Daycare may be risky for babies with tiny lungs

Daycares may put already-vulnerable kids at risk for serious complications from their illness, according to a new study.


The study involved children with a condition that results from premature birth, known as chronic lung disease of prematurity (CLDP), in which infants experience chronic respiratory problems such as coughing and wheezing.


Children with CLDP who attended daycare were nearly four times more likely to visit the emergency room over a one-year period than children with the condition who did not go to daycare. Kids in daycare with CLDP were also nearly three times more likely to have trouble breathing at least once a week, and twice as likely to need medications as non-daycare kids with CLDP.

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Children at daycare are exposed to more germs than kids who stay home, and the resulting respiratory infections, which healthy children can typically handle, may be behind the findings, the researchers say. They advise health care professionals to inform parents of children with CLDP about the risks of daycare.


And they recommend children with the condition not attend daycare until they are at least 2 years old, to give their under-developed lungs a chance to grow and improve.


“We think that the physicians and the nurse practitioners and whoever cares for these children after they leave the hospital should educate the families on the possible risk of daycare exposure [for] the preterm infant and child with lung disease, particularly during the first couple years of life,” said study researcher Dr. Sharon McGrath-Morrow, a lung specialist at Johns Hopkins Children’s Center in Baltimore.


Germy daycares
More than half a million babies born in the United States each year are premature, that is, born at 37 weeks of pregnancy or earlier. About 25 percent of babies born before 27 weeks develop CLDP, but it can show up in those born as late as 32 weeks. These infants are at increased risk for respiratory infections and have a higher rate of premature death and complications from infections. About a quarter continue to have lung problems as adults.


The researchers examined records of 111 children with CLDP ages 3 and under who, on average, were born after 26 weeks of pregnancy. Researchers asked their parents whether their children attended daycare, and whether they visited an emergency room, needed antibiotic or corticosteroid, had breathing problems and whether they were exposed to second hand smoke. (Corticosteroids are hormones sometimes given to children with CLPD to help them breathe.)

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Parents of 22 of the children said their kids attended daycare. Of these, 37 percent had required a visit to the ER for their respiratory symptoms since their last doctor’s visit, compared with 12 percent of the kids who didn’t attend daycare. Half of the children in daycare needed antibiotics and 39 percent needed corticosteroids, while 26 percent and 19 percent of the non-daycare kids required these medications.


The researchers noted their results are based on the parents’ reports, and parents may not always be able to recall this information accurately. The researchers also did not take into account environmental factors that may have influenced the results, such as whether the children were breastfed (breastfeeding may protect kids against respiratory illnesses).


Not a risk for healthy kids
It’s possible that increased exposure to germs and the subsequent respiratory infections may put children with CLDP at risk for problems later in life, the researchers said.


The findings do not mean the daycare setting poses a risk to other premature infants, or to healthy children, the researchers said.


“Most healthy children tolerate respiratory infections and viruses without difficultly, and so daycare would not be considerate a problem for them,” McGrath-Morrow told MyHealthNewsDaily.


The results are published in the October issue of the journal Pediatrics.


MyHealthNewsDaily Copyright © 2010. All rights reserved.


 

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Daycare Puts Childrens with Lung Disease at Risk for Serious Illness – HealthCanal.com

Exposure to common viruses in daycare puts children with a chronic lung condition caused by premature birth at risk for serious respiratory infections, according to a study from Johns Hopkins Children’s Center published in the October issue of Pediatrics.


Lung Disease - DaycareThe researchers say their findings should prompt pediatricians to monitor their prematurely born patients, regardless of age, for signs of lung disease and to discuss the risks of daycare-acquired infections with the children’s parents. These risks, the researchers found, include increased emergency room visits and medication use and more days with breathing problems.


“Daycare can be a breeding ground for viruses and puts these already vulnerable children at risk for prolonged illness and serious complications from infections that are typically mild and short-lived in children with healthy lungs,” said lead investigator Sharon McGrath-Morrow, M.D., M.B.A., a lung specialist at Hopkins Children’s.


Investigators interviewed the parents of 111 children ages 3 and under with chronic lung disease of prematurity (CLDP) about their child’s daycare attendance, infections, symptoms, emergency room visits, hospitalizations and use of medications.


Children with CLDP who attended daycare (22 out of the 111) were nearly four times more likely to end up in the ER with serious respiratory symptoms than those who didn’t attend daycare, were twice as likely to need corticosteroids, and were more than twice as likely to need antibiotics. Children who attended daycare were nearly three times more likely to have breathing problems at least once a week compared to those not attending daycare.


