Keri Spillman, BSN, RNC-NIC, Clinical Supervisor in the NICU at Medical City Alliance, talks about the, “Octopus for a Preemie” movement across the United States.
Interview conducted by Ivanhoe Broadcast News in September 2017.
Tell me about the kind of babies you see here in the NICU generally?
Spillman: We see a wide variety of babies here, anywhere from small 24, 25 week gestation babies to babies who are actually past due, past their due date who have some struggles whenever they’re first born. So we can take care of a broad range of infants who are needing our assistance.
It takes a lot of monitoring, sometimes the babies are hooked up with tubes or different types of things?
Spillman: Yes. All of our babies are connected to continuous monitoring which we can also monitor at our nurses station. We monitor their heart rate, their respiratory rate and also their oxygen levels in their blood to make sure that they maintain good levels.
To do that they have to be hooked up to things right?
Spillman: Yes, they are hooked up to a monitor at their bedside; different leads are on their chest, we also have a little light that goes on a foot or a wrist that tells us their oxygen levels.
So with all these tubes, cords, babies move around a little bit, what happens?
Spillman: They do move around quite a bit, especially our little ones that are born early they feel a little bit insecure because they don’t have the protection of mom’s belly around them. So it’s sort of a shock to their system to not have that barrier. They do tend to grab at their leads, grab at their breathing tubes, and grab at their feeding tubes because they feel very unsafe.
And that’s when they’re in the, what do you call it, isolette?
Spillman: It’s an isolette yes.
So when they’re in the isolette by themselves is this when this happens?
Spillman: Yes. So we do different things to try to help them; developmental positioning, developmental touch, we keep the rooms dark and quiet. We limit noise and exposure to light and also exposure to touch. And we try to let them rest as much as we possibly can.
And then you introduce these baby octopus?
Spillman: Yes, I actually saw a Facebook video about it and I talked about it with my sister-in-law and we thought that’s kind of interesting. It originated in Denmark, nurses at a hospital in Denmark came up with the idea to crochet these octopus and the tentacles of the octopus feel much like an umbilical cord. A lot of babies when they’re inside of moms belly hold on to the umbilical cord for security. So if we can mimic that for them it helps calm them down, it helps with their overall peace, wellness inside of that isolette and makes them feel safe, secure and just helps with their overall well-being.
Who figured this out, somebody in Denmark?
Spillman: Somebody in Denmark, then over in Europe, over in England hospitals it began to pick it up and then it came over to America. There’s a national group called Octopus for a Preemie, which I am a part of and we have very strict guidelines for the kind of yarn that can be used, the kind of stuffing that can be used, the size of the stitches, the length of the tentacle. It’s all very exact and precise. We’re very strict on our quality for these.
Why?
Spillman: Because we need to insure that the fibers of the yarn won’t come loose and get into the babies airway. We need to make sure for safe sleep reasons that the babies don’t have a risk of choking or strangulation from the tentacles. And we also need for infection control to make sure it’s a type of material that can be sanitized.
I guess the babies notice these little octopus?
Spillman: They do because it’s a natural reflex for a baby to grasp something when they feel something touch their hand. So instead of grabbing a hold of their breathing tube and pulling they can grab hold of the tentacle of the octopus and just kind of hold on to that and it keeps us more peaceful as nurses and keeps the babies peaceful as well.
You say there is some research that has gone in to this?
Spillman: It’s more like observation, once the hospitals over in Europe noticed that the babies just seemed to be calmer, they had fewer extubations; which is where an infant’s breathing tube comes out. They had fewer incidents of babies pulling their feeding tubes out and they just noticed an overall increase in their oxygen saturation levels and less oxygen requirement.
Do you know how does it work, what’s going on between the baby and the octopus?
Spillman: Like I said the natural instinct is for the baby to grasp something. So when they’re grasping it, it makes them feel like they’re holding onto the umbilical cord. We do have the mothers of the babies either sleep with the octopus or wear it inside of their shirt for several hours so that the babies will smell their mothers. Babies are very intelligent so they can smell their mother on any kind of piece of fabric or in this case the octopus. So they can smell their mom, they feel the tentacle they feel at peace and it helps them calm down.
It sounds like almost too good to be true.
Spillman: It does but it’s amazing you see these little guys and they just grab a hold of it and they fall asleep and they really enjoy it.
It doesn’t sound all that high tech.
Spillman: It’s not but these ladies that make these, it’s 100 percent volunteer, there’s no exchange of money at all. These are just people from all over the country that do this out of the goodness of their hearts. Be it their granddaughter was in the NICU or they lost their own child in the NICU. There are crafters all over the country who just want to give back and give something to these children to contribute. So there’s a lot of good hearted people out there that are doing this for our children.
And this is all through your organization?
Spillman: Octopus for a Preemie, it’s a national group.
I guess through social media you formed this group?
Spillman: Yes, I’m considered an ambassador for our area as well as my sister-in-law. She’s a crafter; I’m nowhere near skilled enough to crochet an octopus. But I do help with the quality control piece of it.
