March for Babies

Thursday, November 09, 2006

Annie, Annie, Are you Ok?*

Maggie requested I post the steps for reviving a baby who has stopped breathing. She is concerned about her one month old and SIDS. First of all, Congratulations Maggie! Secondly, I am not comfortable at all with attempting to teach these methods on this blog. The responsibility and liability involved is just too great a weight for my weary shoulders. That being said, I didn’t want to ignore the issue entirely. I thought that I could write about what we did for Azure and suggest a couple options for learning more.

Before Azure was released from the hospital we were required to watch a video on infant and child CPR and then demonstrate the techniques on a doll. We are not technically certified but we know enough to get us by in an emergency.

What we did when the alarm went off:
Check her color. Is she pale, blueish around the lips? This is an indicator that she needs oxygen. We would call her name and place a hand on her chest and gently but firmly wiggle her side to side as if to wake her from sleep. (I hesitate to use the work "shake" because of the implications of Shaken Baby Syndrome. I can very easily see someone panic and over-do-it in an attempt to stimulate a non-responsive baby. The irony in the possible tragedy is chilling.) We sometimes would turn her on her side and vigorously rub her back. Most of the time, this was enough to wake her and nothing else needed to be done. We would then spend a few moments calming down our own racing hearts. We usually gave her extra hugs and kisses at this point and told her that we don’t require much from her but the breathing and heartbeat thing were not optional.

If the jiggling was not enough to bring her around, we would try lifting and wiggling her arms by the hands. One nurse showed us how to pinch her big toe. Pinch it enough so that it hurts. Pinch the toe while lifting the foot into the air and then drop it letting the leg fall back onto the bed. It sounds mean, but the pain in her toe should be enough to make her upset and draw her attention to that, which will probably make her mad and possibly cry. When you are trying to save the baby’s life, a little pinch on the toe seems like a necessary evil. I thought that I could never do that to my child, but when I was there alone with her and she needed stimulating, I was pinching that toe and instructing her to get mad at me, cry, yell at me!

You do whatever you have to do to get a response while keeping in mind you do not want to injure her in the process. It is this cool under extreme pressure thinking that scared T out of watching her on his own. He saw that I could handle these situations and do what needed to be done without panic. He did not trust himself to be calm enough to remember what to do.

I would recommend:
#1 Go to an infant and child CPR training class put on by the Red Cross. This will ensure you are given the correct information and instructors can watch you practice the techniques and give you hints or corrections on ways you can improve. This should give you some peace of mind, knowing you did everything you could to educate yourself on these lifesaving steps.

#2 Get a training video and watch it a few times to get familiar with the steps to take. Practice on a doll or teddybear. Watch the video again every couple of months to refresh your memory. We were told this was the best way to keep our up our skills.

#3 You can find a quick and easy to follow guide online here. This is no substitute for a class, but it is better to have some information rather than none. The class is still the best way to go.

Finally, I would like to make the distinction between Azure’s case and SIDS. Azure, being a preemie was in a period of frequent Apnea and Bradycardia and occasional irregular breathing. This is a stage that many preemies go through and eventually outgrow. It is a matter of brain development. They need to "learn" to continue the involuntary actions of breathing and keeping their hearts going. Once the brain "gets it" they do it automatically just like anyone else. I also believe that reflux played at least a partial role in the incident in June when she turned blue. There was milk oozing slowly out of her mouth when I turned her on her side rather than the quick stream of spit up one would expect. I am not an expert on SIDS. I follow the "rules" of back-to-sleep and keep her sleeping area clear of blankets and stuffed toys. She goes to sleep with a pacifier but not a bottle. She is still getting mostly breastmilk from the freezer and we do not smoke (nor does the nanny or my parents who watch her while we are at work). She sleeps in a bedside bassinet right next to me rather than in our bed. (Does that count as co-sleeping? People ask about co-sleeping and I feel very wishy-washy with my answer.) You can find more information on SIDS here and here.

Maggie, I wish you luck and thank you for bringing up this important discussion.

*If you have ever taken a CPR class from the Red Cross you will recognize this as the first step in adult medical intervention with the practice doll named Annie.

1 comment:

Anonymous said...

Thank you - I appreciate your detailed post and the time it took to write it. Hopefully it will never happen but it is best to be prepared. Maggie