NEPAL

Nepal, officially the Federal Democratic Republic of Nepal  is a landlocked country in South Asia located in the Himalaya. With an estimated population of 26.4 million, it is 48th largest country by population and 93rd largest country by area. Public health and health care services in Nepal are provided by both the public and private sectors and fare poorly by international standards.
Source:https://en.wikipedia.org/wiki/Nepal
In Nepal, 81,000 babies are born too soon each year and 3,980 children under five die due to direct preterm complications (May 2017)

• March of Dimes Ranking – 20
• Preterm birth rate – 14%
• Global Average (current) – 11.1

Source:https://www.marchofdimes.org/mission/global-preterm.aspx#tabs-3

 

COMMUNITY

• Free NICU service in Bharatpur Hospital   
• Published: March 25, 2017  Rastriya Samachar Samiti

CHITWAN: The Bharatpur Hospital is set to offer the Neonatal Intensive Care Unit (NICU) service for free of charge from Sunday. The NICU service which is already in operation will be offered free coinciding with 54th anniversary of the hospital, said the chairman of the hospital management committee Raj Kumar Rajbhandari. There are 12 beds in the NICU that started a year ago and eight will be added, he said. Earlier, only the charges for beds were free. Other expenditure cost were borne by the hospital itself, Rajbhandari said. All services in the NICU and infant wards are provided for free, said the hospital medical superintendent Dr. Rudra Prasad Marasini. In general, private hospitals charge the amount of mooney between Rs 5,000 to Rs 7,000 *** per day for using NICU. The free service provided by the hospital has helped poor people visiting the hospital with the need to admit their ailing children to the NICU in many ways.

Full Article: https://thehimalayantimes.com/nepal/neonatal-intensive-care-unit-service-bharatpur-hospital-provided-free/

• Average NICU costs daily in Nepal –  $77.10 – $107.94 (article above)
• Average annual wage Nepal – $ 9,024 (http://www.averagesalarysurvey.com/nepal) 04/02/18
• Glassdoor’s – median salary for U.S. employees – $51,272 (2017)
• Full Article: https://www.fool.com/investing/2017/03/24/whats-the-average-income-in-the-united-states.aspx
• Medela Neonatal Perspectives estimates NICU costs daily average $2369 per day (note – great variance)
• Full Article: http://blog.neonatalperspectives.com/2015/08/07/unraveling-the-cost-of-very-low-birth-weight-infants/

New Wrap Is the Future of Care for Low-Birthweight Babies in Nepal

When a mother gives birth to a low-birthweight baby in Nepal, she is advised by the health care provider to use a “wrap” to carry the baby for skin-to-skin care. This practice is a key feature of kangaroo mother care (KMC)—a proven intervention to help small babies survive by increasing the baby’s weight and regulating the baby’s body temperature. However, the traditional cloth that is commonly used to wrap the baby poses challenges, making it difficult for mothers and families to practice KMC.

As one mother stated, “The family member trained in the hospital for tying the traditional wrap is not always available at home, and when we seek help from other untrained relatives or neighbors, they cannot tie the wrap securely.”

Globally, 60%–80% of newborn deaths are low-birthweight babies. In Nepal, there are 81,000 premature/low-birthweight babies born annually, with approximately 10,400 infant deaths due to premature/low-birthweight complications. KMC can prevent many of these deaths, but it is not widely used in Nepal. Nepal has worked to reduce newborn mortality, but knows there is still more to do.

A recent Jhpiego study in Nepal, which aims to increase the use of KMC, offers hope for families to more easily practice this lifesaving intervention for their babies. Funded by Laerdal Global Health, the study trained nurse-midwives in KMC at two Nepalese hospitals using a Jhpiego-developed training package. After nurse-midwives were equipped with the necessary skills, they counseled, trained, supported and provided follow-up to families with stable, low-birthweight babies. Families were offered a choice between taking home a traditional wrap or a new wrap known as CarePlus and designed by Laerdal Global Health.

