Newborn Safety

Specialties Ob/Gyn

Published

Hi all ~ I am an ER nurse, so I have never had a reason to post to this forum until now. A couple of weeks ago, I had the pleasure of attending the birth of my first grandchild. It was a wonderful experience! My grandson is the most beautiful baby ever (I'll bet all grandmas say that). The reason that I am posting is that our very special day turned into a nightmare and I hope that by relating the experience, I can bring an awareness to others so that perhaps this avoidable occurance can be prevented.

About an hour after the birth, the new mother and baby were moved from the birthing room to the postpartum floor. I was with them and was present during the mom's room orientation. In retrospect, I cannot remember the nurse ever mentioning the importance of having all siderails up when the baby is in the bed with the mom. I was in my grandmother mode and not my nurse mode and I feel all kinds of remorse for not catching this oversight.

Later in the day, the new mom decided to try and nurse her baby. She was alone in the room and fell asleep at some point while the baby was nursing. One of the siderails on the bed was down and, as the mother fell asleep, the baby rolled off of the bed and landed on his head on the hard floor. He suffered an intracranial bleed and was in the NICU for six days. The neurosurgeon was ready to do a craniotomy if the bleed expanded by one more millimeter (it measured 31mm wide x 10mm deep). Luckily, the bleed stabilized after 6 hours and surgery was avoided. My grandson is OK now, but will have to have weekly scans until the hematoma resolves and will be enrolled in a monitoring program for head-injured infants.

As a nurse, I feel horrible for not anticipating the potential risk that nursing a baby in a hospital bed posed. As a grandmother, I feel so much grief that my little grandson had such a rough start in this world. No one is to blame, though...it was a horrible accident. I don't know if the hospital had any policy about mothers nursing their babies in bed and siderails. I would like to see signs posted in every postpartum room that state "If you have your baby in bed with you, all siderails MUST be in the up position". If that were policy and it were made very clear to the new mothers, perhaps accidents like this one could be prevented.

I am very grateful to the nurses who responded so quickly and saw the importance of having the baby examined immediately. Within minutes, he was seeing a pediatric intensivist and a CT was done within an hour of his fall. All of the staff were great about keeping us updated on our little guy's condition. We all seem to have moved beyond the trauma of that day, but I have this nagging feeling that I should have prevented it somehow. Since I can't go back in time and change things, I decided to post our experience here so that those of you who are in a position to effect policy can bring this awareness to your workplace. You guys are in the best position to educate new moms and ensure the safety of our newest little beings. Thank you for being there.

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I am so sorry that this happened to your grandson and I'm relieved that he is ok. You are right, this was a horrible accident and no one is to blame. Thank you for posting your experience, I'm sure that it will help many people. When doing breastfeeding teaching this should also be included. I don't think that anyone told me that when I was in the hospital with my son and I'm sure I fell asleep at least once, if not more.

God Bless you and your family. I hope that everything goes well from here. Enjoy him Grandma!!!!

Gator

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Wow, I am new to ob but have experienced mother's falling asleep alot while trying to nurse. Side rails are up most of the time, which helps pillows and such stay in place while they nurse. What the mother does while the nurse is not in the room is a different story and sounds as though was a very unfortunate accident that I don't know how to prevent(other than the side rails) Our side rails are sort of different than most and come sort of to the middle of the bed, so I am not quite sure if mother was nursing and fell asleep without pillows if the side rails up would even matter.....will have to investigate and keep my thoughts open about this when instructing new mothers. Glad your little grand baby is doing ok, will keep your family in my thoughts. keep us updated.

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Specializes in NICU.

It's not unusual in our pp dept to have the baby in bed with mom, breast feeding or sleeping. It's hard to control what parents will do. Many of these babies will always sleep in bed with mom. They don't have, or want a bassinet or crib at home. We have had babies go to ground, luckily, none of them have been injured as your grandson was.

We had one baby roll off dad's chest, while he was sleeping on a window seat. Maybe we ought to have signs up, in English and Spanish, to advise people of the danger.

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Specializes in ER.

We had a mother pass out while standing by the circumcision table, hit the circumstraint and dump it and the baby and herself on the floor.

Yep, there was a chair there, but she stood up so she could get a good look.

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How awful! I bet everyone involved felt just terribly guilty!

I was actually advised not to sleep with my baby in the hospital. Hard to do when you're on narcotics and breast feeding, but even with siderails up there is also danger of a little head getting caught in them or suffication.

All just too awful to think about. :o

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I like your idea about a sign in every room. It really pertains to any new mom and baby, whether you breastfeed or not. We try and tell all our mothers to stay awake when the baby is in bed with them, but sometimes that falls on deaf ears. I am so sorry for your grandson's experience. I am glad he is doing well.

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Thank you all for your kind replies. Nathan (my grandson) is improving daily. He will have another scan tomorrow to see if the hematoma is resolving. It does not appear that there will be any long term sequelae from his accident. He has passed a hearing test (I haven't a clue how they do that on a newborn) and his eyes respond to light. He eats well, has a lusty cry, and seems just like a normal newborn (with the exception of the lump on his noggin - well, actually I've seen other newborns with pretty lumpy looking heads). And, he is probably the most beautiful blonde baby boy that I have ever seen, not that I am partial or anything.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

First off, congratulations, Gramma! What a blessed and exciting event in your life! Truly happy for you, mom and the family.

This was truly a regretable accident, and I am sure both nurses and mom felt HORRIBLE about it. This is a good wake-up call to us OB nurses to remember to warn parents the potential hazards of co-sleeping in ANY situation, whether in hospital or at home. Where I work, we DO warn parents of the possibilities of babies either falling out of sleeping chairs or beds or being rolled onto when in bed. The nature of most hospital beds makes this a VERY distinct possibility. Why? Well, they are quite narrow, and side rails can actually increase the danger of suffocation, especially if pillows are used to pad them. I warn parents of this, because 2 or 3 years ago, we had a near suffocation, involving a very large-chested mama falling asleep w/baby under her breasts! I also had a mom co-sleeping with twins in a reclining chair drop one on the floor, some years back. Baby was fine; mom and nurses shaken to the core! It's real but preventable. So I really DO discourage co-sleeping in hospital beds for this reason, encouraging and showing proper use of the bedside cribs and positioning of infant (back only) in them. It's that important!

EVERY mom in my care gets this briefing; but I agree with the person who said a sign or written instruction is a good idea. That way, everyone would be getting the same warning and be aware of potential problems with co-sleeping in the hospital or even at home. I am NOT anti-co-sleeping, just making people aware what they risk if not careful when choosing to do so with newborn babies.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

And yes, best wishes for Nathan's recovery, that it be complete and speedy. I am so sorry this happened to him, and to you! All my best to your family.

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WOW! Best wishes to you and your family..they are in my prayers.

I recently had #3 and was so paranoid of falling asleep and having the baby fall. I allways put the side rail up and a pillow behind baby, but was still cautious. What I also did was pull the bassinet up close to the bed and raise my bed up higher so that we were close to each other and it was easier to get my baby when it was time to nurse.

BTW, I was never informed or warned of this by any of my nurses. :uhoh21:

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The hearing test meaures nerve conduction of sound. It somehow measures how the brain reacts when it hears the little soft clicks that the machine emits. You put three little sticky leads (like EKG leads) on the forehead, shoulder and nape of the neck. Then you put little earphones on. Then you turn on the machine which is actually a laptop computer. It does the rest. The baby just has to be absolutely still or it pauses and the test takes longer.

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