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Advocating for more NICU beds

‘We can’t have a temporary solution.’ Surge in sick babies prompts calls for more planning, funding for Ontario neonatal care

When Kelly O’Dwyer-Manuel heard Ontario was grappling with a surge in sick babies needing intensive care, she got teary-eyed and took to Twitter to call for change.

The news brought back all the terrifying feelings of being in the neonatal intensive care unit last year.

“It was a hardship having to move to a new city while Little C was in the hospital. This situation is unsustainable and MUST be solved!” she tweeted.

O’Dwyer-Manuel, who lives in Peterborough, delivered her first baby 26 weeks into her pregnancy last year. She and her husband had to move to Toronto for three months while their infant son, Charlie, was treated at Sunnybrook Health Sciences Centre.

“As first-time parents, we were already really nervous and stressed because this was such a difficult pregnancy and we didn’t know what was going on,” she said.

As Ontario faces an unanticipated surge in sick babies needing intensive care, some doctors and parents say the government should be providing better funding and long-term planning to deal with the issue.

“They shouldn’t be surprised . . . the demand is going to increase even more with the years,” said Fabiana Bacchini, a board member with the Canadian Premature Babies Foundation. She said surges have happened before, and will happen again — especially as hospitals are better able to treat sick infants.

“We can’t have a temporary solution,” Bacchini said. “We need to think ahead of the game, and how we’re going to solve this permanently.”

Ontario’s Level 3 neonatal intensive care units (NICU), which care for the most fragile newborns, have been struggling with an “unusual” surge in demand since early August, Ontario health officials say. The Level 3 units in Toronto — at SickKids, Mount Sinai Hospital and Sunnybrook Health Sciences Centre — are feeling the most pressure, said David Jensen, a health ministry spokesperson.

The Toronto Central local health integration network is bringing in extra bassinettes to deal with the issue, as well as additional staff as needed. Longer term, the network said it will form strategies with provincial partners for managing the “acuity and volume of high acuity neonatal care if increased volumes persist.”

Bacchini — as well as Richard MacDonald, the Oakville pediatrician who raised alarm bells about the problem on Twitter earlier this week — said there needs to be more funding for NICUs.

The Ministry of Health said it has added $518 million for all public hospitals as part of its 2017 budget, a 3.1 per cent overall increase to the hospital sector. It did not specify how much money was going to neonatal care.

The Ontario Nurses Association cited understaffing as one of the issues contributing to NICUs closing. Provincial vice president Vicki McKenna said hospitals don’t always staff their NICUs as if the units are full, so when there’s an influx of sick babies, there isn’t enough staff to care for them.

Mike Dickinson, president of the Canadian Pediatric Society, said access to NICU beds is also becoming “increasingly difficult” where he works in New Brunswick. As a pediatrician at a smaller centre in Miramichi, he has to send fragile babies to the hospital in Moncton — which is “regularly” closed, he said. Dickinson then has to start calling other hospitals in New Brunswick and Nova Scotia to see where there’s space for the baby.

Dickinson said it wouldn’t surprise him if other jurisdictions across the country are dealing with similar situations.

“You’re always living dangerously close to the edge, where a relatively small surge of babies can put you into deep trouble pretty quickly,” Dickinson said.

The Canadian Association of Pediatric Health Centres — which represents organizations that deliver health-care services to children — said their national data shows the number of patients admitted to NICUs across the country has stayed fairly consistent since 2010.

Ontario’s health ministry is unaware of what has caused the sudden increase in demand and is studying what’s behind it, officials said. Efforts are underway to ensure there is enough capacity, and officials say all babies have received required care so far.

In addition to Toronto and Ottawa, Level 3 units are also located in Kingston, London and Hamilton. Babies get transferred to units outside their communities when bassinets at their local hospitals are full or if they live in smaller communities and require more intense care.

O’Dwyer-Manuel now volunteers with the Canadian National Premature Babies Foundation. She said her husband was lucky to be able to work from home while they lived in Toronto, but many other families had to make long commutes, be separated from their children and spouses, or give up months of income while their baby was in intensive care.

“When you add on the stress of trying to procure a place to live, trying to figure out what you’re going to do with your house back at home . . . the extra three months of maternity leave that we hadn’t budgeted for,” she said.

“It’s just added stress that you don’t want to have to deal with because you just want to focus on your baby, and doing whatever you can to make sure he’s going to make it through this journey.”

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