But, Preemies have to get Sick to Build their Immunity, Right?

For some, this post may have reached the point of beating a dead horse, but I’m going to post about it because it’s a question I’m starting to get asked now that Owen’s been healthier. We are still a few weeks from the official start of the cold and flu season, but Owen met with his Pulmonologist on Thursday so I wanted to post it while her thoughts were still in my mind.

To the other preemie moms that are reading this blog and getting the same questions (every single one of you, I know, I follow Life After NICU too!), Dr. Laguna has said we are all free to quote her until we’re blue in the face (well not literally, the Pulmonary folks, and Medical people in general, take exception to that analogy).

So, here’s the typical conversation with fictional character, Imelda:

Me: Cold and flu season is just around the corner, we’re going back into the bubble in September.

Imelda: September, that seems too soon, isn’t that a little overkill?

Me: Once school starts back up, germs seem to spread. We will increase caution in September, with full lock down starting as soon as we get word that the season is in full force. As always we will be very strict on hand washing and limiting kids in our home this fall and winter.

Imelda [in all-knowing voice]: But, if he doesn’t get sick, he’s never going to build up his immunity. It’s good for kids to get sick every once in a while.

What I often want to scream at this point in the conversation is, “He’s STILL on oxygen!!!!!” immediately followed by, “we spent FOURTY-FIVE days in the hospital with Respiratory Illnesses last cold and flu season!!!!!!!!!!”

But, instead of getting all snarky, here’s the Pulmonary approved response (paraphrased).

It is true, for typical babies 6-8 illness per year is expected and normal. However, this is not about building immunity – it’s about lung health. All preemies, and especially those who spent an extended time on the vent, are an exception to that rule. These babies, even when they are acting healthy, have damaged lungs. Every illness that gets into the lungs [anything that gives you the “sniffles” or “a little cough”] damages the lungs further. Every illness increases their chances of hospitalization and prolongs their time with chronic lung disease. We DO NOT want these babies sick! Preemie parents aren’t paranoid – they are right

Imelda typically has one more question: So, how long does this last?

Back to me, on this one: It’s really case by case and should be discussed with the child’s doctors. Some kids had relatively healthy courses and can spend their second cold and flu season in general population. Other kids, like Owen, will need at least two full winters in as much seclusion as possible. We will try to be slightly lighter with Owen this year by letting him go to some in-clinic therapies through the season. However, if he starts heading in the wrong direction, we will go back to only in-home therapies. Even his Pulmonologist doesn’t want to see him in clinic unless absolutely necessary this winter. Next year is still a big question mark, it all depends on how this year goes.

If you’re still not convinced, specifically in Owen’s case, he has three strikes against him.
1)Bronchopulmonary Dysplasia (BPD) – The lung disease that is typical in preemies and is the reason that Owen requires oxygen. Owen is considered to have very severe BPD.
2) Asthma – A second form of lung disease that causes the airways to swell and narrow. It can be triggered by allergies or illnesses
3) Tracheomalacia – a condition that makes the windpipe floppy to the point of collapsing when it’s only supposed to dilate and contract slightly. Tracheomalacia is especially pronounced during coughing or hard crying.

Each of the three factors above, increases a person’s chance of being hospitalized when suffering from a typical respiratory illness. We learned this spring that the three can work together to really wreak havoc. The good news, is we know more this year so can better treat Owen and he has grown and gotten healthier. So, we absolutely do not expect another 45 days this year, but it won’t be surprising if Owen is hospitalized a time or two, even with our precautions.

Okay, I’ll but my soap box away for now. Thank you for reading and thank you in advance to everyone that stays friends with us through another winter of saying “wish we could” to invites. Also, please keep inviting us – babysitters aren’t out of the question!

© Copyright Tatum, All rights Reserved. Written For: Ain't No Roller Coaster

24 thoughts on “But, Preemies have to get Sick to Build their Immunity, Right?

