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Holding Babies During Cooling Therapy: Is it safe?

April is HIE Awareness Month, and I wanted to bring back some of your favorite lectures from our 2022 Caring During Cooling webinar series.

What is HIE?

When a baby’s brain is deprived of oxygen, a serious condition known as hypoxic-ischemic encephalopathy (HIE) may result. HIE can occur before, during, or shortly after birth, leading to potential long-term consequences for the child’s development.

Is Holding Your Baby During Cooling Therapy Safe?

Celia Glennon, a NICU nurse practitioner, has conducted a pilot research project to demonstrate the safety of holding babies in her NICU while they are undergoing therapeutic hypothermia – a treatment where the baby’s body is carefully cooled to (33.5 degrees Celsius) to reduce the impact of HIE on the brain. A treatment that offers hope, but oftentimes results in several days of separation between the baby and their parents during the first days of life.

Many parents long to hold their baby during cooing, but the fear of disrupting the delicate cooling process was ever-present.

A Mother’s Touch: The Power of Connection

Traditionally, holding babies during cooling therapy was considered too risky. The slightest movement, it was thought, could cause a fluctuation in temperature or dislodge vital monitoring equipment. But research is shifting this perspective. Studies have shown that holding a baby during therapeutic hypothermia is not only feasible but can be incredibly beneficial for both the baby and the parents.

Human touch is a powerful force, especially during the earliest days of life. A parent provides comfort and security to their newborn and parental holding can help to regulate a baby’s breathing and heart rate. For babies undergoing a stressful treatment like cooling, this connection may have even deeper healing benefits.

In another presentation on our YouTube Channel, Dr. Malathi Baladasam shares an initiative in her NICU to decrease the delay and increase the frequency of holding in the NICU for babies without HIE.

Holding Hope: A Nurse’s Journey

Celia Glennon wanted to work on a holding algorithm for babies in her NICU and she included babies undergoing cooling treatment too. She wanted more babies to experience the comfort of their parents’ touch, and she wanted parents to be able to truly bond with their child even during the most traumatic times.

The road wasn’t easy. There were concerns from staff about risks, the potential for dislodging equipment, and the worry of temperature changes. But with careful planning, Glennon developed step-by-step protocols and worked with the team to overcome these anxieties. And the results they saw were heartwarming.

The Benefits of Bonding

Babies who were held during cooling maintained stable temperatures and vital signs. More importantly, parents reported feeling more connected to their babies too. They felt empowered to be active participants in their baby’s care journey.

While larger studies are still needed, holding during cooling is gaining recognition as a safe and beneficial practice. It reminds us that even in the most technologically advanced settings, the simple act of holding a baby can be profoundly healing.

A Legacy of Love

If a baby is undergoing or may need cooling therapy, parents should talk to their medical team about whether holding might be an option, especially after the first 24 hours when things have stabilized. It’s important to remember that parents of babies in the NICU are their baby’s greatest advocates.

Healthcare workers are encouraged to remember the power of touch within the complex symphony of medical care. Let’s champion holding as a vital part of treatment.

Frequently Asked Questions by NICU Parents

Can I hold my baby while they are undergoing cooling therapy for HIE?

Yes, you can hold your baby during cooling therapy for HIE as long as it is done safely and under the guidance of medical professionals. After the 72 hours of cooling therapy is complete, plan to start skin-to-skin holding while in the NICU which can help regulate sleep, increase the birthing parent’s breast milk supply and has profound effects on bonding for both parents. Holding your baby can have positive effects on their recovery and overall well-being.

How should I hold my baby during cooling therapy for HIE?

When holding your baby during cooling therapy for HIE, make sure to place a pillow on your lap and under you arms to provide additional support and to minimize your exposure to the cool blanket (although it won’t feel too cold). Follow the instructions provided by the care team on the best positioning and techniques for holding your baby safely during cooing.

Will holding my baby during cooling therapy interfere with the treatment process?

Holding your baby during cooling therapy for HIE should not interfere with the treatment process as long as you follow the guidelines provided by the team caring for your baby. The cooling mattress will remain in contact with your baby while you are holding them, and the brain monitors can continue to record signal while holding as well as the other vital signs monitor.

Are there any specific precautions I should take when holding my baby with HIE during cooling?

Make sure to wash your hands thoroughly before holding your baby to prevent the spread of infection. While holding, be sure to talk softly, sing, or even read to your baby. The care team can teach you how to watch your baby for their individual signs of stress and give your baby times of quiet too so they can rest.

Can holding my baby during cooling therapy help with their long-term development?

It has not been proven that holding your baby during cooling therapy for HIE can have a direct impact on their long-term development. However, holding has been shown to promote parent-infant attachment, reduce stress for both babies and parents, and these things can contribute to a more positive overall outcomes for your mental health and in turn your baby’s outcome in the future.

Frequently Asked Questions by NICU Nurses

I understand the importance of parent-infant bonding, but how can I ensure holding is safe during cooling therapy? What specific concerns should I watch for?

Make sure all wires, tubes, and monitoring equipment are secure before and during holding. Place a pillow on the parent’s lap while holding to improve comfort. Continue all brain monitoring (aEEG, video EEG and/or NIRS) during holding.

Many parents are understandably anxious about holding their baby with all the wires and tubes. What techniques can I use to reassure them and build their confidence?

Acknowledge their feelings, break down the process into smaller, manageable steps, demonstrate how to safely position themselves and support the baby. Assure parents that you’ll be there the entire time, offering support and monitoring their baby closely. Highlight how well they’re doing, building their confidence in their ability to care for their baby.

How can I best explain the benefits of parent-infant holding during cooling therapy to my colleagues in the NICU? Some are hesitant to change traditional practices.

Share research studies that demonstrate the safety and positive impact of holding during cooling. Remind your NICU team that beyond the technology, fostering the parent-child bond is crucial for the baby’s well-being. Propose a trial period with clear protocols and safety measures to address concerns and build confidence within the team.

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