Should you take the Risk?

As you consider adopting a high-risk baby we wanted to encourage you with our own journey towards adopting a baby boy born 10 weeks prematurely. When told of the opportunity, we initially didn’t think twice about it, because we knew what we wanted and were not willing to face the risks involved, but immediately God grabbed our hearts and slowly began to open them to the reality of His sovereign hand making a way for us. We hope that after reading our story, you will be open yourselves to consider How Gods ways can be so much greater than our own.

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From: Dean Greer
Sent: Monday, April 21, 2008 3:21 PM
To: undisclosed recipients
Subject: update!

We found out yesterday that a Caucasian baby boy was born on Wednesday, ten weeks premature. The original adopting family decided that they did not want to deal with a preemie so backed out leaving the little guy in need of a family. All we know at this point is that he apparently is doing better than most in his situation, weighs just shy of 4 pounds (good), has some bleeding on the brain (normal for preemies), and will be in the hospital for another 6-8 weeks. We are scheduling a conference call with the doctor to discuss all of the risks involved before deciding whether or not to pursue it further. The amazing thing is that the baby is right here in Kansas City!

Please Pray!

(Sent to just a few of you – please keep it under wraps for now.)

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At this point we thought it wise to seek the counsel of an authority on preemies:
Vicki Penwell, along with her husband Scott founded the ministry that became Mercy In Action over 27 years ago. Vicki is a midwife and health educator. For years they have lived and worked in Alaska, Asia, and Mexico, setting up clinics, birth centers, medical mission outreaches, malnourished children's feeding programs and schools to help the poor. Vicki has become a dear friend through our work at Desert Stream Ministries
More info on their ministry: www.mercyinaction.org

Following is the thread between Vicki and me:

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On Tue, Apr 22, 2008 at 4:27 AM, Dean Greer wrote:

Hi Vicki,

Blessings to you! I have been looking for some personal insight regarding premature births and thought you would probably have the best personal experience.
We don't know a lot of details yet, but I was wondering if there would be a chance to talk with you regarding potential risks involved with a 10 week preemie. I imagine you would have much insight. It would be ideal to be able to talk with you after talking with the doctor.

Hope things are going well for you!

Blessings,
Dean

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From: Vicki Penwell
Sent: Tuesday, April 22, 2008 5:33 PM
To: Dean Greer
Subject: Dean--premature baby

Wow Dean, amazing to get this note from you. I think about you often and had wondered what was up with you and Chrystal in the "family-making" department!

I am on a little island in the Philippines, but because of amazing modern technology, you can call me easily on my cell phone. It doesn't matter day or night because I am always on call for births here, so my phone is always on, and I am very used to getting woken up and would not mind at all .

This baby boy sounds like he is really doing good to be 4 pounds at 10 weeks early. Maybe he is not quite so premature as originally thought (people are wrong on their due dates all the time) so when you talk to the doctor, ask him or her what the estimated gestational age is according to the physical and neurological signs in the baby.

Premature babies can have health issues, for sure. They are just more fragile, and can have life-long issues. Depending on your health insurance status, it could get expensive. And the next 6-8 weeks could be a roller coaster of emotions. Premature babies rarely just progress along evenly, they often have setbacks and victories and could even have several periods of uncertainties if the little guy will survive. Boys don't do as good as girls, statistically, at overcoming premature birth. Also, you need to know as much as possible about what caused the premature birth. If drugs were involved, you obviously have other problems on top of the prematurity. Babies don't just check out of the womb early for no reason, usually something is going on that has already put the baby at risk, ie bad nutrition, drugs, infection, etc. So ask as many questions as you can when talking to the doctor.

On the other hand, if this is "your" baby, love can overcome anything. I would say the most important thing is to really decide (together with God in prayer of course) as soon as possible if you are to take this baby, because if you are, one or both of you should be in the hospital with the baby almost constantly talking to, holding (as much as is allowed by the hospital) and praying over the little one. Premature babies are for sure at bigger risk for those early "mother wound" issues, as are all babies put up for adoption, but it can be overcome if a new bonding relationship (in this case, a mother and father) comes into the scene as soon as possible and floods the baby with affection, physical touch, the sound of a voice, etc, so the fact that the baby is in KC is totally in your favor, and seems like a very good sign. If you decide to go forward with pursuing this adoption, I would say this baby boy is one lucky little guy, because the time of being alone in an incubator with no one to love him would be significantly shortened, since you could visit him, and another adoptive family may live farther away and not be able to do that.

