Neonatal abstinence syndrome (NAS) and other stories...

Another placement under the belt along with a new set of experiences. The neonatal unit (NNU) was so very different from what I was used to and with it came new challenges. On a normal day working within my normal midwifery role, I have days where I leave a shift feeling absolutely elated, which can be due to new people I have met or if I have had the pleasure of welcoming a new baby into the world. However, on NNU I never had that same feeling, instead I felt a real mixture of emotions. I felt happy when we discharged a baby from NNU because this meant he/she finally got to go home to their family but equally parents often looked scared after long stays on NNU, with the prospect of transitioning back into normal life becoming a daunting realisation.

I have said before that it is horrible that so many babies are born prematurely, some from as young as 24 weeks old, who outweigh the odds, survive, grow and just thrive so early on outside the womb. However, the repercussions for family members is having months off of work with whittling funds, or in other cases partners who are unable to have time off of work to spend with their new baby. These kinds of eventualities can not be prepared for. Sorry to plug this again but hence why charities like ‘Donnie’s Fund’ are so very crucial, it is just sad that this family had to lose a baby to Edwards Syndrome for the idea for the charity to come about. Charities like this provide funding for families who are going to spend long periods of time on NNU looking after their poorly baby.

During my three week placement there were at least 4 babies who had all been born prematurely, between 24-30 weeks gestation. These babies are now 40 weeks gestation and were still requiring 24-hour care on NNU, so essentially that is 16-10 weeks of daily travelling for parents, going backwards and forwards to visit their baby. Visiting aside, the emotional impact on a family and the struggle to bond with their baby, having only seen him/her in an incubator for weeks of their life, without touching or cuddling. I found aspects like this hard to witness during this placement, I often did not leave feeling happy, not that I left sad by any means as I met so many amazing family members but I just left heavy hearted.

We had a baby admitted onto NNU on my second from last shift, who was suspected Neonatal Abstinence Syndrome (NAS), which in its simplest form is withdrawal from prescribed medications or illicit drugs. I will never forget this baby. For the purpose of this blog post I have created a pseudonym to protect the identity of this baby, I will refer to her as Audrey.

Audrey was born full term (between 37-40 weeks gestation) but with babies that are experiencing withdrawal they show signs of distress. Depending on what they are withdrawing from the effects can be instant or can present after 48-120 hours later. Audrey was experiencing convulsions and episodes of shaking at random, she would also cry but it was high pitched, not like a regular baby cry. She was often sick and had terrible diarrhea. When a baby is suspected NAS they are put on specialised monitoring, which determines what type of treatment is required in order to manage the withdrawal as promptly as possible. My role as a student midwife looking after Audrey for the day was to conduct observations every 2 hours, feed her every 3 hours and to cuddle and comfort her if she would struggle to settle. It was a hard day watching Audrey convulse, shake and scream but I know on NNU she was receiving the best treatment by an incredible team. I got to write Audrey a letter about her first day on NNU that she can read in years to come, it truly was a pleasure looking after her and to this baby I will never ever forget you!!!

There is not much time to rest this end, we all finished our essays which were hanging over us like a black cloud! I was so so over the moon with my results and I still am quite shocked. My lovely partner Tim took me out for a slap up meal to celebrate (thanks again Tim). However, no sooner does uni finish (temporarily) and my 3 weeks on NNU draw to a close does another placement begin, this time in the community. Starting Monday I will be back with my mentor from last year and we will be conducting antenatal and postnatal checks and maybe if we are lucky we will deliver another home born baby, we shall see! I will of course share my experiences from community with you all over the next 5 weeks.

Thanks again for taking the time to read my blog, as always it means the world to me! And if anyone would be willing to support Donnie’s Fund and support me running a half marathon then the link is as follows:

https://uk.virginmoneygiving.com/fundraiser-display/showROFundraiserPage?userUrl=jennyprimroserpfhm201821146&pageUrl=1

Running does not come natural to me so please don’t think this is easy for me at all haha! I sound like I am about to pass out when I run, constant gasping for air!! BUT it is an excellent way to clear your mind and just gives you time to enjoy the outdoors, especially after long days on placement.

Love to you all

JP

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