TINY MIRACLES EVERY DAY

Intense joy and hope intermingle with just a hint of fear within parents on that most anticipated of all days -- the day of the birth of their child.

Most of the some 1,600 babies who take their first breaths at Southeast Missouri Hospital annually are born healthy and hearty. Their lusty cries echo intent to take on the world.

But every once in a while, a newborn may need specialized, detailed attention and care. Parents harbor deep, secret dread of such circumstances.

Kim and Floyd Butler of East Prairie already had two healthy children who experienced no complications at birth. When Parker Steven Butler entered the world at Southeast Missouri Hospital the evening of Feb. 20, weighing in at 8 pounds and 7 ounces, they rejoiced.

"Everything was fine. I thought he was all right," Kim Butler recalled. However, she was awakened a few hours later with some startling news. "Somehow, during the birth, he had swallowed some fluid," she said.

The baby was moved immediately to the neonatal intensive care unit.

"I was scared," Butler recalled, the memory still fresh. "I had already had two other babies and nothing was wrong with them. I didn't think anything would be wrong with him." Butler said.

With the help of the nursery staff and the infant's physician, however, her fears soon began to recede -- at least to a degree. "They took such good care of him," she said. "You could tell they knew exactly what they were talking about."

Classified as a level-two nursery, the Southeast Missouri Hospital unit is equipped to address many emergencies and other special needs that may arise among newborns. The unit is equipped to care for babies who experience a variety of conditions, such as infections, pneumonia and mild-respiratory difficulties.

"We have all the equipment a nursery of this size would need," said LaDonna Wills, nursery manager.

The infant's physician decides if and when the child should be transported to a more specialized facility.

In general, babies are likely to be transported to a St. Louis hospital if they're having severe respiratory distress or if they will need assisted ventilation for any period of time, Wills explained. Other conditions could also render transport necessary. Every baby, every situation is different, she stressed.

While pre-term babies are often likely candidates for respiratory problems in their early days, nursery manager Wills noted that "if they're doing fine and they're not having any respiratory distress, we can care for those babies."

"The best way to transport a pre-term baby is in mom's uterus," she noted.

Young Parker Steven Butler's experience is an example of an unexpected event that can occur even when the baby is healthy and strong at birth.

He responded quickly to the special care and was soon weaned from the oxygen unit and introduced to the bottle, his mother said. "All that time and he didn't loose an ounce," she said with amazement. Parker went home to East Prairie and his brother and sister four days after his birth.

The Southeast Missouri Hospital nursery is divided into three areas: the well nursery, the intermediate nursery and the neonatal intensive care unit. Twenty-two registered nurses, five licensed practical nurses and several nurses aides and secretarial staff see to the day-to-day functions of the nursery. About 120 employees work in the obstetrics area as a whole, Wills said.

But to many women who give birth at Southeast Hospital, the nurses become more than uniform-clad care-givers -- they become friends with names.

"The nurse I had all day during labor and delivery called the next day," said Cindie McReynolds, who gave birth to Ellie Grace McReynolds Feb. 4.

McReynolds credits that same brand of attention -- both on the personal level and on the professional level -- with the happy outcome of a serious development at Ellie's birth.

"She was given very quick care at Southeast," McReynolds said.

About two months before the early March due date of their third child, Cindie and Mike McReynolds of Sikeston learned that Cindie's pregnancy was not progressing as it should.

Ultimately, Cindie said, she and her husband learned that "I did not have enough amniotic fluid" to carry the baby full-term.

Upon the advice of her Cape Girardeau obstetrician, she traveled to a St. Louis hospital for further tests. After an amniocentesis and an ultrasound, Cindie said, the St. Louis physician recommended that the baby be born as quickly as possible.

The next day, Cindie underwent induced labor at Southeast Hospital. But, despite the earlier test indications, all did not proceed as hoped. "Her lungs were not ready," Cindie related, and the baby was born with a condition that was described as a tear in her lungs.

"Dr. Gary Olson watched her all night long. At 4 in the morning he came and told me they would have to fly her by helicopter to St. Louis. She needed to be on a respirator," the mother of three said. "I was upset, of course. But they did not scare me. They were very up front about everything. They kept me informed. They were very gentle."

After nearly a week at a St. Louis hospital, young Ellie -- free from the respirator -- was returned to her place of birth to grow stronger under watchful eyes.

"They watched her, and monitored her constantly," McReynolds said. "They were wonderful."

Four and a half days later, Ellie went home to the welcoming arms of her parents, a brother and a sister.

The phase young Ellie entered on her return trip to Southeast is called the "feed and grow" stage, Wills described with a chuckle.

It's the point where the infant has been stabilized, has demonstrated its ability to remain so, and needs to gain weight.

The McReynolds were taught infant CPR during those "feed and grow" days as a precautionary measure. For any parent, caring for a newborn is a learning process.

"Teaching is a big part of neonatal care as they move into this new time in their lives," Wills explained. "We provide the whole gamut," she said. Instructional sessions range from childbirth preparation classes to grandparenting and child-care classes.

Even if there is another child in the family, there's still adjustment involved, she noted. The infant, also, learns much in the first days of life. Heading the list is eating.

"Nippling is hard work for a pre-term baby," in particular, Wills explained. "They have to develop that capability."

McReynolds feared that she would be unable to nurse her child after the baby was rushed away. But the Southeast staff helped her overcome the obstacles.

"The morning they flew her away, the nursing staff at Southeast came in and said, `This is what you need to do,'" McReynolds said. "I had nursed my other two and I was so afraid I would not be able to nurse Ellie. But they were right there on the spot. They were able to make it happen for me."

In cases that call for transport, stabilization of the infant and mother is critical.

It's an experience Juan Crites of Cape Girardeau knows well.

Expecting twins, Juan and husband Rick had intended for their babies to be born at Southeast. But at 20 weeks, Juan went into labor. She went to the local hospital, where she was given medication to halt the labor and was then taken to a St. Louis hospital.

"I got up there and stayed maybe 36 hours. They dismissed me and I came home on a home-monitoring system," Crites said.

Within 24 hours, she was again on her way to St. Louis, experiencing true labor. "We got about 20 miles north of Cape and I said, 'I can't make it,'" she related. "We came back to Cape and went to Southeast."

There, she was again stabilized and then sent to the St. Louis facility where she remained for three months until the Aug. 20, 1993 births of Abby and Luke.

"They're wonderful, they're miracle babies," the first-time mom said.

The miracle of life is evident daily at the Southeast nursery. Wills, who has worked at the Southeast Hospital nursery nine years, said, "I've never known the nursery not to have a baby in it."

"You see a lot of happiness," she said. "When it's happy, it's really happy." Likewise, the nurse noted quietly, "When it's sad, it's really sad.

"You have to be there for the babies, and you have to be there for the families, to support them."

McReynolds related how difficult it was for her 4-year-old daughter to understand why she couldn't see her newborn sister shortly after the birth. Snapshots taken by the nursery staff helped ease the little girl's worries.

"Those nurses went out in the freezing cold and tried to take pictures of the helicopter," as the infant was boarded for her trip north, McReynolds said. "I'm sure that's not in their job description to stand out in 20-degree weather and try to take pictures.

"They just did everything to try to make it easier on everybody."