There are actually two schools of thought on premature babies. The old school thought is that touch should be kept to a minimum to not over stimulate their immature nervous system. But in the last decade some amazing research has come out on the phenomenal health and welfare benefits of massage on premature babies, and how they leave the hospital earlier and have fewer health problems and gain weight faster, etc. if massaged and touched alot. That whole body of research points to the importance of touch, and really ties into our Living Water belief on the importance of early mother bonding and care. I will try to see if I can attach a story on it to an email to you.

But mostly what I can do for you, my friend, is pray, that God will show you clearly what to do, and that He will open all the doors (or close them) according to His divine will for you and Chrystal.

Please keep me updated, and as I said before, call anytime if you want to talk in person.

Much love and prayers,
Vicki


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On Tue, Apr 22, 2008 at 10:10 PM, Dean Greer wrote:

Hi Vicki!

It was such a blessing to get your emails and your kind, encouraging words.

We are going forward with the adoption and are hoping to get to the hospital today to sign paperwork and meet Jeremiah Michael for the first time! He is a little fighter and is doing really well. Supposedly he has captured the hearts of the entire staff.

The best part of the whole situation is that he is right here in KC so we will be able to spend a lot of time with him!

The articles are helpful, thanks you so much! We will keep you posted. J

Much Love,
Dean



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From: Vicki Penwell
Sent: Wednesday, April 23, 2008 1:12 AM
To: Dean Greer
Subject: Re: more research on importance of touch to preterm infants

Dean and Chrystal,

Thanks for letting me know you are going ahead...I love that you are taking a risk on little Jeremiah. It is always a good thing to risk your heart on Christ-like love... even if, and especially if, there is a danger that the adoption may fall through later and break your heart. It is the right thing to do. He needs you two.

And I will certainly begin now to pray that the adoption will go through for you, that he will grow healthy and strong and come home soon to your home, to fill that spot in your life you have longed for so long to be filled by a child of your own.

The spirit of adoption is real, and wonderful (I know!) and I pray it over you three now,

love,
Vicki


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From: Dean Greer
Sent: Wednesday, April 23, 2008 9:10 AM
To: Undisclosed Recipients
Subject: The Suddenly of God


“I know what I'm doing. I have it all planned out--plans to take care of you, not abandon you, plans to give you the future you hope for. When you call on me, when you come and pray to me, I'll listen. When you come looking for me, you'll find me.
Yes, when you get serious about finding me and want it more than anything else, I'll make sure you won't be disappointed."
Jeremiah 29:11-14a - the message

This Friday we are scheduled in court to sign papers granting Chrystal and I custody of Jeremiah Michael Greer, born on April 16th - 10 weeks prematurely - right here in Kansas City! Tonight we were able to meet him for the first time. We will be spending much time with him at the hospital during the next 6-8 weeks as he grows up. He has some minor complications, as preemies are known to have, though he is healing rapidly and expected to grow up to be a healthy, mighty man of God.

Birth weight: 3 lbs, 11ozs
Length: 39 centimeters
Red hair, blue eyes

Our story with him began just this past Sunday, so Chrystal and I are still catching up to it all. We look forward to telling you the complete story as it continues to be a moment by moment reminder of God’s sovereign hand. We covet your continued prayers – they have certainly gotten us this far!



The following articles were sent to us by Vicki:
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Predicting which preterm infants benefit most from massage therapy

