Ep. 9: Developmental Care in the NICU—Perspectives from Yamile Jackson, PhD, PE, PMP

Yamile Jackson.

Yamile Jackson. Photo courtesy of Nurtured by Design.

Episode 9 features Yamile Jackson, expert parent, Founder and CEO of Nurtured by Design, and award-winning inventor/designer of The Zaky and the Kangaroo Zak. During the episode, Yamile provides a comprehensive overview of Kangaroo Care and ergonomics as related to premature infants and the NICU environment. Yamile also shares her son Zachary’s story of prematurity and survival including a near fatal encounter with a natural disaster during his NICU stay, and how their experience led her to found Nurtured by Design—the first in its class, global leader in neonatal ergonomics. She discusses:

  • The premature birth of her son Zachary at 28 weeks,
  • How Zachary had to be kept alive by hand for 9 hours after Tropical Storm Allison shut down their hospital,
  • How hers and her family’s experience with prematurity led her to invent The Zaky and the Kangaroo Zak,
  • The clinical evidence showing a 50% reduction in apnea and bradycardia events with the use of The Zaky, no events with the use of a maternally-scented Zaky, and 30 times more effective self-regulation with the use of a maternally-scented Zaky,
  • The importance of developmental care and family-centered care in the NICU.

Copyright © 2015 The Morgan Leary Vaughan Fund, Inc. This episode was produced in part by the TeacherCast Educational Broadcasting Network.

STEPHANIE VAUGHAN, HOST: Welcome to Episode 9 of Speaking of NEC—a free, audio podcast series about Necrotizing Enterocolitis.

Produced by The Morgan Leary Vaughan Fund, and funded by The Petit Family Foundation, Speaking of NEC is a series of one-on-one conversations with relevant NEC experts—neonatologists, clinicians and researchers—that highlights current prevention, diagnosis, and treatment strategies for NEC, and the search for a cure.

For more information about this podcast series or The Morgan Leary Vaughan Fund, visit our website at morgansfund.org.

Hello, my name is Stephanie Vaughan. Welcome to the show. I’m the Co-founder and President of The Morgan Leary Vaughan Fund.

Today, my guest will be Yamile Jackson, Founder and CEO of Nurtured by Design, and award-winning inventor/designer of The Zaky and the Kangaroo Zak. She’s also a fellow preemie parent.

Yamile will share with me today a comprehensive overview of Kangaroo Care and ergonomics as related to premature infants and the NICU environment. Yamile will also share her son Zachary’s story of prematurity and survival including a near fatal encounter with a natural disaster during his NICU stay, and how their experience led her to found Nurtured by Design—the first in its class, global leader in neonatal ergonomics.

During our conversation, she will discuss in varying degrees:

  • The premature birth of her son Zachary at 28 weeks,
  • How Zachary had to be kept alive by hand for 9 hours after Tropical Storm Allison shut down their hospital,
  • How hers and Zachary’s experience with prematurity led her to invent The Zaky and subsequently the Kangaroo Zak,
  • The clinical evidence showing a 50% reduction in apnea and bradycardia events with the use of The Zaky, no events with the use of a maternally-scented Zaky, and 30 times more effective self-regulation with the use of a maternally-scented Zaky, and
  • The importance of developmental care and family-centered care in the NICU.

With that in mind, let me introduce my guest today.

Hi, I’m here with Yamile Jackson, the founder and CEO of Nurtured by Design. Hi Yamile. How are you?

YAMILE JACKSON, GUEST: Very good. Thank you so much for inviting me today.

STEPHANIE: Oh thank you. So let me have you take a minute and introduce yourself and talk just a little bit about Nurtured by Design. So tell us about yourself.

