Santino was born just under 23 weeks at Sunnybrook, making him a ‘nano-preemie’ very sensitive to respiratory infections.

Katrina holding her baby, Santino

For Katrina, this means ensuring her newborn receives a special preventive antibody in hospital to protect Santino from RSV (Respiratory Syncytial Virus) infection. RSV is a major cause of respiratory illness, particularly among infants, young children, and older adults, affecting the lungs and airways.

“It’s really a no-brainer to say that all babies, especially those born prematurely, should receive the RSV preventive antibody. It’s the most common virus affecting babies and can lead to serious breathing problems, especially in premature babies,” says Dr. Asaph Rolniksky, Chief of Newborn and Developmental Paediatrics at Sunnybrook.

An RSV infection causes inflammation and secretions to buildup in the lungs. This means less oxygen can pass through the lungs, causing breathing and feeding difficulty, hospitalization, oxygen therapy and sometimes ventilation. RSV infection is the leading viral cause of infant death in Canada – almost nine times more than flu, and the most common cause of babies’ admission in hospitals.

Santino

A preventive antibody is a protein that helps the body fight harmful substances like bacteria and viruses. It’s called nirsevimab, or by its brand name Beyfortus.

All newborn babies born during 2024 in Ontario are now eligible to receive the preventive antibody. The NICU will routinely provide the antibody to all newborn before discharge home to ensure protection again RSV. Full-term babies may also receive it in Sunnybrook’s Birthing Unit or Maternal Newborn Unit.

To learn more, check out our Q&A for families.

The post Keeping your baby safe: Learn about the RSV antibody appeared first on Your Health Matters.

“His lungs, brain, heart: that’s all we focused on during the early days,” says Amit, who explains Aaron was born just under 24 weeks and immediately intubated. “Thank goodness the team explained everything in simple terms for us.”

Aaron is now a healthy and active toddler. Most days Amit and Natasha find it difficult to imagine the intense stress and worry they had about their only child. They say they now appreciate the quality of critical care their son received.

This quality was confirmed by the Canadian Neonatal Network which recently reported that the hospital’s NICU has the best clinical outcomes in the country. Sunnybrook has the lowest rates of death or incidence of morbidities combined in babies born under 33 weeks of gestation. Morbidities include chronic lung disease, intraventricular hemorrhage, vision and hearing impairment, as well as cerebral palsy, reduced cognition and motor performance, academic difficulties and attention-deficit disorders.

Every year, approximately 700 infants stay in Sunnybrook’s NICU, and 90 babies are considered “micro-preemies”. Micro-preemies are born at fewer than 26 weeks of gestation, and Sunnybrook cares for the most micro-preemies in Canada.

Being born too early is the leading cause of infant death in Canada. In the NICU, babies born very early are hooked up to many different pieces of equipment—machines to help them breathe; intravenous and other feeding tubes; and devices to monitor their heart and breathing rates, blood pressure and blood oxygen content.

Dr. Asaph Rolnitsky, Chief of Sunnybrook’s Neonatal Intensive Care Unit, says a combination of clinical expertise in focusing on the smallest babies, paired with a caring team who are intensively collaborative, helps explain the excellent outcomes.

“This is a specialized team who are not only working closely with each other, but also keeping in daily contact with the hospital’s high-risk obstetrics team,” says Dr. Rolnitsky, who explains the approach helps the neonatal team to be prepared for new admissions. “We have strong relationships with our system partners – SickKids and Mount Sinai – ensuring we’re on top of trends with preterm births in Canada. We also lead in research, education and technology.”

Sunnybrook’s family-centred care experience is another feature which sets the unit apart. “One of the most important conversations with families, which we have early on, is what having a premature baby means for them,” says Rolnitsky. “We try to keep in mind what prematurity means for each family, both in hospital and later for long-term follow-up, and for development and growth.”
Amit and Natasha agree that the early discussions with the Sunnybrook care team were vital. “They were open and honest with us,” Natasha says. “We knew Aaron would be very fragile over the first few months. And we knew he may have ongoing health issues into childhood and as an adult. We are grateful to the team for not only the excellent care but the emotional support they provided us along the way.”

