Photograph by Kathy De La Torre
Sharlene Rodenberg, a cuddler volunteer, cradles prematurely born Kalista Bowling.
Operation Cuddle
Volunteers in the neonatal intensive care unit take to the rocking chairs
By Kara Chalmers
Photographs By Kathy De La Torre
On a recent Tuesday around noon in the neonatal intensive care unit of Good Samaritan Hospital in San Jose, volunteer cuddler Sharlene Rodenberg of Saratoga sat in a rocking chair, holding and comforting one of three triplet preemies. The infant, swaddled in a pink, blue and white striped blanket to keep her feeling secure and safe, lay in Rodenberg's arms on a pillow that dwarfed her 4-pound body.
"If she gets fussy, I pat her back and she goes back to sleep," Rodenberg said.
Rodenberg, who had been rocking the same baby since her shift began at 11 a.m., then laid the infant down and picked up one of the baby's sisters and held the baby until her shift ended at 1 p.m.
Rodenberg is one of GSH's cuddlers, volunteers who hold the premature babies and other infants in the NICU, as long as they have the OK from the little patients' parents.
Like the other 60 volunteer cuddlers in the program at GSH, which started in September 1999 and was patterned after a similar program at the Lucile Salter Packard Children's Hospital at Stanford, Rodenberg spends two hours every week cuddling, and has committed to the program for a minimum of one year.
Cuddlers are not allowed to change diapers, give medicine, feed, bathe or even kiss the infants, but they can hold and rock them. Cuddlers do not walk with the babies for safety reasons, but they can talk, sing, or read quietly to them.
"Pretty much your job is cuddling," Rodenberg said. "In a way, we get all the fun stuff."
Photograph by Kathy De La Torre
Kalista Bowling experiences a human touch with cuddler volunteer Sharlene Rodenberg of Saratoga.
GSH developed the cuddler program to help fill in any gaps left by parents or nurses in the babies' care. Many babies stay in the NICU for long periods of time, and their stays are not exactly stress-free, as many are pricked with needles for intravenous lines and monitor leads throughout a typical day, and must deal with beeping equipment and the other noises usually present in the NICU.
Some of the babies' parents in the NICU live as far away as Salinas or Watsonville, and can't visit their sons and daughters as often as they would like to, according to Mary McCall, the manager of volunteer services at GSH. Some parents have other children to look after, don't have access to reliable transportation or have to work, McCall said. Furthermore, she added that nurses are overloaded with the demands of their jobs. On a usual day, a cuddler can expect to hold infants whose parent didn't make it into the hospital, infants who are fussy that day, infants who recently underwent painful procedures, or those who need to be upright after a feeding.
Like Rodenberg, cuddlers typically do not have medical backgrounds, but they must be at least 18 years old and be able to sit for long periods.
Rodenberg said she often sits with the same baby for her full two-hour shift. But she also said that sitting in a rocking chair with a tiny baby is actually peaceful and relaxing. She said cuddling is an excellent excuse to take a break from the day.
"It's pretty serene in here," she said.
Photograph by Kathy De La Torre
Jennifer Frisby-Bowling spends time with her 3-pound daughter, Kalista Bowling, at Good Samaritan Hospital. Kalista was born three months prematurely and weighed just 1-pound, 8-ounces when born.
NICUs all over the country have developed cuddler programs since studies of babies born prematurely--born before being in the womb for at least 37 weeks--show that the human touch can enhance preemies' growth, improve their health and help them develop trusting relationships later in life, said GSH Clinical Nurse Specialist Linda Ikuta.
Developmental studies of preemies show that cuddling frequently helps them gain weight and grow faster. For one, preemies that are held spend less of their precious energy crying, so they can use it solely to grow.
Additional research shows that holding full-term or premature babies often makes for happier, healthier and more secure children.
"The human animal is very social," Ikuta said. "It's just that human touch that you can't replace. It's just so important."
Of course, there is such a thing as being touched too much for extremely premature babies, whose skin has not yet fully matured, Ikuta added.
According to Ikuta, there are some parents who don't want their babies to be handled by the volunteer cuddlers, possibly because they have fears about people other than themselves bonding with their children. But many parents are thankful for the program, she added.
Photograph by Kathy De La Torre
Kalista Bowling's mom, Jennifer Frisby-Bowling, takes a catnap near her baby's incubator in one of the five nurseries at Good Samaritan.
Fighting for Survival
Kalista Bowling hit the 3-pound, 1-ounce mark on her 2-month birthday on Jan. 5. Kalista, who weighed only 1-pound, 9-ounces when she was born about three months prematurely at GSH on Nov. 5., was doing well.
"She's on cruise control at this point," said her mother, Jennifer Frisby-Bowling, 31.