  1. We just talked about this on our blog too. Except our pulmonologist said that he wanted Cohen to get sick, not because of immunity purposes, but because he wanted to see how he would do. I told him I was find with not finding out right now. We made it through last winter with NO sicknesses and are hoping to do the same again this year!! Preemie parents have to make a lot of hard decisions that many other people don’t understand, but it’s all for our little ones who have fought so hard to be where they are at today!

    • Agreed, Jana, the decisions aren’t easy, but the babies are so worth it. I hope you enjoy a little more freedom this year!

  2. Well said!! I think I’ll be forwarding your post along to friends and family this cold/RSV/flu season. This will be our first winter in seclusion with our 24 weeker, who came home in April. I’ve already gotten a few weird questions from people who just don’t understand the risks.

    • Good luck with your first winter Lara! I have a feeling we’ll have even more time getting to know other preemie moms online during nap times!

  3. Just came across your blog, i love your writing style. A little background about myself. Gave birth to a 24w2d boy last dec 2011. He came home in April. So he is now 4.5 months corrected. Last week we were able to celebrate our first holiday, Eid. Which was so wonderful, but then the next day he got his first cold. He survived his first cold, and now momma (me) is trying to get rid it as well. But its been so annoying hearing people say well he has to build up his immunity. and in my mind I’ve been screaming NO, its not the case for preemies. I was happy to read your response, i think i will share that with friends and families the next time someone has the need to tell me about my sons immunity.

    • Thank you Seher, I appreciate the feedback. Feel free to use any parts of my words to help communicate the importance of keeping your son healthy. It’s definitely a concern that many of us share. Wishing you and your son a healthy first cold and flu season out of the NICU.

    • Hi Seher, My son was a 24 and 4 weeker born on November 29, 2011. So our sons are close in age. Just wanted to say to trust your momma gut when it comes to your little boy! Sounds like we’ll both be on preemie lockdown soon during our first flu/RSV season. Good luck! Lara

  4. My triplets were 25weekers, my 2 survivors are almost 6 years old. Their sister died when she was 14 months old after being rehospitalized w/ flu & pneumonia (she contracted MRSA during that stay). During our 3rd cold/flu season we were cautious, but not in lock down anymore. My 2 survivors, who had no apparent lung issues after their 1st birthday, were hospitalized for a week with RSV….they were 3 years old. In my opinion, you can’t be too careful with fragile kids. Thanks for posting this, we’ll be sharing it on our Zoe Rose page.

    • Keira, thank you for the note and sharing the post on your site. It was just a couple weeks ago that I found your foundation, in memory of Zoe Rose. I read her story and my heart broke for you all. Thank you for sharing your story and working to help the families behind you.

  5. My 32 weeker is now 4 and we suffer terribly with colds and flu all year round. Any suggestions on how to overcome this? Short of totally isolating her till she is 30

    • Aisha, I’m sorry to hear that you continue to have tough flu and cold season. I wish I has a great answer for you, but my best advice is to see her ped or pulmonary doctor prior to the season to make sure you have the best plan in place. We have an asthma action plan for Owen that details when he should be nebbed, when he should get prednisone and when he needs to be seen. It helps us be proactive and hopefully treat him before it gets too bad. I’d also suggest asking your question on Life after NICU on Facebook. They have a lot of active followers who may have some additional advice for you. Wishing for a better cold and flu season for you and you LO this year.

  6. My 30-weekers had only one strike against them – prematurity. They were on oxygen assistance for only 2 days after their birth. They flew out of the NICU in 35 days. Our pediatrician told us daycare was fine for them, they were doing great – how naive were we….after getting RSV 2 days after daycare began (in June, not RSV season), my daughters now have lung damage. B/c that preemie lung tissue, even if not CLD or BPD, is thin, it’s fragile, it just can’t fight lung infections (once we got a pulminologist on board, he told us that he sees this often with preemies who have had early RSV). My girls are almost 5 now, and whenever they get a cold, they need nebulizers, inhalers, steriods, and sometimes ER visits b/c their saturation levels get so low. So, your words of wisdom reach out to not only the “fragile” preemies, but all preemies born early.

