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Cover Story - Posted December 29, 2017 9:09 a.m.
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Photo by Shannon Richardson

Cuddle Up

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One of Amarillo’s most popular volunteer opportunities is connected to one of its most heart-wrenching places: the neonatal intensive care unit (NICU) at Northwest Texas Healthcare System. This high-tech NICU is the largest in the region. In these quiet halls, a team of passionate community volunteers donates time, energy and love on a regular basis.

All they have to do is show up and sit down. And maybe rock a little. Or sing. Or pray. But those are all corollary activities to the real work. If you ask them, it’s not work at all. It’s a blessing. It puts them in direct contact with peace, quiet, and bundles of joy.

They are cuddlers.

The job entails exactly what you think. For at least an hour – maybe two – these volunteers show up to hold premature infants and others in the NICU, giving them the comfort of a warm embrace.

That’s it. These volunteers serve families by holding babies when, for a variety of reasons, the child’s mother or father isn’t present.

If cuddling sounds to you like the most wonderful volunteer position in Amarillo, then you’re not alone. In a time when most local organizations have to go out recruiting warm bodies – there are hardly ever enough people willing to donate time and effort to good causes – the 20-person cuddling program at Northwest has to turn people down. Its waiting list is 60 people deep.

Apply now and you might snuggle your first baby in, say, 2021.

Holding for Calm
Imagine this scenario. A mother in Stratford or Canadian delivers a baby in a rural hospital a couple hours away from Amarillo. Born premature or with other complications, the child requires the expertise and round-the-clock care of Northwest’s Level III NICU. So that little one is brought to Amarillo – but not always with Mom.

“The mom is recovering and might have other kids,” explains Becky Imel, the child life specialist at Northwest and director of the cuddlers program. As for other family members, they might be able to come into town on a Friday and stay through the weekend, giving the infant three days of close, calming human contact. But what about the rest of the week?

The hard-working nurses and administrators of the NICU may be watching over a dozen babies at once. They are feeding them, monitoring their vitals, and navigating the ins and outs of recovery. These medical professionals don’t always have time to just sit. But a cuddler does.

“Our job is to help in holding that baby on the days that family can’t be here,” says Imel.

Other situations are just as common. A working mom who gives birth to a premature baby may choose to return to work while her child is in the NICU. This saves her maternity leave for when the child actually comes home. In this situation, says Imel, “we’ll hold once during the day and then Mom is here that evening.”

Some babies are born with drug dependencies or may be in the custody of Child Protective Services. Others might be candidates for adoption. Regardless of the scenario, when a parent is not available for a significant length of time, a cuddler gets called in. “Usually they cuddle babies that do not have families here,” says Dr. Jenda Arawiran, a neonatologist at Northwest. “The first determination is family presence. If there is no family presence, that baby will get precedence over other babies.”

She points to research suggesting that human touch is essential to newborns (see sidebar). For all newborns – but especially premature infants – the preference is commonly known as “kangaroo care.” Like a joey snuggled in its mother’s pouch, kangaroo care prizes skin-to-skin contact for newborns. Pressed against a mother’s or father’s warm chest after feeding, a newborn experiences safety and comfort. Those feelings are most conducive to rest. And rest is essential for the improvements necessary before a child leaves the NICU.

“When they’re sleeping, they’re growing,” Imel says. “The goal in any scenario is to get them to rest.”

Research has shown that the experience of being held calms a baby like nothing else. It leads to a variety of scientifically proven positive results, from stabilizing heart rates to facilitating better sleep. “They definitely have better outcomes compared to those who have not done it,” says Arawiran. “The short-term benefit is good weight gain and better temperature control. That means earlier discharge for a baby.”

Over the course of a child’s life, an early discharge and short NICU stay leads to better long-term prospects.

When parents can’t be available for regular contact, cuddlers step in and offer the closest alternative to skin-to-skin kangaroo care.

Imel explains why a warm human touch is so necessary for these infants. “They’re in the mom’s womb and have a steady heartbeat based off Mom. Then, when they deliver and do all these invasive procedures, we’re messing with what was really comfortable to them. Getting back to that human touch is huge,” she says.

