A Lesson in Strength

They have decided to unleash me upon the baby wards again.

I find this funny. My friends joke that they will need to check my handbag before leaving the hospital. Hah. Hah. They have sensors these days that trip an alarm if someone tried to steal a baby. Not that I’d steal a baby. I’m not that broody.

We are in the Neonatal ICU for two weeks. I think I saw a single term baby today – the others were all premature.

Did you know that prone position is best for a preemie’s lung development? But prone is also more associated with SIDS. And did you know that they sometimes give a baby caffeine for lung maturity? I didn’t.

They are so tiny. Their eyes closed tightly against the light, their hair dark and sticking to their scalp, their skin wrinkly, their little fists balled in defiance.

They are strong. They cling to life with a determination I wish I could see in myself.


  1. Hilda says:

    hey there,

    They give baby’s caffeine for lung maturity??
    I’m confuse because when my friend was pregnant I was throwing away sodas and coffee so she wouldn’t get premature birth.
    This is interesting I would like to know more about this. I learn that the the lecithin:sphingomyelin ratio is the important aspect for lung maturity. If infant has a ratio lower than 2 it means that they don’t have enough dipalmitoylphosphatidylcholine (DPPC) to make the surfactant to keep the alveoli from collapsing. Does caffeine have any affect on DPPC by any chance??


    1. Ah, now this question I like (because it forces me to look up the answer). Apparently it’s not quite the same as surfactant – being a stimulant, it’s more respirogenic, so it reduces apnoeic episodes in the infant. And obviously the more the infant uses its lungs, the stronger they get. So it’s more a physical effect whereas surfactant has an actual chemical effect – in simple terms, I don’t recite medical jargon all that well.
      Interestingly though, caffeine does reduce initial weight gain though. So I suppose it comes down to prioritising, which is why it’s not the choice substance in most NICUs.

  2. Yatin says:

    Does crying make babies lungs stronger?
    A community I know in rural Gujarat (Western India) deliberately makes their baby cry once a day

    1. That’s interesting. It’s an old belief that crying is good for a baby (“let him cry, it’s good for his lungs”) but this hasn’t been shown to hold any water. While it’s true that more use of the respiratory muscles is good for the lungs, and also a baby who cries at birth is a healthy baby, crying post-birth has not been shown to have a good effect on Baby. In fact, when a baby cries their oxygen saturation drops… so it’s not quite an advisable practice. I’m also of the opinion that life gives you so many reasons to cry; one shouldn’t give kids any more.

      1. Amber says:

        What we were told was that crying also burned too many calories for preemies, so keeping them as calm as possible was the best for their overall weight gain (which is an obvious problem with such teeny babies).

      2. Thanks Amber, that makes a lot of sense! With tiny babies they lose 100g really easily, and when they only weigh 1kg that’s a lot.

  3. Misaal Shah says:

    “They are strong. They cling to life with a determination I wish I could see in myself”

    Like when their hand, tries to cling onto one of your fingers. Nice post.

    1. Thank you 🙂 yes, it’s such a darling thing when they reach out and grab hold.

  4. Amber says:

    Hey, stopping by from SITSgirls.

    My daughter was in the NICU and received caffeine after being sent home. She had apnea and apparently the caffeine helps to “remind” preemies to breath.
    Here’s a news story on it – http://www.thebostonchannel.com/r/14717177/detail.html

    1. Thanks 🙂 Yeah, apnea is associated with the brainstem so if they’re stimulated by e.g. caffeine their brainstem can’t “forget” – makes sense! Thanks for the visit!

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