors watched the babies’ growth carefully, trying to determine if both would live.

“I tell people that my glass is half full, but I was waiting for someone to kick it over,’ ” says Robyn, dangling over her giggling daughter’s hands. “One day everything is looking good and the next day it’s not. I got to the point where I was looking for the next thing that could go wrong.”

About 12 weeks before their due date, the girls were born. Aira was two pounds, seven ounces and Breleigh was one pound, nine ounces. After weeks of uncertainty, the two girls were doing great, even though they were so small, says their mother.

“Both were stabilized and breathing on their own. Everyone said they were ‘rock stars,’ ” says Robyn. “But 28 hours later, Breleigh declined rapidly and we lost her and Aira started following in her sister’s footsteps.”

It was devastating to lose a child, says Robyn, displaying a necklace made out of Breleigh’s tiny footprints. But after three weeks of life support, Aira was strengthening and improving, due to the care she was getting in the NICU and the milk she got from her mother.

Throughout it all, Robyn was pumping breastmilk every three to four hours, knowing it was one of the few things she could do to help her tiny daughters. She couldn’t even hold little Aira until she was three weeks old, but the NICU nurses and her neonatologist Suzanne Reuter, MD, told her that the breastmilk could help her baby.

Although preterm babies in the NICU, like Aira, often can’t nurse for weeks, and must grow and develop in order to be able to breastfeed, lactation specialist nurses work with new moms to support their efforts to pump milk for their infants, says Johnson. Even if the babies have just a few days or weeks of milk, they’ll benefit, she says.

Immediately after birth, Sanford NICU nurses encourage new mothers to swab their babies mouths with colostrum, that highly important first breast milk that provides antibodies to newborns. In fact, an evidence based practice project done with babies in the Sanford NICU showed that simply rubbing a bit of the colostrum into the preterm babies’ gums and tongues helped prevent ventilator associated pneumonia that can strike preterm babies.

“It’s a challenge to maintain a good milk supply and keep it up when you’re in the NICU, but every day you can do it will help,” says Johnson. “It’s one of the best things a mom can do.”

Over the coming weeks, as Aira grew and developed, Robyn came every day to hold her against her chest, providing “skin-to-skin” contact which helps preterm babies to heal and thrive. They gradually worked their way from tube feeding to letting her nuzzle on her mother’s pumped breast and finally to regular nursing.

“I needed to be there, both for her and for me,” says Robyn. “I never hesitated to ask questions and everyone was so good. They answered my questions and explained everything to me.”

During times when Aira couldn’t drink breastmilk, Robyn saved the milk up for later, even giving bags to friends to store in their freezers until the time when she could use it. Months later, she donated some milk that she couldn’t use to a milk bank for other premature babies.

Aira came home with her family about three and a half months after her birth. Robyn says that doctors won’t know until Aira is about two years old whether bleeding in the baby’s brain during her first week of life did long-term damage.

As the now-chubby little baby wrestles with a stuffed giraffe toy that used to be twice her size, she happily grunts and squeals. So far, she’s developing right on track for her gestational age. She watches her older brother with a playful grin and reaches and stretches, rolling to get the things she wants.

Today, when the family travels to Sioux Falls for Aira’s follow-up doctor appointments, they love to reconnect with the NICU staff that treated their little girl with so much compassion, they say.

“Everyone not only cared for Aira, but we know that they cared about her,” says Robyn. “I’m so grateful for everyone who was there to help.”

Posted Date: April 2013

NICU: A Place of Comfort Healing and Support

At just 27 weeks along, Robyn Amiotte had to prepare herself to give birth to pre-term twins, one who passed away shortly afterwards. Supported by advanced technology, expert care and breastfeeding support at Sanford NICU, her bittersweet experience was worth every minute.