The cuddlers program was launched in 2003 but expanded to its current size in 2008. Like any hospital volunteers, its participants are subject to background checks and the same kinds of immunizations required of staff members. They commit to special orientation and extensive instruction – including hands-on training – to become familiar with holding tiny, fragile babies who are encumbered with tubes, wires, and other medical paraphernalia.

One of the team’s most veteran cuddlers is Carla Thurman.

Filling an Empty Nest
Thurman has been serving with the NICU for a decade. She is a mother and grandmother herself, and takes her volunteer time seriously. “If I had a sick baby and couldn’t be there to be with them, I would hope there would be someone to cuddle my child or grandchild,” she says.

Thurman was already a volunteer with Northwest’s pediatrics division when she was asked to join the developing cuddlers program. Now several decades into a career related to the criminal justice system, she says spending time among innocent children appeals to her – then and now. “I had some free time and felt like I had something to give,” she says.

It also offered a welcome distraction from her career. “All I see are people in crisis,” she says of her criminal justice work. “Being with babies is as cathartic for me as I hope it is healing for them.”

Around the time she got involved at Northwest, Thurman was facing an empty nest. Her children had grown up and moved out. A decade later, she has grandchildren. “It’s an adjustment to have my healthy grandbabies, and then go to the hospital with these sick little ones,” she says. But she sees her time at Northwest as offering a sort of stability in a rapidly changing world. “Lots of things have happened over the last 10 years. My husband is retired. My kids have gotten married and had kids. My life changes, but the needs of the NICU stay the same. There’s always sick babies.”

Imel describes Thurman as one of her “elite cuddlers,” which means Thurman is on-call to help out in Pediatrics any time there may be a traumatic event – for example, a car accident in which an infant is protected by a car seat but family members are hospitalized. “Cuddlers are some of the people we call for some of those instances,” says Imel. “I can call Carla and ask for help for four hours with a baby or the younger kids.” Because Thurman is trained to handle babies in the NICU, she says time spent with healthier babies unencumbered by tubes and wires is relatively easy.

But Thurman doesn’t care whether she’s cuddling an “easy” infant or one who presents more of a challenge. She volunteers once a week and especially likes to stay busy around the holidays, which can be especially poignant in the NICU. “There always seems to be a little one in distress that doesn’t have someone to come up as much [during the holiday season],” she says. “My heart just breaks for them.” For years, if needed, she has tried to spend time cuddling on either Christmas Eve or Christmas morning. “The holidays are built around our babies and children. It’s the time when we want to be together with the family and focus on the children.”

She notes that cuddling a closely monitored preemie feels different from snuggling a healthy infant, but for Thurman, that makes the moments of peace more noticeable. “It is always gratifying to me when I see a baby that’s been struggling, [but] then they can sleep in my arms or have a moment of rest when the monitors stop beeping for awhile,” she says. “That makes me know I need to keep coming back.”

From Chaos to Calm
Another veteran cuddler, Judy Solomon, describes her experience similarly. She joined the program around the time she was planning to retire from a 30-year career teaching elementary school in Gruver, Panhandle and Vega. Like Thurman, Solomon had already begun volunteering in Pediatrics when the cuddlers program solicited its first volunteers. “At the time, they didn’t have the program going yet, so I was just helping kids paint and play games,” she says.

Solomon retired in May of 2008, but she enlisted in the cuddlers program several months before her teaching career ended. “I would go after school and sit and hold babies,” she says. A first-grade teacher, Solomon acknowledges that the quiet, soothing time with a baby offered a necessary antidote to her noisy classroom.

Today, she has two grown children and four grandchildren, all between the ages of 2 and 5 years old. The grandkids are still young, but they’ve graduated from the cuddling stage. Solomon misses that phase, but she still has an outlet for her affection. “My husband calls this my ‘grandkid fix,’” she says, laughing.
“After five years of cuddling grandkids, I didn’t have anyone else to hold. I’ve always loved babies.”

Imel says that’s the best part of cuddling – and a reason grandmothers are so good at it. (Currently, no men are among the 20 active cuddlers.) “That is the best part of cuddling,” she says. “You get to cuddle, but poopy diapers and feeding are [handled by] the staff. You don’t have to do any of that dirty stuff. You just get to be the cool grandparent.”