YAMILE: OK. So my name is Yamile Jackson. I am originally from Colombia. I was born and raised there. And I came to the U.S. because I wanted to pursue my doctorate degree that was not available in Colombia. So I came and I did industrial engineering and always my passion has been ergonomics and human factors. So I worked about twelve years in the oil and gas business because I’m here in Houston, the capital of energy. And then I had my son. His name is Zachary. He was born prematurely 12 weeks, and he weighed less than two pounds. And with my degree and my experience in ergonomics, we always look at the individual and the environment, and how we can improve that environment. So immediately Zachary became my subject because he was,— I didn’t see a lot of things ergonomically done for babies itself. They were more done for the people caring for them. So for example, there’s a lot of ergonomics on the workstation for the nurse and the equipment and the displays. But there was really nothing for this baby and the relationship of the baby with the machines and the parents and the caregivers. And one of the questions that I asked at the very beginning when Zachary was born was, “what is the common denominator of preemies when they grow?” And the nurse said, “they don’t like to be touched.” So being Hispanic, I could not imagine my life without holding him or touching him. And I could not imagine giving him a life without enjoying human touch because that has been so important for me. So I asked is it because they are preemies and they’re born like that or is it something they learn or that happens after they’re born? And my thinking was because every time we touch and it hurts, so they associate touch with pain. And she said we don’t know, and really there’s no research that we could do to test that, right? So I started touching him a lot. Like I said, I’m Colombian where kangaroo care started. And when I was in Colombia, I remember when I was a girl that they talked about this kangaroo care and that’s was for preemies. So I immediately, with the help of the nurses and the therapies who started doing kangaroo care, I held Zachary for about seven to eight hours every day, me and Larry, my husband. Three weeks after Zachary was born, we had a flood in Houston from Tropical Storm Allison, and it shut down the entire hospital. So we had to keep him alive by hand,— until he left,— Oh my God,— for nine hours. So I held Zachary on skin to skin, and Larry had a crash course on how to bag him. So he took turns with the nurses on how to bag him. And then he was evacuated. We went to another hospital and the type of care, more developmental care, was so different between one hospital to the other that it made me realize that not every hospital is the same, which I guess I thought it could be but I didn’t know it was so different. So in one hospital, the nurses, they would teach me how to ask questions, they would say when the doctor comes here, you can ask this or this is what happened and this is the way we can position Zachary. This is how he likes your touch, and this is‚— hold him, let me hold him for a long time. When the other one was a culture more that we are one of the best hospitals and you need to trust us, and we’ll pretty much call you when the baby’s ready to go home. So if I asked to hold him, they would say, “Yeah, you need a doctor’s order.” And so all these different things that happened between the two hospitals made me realize the importance of having developmental care and family centered care even fourteen years ago. Zachary is fourteen now. So during that time when I was holding Zachary, we didn’t know what was happening. They didn’t have a place for us to go to evacuate. I just started praying the hardest, and I prayed and I said, you know, I want to help babies but I want to do it on behalf of Zachary. I don’t want to do it in memory of Zachary. So I said I will give everything, I’ll do anything, I’ll quit my job, I’ll do anything to help babies, but let me do it on Zachary’s behalf. And I also promised Zachary that his pain and struggle to survive were not going to be in vain. So five months‚— well, so in the second hospital, Zachary had a surgery not as‚— he didn’t have NEC, but he had a hernia that got incarcerated because he was not treated on time. So we had to have him in surgery. He lost ten centimeters of ilium, and he had the ileostomy. And then as soon as the first hospital was opened we went back to that first hospital. And that’s where he had the second surgery to repair the ileostomy. Caring for a baby that has an ileostomy, for me was really, really difficult because I knew how much he was hurting. The surgery that they did‚— usually they do the surgery, they put the incision, and then they make two little holes on the bottom for the ilium. Well this doctor put the ilium on the ends on the incision. So the incision opened and with the pressure just opened. And every time we had to change that bag, there was no skin. We were doing it underneath the skin. So that was really, really hard. You know, things like I would make little holes for the bag, I would do all these things that needed to be done, but having the family involved in the whole process, I think is a very important thing. Being able to hold him skin to skin, even with the bag is very important not only for him but for me. One of the very‚— OK, so‚— one of the things that I did before the flood was it was an agony for me to leave like it is for every parent that goes through the NICU. That first day that you have to go home without a baby, that second day, that third day. I went five months without my baby to the house. And it’s nerve wracking. I always thought how does he know that I love him because I know I love him, right?‚— But how does he know?