The findings of the report were based upon data collected from 33 health care organizations that were members of the Canadian Neonatal Network during 2022.

The post Skilled and compassionate care for the sickest and smallest babies appeared first on Your Health Matters.

That was Donna Loi’s first thought after her twins were born unexpectedly at 23 weeks and six days at Sunnybrook. She recalls her fear of having Davin and Dalaila so early, and of learning they were only 600 grams in weight.

“I questioned why this happened to us, to our babies. I was scared and confused about seeing all the medical equipment surrounding their little bodies in the incubators. They didn’t look like newborn babies that I was used to seeing,” says Donna.

The twins spent 132 days in Sunnybrook’s neonatal intensive care unit (NICU). The unit cares for the highest number of ‘micropreemies’, or babies born at less than 26 weeks. About a quarter of these babies are twins.

“We have focused our care on the smallest, most premature infants for many years now because this is the most fragile population of babies and they need us the most,” says Dr. Asaph Rolnitsky, Associate Chief, Newborn and Developmental Paediatrics of the DAN Women and Babies Program.

Sunnybrook’s outcomes are the best in the country for low complication rates associated with prematurity and also high survival. But having two babies in an intensive care unit is a tough emotional journey.

“Everyone describes the NICU experience as a roller coaster ride and they’re absolutely correct. But it isn’t a smooth coaster with one high peak and drop, it’s the kind of ride that forces your butt off the seat, gives you whiplash, and leaves your hair in a complete mess,” says Donna.

Dr. Rolnitsky agrees it is often a very rocky ride for families. He has reassuring words though. “The vast majority of preterm infants survive, and thrive, and reach normal development and quality of life. Even those who face challenges,” he says. “Parents’ involvement and role in the NICU is incredibly important as they are advocates for their babies. Their meaningful interactions with their babies – time cuddling, talking, singing and just being with them helps facilitate brain development. Parents are part of the medical team.”

Donna agrees that Sunnybrook’s family centered approach helps build parents’ confidence. When the twins were stable, Donna and Daniel changed their diapers, fed them, helped administer medication and vitamins and took them out of the incubators on their own. They were also encouraged to take part in decision making. Donna adds that the NICU team was there not just for Davin and Dalaila, but for her and Daniel too.

A highlight for the parents was when the twins were stable enough to come out of the incubators for kangaroo care, when babies are held skin-to-skin on a parent’s chest. “I was able to hold both at the same time, my heart dropped. This was a tiny glimpse of what I pictured having twins would be like,” says Donna.

Now the twins are two years old, going to daycare and thriving. “We are in a different place. We’re a silly, fun and happy family, and very thankful.”

The post The smallest, most fragile babies: One family’s story of their time in the NICU appeared first on Your Health Matters.

When Diana Drake was injured in an ATV accident, she assumed her hopes of becoming a parent were over.

“I was paralyzed and broke my back in two places,” says Diana. “My life was turned upside down.”

Five years after the accident, Diana did become pregnant, and learned about Sunnybrook’s Accessible Care Pregnancy Clinic. The clinic is the first in Canada to care for patients with physical disabilities of all types during their pregnancy, delivery and postpartum phases.

“Patients with disabilities are often highly overlooked in terms of medical care and specifically pregnancy care,” says Dr. Anne Berndl, Director, Sunnybrook’s Accessible Care Pregnancy Clinic. “There is a significant amount of bias towards people with disabilities regarding reproductive care, and stigma when people interact with the health care system.”

The clinic at Sunnybrook was designed to be not only accessible, but welcoming, with the correct equipment and space available to care for patients. Most importantly, the hospital offers a collaborative team of people who are familiar with the concerns a person with a disability may have during pregnancy and birth. This core team pulls in specialists from other areas of Sunnybrook – such as anesthesia, neurology, hematology – to ensure a healthy pregnancy and delivery.