Over a period of five months, nurse-midwives enrolled 96 women with low-birthweight babies. Of those, 82 women chose the CarePlus wrap and 14 women chose the traditional wrap. Results showed that mothers who selected the CarePlus wrap performed skin-to-skin contact for about 77 hours more than traditional wrap users.

In focus group discussions and in-depth interviews, mothers who selected the CarePlus wrap said it was easy to tie and could be tied without the help of another person. They found the wrap secure for the baby, more comfortable, easy to carry and rest with the baby, and family members preferred the new wrap.

 Mothers who chose the traditional wrap reported challenges, such as having difficulty tying the wrap, being fearful that the baby would fall and be injured, and feeling uncomfortable. Fathers were also more reluctant to practice KMC with the traditional wrap because it is a cloth worn by women.

“My husband … had carried the baby during hospital stay, but as I chose the traditional wrap, he avoided carrying the baby in the traditional wrap at home,” reported one mother who did not practice KMC at home.

All of the mothers who chose the CarePlus wrap performed household chores while practicing KMC with the baby; however, none of the mothers who chose the traditional wrap performed household chores while practicing KMC.

The results of this study offer promise for Nepal to increase utilization of KMC and prevent more newborn deaths. The study found that building capacity of nurse-midwives and providing the CarePlus wrap resulted in increased KMC practice. Scale-up of the intervention, including the preferred CarePlus wrap, by the Ministry of Health could help Nepal advance its efforts to decrease newborn deaths.

Full Article: https://www.jhpiego.org/success-story/new-wrap-future-care-low-birthweight-babies-nepal/

 

Helping Small Babies Grow: Scaling Up the CarePlus Wrap

Provider Site (Trainers): https://laerdalglobalhealth.com/products/careplus/

HEALTH CARE PARTNERS

Complications at birth associated with lasting chemical changes in the brain

Date: November 28, 2017 Source: King’s College London

 

Summary:

New research shows that adults born prematurely — who also suffered small brain injuries around the time of birth — have lower levels of dopamine in the brain.

New King’s College London research, published today (28 November) in eLife, shows that adults born prematurely — who also suffered small brain injuries around the time of birth — have lower levels of dopamine in the brain.

This chemical change has been linked to lack of motivation and enjoyment in normal life, and changes to attention and concentration, which could all be early signs of more serious mental health issues such as substance dependence and depression.

The study, which is a collaboration between researchers from King’s, Imperial College London and the Icahn School of Medicine at Mount Sinai in New York, also shows that most people born prematurely have completely normal dopamine levels.

Mental health problems often arise from a complex mix of genetic factors which make people more vulnerable, and negative or stressful life-experiences. Difficulties at birth can be among the most dangerous and dramatic of those life experiences.

Around one in 10 people are born prematurely and most experience no major complications around the time of birth. However in 15-20 per cent of babies born before 32 weeks of pregnancy, bleeding happens in the first week of life in fluid-filled spaces called ventricles, which are contained in the brain. If bleeding is significant, it can cause long-term problems.

The biological link between birth complications and greater risk of mental health issues is unclear, but one theory is that the stress of a complicated birth could lead to increased levels of dopamine, which is also increased in people with schizophrenia.

The researchers used a combination of positron emission tomography (PET) scans and magnetic resonance imaging (MRI) scans of the brain with a range of psychological tests in order to identify the precise changes to chemistry and structure of the brain following early brain damage. They compared three groups of people: adults who were born very preterm who sustained early brain damage, adults who were born very preterm who did not sustain brain damage and controls born at term.

Dr Sean Froudist-Walsh, the study’s first author, who carried out the study at King’s College London, said: ‘People have hypothesised for over 100 years that certain mental illnesses could be related to problems in early brain development. Studies using animal models have shown us how early brain damage and mental illness could be linked, but these theories had not been tested in experiments with humans.

‘We found that dopamine, a chemical that’s important for learning and enjoyment, is affected in people who had early brain injury, but not in the way a lot of people would have thought — dopamine levels were actually lower in these individuals. This could be important to how we think about treating people who suffered early brain damage and develop mental illness. I hope this will motivate scientists, doctors and policymakers to pay more attention to problems around birth, and how they can affect the brain in the long-term.’

