Spring 2005
Riley Simpson: Wow!

In a specially equipped room, monitors beep softly as green lines travel across black screens. Each blip on a line measures a heart beat, a breath, the amount of oxygen traveling through veins no bigger than a thread. Each line tells the experienced nurses something about the tiny occupants of the clear plastic isolettes (incubators) that line the walls.

This is the Newborn Intensive Care Unit (NBICU) at Bridgeport Hospital. Many of the quietly sleeping infants weigh less than 2 pounds—some of them, less than one pound. They could fit in your hand. They are so small, so fragile, you want to hold your breath when you see them.

Just a few miles away, in Trumbull, Riley Simpson's playroom is a different story. Here the walls are lined with toys and a mini-basketball hoop, and the black screen isn't a monitor, it's a TV. Riley, age 2-1/2, is a human dynamo. A slugger with his little blue plastic baseball bat, a budding soccer star, and handy with a jigsaw puzzle, he keeps up a constant conversation. He knows how to work the CD player, and he loads up "Baby Einstein," his current favorite, and settles down to watch.

Hard to believe Riley was once one of those tiny NBICU babies.

Back in October 2002 Riley's mom and dad, Keri and Phil Simpson, were eagerly looking forward to the January birth of their first child. But suddenly, in her 27th week of pregnancy (out of a normal 40), Keri's waters broke. Her obstetrician, Judy Boslow, MD, immediately sent her to Bridgeport Hospital—the hospital of choice in the Greater Bridgeport area for high-risk pregnancies.

And high-risk was what 31-year-old Keri's perfectly normal pregnancy had become, without any warning.

Keri was put on bed rest in The Women's Care Center in The Birthplace at Bridgeport Hospital, and given medication that would hasten the maturing of her baby's lungs. Ultrasound images showed that Riley was coming foot-first, rather than in the normal headfirst position. Worse, his umbilical cord lay over the opening to the birth canal, which could cause it to become compressed during birth, cutting off his blood and oxygen supplies. Dr. Boslow, in consultation with the perinatologists at Bridgeport Hospital, determined that Riley's best chance was for Keri to have a cesarean section. On October 14, 2002, Riley was born, weighing a scant two pounds, six ounces.

Now his life was in the hands of Robert Herzlinger, MD, chief of Neonatology at Bridgeport Hospital, the neonatologists and nurses of the Newborn Intensive Care Unit, and his pediatrician, Richard Freedman, MD, who is also a neonatologist.

Perinatologist: Specialist in high-risk pregnancies.
Neonatologist: Specialist in critically ill or low-birthweight newborns.

In the NBICU Riley's every breath and heartbeat was monitored. His team helped him through several crises, including a collapsed lung, several episodes of apnea (when he stopped breathing), and anemia (a lack of red blood cells) so severe it required a blood transfusion.

"We tested him for eye problems that can occur in premature infants," Dr. Freedman says. "If they're not caught and treated early, these problems can permanently affect eyesight."

Riley at 2 1/2 pounds.

Keri Simpson is a woman who radiates a calm serenity, but "Those days were scary," she says. She and Phil made two trips a day to the hospital to be by Riley's side, to love him through the walls of the isolette that was protecting him.

For the first month of his life, Riley lived in the isolette. He was attached to the monitors, so he couldn't be picked up and carried around by loving family and friends, the way most newborns are. And yet he still received the hands-on caring that all infants need to thrive, thanks to the nerodevelopmental (neuro=nerves) care that is lovingly practiced in Bridgeport Hospital's NBICU.

"We started by carefully positioning him," says NBICU nurse manager Nina Hyde, RN. "We let him sleep as much as he could, making sure that he slept on his side, cocooned in soft blankets. This not only kept him in a comfortable, natural position—it helped him to establish his own sleep rhythm. That's important for normal development.

"We controlled his cycles of light and dark, placing a pretty quilt over his isolette to create days and nights. When Riley fussed, we responded promptly, just as a parent does, to teach him that he could trust people to respond. And to make sure he got plenty of sucking, we gave him a pacifier. Sucking helps calm newborns, eases their pain, and studies show it even promotes growth and development," she adds.

"We know that even tiny newborns have emotional and social needs, so when he was awake, we talked to him and gave him gentle massages. We showed his parents how to do the same. Studies show that massaged babies gain weight faster and go home sooner than non-massaged babies, so it's not just comfy, it's crucial," Nina says.

Keri and Phil were encouraged to take part in Riley's care. "When Riley was able to be held, we could take him into a private room and give him kangaroo care," Keri remembers. "We could snuggle his bare body next to ours, skin-to skin. I think it made all three of us feel better."

It was nearly two months before Riley was strong enough to go home, weighing five pounds, eight ounces. He needed a monitor to alert his parents in case he had an episode of apnea and needed to be reminded to breathe. "It happened a couple of times," Keri says. "We were nervous for a while."

Helping to reassure the Simpsons was the fact that they went home with plenty of information on caring for their son, and that Riley was enrolled in Bridgeport Hospital's Follow-Up Program. One of just a few in the state, the Follow-Up Program monitors the development of at-risk Newborn Intensive Care Unit "graduates" and arranges rehabilitation services if any problems arise. Riley visited neonatologist Christine Butler, MD, at 12 months and 15 months. Dr. Butler's tests and observations showed that his progress was dramatic: By one year, he had caught up with his age group.

"Babies with good catch-up growth, like Riley, do very well in later years," says Dr. Freedman, who sees Riley regularly for well-child visits.

Riley is a living, breathing, running, jumping example that the expertise provided in Bridgeport Hospital's state-of-the-art NBICU enables babies to overcome rocky starts and lead happy, healthy lives. In fact, according to studies, 95% of 27-week infants cared for in the hospital's NBICU survive. Further, the hospital's Follow-Up Program confirms that 90% of Bridgeport Hospital NBICU babies enrolled in the program grow up perfectly normal.

In fact, Keri and Phil Simpson were so pleased with the care Riley received that when they were expecting their second child, only Bridgeport Hospital would do for them. And on March 4, 2005, just as Healthy & Wise was going to press, Anna Elizabeth Simpson was