Because the often serious complications caused by these infections can land children in the hospital and require prolonged treatment, the investigators are urging pediatricians to make parents aware of the risk.


“Repeated infections in children with lung disease of prematurity can also put them on a fast track to lifelong respiratory problems and chronic lung damage, so prevention in early life is crucial,” McGrath-Morrow says.


The researchers advise parents of children with CLDP to avoid — whenever possible — sending their children to daycare during the first two years of life because most of the catch-up lung growth occurs during that time. Most children with CLDP improve with age as their lungs mature, but about one-fourth continue to have respiratory problems as adults, the investigators say.


Among the 22 children with CLDP who attended daycare, 37 percent went to the ER for worsening symptoms since their last day in daycare, compared to 12 percent of children who did not attend daycare.  More than 15 percent of those who attended daycare were hospitalized for viral illness, compared to 6 percent among those who didn’t attend daycare. Thirty-nine percent of those in daycare needed corticosteroids for their illness and 50 percent of them required antibiotics, compared to 19 percent and 26 percent, respectively, for those who were not in daycare. Children in daycare had more respiratory episodes in the week before their visit to the doctor. More than half of the children in daycare had respiratory symptoms in the week before their visit, compared to 29 percent of those not enrolled in daycare.


CLDP develops in about a quarter of babies born at or before 26 weeks of gestation, according to the investigators, but even those born as late as 32 weeks of gestation can develop the condition, the researchers say.


The research was funded by the Thomas Wilson Sanitarium for Children and the National Institutes of Health.


Co-investigators on the study included Grace Lee, B.A.; Beth Stewart, M.M.; Brian McGinley, M.D.; Maureen Lefton-Greif, Ph.D.; Sande Okelo, M.D.; and J. Michael Collaco, M.D., M.B.A., all of Hopkins.


Conflict-of-Interest Disclosure: J. Michael Collaco serves without compensation on the board of directors of PACT-Helping Children with Special Needs, http://www.pact.kennedykrieger.org/about.jsp. The terms of this arrangement is managed by the Johns Hopkins University in accordance with its conflict-of-interest policies. 


Founded in 1912 as the children’s hospital of the Johns Hopkins Medical Institutions, the Johns Hopkins Children’s Center offers one of the most comprehensive pediatric medical programs in the country, treating more than 90,000 children each year. Hopkins Children’s is consistently ranked among the top children’s hospitals in the nation. Hopkins Children’s is Maryland’s largest children’s hospital and the only state-designated Trauma Service and Burn Unit for pediatric patients. It has recognized Centers of Excellence in dozens of pediatric subspecialties, including allergy, cardiology, cystic fibrosis, gastroenterology, nephrology, neurology, neurosurgery, oncology, pulmonary, and transplant. For more information, please visit http://www.hopkinschildrens.org/

MEDIA CONTACT: Katerina Pesheva
EMAIL: epeshev1@jhmi.edu
PHONE: (410) 516-4996

 

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Q & A: Rocco Palmo

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Usually at Q & A, I email one question to five different people, soliciting their replies. This week, to change things up a bit, I emailed five questions to the same person, blogger extraordinaire Rocco Palmo, whose blog Whispers in the Loggia has become a must-read for Catholics.

I first heard of Rocco on a trip to Rome many years ago, when there was speculation his was a pen name for a retired and particularly well-connected Vatican monsignor. I returned to the States, sent an email, and found he was a then-twnety-three year old living in Philly. I drove up I-95 the next day to meet him and have been reading and chatting and emailing ever since. I hope the readers will enjoy his commentary on the state of the Church.

First question: Do you perceive a central characteristic among B16′s appointments to the hierarchy?

Rocco Palmo: In every pontificate, any credible analysis of the episcopacy has to view it in two parts: the bishops a pope inherits from his predecessor, and the “new breed” he adds to their number. As the US church hasn’t seen in living memory, Benedict XVI’s meticulous scrutiny with the case-files has yielded a historically pointed divide between the two, producing a commentary on the status quo that’s as evident as the shift away from it has been relatively smooth, even if its effect will only fully emerge less in days than decades.

Despite the sea-change, in many quarters the perception remains that a typical appointee in the US has little more than the proverbial “six months in a parish” under his belt. While that model — which placed a greater premium on a cleric’s administrative gifts than his pastoral ability (and, as a result, saw the de facto pattern of a “career path” to the high-hat rooted in chancery work) — has largely been the American church’s prevailing one for most of the last century, it’s become little more than myth as the last five years of nods have seen its astonishing, near complete demise.

