Local preemies given a gentle push
In good hands: Joseph Gaona’s arm receives a gentle range-of-motion exercise from Jill Parillo, a clinical nurse at UCI Medical Center’s neonatal intensive-care unit, as part of a study tracking how exercise might help premature babies. Joseph weighed 1 pound, 4 ounces at birth. After 10 weeks, he was up to more than 3 pounds.
BRUCE CHAMBERS, THE REGISTER
Premature births in Orange County
•Each year, nearly 19,000 babies are born prematurely (3 or more weeks early). This accounts for almost 10 percent of all births.
•About 97 percent of mothers (167,635) started prenatal care in their first trimester; starting care later is considered a high-risk factor for premature births.
•More than half of multiple births result in premature deliveries.
•About 6 percent of babies have low birth weights, defined as 5 pounds, 8 ounces or less.
Sources: Orange County Health Care Agency, March of Dimes
Orange Joseph Gaona worked out Wednesday with his personal trainer to increase muscle mass. Weighing in at 3 pounds, 3 ounces, the little fighter needs to bulk up before he can go home. Other premature babies will soon join Joseph in his daily workout sessions at UCI Medical Center.
A team led by nurses at the hospital recently received a $2.7 million grant to study the effects of exercise on premature infants. Nurses will manipulate the arms and legs of the infants, putting slight pressure on the flexed joints to try to increase their range of motion and stimulate growth.
Scientists will measure the babies' bone density, muscle mass and growth- hormone levels to determine their progress. They will then be compared with a control group of premature newborns who are cuddled instead of exercised.
The grant from the National Institute of Nursing Research and National Institute of Child Health and Human Development is the largest ever received for the hospital's nursing program. UC Irvine nurses read about a similar study performed in Israel and launched their own exercise program last year on 58 premature babies. The program led to the four-year grant, which will help pay for more sophisticated testing on up to 200 newborns.
"It really did stem from curious health-care professionals who thought, 'Can we do this better?' " said Robin Koeppel, a neonatal clinical nurse specialist.
In the initial study, the nurses discovered that the babies became more active for about 30 minutes after their exercise sessions. The babies also learned to anticipate the movements in the repetitive workouts, nurses said.
The number of babies born prematurely is rising, in part because of increases in multiple births. Premature babies are at higher risk of developing lung disease, cerebral palsy, vision and hearing problems, and learning disabilities.
Traditional care involves swaddling the fragile infants and keeping movement to a minimum. The nurses at UCI hope the exercises will better stimulate the newborns' development. If the strategy works, parents will be trained to stretch and move their babies' bodies.
"We have a chance to perhaps change how nursing care is delivered to patients," Koeppel said. "Just like medications, suctioning and positioning, we're also going to incorporate exercising."
The nurses believe that premature babies miss out on exercising in the last trimester. Premature babies born at 24 to 34 weeks' gestation spent most of their time floating in amniotic fluid. Full- term babies kick and push against the uterine wall in the last months of pregnancy, developing their muscles.
When nurse Jill Parillo gently stretches out Joseph's arms, which are barely bigger than her fingers, the baby relaxes and closes his eyes. Next Parillo bends the baby's wrists forward and backward. Joseph's elbows, shoulders, hips, knees and ankles all get the same treatment in the 10-minute exercise session.
Joseph weighed 1 pound, 4 ounces when he was born four months too soon. He has gained nearly 2 pounds in his 10 weeks in the neonatal intensive-care unit.
The goal for the exercise study is to help the babies gain weight and leave the hospital sooner than expected. UC Irvine cares for more than 500 premature and at-risk infants each year, and the smallest babies usually stay in the neonatal intensive-care unit until they reach their actual due date.
"We're beginning to understand there are critical periods of development in newborns," said Dr. Dan Cooper, principal investigator of the study. "What we're prepared to do now is to see if in fact the effect of exercise can lead to improved weight gain."
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