Dr Chiara Nosarti, the study’s joint senior author from King’s College London, said ‘The discovery of a potential mechanism linking early life risk factors to adult mental illness could one day lead to more targeted and effective treatments of psychiatric problems in people who experienced complications at birth.’

Professor Oliver Howes, the study’s other joint senior author, also from King’s, said: ‘These findings could help develop approaches to prevent the development of problems in people who were born early.’

The study was funded by the March of Dimes and the Medical Research Council, and was supported by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre.

Full Article:https://www.sciencedaily.com/releases/2017/11/171128090957.htm

Observational study found that even small variations in light can wake up very preterm infants in a neonatal intensive care unit

Abstract

Aim-This prospective observational study evaluated the behavioural responses of very preterm infants to spontaneous light variations.

Methods-We measured spontaneous light variations in the incubators of 27 very preterm infants, with a median gestational age of 28 weeks (range 26–31 weeks), over 10 hours. All of them had been admitted to the neonatal care unit of the Strasbourg University Hospital, France, between April 2008 and July 2009. Two independent raters examined changes in the infants’ behavioural states using video recordings. The percentage of awakenings was recorded when there were light variations and during control periods with no changes.

Results-We analysed 275 periods following light variations and 275 control periods. The overall percentage of awakenings was greater during periods following a change in light than during control periods (16.3% vs 11%, p = 0.03). The extent of light protection affected the percentage of awakenings. In mild light protection, there were more awakenings following changes in light than in control periods (25.6% vs 6.7%, p = 0.01). This difference was not found in high light protection.

Conclusion-Very preterm infants can be woken up by small variations in light, when the light protection in their incubator is insufficient.

Full Article: https://onlinelibrary.wiley.com/doi/abs/10.1111/apa.14261

Science News

Rapid whole-genome sequencing of neonatal ICU patients is useful and cost-effective

Date: October 19, 2017 Source: American Society of Human Genetics

Rapid whole-genome sequencing (WGS) of acutely ill neonatal intensive care unit (NICU) patients in the first few days of life yields clinically useful diagnoses in many cases, and results in lower aggregate costs than the current standard of care, according to findings presented at the American Society of Human Genetics (ASHG) 2017 Annual Meeting in Orlando, Fla.

Shimul Chowdhury, PhD, FACMG, Clinical Laboratory Director at the Rady Children’s Institute for Genomic Medicine, and his colleagues focused their analysis on a broad swath of NICU patients for whom a genetic diagnosis might help inform treatment decisions and disease management. They studied the clinical utility and cost-effectiveness of sequencing infants and their parents.

“Newborns often don’t fit traditional methods of diagnosis, as they may present with non-specific symptoms or display different signs from older children,” said Dr. Chowdhury. In many such cases, he explained, sequencing can pinpoint the cause of illness, yielding a diagnosis that allows doctors to modify inpatient treatment and resulting in dramatically improved medical outcomes in both the short and long term.

Because of the potential for early intervention and immediate adjustment in care, the researchers used a rapid WGS procedure that took three to seven days from sample collection to delivering results to patients’ families. The process can be further accelerated if medically necessary. In contrast, most clinical diagnostic tests take four to six weeks.

In 34 (35%) of the 98 patients enrolled in the study, WGS yielded a genetic diagnosis, and in 28 (80%) of those patients, that diagnosis led to changes in medical management, such as the use of medications targeted to the underlying disease, avoidance of unnecessary surgery, and guidance about palliative care. Cost-effectiveness analyses are ongoing, but among the first 42 infants sequenced, the researchers calculated a $1.3 million net cost savings for that hospitalization versus the current standard of care.

“The cost savings were especially striking, given that sequencing costs are still high — even with those costs, we found that rapid WGS was not just clinically useful but economically prudent,” Dr. Chowdhury said. “Given these benefits, we’d eventually like to see rapid WGS as a reimbursable first-tier test for a proportion of infants in the NICU.”