Researchers at the Department of Pediatrics, University of Miami School of Medicine studied ninety-three preterm infants; the mean gestational age of the infants was 30 weeks; the mean birth weight, 1204 g, and mean duration in the intensive care was 15 days. All of the babies were randomly assigned to either a massage therapy group or a control group as soon as they were considered medically stable.
The fifty babies in the treatment group received three daily 15-minute massages for 10 days. The massage therapy infants gained significantly more weight per day than the infants in the control group (32grams compared to 29 grams). All of the babies in the treatment and control groups were divided into high and low weight gainers based on the average weight gain for the control group. Seventy per cent of the massage therapy infants were classified as high weight gainers whereas only forty per cent of the control infants were classified as high weight gainers.
A closer inspection of the records revealed that the babies who needed the most help (ie. those infants who had experienced more complications before the study began) actually benefited more from the massage therapy. Using those parameters, the researchers accurately predicted that seventy eight per cent of the infants would benefit significantly from the massage therapy. Thus, they concluded from the results, that it was possible to to identify those infants who would benefit most from future massage therapy programs.
Scafidi FA; Field T; Schanberg SM. Factors that predict which preterm infants benefit most from massage therapy. Department of Pediatrics, Touch Research Institute, University of Miami School of Medicine, FL 33101. J Dev Behav Pediatr (UNITED STATES) Jun 1993, 14 (3) p176-80

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Preterm Infant Stimulation Reviews
Early touch interventions and their effects on high-risk infants are reviewed.
Field, T. (1986). Interventions for premature infants. Journal of Pediatrics, 109, 183-191.
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Preterm infants who received tactile stimulation showed greater weight gain. A potential underlying mechanism for the massage/weight gain relationship is an increase in vagal tone, which in turn increases food absorption.
Field, T. (1988). Stimulation of preterm infants. Pediatrics in Review, 10, 149-154.
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Alleviating Stress in Intensive-Care Neonates: Intensive care nursery environments and their effects as well as positive tactile stimulation effects are reviewed.
Field, T. (1987). Alleviating stress in NICU neonates. Journal of the American Osteopathic Association, 87, 646-650.
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Alleviating Stress in Newborns: Stressful effects of intensive care nursery environments are reviewed including the effects of high-intensity noise, bright lights, cold, invasive and painful procedures. Touch interventions were associated with 1) fewer startle responses, 2) decreased need for ventilation, and 3) fewer clenched fists. The stimulated infants averaged greater weight gain, were awake and active for a greater period of time and scored better on the Brazelton Scale.
Field, T. (1990). Alleviating stress in newborn infants in the intensive care unit. Perinatology, 17,1-9.
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In a review of preterm infant massage studies, massage therapy was found to facilitate weight gain only when the intervention was started when the preterm infant weighed between 1100 and 1300 g.
Hernandez-Reif, M., Field, T., Diego, M., & Beutler, J. (2001). Letter-to-the-Editor: Evidence-Based Medicine and Massage. Pediatrics, 108 (4), 1053.
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Review of supplementary stimulation programs for preterm infants including nonnutritive sucking, kangaroo care, and massage therapy.
Field, T., Hernandez-Reif, M and Freedman, J. (2004). Stimulation programs for preterm infants. Social Policy Report, 18, 1-19.


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Preterm Neonates' Responses to Massage and Heelsticks
Routine heelstick procedures and tactile-kinesthetic massage were performed on stabilized preterm neonates to examine the differential effects on Transcutaneous Oxygen Tension (TcPO2). TcPO2 levels during the heelstick were significantly lower than during the massage stimulation. The findings indicate that social forms of touch such as massage do not appear to have a medically compromising effect on TcPO2.
Morrow, C., Field, T., Scafidi, F.A., Roberts, J., Eisen, L., Larson, S.K., Hogan, A.E., and Bandstra, E.S. (1991). Differential effects of massage and heelstick procedures on Transcutaneous Oxygen Tension in preterm neonates. Infant Behavior and Development, 14, 397-414.





