27 Jul 2008

Now for something completely different

The internet preemie support group I'm a member of were discussing hand disinfectant for use at home (post discharge) and it made me realise yet again how different the advice as well as treatments are in US as compared to what we've experienced.

I've often read that in the US the parents are involved in the care of their babies from early on, I think we were allowed to change our first nappy when Ciara was about 5 weeks old, we had to wait another couple of weeks before we were let loose on Enya. We however were encouraged to start kangerooing within a week of birth (with Ciara after 3 days:-)) where in the US they seem to start much later (were our girls particularly stable for preemies? I don't think so as JT, the 23 weeker, also started kangerooing at about a week old). I do know a lot of micropreemies make it home before their due date in the States where here in Germany that is the rare exception.

When we were discharged from hospital no mention was made of the fact we should limit our exposure to people during the RSV season (our discharge was slap bang in the middle of the season which ran from November to March). Maybe they thought we were sensible enough to realise that for ourselves but anyhow it was never mentioned. The other preemie blogs from the US that I read on the other hand write that they were specifically instructed to limit their contacts and avoid crowded places during the first 2 RSV winter seasons. Some are even advised not to place their children in creches for the first couple of years.

We were also discouraged from going along the route of hand disinfection once we were out of the hospital and away from the hospital bugs.The explaination we were given is that our daughters needed to be exposed to normal household germs to start building up their immune system. For this reason also during our hospital stay we used to wear our street clothes in the ICU even when we were holding the girls (except when we kangerooed obviously which is done bare skin to bare skin). The photos I see on the US blogs however show most parents wearing clean gowns over their clothes and I have already mentioned the discussion on what was the best hand disinfectant for home use on the preemie support group.

I wish I knew why there is such a large difference in the advice and treatment. Are the US parents more able than we in Europe that they can start assisting in the care earlier? I can't believe the US has more germs than Europe or that our doctors here are giving us foolhardy advice, given that we have not had any infections or real illnesses since being home. What do you think?

1 comment:

Cathy said...

Honestly, I think many people in the US are germ-obsessed and it's leading to all kinds of problems. (Increased allergies, for example, because immune systems don't have enough exposure to honestly bad things.)

Our personal experience is a lot closer to yours though. We were advised to limit exposure during RSV season, mostly because of how small Daniel was/is - he can't cope with major infection well, and his heart function was in question. And we were also advised to basically isolate them until 1-month adjusted age - the theory there that by then they would have been exposed to enough of OUR germs to have a basis for dealing with other germs. Beyond that, basic hand-washing (though we do sometimes substitute hand sanitizer for convenience sake). Same precautions we take for ourselves - careful around obvious sick people/environments, clean food prep, etc.

But a lot of people here aren't that way. They are truly obsessed and sanitize *everything*. It's ridiculous, unless you have an exisitng immune system problem. Clean is good - super-clean is not.

As for parents taking care sooner .. not sure. We were in Level II, so we started doing stuff pretty much right away. (With help, at first.) There was no reason not to, we just had to juggle a few extra cords and IVs and learn how to feed babies who didn't want to eat. I'd honestly guess it's mostly a different nursing style - we ran into some nurses who were put off by us taking the initiative to change a diaper. (Um, it stunk and he was crying? I saved it for them to weigh ..) I think the lines are blurry between patient and child - and who has control, when.