Currently, the researchers are looking to expand their study and assess the effectiveness of their approach across health systems and populations. This summer, they launched partnerships with children’s hospitals in California and Minnesota, an effort that will involve scaling up the rapid WGS process to meet demand and yield new insights about its clinical utility, cost-effectiveness, and ease of implementation in different environments.

Dr. Chowdhury noted the important contribution of genetics research to their progress so far. “Translational research leading to improvements in the speed and accuracy of sequencing tests is so important to our work and has a real impact on patients and their families,” he said.

Full Article: https://www.sciencedaily.com/releases/2017/10/171019110855.htm

                                          

INNOVATIONS

Tracking preemies’ blood flow to monitor brain maturation

December 11, 2017Share List

Blood is the conduit through which our cells receive much of what they need to grow and thrive. The nutrients and oxygen that cells require are transported by this liquid messenger. Getting adequate blood flow is especially important during the rapid growth of gestation and early childhood – particularly for the brain, the weight of which roughly triples during the last 13 weeks of a typical pregnancy. Any disruption to blood flow during this time could dramatically affect the development of this critical organ.

Now, a new study by Children’s National Health System researchers finds that blood flow to key regions of very premature infants’ brains is altered, providing an early warning sign of disturbed brain maturation well before such injury is visible on conventional imaging. The prospective, observational study was published online Dec. 4, 2017 by The Journal of Pediatrics.

“During the third trimester of pregnancy, the fetal brain undergoes an unprecedented growth spurt. To power that growth, cerebral blood flow increases and delivers the extra oxygen and nutrients needed to nurture normal brain development,” says Catherine Limperopoulos, Ph.D., director of the Developing Brain Research Laboratory at Children’s National and senior author of the study. “In full-term pregnancies, these critical brain structures mature inside the protective womb where the fetus can hear the mother and her heartbeat, which stimulates additional brain maturation. For infants born preterm, however, this essential maturation process happens in settings often stripped of such stimuli.”

The challenge: How to capture what goes right or wrong in the developing brains of these very fragile newborns? The researchers relied on arterial spin labeling (ASL) magnetic resonance (MR) imaging, a noninvasive technique that labels the water portion of blood to map how blood flows through infants’ brains in order to describe which regions do or do not receive adequate blood supply. The imaging work can be done without a contrast agent since water from arterial blood itself illuminates the path traveled by cerebral blood.

“In our study, very preterm infants had greater absolute cortical cerebral blood flow compared with full-term infants. Within regions, however, the insula (a region critical to experiencing emotion), anterior cingulate cortex (a region involved in cognitive processes) and auditory cortex (a region involved in processing sound) for preterm infants received a significantly decreased volume of blood, compared with full-term infants. For preterm infants, parenchymal brain injury and the need for cardiac vasopressor support both were correlated with decreased regional CBF,” Limperopoulos adds.

The team studied 98 preterm infants who were born June 2012 to December 2015, were younger than 32 gestational weeks at birth and who weighed less than 1,500 grams. They matched those preemies by gestational age with 104 infants who had been carried to term. The brain MRIs were performed as the infants slept.

Blood flows where it is needed most with areas of the brain that are used more heavily commandeering more oxygen and nutrients. Thus, during brain development, CBF is a good indicator of functional brain maturation since brain areas that are the most metabolically active need more blood.

“The ongoing maturation of the newborn’s brain can be seen in the distribution pattern of cerebral blood flow, with the greatest volume of blood traveling to the brainstem and deep grey matter,” says Marine Bouyssi-Kobar, M.S., the study’s lead author. “Because of the sharp resolution provided by ASL-MR images, our study finds that in addition to the brainstem and deep grey matter, the insula and the areas of the brain responsible for sensory and motor functions are also among the most oxygenated regions. This underscores the critical importance of these brain regions in early brain development. In preterm infants, the insula may be particularly vulnerable to the added stresses of life outside the womb.”