In its place, the freshly-operative norm for first-time appointees has overwhelmingly veered toward the selection of priests whose CVs have racked up far closer to “six months in the office,” the bulk of their ministries instead spent in the trenches of education and parish life, immersed in the concrete, anything-but-ideological reality of the gifts, challenges and concerns of the church on the ground — and above all, picks with the instinctive, proven ability to take all comers, bring out the best in every side and keep things united and moving… just like a parish. In a nutshell, these days you’ll find far more appointees pastoring multiple churches at once than the most common of duties on their predecessors’ bios: that is, “chancellor,” “vicar-general” and the like.

For all the criticism Rome has taken on the sex-abuse crisis, this upending of things at the top evinces a storyline many will find refreshing, even pleasantly shocking: a whole new ballgame engineered by the Vatican, a concerted reboot drawn from the keen, mostly-unsung recognition in its halls that the managerial mindset which birthed the scandals has seen its day and earned its replacement. In response, the concept is being implemented the only way such a transition can take place to its fullest effect in an apparatus like ours: a systematic evolution — diocese by diocese, appointment by appointment.

To be sure, the necessarily incremental rollout of such a strategy won’t satisfy the internet age’s all-consuming lust for sweeping change, facile, agenda-based interpretations, or blaring headlines. Then again, Joseph Ratzinger’s never been one for playing to the short-term gaggle of insta-analysis — as we saw with last week’s British tour, this pope is well attuned to how quickly opinion can turn.

On the pope’s preferred turf of history’s long march, however, the ongoing remaking of the ranks could end up becoming the most significant shake-up of the American episcopate since the 1830s and ‘40s, when a young church ravaged and weakened by the brutal trusteeism scandals received its first wave of Irish-born prelates armed with a mandate to build strong, clerically-dominated central structures to:

Efficiently organize the church’s growth, and Ensure that no one could be mistaken about who was completely in charge.

As the decades-long trail of decisions that erupted in 2002 revealed the same pinnacle of excess on the chancery side that parish-seizing, control-driven laity wrought in the 1820s, the pendulum has shifted decisively away from the long-default “Irish model” template — and given the short space of time, the result it portends is all the more more dramatic.

With today’s “baby bishops” almost invariably aged between 45 and 55 at the time of their appointments and just settling into the corner offices, we’ve got another quarter-century or longer to fully see how their ministries fully shake out, so further examination will have to wait. In the meantime, though, a couple added things bear noting.

First, while this quick glance has mostly dealt with the priests B16 has elevated since his election, the pontiff’s push for pastors clearly extends beyond first-time appointees to those he’s inherited and moved up the hierarchical chain. For proof of this, one need look no further than the two Stateside archbishops Benedict has, so far, elevated to the College of Cardinals — Boston’s Séan O’Malley, the “founding pastor” of Washington’s Hispanic community for over a decade before his appointment to the Virgin Islands, and Houston’s Dan DiNardo, whose last seven years before the mitre were spent starting a parish in Pittsburgh’s far suburbs, its first worship/office/meeting and religious ed. space comprising all of two rooms in an office park basement.

Likely to join them in time is another celebrated community-builder: Miami’s first ever native-son archbishop, Tom Wenski, whose early priesthood saw him found a parish for the city’s Haitian community and lead it for 18 years — an experience that still usually finds him murmuring the offertory prayers from memory in Creole, whatever language the congregation before him might speak.

This leads to a second point. Not all that long ago, no shortage of active prelates remained who, being of the old school, hadn’t fully grasped the sudden emergence of Hispanics in massive numbers — because, so the line went, the latter wasn’t noticable “on the books.” Yet as a pastor would easily recognize, a sizable chunk of Latinos — especially in areas where the community is freshly-arrived — don’t register in parishes; for one, the Anglo-church fixation on paper and programs has never been a hallmark of Catholicism south of the border, and among the undocumented, a lingering reluctance toward registration remains.

Either way, the still far-too-discounted reality is that, already — at least, by the USCCB’s count — an ever-growing majority of American Catholics under 25 are Hispanic. As a result, a prospective candidate unable to, at the very least, engage and integrate the most crucial bloc to the church’s future on these shores probably won’t end up making the cut anymore, at least across broad swaths of the national map.