“The vast majority of people with physical disabilities can have a healthy pregnancy,” says Dr. Berndl. “If growing a family, and becoming a parent is your dream, having a physical disability does not mean this is out of reach. You can become pregnant. You can become a parent. For most people, this is a safe choice.”

Dr. Berndl strongly recommends patients have a pre-pregnancy consultation and notes it is not always a smooth road for everyone. There are some increased risks across the spectrum, but she notes going into a pregnancy with your eyes open, and a supportive care team, is key.

The clinic has cared for people with spinal cord injuries, like Diana, as well as little people and those with severe arthritis, spina bifida, a history of traumatic physical injuries, cerebral palsy, multiple sclerosis, a history of amputations, and myasthenia gravis.

“Patients sometimes feel apprehension and trepidation, and wonder ‘is this an okay thing I’ve decided to do…to become a parent and to start a family’,” says Dr. Berndl, who has cared for hundreds of pregnant patients with disabilities. “When you see a new parent, holding a baby in their arms for the first time, it’s a wonderful moment.”

Hear more from Diana about her journey in the video above.

The post Inside Sunnybrook’s Accessible Care Pregnancy Clinic: Diana’s story appeared first on Your Health Matters.

Shylee giggles enthusiastically, surrounded by toys, as her mom packs a diaper bag. “There’s a lot to cart around when we go out – her oxygen tank is the most important,” says Shanice, who looks proudly at her daughter, who was born at 24 weeks at Sunnybrook.

The pair are on their way to see the care team at Sunnybrook’s Neonatal Follow-Up Clinic. Shylee still uses oxygen for pulmonary hypertension and continues to smile as they hop in the car. Thankfully, their commute is just a 10-minute drive to a satellite clinic which sees patients in the Peel region once a month.

“Convenience-wise, it’s absolutely incredible,” says Shanice, who lives in Brampton and is grateful to have access to a clinic so close, with the same care team she’s known since Shylee’s four-month stay in Sunnybrook’s neonatal intensive care unit (NICU). “The clinic has all of the same staff we’ve come to know – it’s reassuring knowing we have access to this expertise close to home.”

Baby Shylee as a patient in Sunnybrook’s NICU.

Babies like Shylee, born at less than 30 weeks, and those who had complicated stays in the NICU, are seen in person and virtually by the follow-up clinic. Two satellite clinics, in Whitby and Brampton, provide accessible care for those who don’t live close to the main hospital when it comes time for an in-person visit.

“Sunnybrook’s NICU isn’t a postal code unit,” explains Dr. Rudaina Banihani, Medical Director of the Neonatal Follow-Up Clinic and a Neonatologist and Developmental Behavioural Pediatrician. “Our NICU is a level three unit, which means we care for the most premature and sickest babies from across the province. This model of care, where babies and families are seen close to home, really sets us apart.”

The model is longstanding, with the first satellite set up in the 1990s by Dr. Elizabeth Asztalos, a neonatologist with specialty in developmental pediatrics with the DAN Women & Babies Program. Satellite clinic visits comprise roughly 20 per cent of the clinic visits each month. The care team provide routine check-ins from the time a child is discharged from the hospital up until school age. Care in the clinic focuses on supporting each child’s developmental potential, by looking closely at motor skills, communication, engagement with the environment, and other important milestones. The clinic also prioritizes overall family well-being.

Dr. Banihani is quick to note the care doesn’t replace a child’s pediatrician, who are always the first line of call for acute care issues. That said, the team consults and collaborates with other health-care professionals, such as pediatricians, to identify each child’s strengths and areas for growth.

The Dhaliwal family are big fans of the model of follow-up care. Ranvir was born at 29 weeks and is now a very active six-year-old and a “bright spirit who has so much energy.” At Ranvir’s age, visits focus on the transition to grade level schooling, learning skills and peer relationships to support academic success and enjoyment of learning, as well as friendship building.

A present-day image of Shylee.