Frisby-Bowling, who was 25 weeks pregnant when she gave birth to Kalista, was in the hospital for a week beforehand, taking anti-contraction mediation to no avail.
During Kalista's first month of life, she contracted pneumonia, which her mother said was frightening.
"She was so tiny," Frisby-Bowling said. "I thought, this baby could not possibly survive."
Kalista sleeps in an Isolette, an incubator with two portholes on hinges that keeps Kalista, who has difficulty with temperature control because she lacks fat and energy reserves, warm. Kalista's Isolette was set at 29 degrees Celsius, and it was decorated with signs and stuffed animals, as are many in GSH's NICU. When outside of her Isolette, Kalista is bundled in blankets and wears a hat.
Today, Kalista still is hooked up to oxygen, since she was born too prematurely for her lungs to be fully develop. But her mother says her lungs seem to be developing fine now.
Kalista stopped being fed intravenously and took her first bottle of her mother's milk two days before her two-month birthday. She is starting to be awake more often, Frisby-Bowling said, and added that she was planning on giving Kalista a bath for the first time within the next few days. Barring any complications, Kalista will most likely go home when most preemies do, near her original due date, which is Feb. 16.
Photograph by Kathy De La Torre
This sign hangs outside Kalista Bowling's incubator.
Most of the babies in the 35-bed NICU at GSH are premature, like Kalista, according to McCall, but some infants are there for other reasons. Among them, infants with infections who are taking antibiotics or who had traumatic births, infants with birth defects or ones that are going through drug withdrawal. All babies in the NICU can have cuddlers as long as they are stable enough to be held, but some very premature babies, who are on ventilators that breathe for them or assist with their breathing, cannot be cuddled, except by their parents, Ikuta said.
The infants in the NICU are hooked up to monitors that display heart rhythms, heart rates, and respiratory rates and oxygen saturation. Many of the preemies are hooked up to intravenous lines used for fluids, nutrients and medications, through their hands, feet and heads, as well as wires attached to the monitors.
Rodenberg is more comfortable in this situation than other cuddlers, who at first may be intimidated by all of the wires hooked up to the babies. As a mother of premature twins, a boy and a girl, now 16, who were born 7 1/2 weeks early at GSH, Rodenberg is no stranger to the NICU. She got used to wires then.
When Rodenberg heard about the cuddler program, she knew she would love it. When her own children turned 15 and began driving themselves to their various activities, she decided to take up cuddling. And she loves it.
"From having my own babies in there, I became fascinated with the whole environment," Rodenberg said. She added that for her, while the first few days after her own children were born early were scary, part of the reason she likes GSH's cuddling program is the good memories of the way her children thrived in the NICU there.
Her daughter, Leann, who weighed 3-pounds,7-ounces, stayed in the NICU for one month, while her son, Evan, was one pound heavier and left after two weeks. Rodenberg said there were no complications with her children, but she was at the NICU with the children all the time.
The main requirements for cuddlers are that they are comfortable holding infants and are comfortable handling them in such a high-tech environment, McCall said.
"You just need to love babies," she added.
Kalista Bowling is fed through a tube since she does not yet have the strength to suckle.
Photograph by Kathy De La Torre
There isn't a typical age range for GSH's cuddlers, but there is only one male cuddler. Volunteers in the program go through a three-hour volunteer services basic training, a four-hour NICU training and a two-hour initial training shift with a volunteer. They must get their rubella and tuberculosis immunizations. In training, cuddlers learn about the technical equipment the babies must use, how to sit down and stand up from the rockers, and how to take the babies out of cribs.
Cuddlers must scrub their hands, nails and forearms with antibacterial soap and a scrub brush for three minutes before even touching a baby and also must wash between cuddling sessions. The cuddlers never wear rubber gloves, since it is counter to the whole premise of touching.
The volunteers are not allowed to wear watches, rings or to have fake fingernails and are asked not to come in if they have colds, runny noses, fevers, or are coughing or sneezing, since the NICU patients do not have the same resistance to infection as other older babies might. For NICU patients, bacteria can be deadly.
Besides cuddling babies, cuddlers also make welcome signs, name signs, or milestone signs for the infants. They write in the babies' journals about their visits. Sometimes they write one sentence, or a poem, or a thought about how they feel when they're with the baby, or how the baby looks, so the parents can read it later.
However, GSH's cuddler program has been so successful--and so popular--that McCall is not taking any more volunteers. The program, which runs every day from 6 a.m. to 11 p.m., is completely full.
According to Rodenberg, being a cuddler is rewarding for her since she knows she is helping the infants' physical--and emotional--development.
"The babies that are in there a long time, you see their progress and you think, 'maybe I had an influence in that.' You played a role, maybe," she said.
Saratoga, California Since 1955