— Right. If I, in quotes, “abandon him” every day, I let all these people do the most painful procedures possible, and when he is hurting the most, I’m not holding him because he’s not stable enough to hold. So I created The Zaky. Obviously, I named it later for him. But it was a little glove, basically, and I would sleep with it and my husband will sleep with them and we will leave them with him in the incubator. And the nurses saw the impact on Zach. He was sleeping, he was calm, he was easier to console, and because I didn’t know that the babies knew the scent of the mom through the amniotic fluid. So I was like from 150 people that see him every day how does he know that I am the one‚— that I am the mom? And the nurses would see in the monitors immediately. What they didn’t see was the impact on me, my ability to do something for him even if I wasn’t there, my ability to comfort him, my ability to leave the NICU when he was calm and sleeping instead of disorganized. So three weeks after we came‚— we fast forward five months when we came home, we started thinking what am I going to do because this is a promise that I made and I was very serious about it. So at the time, I was consultant in project management or engineering management, and that was very profitable. I was making really good money, so I used that money to put it in a little fund to do some research because the nurses that took care of Zachary called me after three weeks, and they said, “Those little gloves that you made for Zach, can you make them for the rest of the units?” And I said, “those little gloves were gardening gloves which are not meant to be in the NICU. And I can take the risk for my son, but I cannot take it for someone else.” So I said, “Well, let’s do something. If you don’t mind helping me, I’ll fund a project, but can I have access to all your doctors, your nurses, your therapists, parents, everyone to be able to make the ultimate developmental care that gives nurturing to these children” because that’s what I wanted. That’s what was more beneficial to me was the ability to nurture a child that is really difficult to nurture, especially when they’re in the NICU. And so The Zaky came about three and a half years later. There were several things that I wanted to achieve. One was everybody should be able to use it. So I didn’t want to put like, if the baby has X condition they can’t do it, they can’t use it, or if the baby has X weight, it can’t do it. So everyone can use it. And it is the same size for every child because when I was in the NICU we used different sizes. It was Children’s Medical Ventures that were the only ones doing developmental care at that time. And we had to go to another size and it was the size that was not available. So I said, “let’s make one that is good for everyone,” same size, didn’t have to do small, medium, or large, or light, medium, heavy. And three years later, that’s how The Zaky came about. I gave it to Children’s Medical Venture for review so if they wanted to sell it because the person from Children’s Medical was there looking at all the developments. And she loved it. She took it to a conference, and the nurses really liked it. But then the person making the decision said no because it competes with one of our products and they were talking about Freddie the Frog which at the moment I really didn’t understand how it worked because it didn’t have the family element in it, right? It was just a weight item. And so I started with The Zaky. We would use it in this hospital and then people, nurses and doctors doing work in that hospital, would eventually move to other hospitals and they would bring the idea of The Zaky. And that’s how we started selling it because my decision was since Children’s Medical didn’t want to have it and they were the only ones doing this type of product, then I either let it die, or I do it on my own. And so I did it slowly. I continued working as a consultant and teaching and then on the side I would do The Zaky’s and develop, try to raise awareness of nurturing, raise awareness of the importance of love, the notion that there’s nothing more transformative for a human than love, and we are treating these kids like basically prisoners. We keep them away from all kinds of stimulation, or positive stimulation, and we keep them in a little bag in a little box, which is like a little prison, and even worse, we swaddle them, which is restriction of movement like a straight jacket. And the parents talk through the window and it’s a very sad way to start our lives. And more important for me was I wanted him and I want every baby to know that this is not the world that they came in. This is just a little space where really the real life, the real love, the real joy would be after they leave. Babies that feel love, they thrive. But how do we make them feel that love, and that’s where all our products are about. We have them feel the love of the parents. We have the parents empowered that they can do something for these kids and that if we show them and we give them a reason to survive, they’ll probably do better than we thought, right? And I see it with Zach. I talk to a doctor that took care of Zachary and he said to a colleague of him in front of me, “You know, from all the kids that I have treated in my career, if you ask me which one would be normal, Zachary was not in that category,” and here he is normal, going to school, wrestling, doing things that nobody even imagined that he could do. And I really think that is‚— we need to complement the best medicine that we have, the best equipment that we have, the best professionals that we have, but we have to include the parents. I mean, it’s not just giving them donuts and classes. We need to keep them by the bedside holding the baby as long as they can. So having The Zaky, I go around and I’m sorry I’m talking all this. I’m not letting you ask any questions.

