Family warmth, exceptional care for baby Lucas in the intensive care nursery

Lauren Robinson, 36, was in the home stretch of her second pregnancy when she developed severe itching on her palms and the bottoms of her feet.

After speaking with her obstetrician, she went to the Penn Medicine Doylestown Hospital Emergency Department (ED) as a precaution to make sure there were no issues with her pregnancy.

In the ED, Robinson’s blood work revealed the cause of her itching—elevated levels of bile acids due to a relatively rare liver condition called intrahepatic cholestasis of pregnancy (ICP).

Unrecognized ICP can lead to serious birth complications, the worst being stillbirth. Treatment may involve medication, or, as in Robinson’s case, doctors may recommend delivering the baby early.

Adjusting to the unexpected

Robinson’s obstetrician admitted her to Doylestown Hospital for overnight monitoring and observation. Her baby would be delivered the next morning via a Cesarean section.

“At first, I was shocked,” she said. “It was three weeks before my due date. I didn’t have anything with me and had no chance to prepare my daughter."

Fortunately, her husband, Ben, and other family members arrived, delivering the extra dose of love and support Lauren needed, along with her hospital bag.

The next morning, the Robinsons welcomed Lucas into the world. He weighed 7 pounds and was healthy but was struggling to breathe.

“Lucas took fluid into his lungs during the Cesarean section, which takes time to resolve. In the interim, we admitted him to Doylestown Hospital’s Level II Intensive Care Nursery, where we could provide respiratory support to keep his lungs open and relieve his distress,” said Shehla Siddiqui, MD, a Children’s Hospital of Philadelphia (CHOP) neonatologist and medical director of newborn care at Penn Medicine Doylestown Health.

Stepping into the unknown

Lauren recalled of her first time in the ICN, “I was still groggy and struggling to comprehend what they were telling me about Lucas. The neonatologist understood this. Not only did she sit with me, but she sat with my family members, explaining Lucas’ situation.”

According to Siddiqui, family-centered neonatal care empowers parents by involving them in their baby's care and decision-making. “The best part is that the parents get to spend lots of time with their babies,” she said.

Recognizing that nurturing touch plays a vital role in bonding, the ICN follows a research-based approach called Kangaroo Care.

“Kangaroo care involves placing a baby skin-to-skin on a parent's chest to promote bonding, stabilize vital signs, and support growth,” Siddiqui said. “In the ICN, we ensure the mother or father has an opportunity to hold the baby skin to skin within the first 24 hours, with the baby's interests always in mind.”

Each ICN bed space is fitted with the AngelEye Camera System, which provides families password protected, secure access to a live video feed of their baby.

“Even knowing Lucas was in the best of hands, it was hard to leave him,” Lauren said. She said having the ability to view Lucas from home was a game-changer, especially for his big sister, Emilia. At age 4, she was too young to visit in person.

“The cameras helped our family stay connected. It was comforting to watch Lucas from home,” Lauren said. The Robinsons also tuned in to join doctors on rounds, so they could stay involved with Lucas’ care when they couldn’t be there in person.

The AngelEye camera system was donated to Doylestown Hospital by The Superhero Project, as part of a larger program to ensure access for parents and families who cannot always be on site, according to Siddiqui.

“When a newborn needs intensive care, the family experience shifts dramatically,” Siddiqui said. “Through our ICN Family Council, we collaborate with parents of former patients who provide valuable feedback on ways to improve the family experience.”

Changes made with parental input include:

• Books for babies: A little bookshelf in the ICN allows people to read to the babies.
• Physician pictures: The name and photo of the neonatologist on duty are posted in the unit to help parents get to know them.
• ICN phone: The neonatologists have a dedicated ICN phone for parents to call at any time.
• Trial run: Parents can sleep overnight with their baby in a hospital room before taking their baby home. The baby's monitor is removed, and parents can call ICN doctors or nurses if questions or concerns arise.
• ICN Reunion: The first ICN reunion for Doylestown Health is planned for September 2025, bringing the parents and babies back together with the staff.

ICNs at several other Penn Medicine hospitals have similar family-centered programs, catered to local needs.

Lucas went home after 10 days in the ICN, where his breathing was supported by a steady flow of oxygen into his lungs. A small collection of air outside of his left lung, called a pneumothorax, resolved without intervention, according to Siddiqui.

“We love having Lucas home, but the care and compassion of our doctors and nurses will forever stay with us,” Lauren said.