“Relaxed, comfy and no stress – that’s what it’s like visiting the satellite clinic,” says Kiranpal, Ranvir’s mom. “I know we’re getting the developmental support we need, and it’s close to our house. For Ranvir, it’s a lot of fun as there are so many toys and he gets to play.”

The interdisciplinary team is comprised of physicians with a knowledge of neonatal and developmental care, occupational and physical therapists, speech and language pathologists, and a registered nurse. All care providers specialize in the care of preterm infants and strive to collaborate with each family.

“From feeding to sleeping to toileting, we are focused on each child’s development related to their prematurity,” adds Dr. Banihani. “It’s fulfilling to meet families at different points in their child’s journey, from the hospital to starting school and beyond.”

For kids like Shylee and Ranvir, a visit to the clinic is all about play. “It looks like a play place – it’s bright and colourful. And we get to see familiar faces who truly support and cheer us on,” says Shanice.

The post Caring for families close to home appeared first on Your Health Matters.

What sets him apart is his start to life. Gage was born at 22 weeks and five days and spent four months in Sunnybrook’s neonatal intensive care unit (NICU).

“It hasn’t been an easy path, but it has been so rewarding,” says Heather, Gage’s mom, who explains Gage has low vision, autism and receives therapy for mobility issues. “He has disabilities but we make the best of it and celebrate every milestone.”

Dr. Eugene Ng, Medical Director of the NICU at Sunnybrook, is on the frontline when an extremely premature baby is about to be born. “Caring for a micro-preemie like Gage draws in a whole support from the inter-professional team so we can ensure the best possible outcomes for these infants,” says Dr. Ng. “For example, we give steroids to the mothers at the right time, to help babies’ lungs develop, which helps reduce the risk of serious complications and death. One of the most important steps centres on discussions with families about what having a premature baby means for them.”

Dr. Ng and Heather share thoughts for families who are facing a very preterm birth:

Dr. Ng: These are often difficult conversations. As health care providers, we need to outline for families the possible outcomes of having a very premature baby. These babies are at high risk of many developmental challenges, including vision and hearing problems, motor delay, impaired learning and behavioural and other developmental challenges. Sunnybrook is a leader in developing treatments for infants born at 22 and 23 weeks. However, it’s a very heartbreaking reality that not all of these babies will survive. We provide information to families that if their baby lives, they will be very fragile over their first few months of life, and may have ongoing health issues into childhood and as an adult.

Gage, born at 22 weeks and five days, in Sunnybrook’s NICU

What we try to keep in mind is that families’ concept of disability varies and depends on their family circumstances and value systems. I see the role of the health care team as experts providing information to the family, but ultimately the family has to make decisions that are right for them. There is no right or wrong decision in these situations.

Heather: “What do you want?” I remember my doctor asking that question. In my heart, I knew that I wanted to try. I wanted the team to resuscitate Gage. I knew my values and this was the right path for my family. I know many families wouldn’t have chosen the same path and I’m okay with that. You need to do what is best for you and your family.

Dr. Ng: I heard these early discussions referred to as “a meeting of two experts,” which I thought was great. The health care provider offers their expert clinical knowledge and the family are experts on their lived experience with health and illness. Bringing this all together results in ‘shared decision making.’

Heather: That’s right. For one family, one condition might mean something. For another, it might mean something totally different, even though the condition is the same. Gage ticks the ‘disabled box,’ and it hasn’t been an easy path, but we find love and joy everyday.

Dr. Ng: A centre like Sunnybrook, with a maternal fetal medicine team specializing in high-risk pregnancies and a Level 3 NICU team specializing in the care of the very preterm infants, enables us to not only provide expert treatment to these infants, but also to start educating and offering strategies to their families in caring for their special infants as early as possible. We have a team called BOOST (Building Opportunities for Optimal and Smooth Transitions) that focuses on the transition from the NICU to home by engaging in family integrated care, empowering families in providing care and to advocate for their infants. In this stage, we shift much of the decision making for the child to the parents while in the NICU. In doing so, we are starting to build their “parental capacity” muscles before babies are discharged from the hospital.