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Preterm Newborns Gain More Weight
Preterm infants gained 47% more weight, became more socially responsive, and were discharged 6 days earlier at a hospital cost savings of $10,000 per infant (or 4.7 billion dollars if the 470,000 preemies born each year were massaged). The underlying biological mechanism for weight gain in the massaged preterm newborns may be an increase in vagal tone and, in turn, an increase in insulin (food absorption hormone).
Field, T., Schanberg, S. M., Scafidi, F., Bauer, C. R., Vega-Lahr, N., Garcia, R., Nystrom, J., & Kuhn, C. M. (1986). Tactile/ kinesthetic stimulation effects on preterm neonates. Pediatrics, 77, 654-658.
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Preterm infants gained more weight following as few as 5 days of massage therapy.
Dieter, J., Field, T., Hernandez-Reif, M., Emory, E and Redzepi, M. (2003). Stable preterm infants gain more weight and spent less time sleeping and more time in the drowsy states following 5 days of massage therapy a. Journal of Pediatric Psychology, 28, (6) 403-411.
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Preterm Infants received tactile/kinesthetic stimulation over a 10-day period. The infants averaged 21% greater weight gain per day and spent more time awake and active during sleep/wake behavior observations.
Scafidi, F., Field, T., Schanberg, S., Bauer, C, Tucci, K., Roberts, J., Morrow, C., & Kuhn, C.M. (1990). Massage stimulates growth in preterm infants: A replication. Infant Behavior and Development ,13,167-188.
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Preterm infants received three daily 15-minute massages for 10 days. The massage therapy infants gained significantly more weight per day than did the control infants. For the massage therapy group, the pattern of greater caloric intake and more days in Intermediate care before the study period along with more obstetric complications differentiated the high from the low weight gainers, suggesting that the infants who had experienced more complications before the study benefited more from the massage therapy.
Scafidi, F., Field, T., & Schanberg, S. (1993). Factors that predict which preterm infants benefit most from massage therapy. Developmental and Behavioral Pediatrics, 14, 176-180.
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Although the underlying mechanism for this relationship between massage therapy and weight gain has not yet been established, possibilities that have been explored in studies with both humans and rats include (a) increased protein synthesis, (b) increased vagal activity that releases food-absorption hormones like insulin and enhances gastric motility and (c) decreased cortisol levels leading to increased oxytocin.
Field, T. (2001). Massage therapy facilitates weight gain in preterm infants. Current Directions in Psychological Science, 10, 51-54.


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Preterm Newborns Sleep Better
Preterm infants who were massaged before sleep fell asleep more quickly and slept more soundly with better sleep patterns. They showed improved weight gain as compared to infants who were not massaged before sleep.
Scafidi, F., Field, T., Schanberg, S., Bauer, C., Vega-Lahr, N., & Garcia, R. (1986). Effects of tactile/kinesthetic stimulation on the clinical course and sleep/wake behavior of preterm neonates. Infant Behavior and Development, 9, 91-105.
Preterm Infants Develop Better: Preterm infants who received massage therapy as newborns showed greater weight gain and more optimal cognitive and motor development eight months later.
Field, T., Scafidi, & Schanberg, S. (1987). Massage of preterm newborns to improve growth and development. Pediatric Nursing, 13, 385-387
Examined the effectiveness of pre-bedtime massages for infants and toddlers with sleep onset problems. Found that, compared to bedtime stories, massages produced fewer sleep delays and a shortened latency to sleep onset. Field, T., & Hernandez-Reif, M., (2001). Sleep problems in infants decrease following massage therapy. Early Child Development and Care, 168, 95-104.
Depressed versus non-depressed mothers were interviewed on their breastfeeding practices and perceptions of their infants' feeding behavior when their infants were eight-months-old. The depressed mothers less often breastfed, they stopped breastfeeding their infants significantly earlier in infancy and they scored lower on a breastfeeding confidence scale. Independent of maternal depression, mothers who breastfed rather than bottle fed their infants had higher confidence levels and rated their infants as less alert and less irritable during feedings.
Field, T., Hernandez-Reif, M.,, Feijo, L. (2002). Breastfeeding in Depressed Mother-Infant Dyads. Early Child Development and Care 172, 539 - 545
Healthy, low-risk preterm infants gained more weight and slept less with just 5 days of massage, in contrast to 10 days in previous studies. Results support the continued use of massage as a cost-effective therapy for medically stable preterm infants.
Dieter JN, Field T, Hernandez-Reif M, Emory EK, Redzepi M. (2003) Stable preterm infants gain more weight and sleep less after five days of massage therapy. J Pediatr Psychol, 28, 403-11.
Compared with preterm neonates receiving sham massage, preterm neonates receiving massage therapy exhibited greater weight gain and increased vagal tone and gastric motility during and immediately after treatment. Gastric motility and vagal tone during massage therapy were significantly related to weight gain. The weight gain experienced by preterm neonates receiving moderate-pressure massage therapy may be mediated by increased vagal activity and gastric motility.
Diego MA, Field T, Hernandez-Reif M. (2005). Vagal activity, gastric motility, and weight gain in massaged preterm neonates. J Pediatr. 147, 50-5