Of note, compromised regional brain structures in adults are implicated in multiple neurodevelopmental disorders. “Altered development of the insula and anterior cingulate cortex in newborns may represent early warning signs of preterm infants at greater risk for long-term neurodevelopmental impairments,” Limperopoulos says.

Research reported in this post was supported by the Canadian Institutes of Health Research, MOP-81116; the SickKids Foundation, XG 06-069; and the National Institutes of Health under award number R01 HL116585-01.

Hydrotherapy in the Sharp Mary Birch NICU

Published on Jan 2, 2018  Youtube-Sharp Mary Birch Hospital for Women & Newborns is one of only a few hospitals to offer hydrotherapy, a unique form of developmental care that helps strengthen the bodies of premature babies.

 

APP: Zero Mothers Die Application

The Zero Mothers Die App (ZMD App) is a source of essential maternal, newborn and child health information for pregnant women, new mothers and health workers providing care to their community.

As a unique mobile health app, the ZMD App delivers crucial information on healthy pregnancy and taking care of newborns for both the general public (women and their families) as well as frontline health workers, to help bridge the knowledge and skills gap as well as reduce maternal and newborn mortality across the globe.

The ZMD App has been launched for Android devices and is available in English, French, Spanish and Oromo.

Published on Sep 18, 2014-Zero Mothers Die is a global partnership initiative to reduce maternal mortality through the use of mobile technologies and cross-sector partnerships. Our aim is to support pregnant women, new mothers and local health workers to overcome barriers to maternal, newborn and child health using accessible mobile technology.

 

PREEMIE FAMILY PARTNERS

Premature babies healthier when parents help with hospital care, study shows Babies in trial put on more weight in first three weeks and parents were less stressed

Sarah Boseley – Health editor – 7 Feb 2018

Premature babies do better if their parents are allowed to help care for them in hospital alongside the nurses, rather than being treated as visitors and left on the sidelines, a new study shows.

Many parents feel acutely anxious, stressed and out of control when their child is in a newborn intensive care unit and there seems to be nothing they can do for her. Inspired by the example of a hospital in Estonia that brings in parents to help with basic care of their baby, doctors in Canada organized a major study in three countries – Canada, Australia and New Zealand – to see what the effect is on the baby.

Mothers in early 30s have lowest premature birth risk, study finds.

In their paper in the Lancet Child and Adolescent Health journal, they say that feeling excluded in the premature baby unit could have long-term consequences for the parents. “These feelings of helplessness, anxiety, depression, and fear might contribute to their inability to assume normal parenting roles,” they write.

The study involved 26 hospitals and nearly 1,800 babies, half of whom had basic care from their parents alongside the nursing staff, while the other half did not. Parents had to commit to spending six hours a day, five days a week, in the unit and were trained to help. They bathed, fed and dressed their babies, changed nappies, gave oral medication and took temperatures. They were encouraged to take part in decisions about the baby’s treatment, join ward rounds and chart their infant’s growth and progress.

The babies on what was called FiCare – family integrated care – had put on more weight by 21 days, their parents were less stressed and once the baby went home, the mothers were more likely to breastfeed frequently than mothers who had been less involved in the hospital.

“How care is provided to the family, not just the infant, has a positive effect on the wellbeing of both infant and family,” says Dr. Karel O’Brien, of the department of paediatrics, Sinai Health System, Toronto, Canada. “Weight gain, breastfeeding and reduced parental stress and anxiety are all associated with positive neurodevelopmental outcomes, suggesting that integrating parents into the care of infants at this early stage could potentially have longer-term benefits.”

Full Article:https://www.theguardian.com/society/2018/feb/07/premature-babies-healthier-when-parents-help-with-hospital-care-study-shows

Can you reduce your risk for preterm labor and premature birth?