Heather: I have a photo of the first time I held Gage. He’s on my chest in the NICU. He was so tiny. A few months later, he left the hospital breathing on his own and breastfeeding. Now he’s skiing and loves anything to do with animals. He works hard to do the same things kids his age do, but he does them. It has taken work to get there, but he’s come out on the other side.

The post Meet Gage, born under 23 weeks: “It hasn’t been easy, but it has been so rewarding” appeared first on Your Health Matters.

As a volunteer with Sunnybrook’s Pregnancy and Infant Loss group, I was honoured to share my story yesterday with a group of health-care workers. The purpose of the workshop was to educate and empower health-care professionals on how to deal with patients experiencing possibly the worst day of their lives and the fallout of their loss(es). Here was some of my advice:

1. Never assume.

When I was in hospital after experiencing a 20-week loss, a hospital porter entered my room with a flower delivery. As she set the bouquet near the window, she innocently looked around and asked, “Where’s the baby?”

Years later, in another hospital high risk unit I was in, I noticed butterfly stickers outside some of the hospital rooms. Those stickers symbolized to outsiders that the patient behind the door had experienced a loss. Every hospital needs something like this. And/or, ensure grieving moms don’t have to share the ward with celebrating moms.

2. Never start a sentence with “At least you have…” or “Just be grateful for…”

I tended to attract these well-intentioned comments because I have other kids. But, these comments felt like they were suggesting I wasn’t thankful enough for my current family. Losing one baby, doesn’t require a reminder (from your doctor) that you should “just focus on your babies that are alive.”

3. Please stop with the “how many pregnancies” and “how many live births” questions.

Surely, this information is already in my file. Please take a minute to find the answer before asking me to recount how many of my babies have died and at what gestation. While this might be a routine question for you, it’s triggering to someone who’s experienced loss. There were times that I was asked the same question during every weekly ultrasound, and sometimes, during the same hospital visit by various staff. Please have a better system in place.

4. Have a bad news plan.

Ensure that if bad news is delivered, your patient is going to be cared for when she leaves the appointment, is given written information on what to expect and what comes next because she won’t remember what you tell her. And, make sure she gets home OK (rather than going back to the office — which I did, more than once and, do not recommend). After one of my losses, I was given a backpack of self-care items and reading material and recall being so touched by this act of kindness, from a hospital volunteer versus another loss when I was told by the radiologist to “follow up with your doctor on Monday because he’s probably gone for the weekend since it’s Friday afternoon.”

Pregnancy and infant loss is not a “women’s issue.” It’s a terrible fact of life and it affects parents, families, companies, health-care systems and communities. I’m grateful to finally be in a place where I can share my experience without shame, and hope that through my sharing, I can help inspire small but meaningful changes in our health-care system.

The post Lisa Marie, a Pregnancy and Infant Loss Network volunteer, shares her story and advice for working with grieving parents appeared first on Your Health Matters.

Pre-pregnancy / Trying to conceive

Will the vaccine impact my fertility?

Dr. Dixon: The information we know is very reassuring. There is no evidence that any of the vaccines affect fertility. I encourage everyone to get their COVID-19 vaccine when they’re eligible. This includes if you’re actively trying to have a baby or even just thinking about having a baby in the future.

I am 39 and am trying to conceive. Will the vaccination decrease my chances?

Dr. Dixon: I’ve been assuring my patients, regardless of their age, that there’s no evidence the vaccine leads to loss of fertility. While fertility was not specifically studied in the clinical trials of the vaccine, no loss of fertility has been reported among trial participants who have received the vaccines since their rollout.

Is it safe to conceive while awaiting the second dose?

Dr. Dixon: It is safe if you become pregnant at any point around your vaccine doses: immediately before or after your first dose, between your first and second doses, or immediately after your second dose. I advise my patients to get vaccinated as soon as they are eligible to ensure they do not become seriously ill from COVID-19.