STEPHANIE: No, no. You’re sharing a ton of information. It’s wonderful.

YAMILE: So with all this work with this Zaky, I had an opportunity to go to a lot of NICUs and not only in the U.S. but internationally because I was working internationally with my work in consulting, so every time that I go to a place, I always visit a NICU, and I ask if I can visit the NICU. And some of them had my product; some of them didn’t know about my product. And I still do that. Every time I go anywhere, I’ll visit a NICU and I give some of our products to them. But with these visits, I would see that kangaroo care was not being done. I go to NICU’s and there is not very many moms in the NICU and if they are, they’re not kangarooing. And so I started a study of why we’re not kangarooing more. If kangaroo care is the most researched procedure than anything else has been researched in mankind for babies. There’s no negative or there is no side effect. Everything that comes out is positive. If it’s not positive, at least it says it doesn’t harm. You know, when we talked about cardiovascular outcomes when we talk about the hormonal and metabolic outcomes, when we talk about stress and pain, we see that babies that we do painful procedures on the chest that they either don’t feel pain or they feel much less pain. Mental development. Mental development is huge because babies only develop the brain when they are sleeping. And this is something that a lot of people don’t know‚—

STEPHANIE: I was going to say, I didn’t know that.

YAMILE: Right, we keep waking these babies up for different things, right, for interventions or because it’s time to eat or because X reason, but babies in the womb, and talking about preemies, at 32 weeks, they’re supposed to be sleeping 22 hours a day. But in the NICU, they don’t get not even a fraction of that. Imagine how much sleep they’re getting, babies in the NICU. So when we put them in kangaroo care, and when we put The Zaky’s on them, or The Zaky’s on the bed, they have an environment where it is conducive to sleeping and that’s why babies that are kangarooed, they have better brain development because they have time to rest and to sleep, right? And when we talk about sleep and brain development, we’re not talking only about the IQ that this kid is going to be super-smart. We talk about all the sensory that happens, that develops. So the touch, the eyes. Everything develops when they’re sleeping. The relationship with the parents that happens when they are sleeping, memory, touch, everything happens, develops, when they are sleeping. So obviously the best environment for them is the chest of the mom. And that’s why it’s called kangaroo mother care. In the absence of the mom or if the dad is around, we want the dad to do it. And why? Because we want dad to be a source of comfort for this child as soon as they’re born. And that’s why also with The Zaky we send one with the mom and one with the dad scent. And they put the scent on them by putting it on the chest or behind the neck for about an hour or if you have time to do it all night because we see that parents that do that at night, they sleep better because they’re doing something for their kids. So I was like “Why are we not doing this?” I mean, the motor development, the temperature regulation babies don’t need‚— in an incubator, for example, they are in a thermostat, right? So it’s like in your house. If you put the thermostat at 72, the thermostat is going to go to 74 and then 73 and then 74 and then 73, and that’s what happens in the incubator. When they are on the mom or the dad or any chest is better than an incubator. Then they have a constant level of temperature, right, and it’s natural. And one thing that I don’t know if you know but the temperature of the mom‚— the mom has the most amazing machine in their body because if you have a mom and the baby is cold, the temperature of the mom will automatically raise to heat this baby. And if the baby is hot, the mom’s temperature will lower automatically. If you put twins on skin to skin on their mom, one is cold and one is hot, the breast will automatically adjust to the need of the baby on each of the breast‚— Now that’s‚—

STEPHANIE: That’s amazing.

YAMILE: Yeah. So dads don’t do that. So dads, we have to keep an eye on the temperature of the baby when they’re on dad, right, because dads don’t do that. But there’s no evidence whatsoever done on the developmental care outcomes that the incubator is good for the baby. There is no evidence. On the contrary, developmentally, it’s not good. That’s why we want babies on the chest on the parents. If the parents are not available, the grandparents, whoever the parents give permission to hold this baby, and they’re willing to follow instructions and guidelines and they qualify, then they should be able to kangaroo. The confidence of the mom, the parents, improve dramatically when they can hold this baby and the confidence of being able to take care of this fragile baby and all this kangaroo evidence is good for healthy babies and for little babies and for preemies. Another piece of information that I want your listeners to know is rule of thumb. Babies kangaroo up to three months after due date. So for example, if your baby is twelve weeks early, then you kangaroo for twelve weeks plus three months more. And the way that you stop kangarooing is because the baby already self-regulates the temperature so they start wiggling and they’re like OK, I’m done. And that’s when they stop kangarooing. This is the first time they become really independent. When they get to be teenagers, they’re more independent. But the reason that we found that we’re not kangarooing babies, even though the evidence is overwhelming, is education. We don’t know when to kangaroo, why? Different hospitals have different guidelines, and there are basically two trains of thought: One is we cannot kangaroo babies because they are unstable. The other one which is the one that I believe is the babies are unstable because they’re not being held in kangaroo care. So, the latter is where the more progressive hospitals are doing and then they see that these babies‚— obviously with all‚— they follow all the evidence. These babies do so much better when they’re in kangaroo care. Go ahead.

