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> NICU neonatal intensive care unit, Planning to switch hospital

lowlowc
post Jan 11 2019, 02:27 PM, updated 2w ago

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Has anyone ever switch their baby from one hospital NICU to another? My baby is in NICU at govt hospital. I can see they are understaffed. Most babies were fed n a rush using syringe and most of the milk just overflowed from their mouth. I ve tried to breastfeed as much as i can but not always succesful because premature baby tends to fall asleep all the time. If nurses saw me therrle, they just assume they dont have to feed my bb later. My baby's weight keep dropping and i m thinking to switch to nearer private hospital.

My baby can have 3 change of diapers per feed, but wheb i voiced concern, they just told me it s normal. The earlier estimated stay at nicu just keep on prolonging. Will govt hospital allow release of baby from their nicu to private hosp?

This post has been edited by lowlowc: Jan 11 2019, 02:30 PM
ijan
post Jan 11 2019, 02:30 PM

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stay at government hospital

Kalau small matter can go private, things like this, no no

The hospital has NICU means is the higher and better equipped and staffed hospital.


doczane
post Jan 11 2019, 02:42 PM

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NICU in private may go up to RM1k per day. So think wisely before going. Due to low patient numbers and better nurse to baby ratio, your child may have better care. But don’t underestimate the better experience of gomen nicu staff who handles much larger numbers. They can be better than docs sometimes.
Babies will BO usually within post feeding. Not necessarily few times per post feed. If no BO more than 3 days, only should u be concerned. Be patient, u can attend to your baby as frequently as possible to improve mum baby bonding rather than expecting the overworked nurses. It improve your baby’s immunity as well so less incidence of infection while waiting for weight gain. What’s his weight now? Usually >1.8kg can go home

This post has been edited by doczane: Jan 11 2019, 02:42 PM
doczane
post Jan 11 2019, 02:48 PM

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QUOTE(lowlowc @ Jan 11 2019, 02:27 PM)
Has anyone ever switch their baby from one hospital NICU to another? My baby is in NICU at govt hospital. I can see they are understaffed. Most babies were fed n a rush using syringe and most of the milk just overflowed from their mouth. I ve tried to breastfeed as much as i can but not always succesful because premature baby tends to fall asleep all the time. If nurses saw me therrle, they just assume they dont have to feed my bb later. My baby's weight keep dropping and i m thinking to switch to nearer private hospital.

My baby can have 3 change of diapers per feed, but wheb i voiced concern, they just told me it s normal. The earlier estimated stay at nicu just keep on prolonging. Will govt hospital allow release of baby from their nicu to private hosp?
*
Parents have autonomy over their child’s care, of course u can take him out to another hospital if condition is permitting. If he’s unstable, hospital won’t allow but u can overrule them by signing AOR ( At own risk ) discharge which frees the hospital from any legal liability due to the decision.
Nurses have proper charting of the baby’s feed, they observe or will note you feeding him and they’ll chart it accordingly. So they’ll feed once the next cycle due if u are not around. All has system dear, we are not 3rd world country. But human error can happen, support them and make their life easier as well. Mistrust will cause over cautious and avoidance in their part which could lead to neglect. So loosen up

lowlowc
post Jan 11 2019, 06:34 PM

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QUOTE(doczane @ Jan 11 2019, 02:48 PM)
Parents have autonomy over their child’s care, of course u can take him out to another hospital if condition is permitting. If he’s unstable, hospital won’t allow but u can overrule them by signing AOR ( At own risk ) discharge which frees the hospital from any legal liability due to the decision.
Nurses have proper charting of the baby’s feed, they observe or will note you feeding him and they’ll chart it accordingly. So they’ll feed once the next cycle due if u are not around. All has system dear, we are not 3rd world country. But human error can happen, support them and make their life easier as well. Mistrust will cause over cautious and avoidance in their part which could lead to neglect. So loosen up
*
I trust that the medical personels are doing their best, but i am unsure about the system. They only feed once every 3 hours without taking into account the baby was fed with formula or breastmilk (mothers will pass milk to nicu but not everyone has enough milk, where formula will be used.) Isn't breastmilk will be digested faster, and babies will get hungry faster?