Timing of vaccination during pregnancy

Is there an ideal time during pregnancy to get vaccinated? First or second or third trimester?

Dr. Ladhani: The best time to get vaccinated is when you become eligible. We know that COVID-19 in pregnancy can increase your risk of being hospitalized and also cause an increased risk of preterm delivery. Statistics suggest between eight and 11 per cent of people who are pregnant who contract COVID-19 will be admitted to hospital, and between two and four per cent will need intensive care. That’s compared to about eight per cent of all COVID-19 patients who have needed hospitalization and about 1.5 per cent who needed intensive care, so pregnancy puts you at higher risk than the general population. A recent study in the American Journal of Obstetrics and Gynecology found those who were pregnant had a strong immune response after vaccination, suggesting strong protection. The study also showed that COVID-19 antibodies were transferred to babies, and we are going to see the effects of this soon. 

I’m in my third trimester. Should I get the vaccine while pregnant or when the baby is born?

Dr. Ladhani: I would advise receiving the vaccine as soon as you can. You’ll be protecting yourself, as well as your baby, once your immune response begins to kick in (usually two weeks after vaccination). Please be sure to receive your second dose at the scheduled time. The antibodies you produce will be passed on to your baby through the umbilical cord and in the breast milk.

Pregnant and patiently waiting. Is it ever too close to the due date to get the vaccine?

Dr. Ladhani: Close to your due date is absolutely fine. You’ll be protecting two people – yourself and your baby – it’s a win-win situation.

Pregnancy & the COVID-19 vaccine

Can antibodies be passed to baby if vaccinated during pregnancy?

Dr. Ladhani: A recent study showed there was immunity transferred to babies via placenta and breast milk. This evidence points to the strength of vaccination, at any stage of pregnancy, and also for those who have delivered their baby and are breastfeeding.

What effects will the vaccine have on my baby?

Dr. Ladhani: The COVID-19 vaccines available for people who are pregnant don’t contain any live virus and do not put you at increased risk for pregnancy loss or harm to your baby. They will not give you or the baby COVID-19, and will not interact with yours or the baby’s DNA. You may develop a fever after you get the vaccine, but this will not harm the baby.

Does vaccination during pregnancy mount less of an immune response compared to non-pregnant?

Dr. Ladhani: In a recent study, COVID-19 mRNA vaccines generated strong immunity in pregnant and breastfeeding people. The immune response was the same as that observed in non-pregnant individuals. Immune responses from being vaccinated were significantly greater than if you had been infected with COVID-19.

Could post-vaccine symptoms be heightened due to pregnancy?

Dr. Ladhani: There’s no indication that if you’re pregnant you will have more severe post-vaccine symptoms. The vaccine can cause fever in some people (around 16 per cent of those vaccinated) and usually takes places following the second dose. The evidence shows there is minimal risk to your or your baby. A few hours after receiving the vaccine, if you have a fever, you can treat it with acetaminophen/Tylenol.

How do we know the vaccine is safe during pregnancy if trials have just started for that group?

Dr. Ladhani: Early clinical trials for the COVID-19 deliberately did not include people who were pregnant. It’s common practice for clinical trials to exclude those who are pregnant, with concerns about fetal development cited. However, we do know that some vaccine study participants became pregnant and to date there have been no adverse effects reported during pregnancy or related to the health of babies. The COVID-19 mRNA vaccines studied in people who were pregnant, breastfeeding and trying to conceive have been found to be safe.

I received the Tdap (Tetanus, Diphtheria, Pertussis) vaccine and Rhogam today. Do I have to wait two weeks to get the COVID vaccine?

Dr. Ladhani: There is no need to wait between vaccines. You can get both vaccines on the same day or within two weeks of each other.

Will the vaccine cause birth defects, miscarriages, or any other fertility or pregnancy complications?

Dr. Ladhani: From the data we have, there is no increased risk for miscarriage, stillbirth or congenital anomalies with the COVID-19 vaccines. I assure patients that there is no evidence that the vaccine can cause birth defects, miscarriages or fertility or pregnancy complications. This is based on the millions who have received the vaccines to date and were trying to conceive or were pregnant.