STEPHANIE: I think I had told you this one of the times we had talked that when Morgan was in the NICU, they would actually wait to do his blood pressure until I came in and he was sitting with me because they couldn’t even put the blood pressure cuff on him because he would get so upset. And then if I came in and was holding him, he would calm down.

YAMILE: It is so‚— and that’s what I said. I mean, the body of the mom is where the baby has to be. They’re coming from inside, and if they can’t be inside, let them be on top at least. We see heel sticks, something so simple as a heel stick they’re warm so they don’t need the warmer. They do the heel stick, and they don’t even budge. It’s incredible. They do ultrasounds on the babies. And that was fourteen years ago. Even fourteen years ago, we did blood transfusions on Zach, we did every possible evaluation, we changed diapers on him on me, we did heel sticks, we did all kinds‚— and this was fourteen years ago. And remember, fourteen years ago, it was just nice to kangaroo. It was good. It’s nice for you and the baby. Now it’s not just nice. It’s evidence-based practice. So hospitals that‚— hospitals that do evidence based and they strive to provide evidence-based care, they should be kangarooing, right? So I talked to all these hospitals that are evidence-based care. They know the importance of kangaroo care, but then why are we not kangarooing? So the one huge other than education for not only the parents but for the clinicians is safety. And safety for me obviously, as an engineer, was first and foremost, the top priority. There’s nothing we can do unless it’s safe. It doesn’t matter if it’s pretty, if it does something else, but if it’s not safe, then we can’t do it. And the risk of accidental falls during kangaroo care is very large especially if the moms fall asleep, right? So I’m like, OK, so if the mom falls asleep and I know by experience that the only sleep that I got when Zachary was in the NICU was when I held him because my adrenaline was zero, my oxytocin was going 100%. I didn’t think about what the doctor said, what the nurse said, anything. I mean, I was just in a date with my son. It was just me and Zachary. The monitors were quiet, he was sleeping, it was like the most beautiful time that we had together. Now I don’t know if when you held, did you hold them with something around them or did you just put them on the chest when you held?

STEPHANIE: No, we just put them on my chest.

YAMILE: Yeah. And that’s what I did, right? That’s what I did. But then we talked to the nurses and they say, you know, we have to become police officers because we have to check them more. It’s more work for me to take care of a baby that is outside the incubator than when they’re inside. If the mom closes their eyes, I have to tell her, “please, don’t close your eyes because then I need to remove your baby from your chest.” And so I was, like, well, if‚— we have a problem, right, which is why I was trained in engineering of problem solving instead of having them wake up or tell them, “OK, I’m going to put the baby on your chest. You have to use your hands to provide the X positioning. You make sure that the baby doesn’t move up and down because then he will dislodge his equipment. You need to hold his weight, you need to make sure that you’re giving containment and don’t move your hands very much because then he will be overstimulated and don’t close your eyes because then I’ll have to remove your baby. But then enjoy it because it’s the best time you’re going to have with your child.” And that can’t happen, right? We can’t do all that and do it well and relax at the same time. And when we don’t relax, the babies don’t relax. So it defeats the whole purpose of having the baby on the chest, because we want the mom to be calm so the babies can be calm. And that’s why I invented or I designed the Kangaroo Zak. And the Kangaroo Zak is meant to hold the baby the way their positioned, make sure that they don’t go up and down, they don’t have air drafts. If the mom moves, the mom and the dad can hold hands free, and we can access the baby immediately and with minimal disruption which is what we always strive for is how can we take care of these babies with minimal disruption, minimal sound, minimal handling? And that’s why we did the Kangaroo Zak. So the nurses are happy because they know the baby’s not going to fall. The moms are happy because the babies are more on skin to skin, we push the babies in a little bit so we have more area of contact and they know that the baby’s not going to fall if they fall asleep. And there is a hospital, Rex Healthcare, that implemented The Zaky’s and the Kangaroo Zak’s as their standard of care in their NICU. And they did a survey. They did a study on both customer satisfaction which was done for the parents and clinicians or staff satisfaction which was given to all the staff. And they both went through the roof. And for the work that they did, they got a reward from the hospital. So when we‚— OK. So you asked me about the research, right, that just happened?