What was your sister’s involvement in all this, why did she get involved in all of this? Is she in healthcare?
Spillman: She’s not, she is just a good hearted woman who knows how to crochet and I told her, I said I’ve got this idea I saw this video on Facebook and she said I want to do this, I want to give back. And through word of mouth we’ve gotten volunteers. We get donations like I said from all over the country. So when our hospital comes up on the rotation list we may get octopus from Iowa or California or Oregon. And they just mail them in and they’re all different kinds of colors and some are themed with different cartoon characters or some look like a puppy dog. These ladies get so creative, far more creative than I could ever be.
So do they all have eight tentacles?
Spillman: Yes.
Which gives the baby more things to grab on to?
Spillman: Yes, and also an octopus with only two might look a little funny. So they do stay true to eight tentacles coming down and I guess the sizing is exact. We have to have exact measurements.
Probably to mimic the umbilical?
Spillman: Yes, and we have to make sure that they don’t stretch out too much to risk strangulation and the head of the octopus, the stitches have to be extremely tight so that none of the stuffing will come out and risk getting in to the infant’s airway.
What kind of results have you gotten here in your unit? How long have you been using this?
Spillman: We started in March. We started using these in March of this year. I’d put a lot of research together and different flyers, I had to present it to our medical director and also our CEO of the hospital. And they said if you think this will work try it and see; we’ve gotten really good responses. We’ve even had some parents whose babies have not survived and they say this octopus was the only thing my baby every actually got to hold onto and now I have it forever. Which just makes it worth it, it really does touch these family’s hearts to know that there’s people out there that just want to give back. So some stranger crafted this for their child and now they have it forever as a keepsake.
It goes without saying when parents find that their baby comes too early this is an extremely traumatic time for the family.
Spillman: It is. It’s very hard transition, it isn’t what they envisioned when they found out that they were pregnant and especially if they have friends who have also had babies at the same time who were full term healthy babies and they’re here. Any little thing we can do to personalize the experience, anything we can do to make it not so focused on the child being sick we like to do. We like to make them feel more like they’re having a quote, unquote normal child.
How does the octopus help the parents?
Spillman: The parents feel like because mom has to sleep with it or wear it first like she’s doing something to give back. A lot of the times the parents feel like they don’t have control over this situation of their child being sick and in the NICU. So they feel like that this is one thing that they can give to their child to make a difference. They feel like they don’t have control over how my baby is breathing today or how my baby is tolerating breast milk today but they can have some control over what they bring to give to their child as a gift. And when they see their child hold onto it, when they see their child is comforted, it helps them. Because they have to leave here at the end of the day, they have to go home to an empty nursery where their child should have been and now they feel like they’ve actually done something. And it helps them emotionally cope with the situation.
Does each parent have more than one, they take them home and they sleep with them at home and they bring them in to their baby?
Spillman: Because our supply is limited to what we receive in donations we do only do one per baby. But the parents do receive a card that explains our program and it also explains the washing and care instructions for the octopus. Because they will get dirty so the parents can take it home, wash it, mom will sleep with it again get her smell on it and then she can bring it back for the baby all nice and clean.
Are there any drawbacks to this?
Spillman: Not that I’ve seen so far. We do have limitations; we do not give it to the very small babies as they initially have humidity inside of their isolettes due to infection control reasons. We don’t give them that early on because we want to make sure that we don’t create an environment where bacteria can grow. And also when a baby is ready to go home we take it out of the crib to model safe sleeping practices for our family.
Is there anything else about the program or the results you’re getting that I haven’t quite got to that you want to share?
Spillman: I will say that if we ever have an octopus that does not pass, doesn’t quite meet the standards, it does not go to waste. We can actually donate it to other children, maybe older children who are either in another hospital going through a procedure, also a scary time. Even older children like to have something to hold onto. We can give it away to children that come in through our emergency department. Maybe they’ve had a scary situation that they’ve faced and it’s just something that we can give them to comfort them. So no octopus goes to waste.
It’s like a security blanket of sorts?
Spillman: It is, it is. It’s multifaceted, my own children love playing with them too.
And you don’t call them toys?
Spillman: No, they are developmental tools. Because we don’t want to give the impression that it’s okay to put a toy in a bed with a child to model safe sleeping practices.
So that’s important.
Spillman: It is.
Because these little ones, you don’t want to put toys in the bed with them?
Spillman: No, we don’t and because our babies are continuously monitored until the moment they go home that’s why it’s okay for us to leave the octopus in the bed with the child. But we do not recommend that they’re left in the bed once the child goes home.
They can play with it?
Spillman: Yes, they can play with it but just don’t let the child sleep with it. We want the child to be in a safe sleep environment.
But they can sleep with it here because at your stations you’re electronically constantly monitoring every baby?
Spillman: Yes, we can see the way the child is doing in their room; we can even see it from another baby’s room. We can pull up their vital signs on another baby’s monitor and we can also see it on our central monitoring out at our nurse’s station.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
If you would like more information, please contact:
Matthew Eiserloh
Matthew.eiserloh@medicalcityhealth.com
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