    • Kristen, thank you for sharing your story. You speak so well to the risks for preemie lungs and that’s a great example that it’s not just the CLD children that are at risk. All preemies need to be protected. Wishing you less nebs, inhalers and steroids this winter. RSV is evil stuff!

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  8. Just saw this post on Life after NICU. I wanted to add that even full term babies who have been on the ventilator are at risk for lung related problems. My daughter had PPHN and was placed on the ECMO, a heart lung bypass machine. So for 5 days, she needed a machine to oxygenate her blood and pump blood, while her lungs and heart tried to recover. After that it was back on the vent for couple of more weeks, then nasal cannula etc. At one point, she developed pneumonia and had to emergency vented again. I have seen my child turn limp and blue from lack of oxygen and that pale face is still all too clear on my mind. We have a friend who is a neonatologist, and he said that no matter what anyone says, keep her away from flu/cold etc for as long as possible. Every child’s lung grows till they are 8 or so. The ventilator has already damaged their lungs. Add to this repeated insults of cold and flu, the lungs just don’t have time to heal. This results in asthma and other breathing issues that may continue to adulthood.
    I left my job after my daughter came home since we did not want to take any chances. This past flu season was our second one. The first flu season when we were just back from the hospital, we were in a bubble. This one is a little better and we do go out. We still wash hands often, don’t go to birthday parties, don’t let anyone sick come nearby and wear masks in the even we get a cold. So far, at 16 months she has had one cold (touch wood). I am willing to stay home as long as possible just to keep her away from illness.
    As for the “we have to get sick to built our immunities” statement, why is it that even adults still end up catching colds from their kids? Like you said, the older our kids, the stronger they will be to fight colds (inevitable once school starts).
    Lastly (sorry, long comment!) I belong to an ECMO group on FB, and there are many parents whose kids ended up on the ECMO when a simple cold/RSV got out of hand. Some stories didn’t have happy endings either. Thank you for this post, and thank you for letting me vent!

    • Hi Keya, Nice to meet you and thank you for the comments. Yes, I do sometimes generalize preemies since that’s my NICU experiences, but absolutely, any child that spent time on a vent at birth can relate. I’m happy to hear your daughter is doing as well as she is. ECMO is scary stuff. Thank you for sharing your experience with us. I wish you and her continued health!

  9. I hear that a lot…gabby has avoided illness….for two-years…and she was on vent for 51 days…and came home on oxygen…I do not want to risk anything…I keep her home..we have two school aged kids too…and by the grace of God..we have stayed healthy…..we are looking at getting tubes in her ears…all that scares me is the anastischia because of her lung damage…its very scary when it comes to breathing… great blog…

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  11. my wife and son have been staying at my mother-in-laws for almost a week and sadly my daughter and I have been home sick, its been 5 days, were feeling better but not quite “not contagious” yet.

    today she said he spit up and she heard him cough and sneeze a few times, Im freaking out, I don’t know if he is getting sick and if so, Taking him to the ER seems even worst, What do we do in a situation like this? where does he go? do carseat covers provide any protection against airbourne germs?

  12. Sorry forgot to mention, my son is exactly 1 month old, spent 3 weeks in NICU, was on and off oxygen for first 2 weeks, Still breaths alittle rough because lungs are immature but so far ok, Am I being too paranoid?

    • Hi Victor, Coming home for the NICU is such an anxious time, isn’t it? I hope your son had a better night. My rule of thumb is to always ask the doctor when in doubt. They tend to take special care and are always nice when I’ve taken my kids in and it ended up being nothing. I hope it’s nothing, but my advice is it’s always best to be safe than sorry – if nothing else, then you’re not worried.

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