Yes, you may be able to reduce your risk for early labor and birth. Some risk factors are things you can’t change, like having a premature birth in a previous pregnancy. Others are things you can do something about, like quitting smoking. Here’s what you can do to reduce your risk for preterm labor and premature birth:

• Get to a healthy weight before pregnancy and gain the right amount of weight during pregnancy. Talk to your provider about the right amount of weight for you before and during pregnancy.
• Don’t smoke, drink alcohol use street drugs or abuse prescription drugs. Ask your provider about programs that can help you quit.
• Go to your first prenatal care checkup as soon as you think you’re pregnant. During pregnancy, go to all your prenatal care checkups, even if you’re feeling fine. Prenatal care helps your provider make sure you and your baby are healthy.
• Get treated for chronic health conditions, like high blood pressure, diabetes, depression and thyroid problems. Depression is a medical condition in which strong feelings of sadness last for a long time and interfere with your daily life. It needs treatment to get better. The thyroid is a gland in your neck that makes hormones that help your body store and use energy from food.
• Protect yourself from infections. Talk to your provider about vaccinations that can help protect you from certain infections. Wash your hands with soap and water after using the bathroom or blowing your nose. Don’t eat raw meat, fish or eggs. Have safe sex. Don’t touch cat poop.
• Reduce your stress. Eat healthy foods and do something active every day. Ask family and friends for help around the house or taking care of other children. Get help if your partner abuses you. Talk to your boss about how to lower your stress at work.
• Wait at least 18 months between giving birth and getting pregnant again. Use birth control until you’re ready to get pregnant again. If you’re older than 35 or you’ve had a miscarriage or stillbirth, talk to your provider about how long to wait between pregnancies. Miscarriage is the death of a baby in the womb before 20 weeks of pregnancy. Stillbirth is the death of a baby in the womb after 20 weeks of pregnancy.

Full Article: https://www.marchofdimes.org/complications/preterm-labor-and-premature-birth-are-you-at-risk.aspx

 WARRIORS:

Our next blog will begin to integrate Kat’s story as a preterm birth survivor into our Writing-for- Wellness experience. Please share her journey and reflect on your unique life adventures. In doing so, you will empower your-SELF!

Our (Kathy) Story Continues –Writing for Wellness:

After Kathryn’s distance healing at about age one, the ER visits ended and a new-normal developed. I nursed Kat until she was a bit over three years of age, believing with conviction that breast milk was crucial for her survival. I continued to provide Kat with the back and chest massage and tapping that the Respiratory Therapist/healer had empowered me with. In prayer and meditation daily I saw Kathryn and her siblings healthy and happy. Playing biddy sports and taking swimming lessons starting at the age of 3 yrs. Kathryn seemed different from the other kids in that she was so small and so affectionately distracted by her fellow classmates and team members. Playing tee ball, Kat would stop and hug each player as she ran the bases. The deep grove the intubation tube had created in Kathryn’s mouth generated a series of very displaced and disorganized teeth, requiring braces starting at age eight (an eight-year process). Around the time the braces were applied, Kathryn came home from school and announced that she wanted to be called Kat and then she said “I want to be a humanitarian when I grow up”. I stared at her and thought “you have got to be **** kidding me!”, and in that moment my role in her life changed and my parental responsibilities were dramatically redirected.

Entering the pre-teen years Kat’s height surpassed the estimated maximum height of 4’10” the medical professionals had anticipated. At age 17 yrs. Kathryn underwent a hymenectomy, and we were told that it was not uncommon for female preemies to require the surgery. Kat played various school and private league sports, usually in a leadership capacity. She was strong willed and often chose to do things her own way, creating conflict with authority figures. Kathryn determined she wanted to attend the most culturally diverse high school in Washington State at that time in order to globalize her worldview, and Mariner High School in Everett, WA. was the perfect place to accomplish that objective. Over time, Kathryn exhibited unexpected skills such as the ability to Latin dance, Krump and perform dissections in science classes with ease. Attending college in Missouri, Kat made friends with students from all across the globe and in the process developed intermediate Portuguese language skills. I wonder what effects the 60 plus transfusions Kathryn received while in the NICU played in the development of her global attraction and development of unanticipated talents. Did her emergent connection with her heart surgeon transfer to Kathryn, whose current intent is to become a trauma surgeon, influence her path forward?

