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BABY BOOK 2018 13 FRIDAY, January 25, 2019 The Grand Island Independent www.theindependent.com Continued from page 4 physicians to choose from) when you come to deliver. Instead of being seen by whoever is on call, your provider is with you and be- gins to see you. n Able to implement best prac- tice changes and implement cut- ting-edge technologymorequickly due to fewer layers to process change. n Enhancements: bassinets, nitrous oxide, labor tub, wireless fetal monitor, Kaya birth stool, joey bands for skin to skin and fall prevention. n Childbirth classes, includ- ing a five-week HypnoBirthing Mongan Method instruction for gentle birthing (two certified in- structors). Hypnobirthing is a method of managing pain and anxiety during childbirth, involv- ingvarious therapeutic relaxation techniques, such as deep breath- ing and visualization. n Two Certified Lactation Counselors, inpatient and outpa- tient breastfeeding support. n Safe Sleep Hospital Cham- pion designation— teaching the ABC’s of safe sleep. “They get to see their owndoc- tor when they come in at Memo- rialHospital,”Thomas said. “They get to see their own doctor that they saw at the clinic. With a lot of the bigger facilities, you get whoever is on call. Here, you al- ways get your doctor, who you have been doctoring with the whole nine months.” Thomas said Memorial is al- ways adding other options in the services they provide to pregnant women, whether it is new tech- nology or education for mother and baby to produce the healthi- est outcome possible. “We are always trying to en- hance that experience and add to it,” she said. Thomas said the hospital is in the process of adding a hydro- therapy tub or laboring tub to pro- vide a soon-to-bemother another option of care. “Evidence-based research shows that the tubs canreallyhelp withthosepainsof labor,”shesaid. Thomas said the reason Me- morial provides a birthing ser- vice is so “people don’t have to leave their community and that they can stay close to home.” “Just to have it close to home and have that hometown feel to it,” she said. “It is nice to be able to do ev- erything you need to do in your hometown community,” said Bobbi Jo Sandberg, RN, CLC, HBCE, diabetic educator. “You knowyour physician be- causeyouhavebeenwith that phy- sician, in some cases, maybe your whole life,” Sandberg said. “That isexciting, and itprovides thecom- fort level to the patient.” While Memorial provides the best-quality care for the patient, there are some limitations in the services they provide, such as high-risk pregnancies where a bigger hospital is better equipped to handle and provide the special- ized care needed for the patient and her baby. AtMemorial, if there’s a high- risk pregnancy, their doctors re- fer to an OBGYN. If the patient already atMemorial, the OBGYN comes to the facility. “Theotherdifficulty is training newemployeesandkeepingupour competency skills,” Thomas said. She said for employees who need specialized training, they partner with area hospitals, such as Grand Island, Hastings, Kear- ney and Lincoln, where those em- ployees can update and add new skill care techniques. “We do this pretty regularly for preceptorships, observation experiences and training as well as getting that evidence-based re- search that can help keep up our skills on those things,” Thomas said. “It is critical that we do that so we can keep all of our skills com- petent sowe can take good care of our patients,” Sandberg said. To make sure that their em- ployees keep their skills compe- tent, Memorial provides ample trainingwith fellowships, precep- torships, classes, onlinemodules, simulation training, case studies and drills — some on site, others at collaborating facilities. BothThomasandSandbergsaid the hospital has already delivered babies so far this new year. Last year, theyhad35births, down from the previous two years where the numberof deliverieswasabout 40. “We do provide the basic care that most childbirths need,” said Thomas. “Themajority of deliver- iesgoasnatureintendedthemto.If theycangetcontinuityof carefrom before they got pregnant and then afterward for their entire familyso theycanstaywith the samedoctor, thatprovidesahugecomfort toour parents and community.” As the population continues to decline in rural areas, and ru- ral hospitals are not able to pro- vide birthing services to their communities, Sandberg said it is important for thosehospitals, such as Memorial, to let people know