103 Days in the NICU—Bonding Through Storytime

By Krystin Dean

Lori Bennett was put on bed rest 10 weeks into a high-risk pregnancy. She was unable to work, and then her husband lost his construction job. By the time Mikah arrived 12 weeks early, weighing less than 3 pounds, the Bennetts had lost their home and moved in with Lori’s mom.

During Mikah’s 103-day hospital stay, Lori spent seven hours each day in Grady’s NICU in Atlanta. When she saw a flyer for the “Let’s Read a Book Today!” shared reading program that provides new books each week for parents to read with their babies, she welcomed the distraction.

“Instead of just sitting there in silence not really knowing what to say, you have something to do to keep your mind busy,” said Lori. “Whether your baby’s in the incubator or in your arms while you’re reading, it’s something that allows you to have personal bonding time and let go of that stress for a while.”

Bennett, who has four children and a stepson, spent time in the NICU with her first three. She made up a special song to sing to each of them in the hospital every day—but Mikah is the first one who she read to daily.

“I was 21 when I had my oldest, who is 21 years old, so reading wasn’t really something I thought about with him,” said Lori. “When I had Madison 10 years later, I brought my Bible to read—but I didn’t have the opportunity to have children’s books there all the time like I did with Mikah.”

This partnership between Grady’s NICU and the Atlanta-Fulton County Public Libraries offers research-based support and encouragement about the benefits of reading and talking with babies and connects families with local libraries to ensure continued access to books.

“Parents get tons of information, appointments, and referrals. The patient
 gets lost. It’s not a perfect system,” said Angela Leon-Hernandez, assistant professor of pediatrics at Emory University School of Medicine. “Neonatologists and NICU nurses have a role to play. I believe that, in four to six months, we can change beliefs and habits in a family.”

Research indicates that babies who are exposed to biological adversity due to prematurity or other medical conditions and require a prolonged NICU stay are at high risk for developmental problems, including speech delay, learning disabilities, and behavioral and emotional difficulties.

Leon-Hernandez researched strategies to help families cope with stresses they face in the NICU and prevent behavioral issues after discharge. Shared reading programs create increased sense of control, normalcy, intimacy, and a source of comfort for parents—and an increased likelihood of continued shared reading habits for children.

“All parents want to do their best. But if you don’t know reading to your newborn is important, you aren’t going to do it,” said Leon-Hernandez. “And a baby with a brain injury from prematurity or other cause could be less responsive or hyper-responsive—and that’s a difficult situation. So we have to intervene.”

Leon-Hernandez assembled a team comprised of neonatologists, psychologists, social workers, and others invested in supporting these high-risk children’s healthy growth and development.

“You have to share and network,” she said. “If I hadn’t sent an email to my faculty asking for help, I wouldn’t have met Get Georgia Reading Campaign Director Arianne Weldon. And that was the single-most important connection to help us advance in this process.”

The program, which enhances existing efforts like Books for Babies and Talk With Me Baby, came together through relatively small investments and book donations secured through Campaign connections.

Weldon suggested that the NICU and the Georgia Public Library Service form a partnership, marking the first collaboration of its kind in Georgia. NICU and library staff members and volunteers receive training to work with parents to promote shared reading.

New parents have logged more than 6,000 minutes of NICU reading since the program launched in 2017, and families like the Bennetts continue to record progress after discharge. During weekly library visits, Mikah logged more than 250 books in her first year.

“We read to Mikah every day,” said Lori. “When we sit down with a book, it doesn’t matter if it has pictures in it. She’s glued. She will look at the book and look at you as you’re reading. She’s engaged. She knows people are spending time with her and talking to her.”

Leon-Hernandez is planning a landmark study to track data on program graduates and hopes to eventually analyze the program’s impact on third-grade reading proficiency.

Other regional perinatal centers in Georgia are on board to replicate this low-cost, high-impact program. Leon-Hernandez’s team is working on a standardized plan to prepare families for discharge from day one of their NICU stay. Training and empowering team members who conduct weekly home visits after families leave the NICU is also a priority.

“We have to join efforts,” said Leon-Hernandez, who established an annual conference in 2016 that brings together health care providers and educators from different backgrounds to discuss behavioral and emotional problems in children born prematurely and find ways to help families.

“You see this one child who is overcoming and doing so well and another who isn’t. We look at the social exposure and it’s totally different,” said Leon-Hernandez. “We believe there are things we can do in the NICU that can improve outcomes, but what happens after discharge in the first three to five years of life is going to determine the real meaningful outcomes we have to measure.”