Vaccinate Your Baby and Do Not Smoke: Integrated Approach of Lung Health for Premature Babies

Background and context: Since 2008 Republic of Moldova registers and provides medical care to newborns from 500 g and 22 weeks of gestation. Thus, challenges related to lung health (respiratory distress in neonatal period, respiratory infections in childhood) are faced while taking care of premature babies. More 400 of them (from 2000 preterms in the country) are born in our institution. While in neonatal period we succeed to save them, the quality of their life depends on further protection from risk factors, as infections, environment polluants and second hand smoke. Aim: To rise awareness among parents about evidence based approaches for protecting a premature baby from infection (one of that being the immunization) and from second hand smoke harm (through smoking cessation among parents, but also among other family members). Strategy/Tactics: Early neonatal period is a very sensitive, but also a precious opportunity to speak with parents about risk factors for a healthy childhood. Smoking being one of factors for premature birth, but also for lung diseases in childhood, our neonatal team included “smoking” issue while speaking with parents about the severity of baby´s condition in neonatal intensive care unit. The discussion target the risk factors for respiratory diseases. This year we changed the approach - we include in the same discussion not only smoking issue, but also immunization, to see if it´s more effective than to aware about smoking only. Program/Policy process: When combining two topics (immunization and no-smoking) parents are less reticent to discussion, thus measured by: •How often they recall discussion, or come back with other questions. •Their reaction (body language, duration of discussion) to physicians´ explanation. Outcomes: 1. Targeting both topics help a smoking parent “not to fill so guilty”, “obtaining other leverages to ensure good quality of life for the baby”. Comparing to the period when we were targeted only smoking issue, parents (especially fathers) were more likely to recall discussion (72%, compared with 41% in the previous stage) and they were more willing/open for communication (77%, compared with 48%). 2. This strategy it´s an opportunity to catch parents´ attention for important things. Usually, when they come in neonatal intensive care unit to see their baby, they expect to be told only about the treatment the baby receives in the unit, and not about smoking (“this is not a drug?”) or vaccination (“something that they see long further”). What was learned: A holistic preventive approach for healthy lifestyle (vaccination + not to expose to tobacco smoke) as measures for premature baby respiratory health, seems to be better accepted by smoking parents, that related on smoking only.