that there are options where they can “get that really good quality care close to home.” “We will continue to enhance our services and raise awareness and keep our skills up,” Thomas said. To learn more about Memo- rial Hospital, visit its website at www.memorialcommunityhealth. org. Independent/Barrett Stinson Registered nurses (from left) Rachel Griess and Allyson Wilson stand together in one of the two birthing suites at Aurora’s Memorial Commu- nity Hospital, which was recently recognized with a 2018 Rural Provider Excellence in Quality Award. By Chuck Lentz For The Independent Whenaskedaboutmilestonespar- entsshouldexpectinthefirstfewyears of their children’s lives, Dr. Douglas Boonof TheGrandIslandCliniclisted landmarks in at least four different areasof development.Buthealsocau- tioned against premature parental concern. “Everyagehas its expectedmile- stones,”Dr.Boonsaid.“Kidswillvary as to when they reach them, so we don’t get too concerned if they’re a little delayed in one area or another. We look for patterns. “If a child is consistently behind on their motor skills — they don’t roll over at four months of age, or they’renot crawlingbyninemonths of age, then you start to get wor- ried: ‘Is there a problemwith their motor skills?’” It’s the same with language development. “By a year of age we’re looking for one to three words with kids: ‘mom,’ ‘dad,’ ‘bye-bye,’ ‘no.’ Each visit after that we expect them to be sayingmorewords, and two-word phrases,” Boon said. Social skills, not very obvious at birth, become increasingly sig- nificant as a child grows older. When doctors examine children at different ages during well-baby checkups, he said, “we focus on all the different areas: what their mo- tor activity is — their fine-motor skills (such as finger movements) and their gross-motor skills (such as moving their bodies) — their speech development and, as they get older, their social skills, their interactions with other children and adults.” “Behavioral skills” should also be monitored as a baby becomes a toddler, Boon said. Parents of more than one young child might at first find it surpris- ing—even a bit alarming, perhaps — that two siblings may be very different in their development pat- terns and yet both are considered healthy. AaronandCharleyFalmlenof ru- ralWoodRiverareraisingthreeyoung children—ages8,6,and3—andthat’s been their experience. Charley Falmlen spoke of “the vast differences that existed in the children from day one.” “They can be so completely dif- ferent in themilestones that they’re meeting, and the timeframes that they’re meeting, and still be on course,” Falmlen said. “My oldest did everything ex- tremely early and so it was a bit of a shock to our systems when our second one wasn’t a really early bloomer,” she added. “But he’s still developing at the best pace for him. And then by the time you have a third one you’re thinking, ‘What milestones?’ At first it was a shock to the system giving them enough space to develop on their own.” What happens if a doctor deter- mines that a child has a significant delay of some kind? According to Dr. Boon, typical prescribed treat- ments exist: n for motor skill delays, physi- cal therapy and/or “occupational therapy” (for finemotor skills) and/ or home exercisesmay be called for; n for language development de- lays (after one year of age), speech therapy is appropriate; n for social skill delays (includ- ing a diagnosis of autism), enroll- ment inHead Start or a similar pro- gramand possibly physical therapy or occupational therapy are prescribed. “For social skills we screen for autism, and we screen at a lot youngeragenowthantenor15years ago,” Boon said. “Sometimes there isn’t a lot that you can do to mod- ify that — a lot of them as they get older will learn to some extent. So one of the things we always talk to parents about is, especially between one and two years of age, ‘Are they interacting with the other kids or are they just sitting off to the side watching the other kids?’” A doctor’s assistance should al- ways be helpful to parents inmon- itoring children’s development. “We start assessing babies’ de- velopment when they’re twoweeks old and we monitor it very closely, especially in the first year; they come in at two weeks of age, two months, four months, six months, ninemonths, oneyear—andat each visit we’re looking for different de- velopmentalmilestones,”Boonsaid. Parents should look for developmental landmarks Every child meets milestones at own pace RURAL HOSPITALS