Flourishing as a NICU parent: Q & A with a local NICU doctor

by Katie Atherton

We sat down with leading neonatologist, Robert Kahle, MD, founder of Mercy San Juan Hospital's Neonatal Intensive Care Unit (NICU). Inspiring and insightful, Dr. Kahle shares some of his experience caring for NICU babies in the exclusive interview.

Tell me a little about your NICU at Mercy? Why did you set it up?

I was recruited to start the NICU in 1988 by the President of Mercy San Juan Hospital as they were looking to grow their Obstetrical Services within the region, and they saw a need to be able to better support the infants born at the Mercy facilities in the Region.

I wanted an opportunity to develop my own program and recruit doctors I really wanted to work with. For the first two years I was running a small six-bed NICU and was on call 24 hours a day, 7 days a week, 365 days a year. In 1989, I was able to take a vacation as Dr. Carolyn Getman was able to cover me for a week. She later joined me full time after finishing her fellowship, and it has truly been a great collaboration growing the NICU and expanding our group. If it weren't for her, I am not sure I would have made it to this point and I am not sure that our NICU would be as successful as it is.

What do you see as your mission and goals as a founder and doctor there?

My main interest from the very beginning has been to provide excellent care to all of the babies and their families.

General pediatricians are busy in the office. Patients in the hospital require devoted attention to be able to overcome their issues and thrive. In this vein, we have developed a very successful Neonatal Joint Practice Committee that meets monthly and looks at every aspect of the care we provide and always seeks ways to improve.

This is truly a team effort and requires the expertise of everyone in the unit, the nurses, the respiratory therapists, the nutritionist, the developmental specialist, the ward clerks, the social workers and the discharge planners.

We are not afraid at looking critically at ourselves and change is embraced in order to improve.

What is the best thing a parent can do for their baby's well being while in the NICU?

Involve themselves in their babies completely. Do not fear the invasive nature of the care, but embrace the loving environment that surrounds you and your baby.

All of the dedicated people mentioned above would not be doing this very difficult work if it were not for the love they have for the babies. Parental involvement in care, kangaroo care, breast feeding, pumping, holding, nurturing are the areas that are most important and can be done in the midst of all the tubes and lines.

Carry a great deal of optimism, as babies are exceedingly resilient. Have faith that things will all work out. The vast majority of babies survive the NICU and do well in follow up.

What's the best way for a parent to be an advocate for their baby in the NICU?

Talk to the doctors. Although everyone is involved in the care of the baby, physicians are the team leaders and are anxious to make sure that everything goes well for you and your baby.

It is important that you first of all have an understanding of the issues your baby faces and the care that is being provided, and this information is best provided by the physician. If there is anything you do not understand, please ask. The better educated the parent, the better working relationship we have with them, and the better they are at helping us to help their baby. If a question comes to you, write it down.

Why is family-centered care so important?

Though the baby is the patient, the family is the real unit that needs assistance. Every parent expects the birth of their infant to be without difficulties. We envision only the good, and do not want to recognize that all things in nature do not work out quite as planned.

In having a sick newborn, there is frequently shock and grieving, and fears about the future. In order for the parents to be the best that they can be for their infant, we need to help them through these difficult times so that they can be strong for their babies.

We are only helping babies get through the initial difficult start, it will be the parents that takes it from there on out and they need to know they have the capacity to stand up to the task.

What are your favorite resources for parents to use?

The physicians are the best resource for parents. Only the physician knows the unique circumstances of your infant and is able to decipher all of the information out on there in books, and Web sites, and apply it appropriately to your infant.

Is there any advice for parents you'd like to add?

Love your baby, have hope and faith.

Katie Atherton's son Ames spent 70 days in Mercy San Juan Hospital's NICU. Born at 27 weeks, Ames weighed 2 pounds 2 ounces. Now a happy and healthy toddles, Ames is on the verge of a new frontier--potty training--and Katie is along for the ride.