Judy Solomon and her husband, Craig, manage a family farming operation between Vega and Hereford. Judy drives into Amarillo once a week to get her grandkid fix. “Usually it’s for two hours at a time,” she says. “Mostly it’s with the same baby, but if there are multiple ones, I’ll cuddle for an hour and then switch.”

Premature infants are not always ready to be cuddled. According to Imel, some babies need to be “trained” before they can last that long with a cuddler. This is especially true of the smallest babies, who might weigh less than 3 pounds. “Some of our itty-bitties, we have very experienced cuddlers with,” says Imel. “They’re going to be the most comfortable and have the most experience in some of those situations. Some of our babies might make it five or 10 minutes but they’re not calming down. Their heart rates aren’t settling or they’re fidgety.” In those cases, a baby might go back into his or her crib. “They might not be ready to come out today, so we can do something as simple as putting our hand on their hand or back, to try to calm them that way, to get them used to touch. We work towards [the baby] coming out and being held. It takes practice on everybody’s part.”

Solomon says the proximity to a dedicated, experienced neonatal nursing staff helps her feel calm even around such fidgety babies. “It doesn’t bother me, the tubes and stuff,” she says. “I have had a baby where beeps started going off and [the nurses] came running. I know I have trained nurses right there who can help and know what to do. It would be much more stressful without the security of the nurses right there.”

She loves that so many people benefit from her volunteer hours. “It’s something I can do to help the nurses, help the parents, and help the baby,” she says. “I find it a real satisfying way of volunteering and I enjoy it as much as they do.”

Prayers and Blessings
Not all babies in the NICU are premature. Some are just infants who require intensive care. “We have those who are 10 or 11 pounds and still get held in the NICU,” says Imel. “You don’t always think of big babies in there, but they can be just as sick as the littlest one.” She says she and the nursing staff try to match the baby’s needs with the personality of the cuddler. “It’s a magic that works,” she says. As those needs change, Imel might bring in different cuddlers. “They each have their own identity in how they work with the babies. That’s the beauty of it –that these babies get to experience multiple cuddlers throughout their journey in the NICU. Each has a different experience.”

Because infants grow best as they rest and sleep, the smallest infants require minimal stimulation. But as they add weight and make progress, some cuddlers begin adding different elements to their efforts. “As they get older, they’re going to [need] to get used to noises and different things,” Imel says. That’s when some cuddlers begin communicating with the children. They talk, sing or pray.

“I always pray a blessing over those babies,” says Thurman.

So does Solomon, who thinks of her time as both a form of ministry and a volunteer pursuit. “I pray for the babies and their families,” she says. “For their health and the homes they’ll be going home to. I pray for strength, wisdom and peace for the parents.”

Imel smiles at this aspect of her cuddlers. “We have some that sing with them, some that pray with them,” she says. “I love to hear stories of cuddlers saying, ‘I was giving them advice about when they get older and what it is like to be treated like a princess.’ That’s great to hear.”

Occasionally, cuddlers get to meet the parents of the child with whom they have spent so much quality time. “Every cuddler is very much aware that, if they’re here, it’s because the mom is not – and how difficult that can be,” Imel says. “It is hard to leave your baby in the NICU and step away, but we also know that they have to take care of themselves to be able to take care of their baby when they come home.”

Thurman has met a handful of parents during her time with the program. “That’s something to celebrate,” she says. “When you see them so sick but then they are getting close to going home, it’s wonderful to know they’ve made it. I’m sure their struggles continue long after they leave the unit, but the resilience of those little ones is amazing. With every struggle, to hear that they’ve gone home makes my heart smile.”

The parents are grateful, too. “The one thing we hear from parents is ‘I’m so glad there was somebody there to love on my baby,’” Imel says. In situations where a mother might have to leave her child in the NICU and return to work, she will return each evening to find a comprehensive report of her child’s day. “They have a little schedule on their bed that shows they’ve been cuddled today. It may be hard, but at the same time, they’re appreciative that there was somebody that took the time to give their baby a little extra tender love and care.”