It is the universal lesson of being present and letting go that our children, no matter how long or short their journey, presents to us. Following Kathryn’s announcement that she wanted to be a humanitarian, I exposed her to many great minds and healers through the process of attending book signings and lectures. Kathryn would carry the books through the lines for a handshake and a signing by the likes of Dr. Larry Dossey, Dr. Bernie Siegal, Bruce Lipton Ph.D., Marianne Williamson, and Dr. Deepak Chopra. I recall Deepak’s surprised look at seeing a child so small asking for her book to be signed. He said to her, “Where is your mother?” Kathryn’s spirituality and healing abilities developed over time. She sought shamanism training through Bastyr University, attended lectures by Dr. Mehmet and Lisa Oz, and participated in a non-traditional volunteer experience and medical shadow with John of God in Brazil. Kathryn nourished a loving connection with our beloved minister and teacher Imam Jamal Rahman (The Three Amigos), his dear friend, Rabbi Falcon, and she shared a hug and prayer with the beautiful and generous Amma. I was gladdened as Kathryn connected with the amazing health care providers and staff, magnificent doctors, NICU babies and family members at the University of Washington and Harborview Medical Centers as her mentoring process was thus enhanced and my responsibilities shared.

At times I think about the lyrics of the song “The Dance” (lyrics by Garth Brooks) and wonder if I would have agreed to this dance with Cruz and Kat knowing the challenges I encountered? In reflection, I so appreciate the surrender that not knowing presents, the richness and power that faith reveals.  Out of such pain and chaos, unimaginable beauty and exquisite love prevail.

One in every 10 babies born in the U.S. is admitted to a neonatal intensive care unit, according to the March of Dimes. Statistically NICU parents encounter a very high level of divorce and often experience the effects of post-traumatic stress disorder. PTSD in NICU parents is socially unrecognized and is often undiagnosed and untreated. The constant exposure to death, the breath by breath effort to sustain life, a myriad of medical complications due to preterm birth, interacting with a womb so different than the natural womb, overwhelming financial challenges, the unexpected and permanent disruption and reorganization of so many lives and immediate need to create balance within chaos produces untold stress for NICU/preterm birth journeyers. As preterm birth parents, we have the longing and potential for healing. So often, the one-foot-in-front-of-the-other rhythm that carries us through the NICU orientation becomes a life pattern, and the needs of our feeling bodies are never heard or healed.

At 27 years of age, Kathryn stands tall at 5 ft. 5 inches. Proudly wearing her surgical scars as her Zumba Instructor shirt whirls around her, Kathryn dances to the music of the global community she embraces. Knowing she has much to experience as a preterm birth survivor Kathryn’s life journey continues to expose itself, seeking to be heard and healed. Despite the common thought that a NICU survivor cannot remember the early trauma of their human beginnings, nothing could be further from the truth. The body and brain are one, and although a preterm infant is without language skills, the body has memory, feeling, and knowledge stored within the vast energetic system that contains the human experience. Epigenetic and super gene sciences continue to expand our understanding of the wildly complex, beautifully sensitive nature of a life journey.

As Kathryn continues to understand, explore, recognize and empower her healing potentials, both self and other oriented, my hope is that she will continue to heal, grow and engage with other NICU/preterm birth survivors. Perhaps through connection they will shed light into the mysteries of life for a preterm being nurtured and supported within the Neonatal Womb, and their companionship will deepen their breathe, open their hearts, inspire them, and carry them forward with courage and resolve.

KAT’S CORNER

May the Gratitude in My Heart Kiss all the Universe – Hafiz

In the writing above we identified some critical events that lead me to my current path in life. Warriors, if you were to list the important events in your life and connect the dots what kind of picture would it create and would it reflect where you are at in your journey?

White Water Surf Racing in Nepal

Published on Aug 16, 2016 – 2017 will ca 4 Event White Water Surfing Race Series in Nepal.Hosted by the Nepal National Surfing Association and organized by Surfing Nepal.