Excela used special CPAP for baby for first time

Ian and Samantha Wirth of Hempfield Township and their newborn daughter, Ayla Joy, enjoy some family time at Excela Health Westmoreland Hospital. Ayla was born five weeks early and was treated for breathing problems with a portable bubble CPAP (continuous positive airway pressure) therapy device at the Greensburg hospital, which helped prevent her from having to be transferred to Children’s Hospital of Pittsburgh.

Ayla Wirth’s breathing was fast and labored when she was born five weeks early at Excela Health Westmoreland Hospital on Feb. 3.

Because she did not respond well to CPAP (continuous positive airway pressure) therapy, the next step would have been to intubate her and transfer her to Children’s Hospital of Pittsburgh where their neonatal ICU would have provided her with the oxygen she required.

Instead, tiny Ayla became the first newborn at the Greensburg hospital to be treated with a portable bubble CPAP.

“Her color was terrible when she was first born,” said her father Ian Wirth of Hempfield, a registered nurse in the ICU at Excela Health Frick Hospital in Mount Pleasant. “She was not doing well at all. But within an hour, the bubble CPAP turned her breathing around and she was requiring less oxygen.”

The bubble CPAP is a non-invasive respiratory support for spontaneously breathing babies. It has saved thousands of newborns’ lives, according to a report in RT Magazine For Decision Makers in Respiratory Care.

The delivery system uses a humidified gas source, an interface that connects the CPAP circuit to the infant’s airway through short nasal prongs, and an adjustable CPAP generator filled with sterile water. Bubbles are created as the gas exits the generator, and that in turn produces small airway pressure oscillations. That results in improved gas exchange and lung function when those oscillations reach the baby’s lungs.

According to Jeff Oliver, RRT/RPFT, the system director of the hospital’s respiratory care, Excela Health developed the bubble CPAP protocol more than a year ago, under the guidance of neonatologist Andrea Willeitner, MD, IBCLC, FAAP. Dr. Willeitner is medical director of Excela Health Level II, Special Care Nursery.

Ayla also became the first recipient of another new program when the hospital obtained donated breast milk for her from the Pittsburgh-based Mid-Atlantic Mothers’ Milk Bank. It was provided for her as a “bridge” until her mother’s milk fully developed.

According to Wirth, he and his wife Samantha had lost a son who was stillborn at just over 22 weeks of gestation, and she was at risk for another early labor.

“We weren’t expecting Samantha to go so soon with Ayla,” he said. “She went into labor that Sunday night, at just over 35 weeks, which is premature. I was at work when she called me, and we weren’t sure it was for real. I left work.”

Their daughter was born early that Monday morning, weighing in at just 5 pounds and 12 ounces. The parents were able to stay in Samantha’s post-partum room even after she was discharged.

Dr. Willeitner noted the importance of keeping the parents and baby together.

“The parents and the baby would have been separated if she would have gone to Pittsburgh,” she said. “That’s physically and emotionally taxing, and that would put additional stress on the newborn and the mother.”

Excela Health has two of the gentle and efficient bubble CPAP systems as part of the Family Additions Maternity Center. More than 1,200 babies are delivered there every year, and approximately 10% of those newborns require some type of intervention or special nursery care.

Ayla needed not only that, but also the mother’s milk until her own mother was able to produce it herself.

Dr. Willeitner is a board certified lactation consultant.

“Breast milk is very important for premature babies,” she said. “Pre-term babies who are breastfed are less likely to develop intestinal infections than are babies who are formula fed. The milk that Samantha Wirth produced in the first few days contained high antibodies to help her daughter to fight infection.”

Ayla went home on Feb. 8 and is doing well, according to her father.

“Her breathing stabilized and she has been off oxygen,” he said. “We have to be careful that she doesn’t get sick and we are being careful about screening family and friends. We have lots of people asking about her, but we’re really trying to keep her at home for a month or two.”

He and his wife, who teaches at Armbrust Wesleyan Christian Academy, are grateful for the care that Ayla received at the hospital, and that they had the bubble CPAP and breast milk available for her.

“We want to give God the glory, too,” Wirth said. “There were so many people praying for us.”

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