Of course, not every story has a happy ending, and some infants don’t make it out of the NICU. This generally occurs after a multi-month stay, which means cuddlers may sit with the same child for several weeks in a row. “I had one who was there for a very long time,” says Solomon. “He had so many issues and infections. Since he was there so long you felt like you got close to him.” The cuddlers don’t know the names of the children or any identifying details. But they do know what it means when a child’s health doesn’t improve. They know what it means when, suddenly, he or she isn’t around the next week.

“That’s just heartbreaking,” says Thurman. She gets teary talking about it, and she and Solomon both have stories about infants that didn’t make it. They may not know names, but they remember little faces. They remember little personalities. They think about the grieving families that get left behind. And still these women keep coming back, week after week.

That’s because, more than anything, cuddlers like Solomon and Thurman focus more on the sacred value of their work than the occasional heartache. “It blesses my heart,” Thurman says. “Through the years, I’ve developed relationships with the nurses and staff and they are incredible heroes. I see them struggle and fight for those babies. It’s rewarding to see people in any profession where it’s not just a job to them. I stand in awe of them daily.”

That’s music to Imel’s ears. Fulfilled, calm, volunteer cuddlers are essential to rested, happy and healthy infants. “At the end, it’s a great experience for both of them,” she says. “The baby and the cuddler.”

The Magic Touch

Over the past few decades, more and more hospitals like Northwest have been enlisting volunteer cuddlers to leverage the well-researched benefits of human touch for infants. For babies, physical contact is crucial for the healthy development of their brains, their physical bodies, and even their immune systems.

The best kind of contact is skin-to-skin, which Northwest reserves for a child’s parents. But the next best contact is the warm snuggling of a cuddler. “Human touch and human warmth is better than nothing,” says Northwest neonatologist Dr. Jenda Arawiran. “We love our cuddle program because they can help us give the human touch to these patients.”

A 2014 study from the journal “Biological Psychiatry” revealed that premature babies who were cuddled – even just an extra hour a day – enjoyed better sleep habits and showed improved focus over those who did not receive that extra attention. Amazingly, the study showed that the benefits of extra touch during those first few weeks of life were still measurable up to 10 years after the child’s birth.

Streaming Preemie

Two years ago, a grant from the Children’s Miracle Network allowed Northwest to purchase 15 NicView web cameras. These small, wifi-equipped cameras suspend over a NICU bed and are directed at the child. Each family gets a secure username and password to access their child’s camera, allowing them to view their child even when they can’t be at the hospital.

Families love this technology because, for premature births, a mother’s hospital stay typically ends long before the child’s. “With those cameras, they’re still able to see their baby when they’re not able to be here,” says Becky Imel. Other family members, from siblings to grandparents, can also take advantage of the technology, which can be accessed on a laptop computer or smartphone. “The cameras serve as a way to make sure that family that isn’t able to be here has the ability to have access to their baby at any time through any type of electronic device – especially families that don’t live here in Amarillo.”

Research has shown that NicView cameras enhance family bonding and improve peace of mind during what can be a very stressful situation. Imel says the benefit becomes clear when childbirth occurs when a baby’s father is in the military. “These cameras are great for anyone who is deployed. They can gain access and see at anytime their baby that is born here and is in NICU,” she says.

Mothers recovering from surgery or more traumatic births also benefit. “If we’ve got a mom who’s delivered, and she can’t see that baby for a day, we can instantly get that camera on and Mom can see just from the phone. That’s a big sigh of relief,” Imel says. She says the NICU nursing staff occasionally even hears from families who are so dedicated to watching their baby that they begin to worry about the smallest details. “We have moms call in and say, ‘Oh, they moved their oxygen [tube] a little bit,’” she says. “It’s very sweet. You know they’re being checked on and loved on. For them, it’s a huge affirmation that their baby is being taken care of. They can’t be there but they’re as close as they can get. The technology is a way of connecting them.”

by Jason Boyett

Jason has written more than a dozen books and is the host and creator of “Hey Amarillo”, a local interview podcast. Visit heyamarillo.com and jasonboyett.com.
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