And i have observe some of the things:

1. If the baby happened to fall asleep during the scheduled feeding time, they will be fed, but try to force down the milk where most of them ended up on the napkin rather than in their stomach. At non-feeding time, baby won't be fed even though they're crying hungry.

2. Few days ago, the parent of the baby next to mine told me, my baby had cried non-stop for 30 minutes the day before (after I went back home). She had to call a nurse to calm my baby down with more feeding. He's hungry, but because it wasn't feeding time, he wasn't fed.

3. Yesterday, I had personally seen the another baby (in same room as mine) cry for 15 minutes without anyone checking on him. I too, have to call a nurse to check on him.

4. The feeding time was 12pm, 3pm, 6pm and go on.. Yesterday I had breastfed him at 12pm. At 2pm, my baby cry for more milk at 2pm. I gave him some, but he fall asleep after only drinking for 5 minutes. When nurse came at 3pm, she asked, and I answered I only managed to fed him for 5 minutes at 2pm. So she said she will skip feeding my baby, but I told her i would prefer her to top up as I really fed him very little. I went out for lunch and nursing, came back 5pm. I was told that since he hasn't woke up, she didn't top up milk for him. Considering he only drank so little at 2pm, he has gone 4 hours without milk before they feed him at 6! If I don't take the 2pm into account, he hasn't drink for 5 hours! So today, my baby's weight dropped by 40g. Sounds like small weight but for a 1.6kg baby, it's a lot.

We are constantly working very hard to make him gain 10g, then he just easily dropped 30, 40g in one day.

I admit that my baby is frequently lethargic and sometimes sleeps through feeding time, but the system failed to be flexible for babies with erratic hungry time.

5. I had witnessed a nurse accidentally knocking my baby's head on the phototheraphy machine. I was shocked and can only pray this only happen once and no permanent damage on him. What if this happens more frequently than I thought?

6. One nurse vs 4-5 babies at one time and they still have other duty to do, than to stay in the same room with the babies. Most of the time, the babies were unattended.

For almost two weeks now, we had been spending 10 hours daily at hospital, but unfortunately I cannot stay there throughout the feeding. I am still post partum and post-csection and I am starting to have dizzy spells and my surgery site hurts. Today is the first day when only my husband go there, insisting I stay at home to get more sleep. But I can't stop worrying. I am trying to find the best decision for my baby.

We had talked with other parents and many of them had easily spent 1 month, 2 months there. I am starting to worry because without the real 'intensive' care, I think it will be long before my baby can gain enough weight to come home with us.

I am also concerned that having breastfeeding him, he had since rejected syringe feeding cause he got used to snuggle with me. We can't stay at the NICU 24 hours to breastfeed him.

This post has been edited by lowlowc: Jan 11 2019, 06:40 PM
doczane
post Jan 11 2019, 09:07 PM

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Your concern sounds valid and you have been observant enough about it seems. My suggestion is you could first bring up your concern to the sister or matron in charge of the nicu about the issues to let them be aware of your concern or clarifies with you of their routine and handling of missed feeding. Any dismissal or reluctance about it from their part, you can bring it up to the specialist neonatologist in charge of your baby. Make an appointment to see him/ her, they’ll surely oblige.
Prem babies are given either breast milk or specialized higher calorie formulation made for prem babies. Nurses will give them to your baby only if your expressed breastmilk is insufficient for his requirement as supplement
Other option of handling babies with poor weight gain is giving milk by orogastric tube by continuous infusion in a scheduled period of time. If this is also insufficient, only then they will supplement your baby with nutrition solution through intravenous administration, the Neonatalogist in charge will decide on this upon monitoring your baby’s progress.
All this method are routine in nicu setting even in government hospitals, it can be expensive in private hospital setting as all these are heavily subsidized in gomen. A pack of IV nutrition can cost few hundreds per day. Unless there is true neglect and poor progress on the hospital part despite you discussing with them about it and certain there is no other cause for it, then its fair for you to take him elsewhere. Anyhow, do discuss it properly with the managing team and be tactful about it sincerely for the best outcome for your precious baby. He’s already 1.6kg, 200g to go, won’t be long now, stay strong for him at this critical period of his life ya.

powerlinkers
post Jan 11 2019, 09:27 PM

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You are free to AOR discharge your baby at any point. No government hospital doctor can stop unless you have abused your child.

Milk overflow from the mouth will not kill your baby unless they cause aspiration( which I do not think the case here). If you prefer to feed your baby on your own: you should tell the staff nurse in charge and be a more responsible mother to feed the baby by yourself.

Human breast milk is the best for neonates. If you have cared about your baby: you would have made effort to EBM prior posting. If you are unable to express breast milk, find pumps or seek doctor consultation to increase your breast milk production by taking medication.

If you go private hospital : it could cost you RM2k-4k/day for stay at NICU.
Insurance will not cover these costs.

Not all private hospitals have Neonatologists.

Not all private hospitals follow the protocols set by Ministry of Health fully.
Government hospital staff nurses are good, unfortunately they are burdened with high workload.

Moreover, do not ever think that private hospitals will deliver a better care for Intensive Care in Malaysia: with exception to certain big hospitals in Greater Kuala Lumpur, Penang, Malacca and Johor Bahru: which would charge 2-3x of other private hospitals.

Personally : I would suggest you to meet with pediatrician(specialist) in charge or sister in charge of NICU for your child and voice out your concerns to find a solution.

Unfortunately : you have made up your mind that these staff nurses are incompetent , so AOR discharge your child . Find out how the private hospitals would treat your neonate and you will learn a life lesson by the hard way. If you are planning for 8 week stay of your child in a private hospital: be prepared to pay at least RM 110k.

This post has been edited by powerlinkers: Jan 11 2019, 09:32 PM
Mrs.A
post Jan 12 2019, 05:03 PM

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Can, with a footnote.. your hospital should have the same/higher standard equipment+Service than your current hospital. Otherwise your current hospital would let you go, but other private hospitals with lower standard won’t accept you. For your concern, if let’s say you want to relocate your preemie to Gleneagles, you should be ready to pay 3x the price of government hospital’s fee. The good news, you can request for private nurse(additional charge). So you don’t need to worry about your son’s daily care/treatment. Good luck.
Mrs.A
post Jan 12 2019, 05:42 PM

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QUOTE(powerlinkers @ Jan 11 2019, 09:27 PM)
You are free to AOR discharge your baby at any point. No government hospital doctor can stop unless you have abused your child.

Milk overflow from the mouth will not kill your baby unless they cause aspiration( which I do not think the case here). If you prefer to feed your baby on your own: you should tell the staff nurse in charge and be a more responsible mother to feed the baby by yourself.

Human breast milk is the best for neonates. If you have cared about your baby: you would have made effort to EBM prior posting. If you are unable to express breast milk, find pumps or seek doctor consultation to increase your breast milk production by taking medication.

If you go private hospital : it could cost you RM2k-4k/day for stay at NICU.
Insurance will not cover these costs.

Not all private hospitals have Neonatologists.

Not all private hospitals follow the protocols set by Ministry of Health fully.
Government hospital staff nurses are good, unfortunately they are burdened with high workload.

Moreover, do not ever think that private hospitals will deliver a better care for Intensive Care in Malaysia: with exception to certain big hospitals in Greater Kuala Lumpur, Penang, Malacca and Johor Bahru: which would charge 2-3x of other private hospitals.

Personally : I would suggest you to meet with pediatrician(specialist) in charge or sister in charge of NICU for your child and voice out your concerns to find a solution.

Unfortunately : you have made up your mind that these staff nurses are incompetent , so AOR discharge your child . Find out how the private hospitals would treat your neonate and you will learn a life lesson by the hard way. If you are planning for 8 week stay of your child in a private hospital: be prepared to pay at least RM 110k.
*
You are free to AOR discharge your baby at any point. No government hospital doctor can stop unless you have abused your child. ———— come on! TS open this thread because she concern so much about her baby. I don’t think “abusive” possibility should be on that comment.

Milk overflow from the mouth will not kill your baby unless they cause aspiration( which I do not think the case here). If you prefer to feed your baby on your own: you should tell the staff nurse in charge and be a more responsible mother to feed the baby by yourself. ————— she’s a first time mother, just because she’s not give the milk by herself doesn’t mean she’s irresponsible. Every woman are different, especially after everything she has been through, it’s really understandable if she has less confidence and prefer let the professional manage. Inside her mind now, she just want the best for her baby, in case you never read TS earlier post... please do.. her bundle of joy arrived much much more earlier than the due date.

Human breast milk is the best for neonates. If you have cared about your baby: you would have made effort to EBM prior posting. If you are unable to express breast milk, find pumps or seek doctor consultation to increase your breast milk production by taking medication. ———— I’m speechless.

If you go private hospital : it could cost you RM2k-4k/day for stay at NICU.
Insurance will not cover these costs. ———— not true

Not all private hospitals have Neonatologists. ———— most of the hospital that have the lisence/permit to operating the NICU have neonatologist as the head of NICU, if not it will be headed by senior paediatrician.

Not all private hospitals follow the protocols set by Ministry of Health fully. ————— not true, Services and equipments might vary. But the safety and standard protocol should follow the MOH requirement.


Government hospital staff nurses are good, unfortunately they are burdened with high workload. ——— True

Moreover, do not ever think that private hospitals will deliver a better care for Intensive Care in Malaysia: with exception to certain big hospitals in Greater Kuala Lumpur, Penang, Malacca and Johor Bahru: which would charge 2-3x of other private hospitals. ————— it’s too exaggerated

Personally : I would suggest you to meet with pediatrician(specialist) in charge or sister in charge of NICU for your child and voice out your concerns to find a solution. ———— I’m agree with this

Unfortunately : you have made up your mind that these staff nurses are incompetent , so AOR discharge your child . Find out how the private hospitals would treat your neonate and you will learn a life lesson by the hard way. If you are planning for 8 week stay of your child in a private hospital: be prepared to pay at least RM 110k. ————— whoever you are, don’t you think that your comment a bit exaggerating? Anyway, why she would learn a life lesson in a hard way??? If it’s 110K and she can afford so what??? You never know! You don’t know anything about her, don’t you? She just seeking for an advice. Why don’t you share your knowledge in a positive way??? 110K is nothing if it could give a mother peace and a healthy baby in her arms. Oh if your next comment gonna be like “110K is nothing? Yeah you can say that because you don’t spend that money!”, I’ll give you a direct statement before you wrote other negative comment, I spent RM130K when gave birth to my son just because I can afford and I want the best experience. And my RM130K worth every penny!!! smile.gif

This post has been edited by Mrs.A: Jan 12 2019, 05:46 PM
Mrs.A
post Jan 12 2019, 05:49 PM

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QUOTE(lowlowc @ Jan 11 2019, 02:27 PM)
Has anyone ever switch their baby from one hospital NICU to another? My baby is in NICU at govt hospital. I can see they are understaffed. Most babies were fed n a rush using syringe and most of the milk just overflowed from their mouth. I ve tried to breastfeed as much as i can but not always succesful because premature baby tends to fall asleep all the time. If nurses saw me therrle, they just assume they dont have to feed my bb later. My baby's weight keep dropping and i m thinking to switch to nearer private hospital.

My baby can have 3 change of diapers per feed, but wheb i voiced concern, they just told me it s normal. The earlier estimated stay at nicu just keep on prolonging. Will govt hospital allow release of baby from their nicu to private hosp?
*
Please stay strong and consult your Paed. I hope you can find a solution.

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