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Preterm Infant Communication: Are We Listening?

Last year at this time, as I was preparing for my keynote speech for the upcoming NANT Conference, I reflected on Dr. Jill Bolte Taylor’s incredible keynote at our very first event in 2011. Her keynote as well as her book taught me many lessons about the brain and what it’s like to attempt to heal within an ICU environment. (She is a neuroanatomist who had stroke.)

In this passage from her New York Times bestselling book titled, My Stroke of Insight, Dr. Taylor describes a moment from her hospital experience the first day of her stroke:

“Light was uncomfortable and my brain throbbed in agony when they shined that bright pen-light to check my pupillary reflex. The IV in the back of my hand hurt like salt in an open wound, and I craved being unconscious to their physical manipulations. So I escaped by delving back into the sanctuary of my own silent mind…well, at least until the next neurological exam.”

When I read this passage, like so many in her book, I became more deeply concerned about how we treat all patients in the hospital, especially those who are nonverbal, like babies in the NICU. How should we best care for patients who are not only nonverbal but many times physically unable to respond to pain and discomfort? (Think about how differently a baby born at 24 weeks demonstrates a pain response compared to those born at 34 or 44 weeks.)

There’s so much we don’t know. So much we could safely assume. And much to improve.

You take this stuff home with you. I know you do.

So do the babies. Sometimes with life-long consequences.

Part of any bedside caregiver’s job in the NICU is becoming an expert interpreter and translator of preterm infant behavior and provider of age appropriate care. The babies’ erratic movements, vital signs, furrowed brows and clear eyed alertness (to name a few) are all telling you a story. Their story. What story did they tell last shift? Last time they were held skin-to-skin? Last time they were fed?

Keep learning, communicating, and advocating. Keep teaching parents.

There is great relief, joy, and purpose in being part of the solution.

(If you’ve never heard Dr. Taylor speak take a moment and listen to her TED talk that now has more than 18 million views: