The Department of Pediatrics

Neonatal Intensive Care Unit (NICU) Articles

When 14-month-old Christopher Niro visits the Neonatal Intensive Care Unit (NICU) at Saint Barnabas, there is great excitement among the staff members. Shyan Sun, M.D., NICU Director, refers to Christopher as “the zero Apgar baby,” meaning that he scored zero out of 10 points on the fetal test that conveys information about the baby’s condition in the first minutes of life. At birth, Christopher had no heartbeat, he was not breathing, and his limp, blue body did not respond to the airway being suctioned. By all tests and measures, he appeared to be lifeless.

And yet, 14 months later, he returns with a healthy smile to visit the neonatologists who brought him back to life. Christopher is a sociable child who laughs and claps often, a bundle of energy.

“To see this baby so healthy and his parents so happy is a miracle,” says Dr. Sun. “He was born with no heartbeat— born dead—and then after five minutes his heart began to beat. Now Christopher is so beautiful and healthy. He does everything at the right time for his developmental age.”

A MOTHER’S INTUITION
In October 2002, Kimberly Niro, who was due to deliver in seven weeks, felt something was wrong with the baby she carried. Although she felt movement, “the sensation was different,” and she instinctively felt uneasy. Mrs. Niro called and spoke with Jennifer O’Neill, R.N., A.P.N.,C., a nurse practitioner at the office of obstetricians Anthony Quartell, M.D. and Robert Koch, M.D. Even though Mrs. Niro had been in the previous day, Ms. O’Neill acknowledged the pregnant mother’s concern and suggested that she come back in. It was a decision that would save Christopher’s life.

“I credit Jennifer because if she had not taken me seriously, Christopher would not be alive today,” says Mrs. Niro.

At the office, the baby was given an assessment with a fetal monitor. Although there was a heartbeat, it lacked the normal rises and declines of a healthy heart. Mrs. Niro was immediately sent to Saint Barnabas where Dr. Koch gave the baby a biophysical profile, which involves an ultrasound reading to assess movement, breathing, amniotic fluid and muscle tone.

The results were startling. The heartbeat showed a plateau and the baby scored only two points out of a possible ten. A Caesarian section was immediately performed.

“There was no time to even wait for my husband or Dr. Quartell,” recalls Mrs. Niro. “I remember Dr. Koch relating that we could not wait 30 seconds for anything.”

COMING BACK TO LIFE
The lifeless baby was delivered and immediately turned over to a team of neonatologists who began lifesaving techniques. As Mrs. Niro lay in the delivery room, her mother was permitted to follow the baby with the NICU team. Her mother recalls how blue Christopher appeared, a memory that still haunts her.

As the team worked to save the baby, who began breathing after five minutes, the wait began for the new parents to see, first, if Christopher would live, and next if he would suffer permanent brain damage. Throughout the night the NICU and maternity staff updated the parents on Christopher’s progress and comforted them.

“The nurses were terrific and the NICU staff constantly updated us,” says Mrs. Niro. “The entire hospital staff was wonderful.” As Christopher’s condition improved, the NICU performed MRIs and other tests of brain function.

Miraculously, there appeared to be no brain damage. After four weeks the baby came home without a monitor, and the Niros finally opened the door to the room in their house where they had been keeping all their baby gifts in hope of a miracle.

On his first birthday they rented a hall and celebrated with friends and family. The party was decorated with a teddy bear theme. Many medical assessments later, Christopher is still thriving and meeting all developmental milestones.

“He is a true miracle baby,” says Mrs. Niro. “Based on all evaluations
he is doing very well,” says Mrs. Niro. “With the exception of some minor issues with hearing and muscle stiffness, he is fine. We were prepared to deal with severe disability. I guess God had other plans for him. We are so thankful.”

ALMOST TWO YEARS LATER
In the fall of 2003, the Niro family participated in the Miracle Walk, an annual event that raises money for the NICU. The Niro family appeared on “The Today Show” and on Channel 7 to promote the walk.

She and Christopher also regularly visit Jennifer O’Neill and Drs. Quartell and Koch. “We can’t thank all of the doctors and staff enough,” says Mrs. Niro. “Now we get to play with him and watch him grow,” says Dr. Quartell, who theorizes that Mrs. Niro probably suffered from a viral infection that affected her placenta and caused the decline in the baby’s condition. “He is a true miracle.”

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