What happens if I get COVID-19 while pregnant?

Dr. Ladhani: If you begin to feel unwell with symptoms of COVID-19, please contact your obstetrician. Most people who are pregnant will have mild-to-moderate illness if they contract COVID-19. Your obstetrician will provide you with support and resources for managing COVID-19.

High-risk pregnancy & the COVID-19 vaccine

Is the vaccine right for me if I have an autoimmune disorder, asthma and recurrent losses?

Dr. Ladhani: Yes, we would recommend that you get the COVID-19 vaccine. Being pregnant and having asthma are both risk factors for moderate to severe illness with COVID-19. People with autoimmune disorders weren’t included in the vaccine trials, and so the effectiveness and safety profiles aren’t known, but NACI and the Canadian Rheumatology Association are recommending that people with autoimmune disorders are offered the vaccine. Given your risk profile, the vaccine may protect you from the severe forms of COVID-19. It may be worth discussing this more with your health-care practitioner.

I’m having a high risk pregnancy. Should I get the vaccine?

Dr. Ladhani: Yes, in most cases people who are pregnant with high or low-risk pregnancies will benefit from receiving the COVID-19 vaccine and being protected from the disease. Please speak with your high-risk obstetrician about the specific details surrounding your pregnancy to determine if you will benefit from the vaccine.

I’m expecting twins. Is it safe to get the vaccine?

Dr. Ladhani: Yes! You’ll protect yourself and potentially protect both of your babies!

I am pregnant after experiencing a pregnancy loss. Should I get the vaccine?

Dr. Ladhani: A pregnancy loss can be devastating, and it’s understandable you may feel anxious being pregnant again. I would recommend receiving the vaccine for additional peace of mind during your pregnancy, especially as contracting COVID-19 during pregnancy can put you at higher risk of hospitalization and preterm delivery. Please remember there is always support available for pregnancy and infant loss through Sunnybrook’s Pregnancy and Infant Loss (PAIL) Network.

Are there complications with heart arrhythmias?

Dr. Ladhani: COVID-19 can be dangerous for those who have an underlying heart condition. Both of the COVID-19 mRNA vaccines were tested in people with heart problems and found to be safe and effective.There is no evidence that the vaccine has worse side effects for people with underlying heart conditions, and having COVID-19 is much riskier than getting the vaccine, so we would recommend you get the vaccine.

Breastfeeding & the COVID-19 vaccine

Is the vaccine safe for both me and my baby while breastfeeding?

Dr. Ladhani: The vaccine is safe for your and for the baby. There is new data showing antibodies for COVID-19 in breast milk after vaccination. So you’re not only protecting yourself against COVID-19 with the vaccine, but also possibly passing along some immunity to your little one. A huge win!

Fertility treatments & the COVID-19 vaccine

Is the vaccine safe when undergoing fertility treatment, like IVF?

Dr. Dixon: I suggest speaking with your fertility specialist who knows your history and care plan, and can answer your questions to help you make an informed decision. Undergoing IVF can be a stressful time and your fertility team is a wonderful resource to help guide you. Your specialist may suggest waiting a few days between some treatment procedures (for example, egg collection in IVF) and vaccination, so that any symptoms, such as fever, might be attributed correctly to the vaccine or the treatment procedure. 

Is it safe to get the vaccine if you have a planned intrauterine insemination (IUI) or embryo transfer?

Dr. Dixon: We may consider postponing the start of assisted reproductive treatments – like IUI, ovarian stimulation and embryo transfer after your first or second vaccination. This allows time for the immune response from the COVID-19 vaccine to settle down – this recommendation is purely to help patients cope with potential side effects IF they occur. Please talk to your fertility specialist if you have any concerns about the timing of your vaccine with upcoming fertility treatments.

I did IVF and I’m still in my first trimester. How long should I wait to get the vaccine?