STEPHANIE: Yes.

YAMILE: The research that was published was actually started in Georgia, in the Regional Medical Center of Central Georgia. And it was a couple of nurses that had taken care of the babies with The Zaky’s for a couple of years. And they didn’t have them as a standard of care. They just had several of them in the NICU. And they said that observationally, they see that babies that had The Zaky’s‚— they had The Zaky’s, period‚— were doing better than those that didn’t.

And they just wanted to put some numbers behind it. And they did the research. It was funded by Georgia College. We supplied The Zaky’s and the training for the nurses for this. I did train the trainer. And I had position as an adviser. I didn’t have anything to do with the research. And because I really wanted it to be 100% independent. And they found that‚— so they divided babies in four different groups. One was the standard nursing care where the nurse took‚— they had different aides, right, and the nurse had a personal choice of what to select to provide care for these babies. The second group was The Zaky’s only, two Zaky’s with no scent of the mom. The group three was the Zaky’s only but it was one pair of The Zaky’s but they had the scent of the mom. And they put the scent of the mom by putting it on the chest or behind the neck, and they did it for an hour before the study. And the fourth group was the same group A so the nurse will choose what to use, but they also added the scent of the mom because we wanted to know if it was the scent of the mom that did the trick‚— Alright‚— Yeah. And they found‚— it was really interesting. They found that babies that had‚— the group A and D, so where the nurse makes the decision, whether with the scent or without the scent of the mom, they had 80 episodes of apnea and bradycardia. They were about 40 and 40, right? And so they were not statistically different. Now when they put‚— when they saw The Zaky with no scent of the mom, the numbers came to half. So we reduced by 50% apnea and bradycardia events. And what was most impressive is that babies that had the scent of the mom with The Zaky had zero apnea and bradycardia events. These are babies between 24 and 38 weeks. And what I am so impressed about is that we are shedding light to the possibility that apnea and bradycardia can be prevented. Apnea and bradycardia is the number one enemy of sleep, right, because when babies have apnea and bradycardia, we wake them up. Plus if they give any medication, it’s usually caffeine which caffeine keeps them awake. So by being able to think and look at how‚— and there also some research from kangaroo care that shows lowering of apnea and bradycardia events. So that, to me, was the most impressive. And then the other section‚— and that was for the doctor wanted to know that on the medical side. From the nurse’s side, they wanted to look at self-regulation. Self-regulation is when‚— for example, if you are sleeping‚— I mean if you are reading a book in your living room and somebody slams the door and scares you, how long does it take for you to go back to that calm state and keep reading the book, right? For babies, babies are the same. It’s neurological, their ability to self-regulate after a procedure. And babies that did The Zaky’s maternally scented, self-regulated 30 times more effectively than those that didn’t have The Zaky’s maternally scented. And even without the scent, it was a huge difference, and it is not‚— to me, it was amazing and the ability to give a baby a constant level of care, right, because if we have nurses choose what product to use in what position and what size and all that, then the babies‚— it’s like if I tell you you need to sleep, right? But every time that you turn or I have to move you, I change your blanket or I change your pillow or I change the things, your clothing and pajamas and all that. It’s going to be harder than if I just move you but I leave everything around you the same. And that’s where the ergonomic idea comes is how do we keep these babies‚— yes, we do have to do interventions. Yes, we do need to move them. Yes, we need to turn them. We need to do all these things. How do we do it in the best possible way for them? And I mean this research is incredible. For me, as a designer, as a mom, as everything, I remember when Zachary had apnea and bradycardia, their response was he will outgrow it. So there’s nothing you can do other than give him some medication and see, wait until they outgrow it. Because if you see research, it says it is likely that the apnea and bradycardia are due to the immaturity of the baby. So the brain, the lungs, and the heart cannot talk to each other. But again, with this research, and some research done with kangaroo care, we can probably put that one to rest and start looking at how do we prevent it instead of having to treat it. And then same thing with the musculoskeletal system. If we position the babies wrong, they’re developing so the muscles and the joints and the bones are learning where to be placed. If we place them wrong, they grow wrong, and then we have to go through surgeries or we have to go through therapies or we have to go through things to repair that instead of preventing it, which is what we prefer to do. And what our company is about is how do we prevent all these things that traditionally have been thought of being caused by prematurity. This was an amazing conversation. That’s not in a nutshell. That’s a long‚— that’s the 14 year summary.

