Re: "Never trust a 35 weeker"

I'd read this thread quite a while ago, and again right before I started my NICU orientation, and lo and behold I've already experienced the truth to your statement.

Assigned back room for 35 and change week twins sectioned early because one of the twins was having problems. My preceptor and I were to be caring for the "healthy" twin. Hah! That'll teach me to never again believe it when they tell me that...

Re: "Never trust a 35 weeker"

I am living proof that premies are fighters!! I have a fraternal twin (only 1 minute older than me) and we were 3 months premature. She weighed in at 1 pound 12 ounces, while I was 1 pound and 10 ounces. I stayed in the hospital for 9 months after I was born. I had heart surgery and needed an oygen with me 24/7 until I was about 2 years old. I was baptized twice and my parents planned two funerals for me. Well here I am today, a 23 year old pre nursing student who is thinking about working in the NICU and passing on my strength to all those premies who need hope and love.

Re: "Never trust a 35 weeker"

My son was born at 35 weeks and had to be intubated he was in the NICU for 17 long days. The first week we weren't even allowed to touch him. My niece was born at 35 weeks and was fine, her and her mom stayed in a couplet room for a week and that was it. I was so jealous.
p.s. he a huge 2 year old now, rough tumbly, you would never know he was early.

Re: "Never trust a 35 weeker"

Originally Posted by marie229

My son was born at 35 weeks and had to be intubated he was in the NICU for 17 long days. The first week we weren't even allowed to touch him. My niece was born at 35 weeks and was fine, her and her mom stayed in a couplet room for a week and that was it. I was so jealous.
p.s. he a huge 2 year old now, rough tumbly, you would never know he was early.

Yep, that's a boy for ya!

I'm sorry your son had such a rough start, but so happy to hear that he recovered with no long-term complications!

Re: "Never trust a 35 weeker"

My 35 week baby aspirated mec, was addicted to MS (Mom with Lupus, severe during pregnancy) and was almost sent to the nursery...went limp and white; ended up on a jet vent and a canidate for ECMO. Babies problems were almost overlooked due to her size, 8lbs 5oz. Mom had gestational diabetes. Went home on O2 after a rally rough first week. Thank God for sharp NICU RN's.......

Re: "Never trust a 35 weeker"

Originally Posted by Gompers

Yep, that's a boy for ya!

So Agreed!
My preceptor and I cared for 35 and change weeker twins last week, one boy and one girl. The girl, although smaller, was breathing and feeding well. The boy unfortunately was on NCPAP, could not nipple at all, and would dip to 96 degrees at the drop of a dime (had to constantly go up on the temp in his isolette). In addition, the orders had him 'sprinting' with NC for 3 hours per shift. Of course when the doc came in to assess he seemed to be doing well, so she d/c'd the NCPAP and had him on continuous NC @ 2LPM. Needless to say, that lasted approx. halfway into the next shift, and he is back on NCPAP.

Re: "Never trust a 35 weeker"

In our NICU, we never discharge a baby until they have reached 40 weeks gestional age no matter how long they have been there. I have seen 35 weekers with more problems than 28-30 weekers. It is a transitional stage and you just have wait and watch. You do not know what is going to happen.

Re: "Never trust a 35 weeker"

Originally Posted by delorip7

In our NICU, we never discharge a baby until they have reached 40 weeks gestional age no matter how long they have been there. I have seen 35 weekers with more problems than 28-30 weekers. It is a transitional stage and you just have wait and watch. You do not know what is going to happen.

Wow! Most of our kids are pushed out by their insurance companies as soon as they're PO AD LIB. There's no way we could keep them all until 40 weeks but it is a very good idea, I agree! We end up sending a lot of kids home on oxygen and apnea monitors, some with NG tubes if the parents want them home sooner. We have a home care program through our NICU with our own nurses doing the visits, so that helps.

I do think that we should at least keep them until 37 weeks, though.

Re: "Never trust a 35 weeker"

Wow. You keep them until 40 weeks. That is amazing. Our situation is similar to Gompers. If they are PO feeding well, maintaining temp, and gaining weight consistently then they are out the door and the insurance companies are keeping a watchful eye on their progress and if they meet the criteria then they are asking when are they going home. I've never seen a baby go home on gavage feedings though unless PO feeding was not an option for the baby. I'm not sure at what gestational age we allow them to go home, but I think it is about 35 weeks and sometimes 34 weeks.

Re: "Never trust a 35 weeker"

Our Neo docs on under a lot of pressure to discharge 34-35 weekers home with no monitor or O2. It is up to us to keep close tabs on our docs. We have to remind ourselves to document every event with As & Bs so they will need to follow NICU policy and place infant on caffiene, have parents have monotor/ O2 training and set up Ped appointments within 2 days of discharge. I agree this is the time that in utero they have slowed down on their breathing exercises and conserve energy so they can put on weight and add the brown fat they will need once they are delivered. They miss this part when they are delivered at less than 35 weeks and many docs forget that. Most go through this A&B if they are micro premies, premies and even near term infants. I guess it is up to us NICU nurses to keep reminding them of this and tell the insurance companies or Medicaid to learn more about premies. Let us do our job and they will have less re-admits and save money and lawsuits in the long run. PremieOne