LINCOLN — Nurses read charts with penlights. Padded linoleum floors muffle the sound of shoes, and monitors blink a soft red light instead of buzzing.
The newborn intensive care unit at BryanLGH Medical Center almost puts you to sleep.
And that's the point.
As hospitals in the region renovate and build new units, they are making small changes that together can make a big difference in softening noises and keeping lights low.
Creating an environment more like the womb is the goal. Sleep is crucial for tiny preterm babies, some weighing barely a pound and born as many as four months early. A baby born two months early needs 23 hours of sleep per day compared with 20 hours for a full-term infant.
“We have to give them every advantage because they are born so sick and so small,” said Dr. Ann Anderson-Berry, medical director of the neonatology unit at the Nebraska Medical Center.
Research suggests that preterm babies who spend their first weeks and months in a quiet, dim environment can have less risk of developing asthma and other lung problems, and face fewer problems learning words and developing other language skills, she said.
Sleep also helps babies to gain weight — crying or unnecessary movements burn precious calories. A 2-pound infant who is awake and restless for a half-hour can burn calories proportional to the number an adult would burn running and lifting weights for that same time, Anderson-Berry said.
Keeping the units dim and quiet is key. Decibel meters warn staff and families if they are talking too loudly. Blackout shades cover windows. Carts are designed to eliminate even tiny squeaks. Small spotlights provide illumination for inserting IVs. In-room TVs can be used only with headphones.
Some hospitals are creating private rooms.
Bryan and other hospitals used to have big, open rooms with bright overhead lights. Monitors and equipment buzzed, whirred and squeaked.
Bryan built private rooms for the neonatal intensive-care unit, or NICU, as part of a $36 million women's and children's health tower that opened last August.
The $120 million Methodist Women's Hospital scheduled to open next year in west Omaha will offer all private rooms in the NICU. Good Samaritan Hospital in Kearney built all private rooms in its NICU as part of a $1.7 million renovation completed two years ago, and St. Luke's Regional Medical Center in Sioux City, Iowa, did the same four years ago in a $10 million renovation of its birth center.
Children's Hospital & Medical Center in Omaha was among the first in the region to reduce light and noise. The hospital created private rooms, installed sound-absorbing ceiling tiles and took other steps in a renovation completed eight years ago.
Jack Malizzi, director of women's and children's services at Bryan, said private rooms at his NICU close off newborns from sounds and lights in hallways and nurses stations.
But private rooms are not enough. Steps were taken within the rooms to keep them quiet and dark. At Bryan, instead of installing a bright heat lamp to keep the baby warm during baths, the hospital put heat-radiating coils in the ceiling. Fans regulating the temperature in the enclosed bassinets are quieter than previous models.
Ryan and Suzanne Meikle of Lincoln experienced the quiet and darkness when their daughter, Amelia, was born in April, more than three months early, weighing 2 pounds.
Ryan Meikle said the room was so dark, nurses used small spotlights when inserting medicine tubes into Amelia's bellybutton. “It was an easy place to sit and fall asleep,” he said. “I had more than one nap there.”
He said he understands the reasons for the dim lights and quiet atmosphere — he has three other children and knows that sleep helps keep them healthy.
“Intuitively, it makes a lot of sense,'' Meikle said.
After three months in the NICU, his daughter came home June 24. She's still on oxygen to help her lungs grow stronger. But she is nearly 8 pounds, which doctors have told the Meikles is good, considering her birth weight.
Dr. Robert White, an Indiana neonatologist and an expert on NICU design, said the weeks and months an infant spends in an intensive-care unit are a crucial period.
The brain of a baby born at 26 weeks — about 14 weeks early — grows four times in size in the subsequent three months. While the brain grows, nerve cells that store and process information are created.
When sleep is interrupted or deprived, those cells and the connections between them don't always develop properly, White said.
Sleep also is essential for the development of lungs and other organs, Anderson-Berry said. Breathing problems are a common complication for preterm babies. The crying of a baby who has been awakened by a noise can aggravate an existing lung problem and require more time on a respirator.
Anderson-Berry said there are no large clinical studies of the effects of noise and light on preterm babies. A number of smaller studies have been done over the years.
A review of a number of those studies published in 2006 in the Cochrane Library, an online medical journal, indicated that reducing noise and light may help preterm babies develop better. The review said, though, that there continues to be conflicting evidence among the studies and more research is needed.
Anderson-Berry said preterm babies at the Nebraska Medical Center are experiencing fewer complications after birth since the NICU underwent a major Srenovation four years ago aimed at making it quieter and darker.
For example, the rate of chronic lung disease that develops among babies during their stay in the NICU has decreased, an improvement at least partly tied to the design changes in the unit, she said.
“We see them leave healthier,'' she said. “The families are thrilled.”
Contact the writer:
444-1122, michael.oconnor@owh.com
Copyright ©2012 Omaha World-Herald®. All rights reserved. This material may not be published, broadcast, rewritten, displayed or redistributed for any purpose without permission from the Omaha World-Herald.