STEPHANIE: 14 year summary.

YAMILE: The 14 year summary.

STEPHANIE: No, I find it very interesting, and­ it’s— anything, like you said, that we can do that would be consistent, not causing added stress can only be beneficial. So I appreciate you calling in and talking to me today. I think it’s amazing work, and I think we started this charity because of our experience with Morgan and you started this company because of your experience with Zach, and it’s just amazing what preemie parents, the impact that that has and all the wonderful things that they do‚— Thank you‚— I mean, yeah.

YAMILE: The organization that you have and all the organizations, all the people that I know that are helping in any way these kids, we help through a different way from the way that we know how, right? All I know is engineering, all I know is that I love my son and, I mean, the same for you. So we just need to put our heads together and see how we can help and spread the word because many of the things that we know are not being spread. Like, for example, the importance of kangaroo care. Some people think that it’s optional. Some people don’t know the real importance of it. And it’s important to have. For us, it’s important to provide the right tools so moms and the staff can do a good job with these babies. Oh, and remember that I said that Children’s Medical Center thought that we replaced one of their products? So we found that now when we use The Zaky’s, we replace all the developmental health products on the web. So all the positioners, the transitional items, the soothing items, the bonding items for scent, the weighting items like the one they were talking, the Freddie the Frog. So we changed everything with two Zaky’s. You can imagine the benefit for the hospital and for the parents to be able to learn how to position their babies, be calmed by them too and know that they can do a lot for their babies, they’re not just visitors. And for the hospital because they don’t have to buy different items, train the people how to use them, do different sizes, store huge things, the storage, the quality control. We streamline all their supply chains. So that’s the other reason that the hospitals love using The Zaky’s because they’re not only providing the only evidence-based tool that there is in the market, but all their work is simplified and providing better care for the parents and the babies. So it’s a win/win for everyone.

STEPHANIE: Right. Well, thank you again for coming on. I really appreciate it. And I’m going to have links to your website and to the research that we discussed in our show notes. So thank you so much.

YAMILE: And thank you for inviting me.

STEPHANIE: Oh thank you.

YAMILE: And if anybody has any questions, you put the information, again my name is Yamile Jackson, and our company is Nurtured by Design, and we love to hear from parents and clinicians and have them learn about what we’re doing.

STEPHANIE: OK, and we’ll definitely have links in the show notes as well.

YAMILE: Wonderful.

STEPHANIE: So we will definitely make sure people can contact you.

YAMILE: Thank you.

STEPHANIE: OK.

For more information about Yamile or Nurtured by Design, visit: nurturedbydesign.com. A direct link can also be found in this episode’s show notes.

In closing, I’d like to share a few thoughts about today’s conversation with Yamile.

When Morgan came first came home, we saw first-hand the effects of stress and negative association with touch had on him. As I’ve shared on our website:

Understandably, he had quite an aversion to “hands-on” manipulations, like having his diaper and/or clothes changed. He would get extremely distressed and cry, hit, and kick — easily becoming inconsolable. However, other than these necessary “hands-on times,” he was very content to be held and cuddled. Our visiting nurse likened it to suffering from Post-Traumatic Stress.

Thankfully, these emotional responses gradually faded over time.

One of the ways that we supported Morgan during his difficult transition home was that I continued to do Kangaroo Care with him. No one suggested it, although I wish someone had. It was simply an intuitive response that I had because I knew that he was at his calmest while laying on my chest.

As Yamile pointed out, Kangaroo-Mother Care and developmental tools like The Zaky and the Kangaroo Zak empower parents by providing “the ability to nurture a child that is really difficult to nurture especially when they are in the NICU.”

Show your support for our smallest and most fragile babies, those who have the greatest risk for developing NEC. Show your support for continued research in NEC. And join our effort to raise awareness about, and funds for research in NEC by making a donation to Morgan’s Fund at morgansfund.org/donate.

If you’ve had a personal experience with NEC and would like to share your story, or have a question or topic that you’d like to hear addressed on our show, e-mail us at feedback@morgansfund.org. We’d love to hear from you!

Copyright © 2015 The Morgan Leary Vaughan Fund, Inc.

The opinions expressed in Speaking of NEC: Necrotizing Enterocolitis (the Podcast series) and by The Morgan Leary Vaughan Fund are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis and treatment. Please consult a local physician or other health care professional for your specific health care and/or medical needs or concerns.

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