LBJ Hospital Pediatricians Join First Nationwide Effort
Aiming to Improve Care for Newborns
HOUSTON – (Oct. 1, 2007) – Pediatricians at The University of Texas Medical School at Houston are participating in a project, sponsored by the American Academy of Pediatrics, with the goal of improving the care given to newborn babies.
Lisa de Ybarrondo, M.D.
A total of 9 nurseries and 13 pediatric clinics nationwide were chosen to take part in this pilot project named, “Safe and Healthy Beginnings.” The Harris County Hospital District’s Lyndon B. Johnson Pediatrics Clinic and Well Baby Nursery are two sites in this collaboration.
The project has two key areas. The first: early detection of neonatal jaundice. Pediatricians and nurses are working to improve the early detection of this common newborn condition. The early diagnosis will help improve newborn safety, reduce the number of return trips a new parent has to make to a pediatrician, and reduce the risk of re-hospitalization for phototherapy.
“Although it is quite rare, the yellow pigment that can build up in a baby’s skin and eyes can also affect the brain. Many first-time parents may be alarmed at jaundice, and even experienced parents may have a baby that has this condition, when their earlier babies did not,” said Laura Ferguson, M.D., associate professor in the Department of Pediatrics and medical director of the LBJ Hospital’s Well Baby Nursery. “If we can detect it early, we can reduce the chances of this condition worsening and help calm parents’ fears.”
Neonatal jaundice is a yellowing of the skin and other tissues. It is caused by increased levels of bilirubin in the blood. The condition is usually harmless and is often seen in infants when they are about two days old. It can be caused by:
- Too many red blood cells – the infant’s body is working to break down the excess amount, causing the skin to take on a yellowish color.
- Immature liver – the newborn cannot process bilirubin, quickly. This slow process means that the baby’s liver is not as fully developed as it will be, causing a delay in the breakdown of the bilirubin.
In most cases, this jaundice will disappear after a few days, often without any special treatment. If treatment is required, a Bililight is usually used. This treatment is also known as phototherapy. It helps the infant breakdown the excess bilirubin.
The second focus of the project is on breastfeeding. New mothers will have better access to lactation support, more maternal comfort with breastfeeding, and be given more information on the benefits for both mother and baby.
“Breast milk happens to be the perfect food for infants. It contains the right amount of protein, sugars and fatty acids which are essential for the development of a growing baby,” said Lisa de Ybarrondo, M.D., assistant professor in the Department of Pediatrics and LBJ Pediatric Clinic director. “Breast milk also has immunological benefits. Studies suggest that breastfed infants have decreased incidents of Sudden Infant Death Syndrome (SIDS), diabetes, leukemia, lymphomas, obesity, allergies and asthma. Breast milk can also protect an infant against all types of bacterial and viral infections, many of which can be life threatening.”
Each month, the staff at the LBJ Pediatric Clinic and Newborn Nursery will participate in educational conference calls and review charts to ensure continued improve with regard to documentation of risk factors for jaundice and the success of breastfeeding.
“Anything we can do to help promote breastfeeding will help more mothers be a success and nurse longer,” said de Ybarrondo. The American Academy of Pediatrics recommends for mothers to breastfeed exclusively until their baby is six months old. They can begin adding solid foods after that, and continue breastfeeding until their baby is at least 1 year old.
Ferguson says pediatric residents and nursing students will benefit from this project as well. They will learn a lot about these common pediatric issues early on in their careers.
This program is underway and will continue through early 2008.
When the pilot project has finished, the American Academy of Pediatrics will use the information and tools developed for chart review and education to put together “toolkits” that other practices may use to improve quality of care nationwide. This data will also help develop future pilot projects for quality improvement in other areas of pediatric practice.
LBJ General Hospital, 5656 Kelley, is a major teaching affiliate of the University of Texas Medical School at Houston. A full-service community hospital of 332 beds, it is located in the northeast section of the city, just 15 minutes from the Texas Medical Center.