Dr. Dixon: You should take the vaccine as soon as it is made available to you. Please speak with your provider about the specifics of your case. This is consistent with the most recent fertility practice guidelines.

I got pregnant after my second IVF cycle, I’m on my fifth week. Is it safe to receive the vaccine?

Dr. Dixon: It is safe to receive the vaccine in your first trimester. The data from those women who became pregnant immediately after receiving both of the COVID-19 mRNA vaccines showed no adverse outcomes in the pregnancy and the vaccines have thus been deemed both safe and effective. Further, there is no evidence that the vaccine can cause birth defects, miscarriages or fertility or pregnancy complications.

Read more: Got your COVID-19 vaccine? What you need to know about infection prevention after getting vaccinated

The post Pregnancy, fertility and the COVID-19 vaccine: Sunnybrook experts answer your questions appeared first on Your Health Matters.

David Steane recalls stretching his legs after hours of holding his premature son skin-to-skin in Sunnybrook’s neonatal intensive care unit.

“I would stare at the ‘Wall of Fame’ – stories of babies who left the unit and were thriving. It was emotional, and it gave me hope for the future,” says David.

For two months, David and his wife Nicole took shifts holding and talking to Nathan, who was born weighing two pounds and six ounces.

Nathan in the Neonatal Intensive Care Unit (NICU)

Now, the couple are watching with pride as Nathan enters his third year at Wilfrid Laurier University. Pursuing a criminology and policing major, he’s passionate about hockey and keen to join the university’s intramural hockey clubs.

The family’s journey with the hospital didn’t end with Nathan; his two younger brothers both spent time in the NICU. Matthew was born five weeks early (he’s about to begin his first year at Brock University and hoping to eventually earn a golf scholarship) and Mike, the family’s youngest at 14 years of age, was born six weeks early.

Present day photo of Nathan

“We grew up feeling like every other kid,” says Nathan, who saw the team in the Neonatal Follow-up Clinic after leaving the hospital. “You would never have thought we were in the hospital with our parents going through all of that worry about us.”

Nicole and David say connecting with other families was particularly meaningful during each of their son’s stays in the unit. “We talked to everyone, particularly other parents. It’s an unusual start as a parent to have your baby in an intensive care unit. The other parents knew the highs and lows and were such a support,” adds Nicole, who adds she also keeps in touch with members of her sons’ health care team.

The family also made an effort to learn about research studies, such as one about caffeine reducing apnea in preemies and volunteered to participate. “Our approach was that the information could not only help our babies, but other families down the road,” says David.

With days to go until the start of university, the family sits in their kitchen, jokes flying between them. David says he wants to reassure families with babies currently in the NICU.

“They can make it out and have a normal life.”

The post From the Neonatal Intensive Care Unit (NICU) to Laurier University: Read Nathan’s story appeared first on Your Health Matters.

“They both have such funny imaginations,” says their mom Natasha, laughing.

The twins started life at just over 25 weeks. Asha weighed only 600 grams and Surabhi weighed 700 grams, and both girls had brain bleeds. They spent three months in Sunnybrook’s neonatal intensive care unit (NICU) and one month at Credit Valley Hospital.

Each year, Sunnybrook cares for around 70 ‘micro-preemies’ who are born before 26 weeks of pregnancy. Nearly 200 families are also cared for in Sunnybrook’s Twins Clinic, which provides state-of-the-art care and support to families with twins in an effort to prevent pregnancy complications and improve the health of the birthing parent and their babies.

“When you have such a premature baby, your mind races. What will the future look like? It’s a stressful time,” says Natasha, who says both girls, now in grade one, have met all of their milestones.

On Multiple Births Awareness Day, Natasha says her advice for other parents of premature infants is to not sweat the small stuff, and don’t compare your children to other kids.

“Take it day by day, and lean on the team in the NICU. I felt so alone at the time and didn’t understand what was happening. The way the health care team gets the whole family involved is incredible. The NICU staff will always be a part of our family.”

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