On the flip-side, Benedict’s scouting has yielded another under-noted trend: the birth of the “crossover” bishop — an American-born, Hispanic-bred prelate native to both sides of the cultural divide and, above all, able to unite the two. To a degree, the pope’s had the benefit of timing on this one; only now is the rise of bishops like Brownsville’s Daniel Flores, Austin’s Joe Vasquez of Austin and Sacramento’s Jaime Soto bringing to full flower a decades-back push that saw Latino seminarians placed on the long-established leadership track (Roman training, advanced studies, top chancery posts, etc.). Still, what’s significant here is the staggering speed with which they’ve been sent upward — each the youngest member of the bench when they were named auxiliaries (44 at the oldest), the trio have since received key postings as diocesan bishops, two of them now in the capitals of the twin largest states.

While such a scenario would’ve seemed far-fetched to many not all that long ago, the third of the above might just be the most notable of all: when Flores was named to the booming, million-member diocese encompassing the Rio Grande Valley last December at all of 48, it proved a watershed. No cleric of Latin roots had ever been tapped to lead a Stateside see of a million Catholics or more… and the last time any American bishop under 50 took the reins of a church of said size came in 1985, when, five months shy of the half-century mark, Roger Mahony was sent home to Los Angeles.

As game-changing company goes, that’s pretty tough to top.

Lastly, while this pontificate’s chosen crop is far less dominated by the church’s traditional “management” class, it might just come all the more prepared for objectively top-shelf leadership. Because what the new breed lacks in its reliance exclusively upon the Roman universities, it more than makes up for not just in the thick of pastoral service, but in its considerable cred with the most vaunted training-grounds of the society in which it serves.

Especially these days, no bishop can even think of ruling by edict, and effective leadership and credible persuasion have ever more become the measure of one’s ministry. And, almost as if to indicate the degree to which Rome “gets” that, seemingly as never before, the Professor Pope has shown a distinct penchant for launching Ivy Leaguers onto the bench — Bishop Bernie Hebda of Gaylord earned his BA from Harvard and a degree from Columbia Law; both Soto and Twin Cities’ auxiliary Lee Piché likewise picked up graduate degrees in Morningside Heights; Allentown’s John Barres got his bachelor’s at Princeton before scoring an MBA from NYU; the freshly-ordained auxiliary of San Francisco, Bishop Robert McElroy, spent his undergrad days in Cambridge, then went on for a Master’s and Doctorate from the “Western Ivy” of Stanford, another of whose alums, Bishop Cirilo Flores — a Law grad before he entered seminary — was named an auxiliary of Orange last year.

As education and experience ad extra goes among Benedict’s picks, that’s just scratching the surface: born a Lutheran, Bishop Paul Swain of Sioux Falls was General Counsel to the governor of Wisconsin before entering the church and ditching the Capitol for the Cathedral, Bishop Tim Doherty of Lafayette in Indiana earned a doctorate in health-care ethics from Loyola University in Chicago between stints as a highly-regarded pastor of four parishes while, as a priest of New Orleans, Bishop Roger Morin of Biloxi (currently doing double-duty as lead hand for the besieged Catholic Campaign for Human Development) served as a special assistant to the Crescent City’s mayor for Federal programs, in a unique arrangement that saw him paid $1 a year. (For good measure, Morin’s predecessor along the Gulf Coast, Archbishop Tom Rodi — sent to Mobile in 2007 — earned his pre-divinity degrees from Georgetown and Tulane Law.)

Shortly after becoming Benedict’s hand-picked representative to the States in 2006, the story goes that, behind closed doors, Archbishop Pietro Sambi bluntly put the bishops on notice that, in as many words, “your successors will not look like yourselves.”

Barely a half-decade into the reign of Ratzinger, the ground-shift might remain in its early stages. Even so, “mission accomplished” would hardly be a premature assessment.

View the original article here

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Couple Says ‘Kangaroo Cuddle’ Brought Baby Back to Life – AOL Health (blog)

mom cuddles babyThis week, an Australian couple, Kate and David Ogg, said that a “kangaroo cuddle” saved the life of one of their twins. Doctors told the couple that baby boy Jamie, who was delivered prematurely at 27 weeks and weighed 2.2 pounds, would not live.

Hospital staff tried to resuscitate the child for 20 minutes before giving the parents the heartbreaking news that Jamie had died, meaning only one of their babies would make it, French news agency AFP reported.


But Kate placed the baby on her chest and used the kangaroo method, which involves skin-to-skin contact between mother and child. She remained in that position for two hours and soon the infant’s gasps became more regular and, after a while, he opened his eyes. When the Oggs sent their doctor a message that Jamie was showing signs of life, he dismissed the movements as reflexes.


Kangaroo care is a method that’s often used on premature babies where the infant has skin-to-skin contact with his or her mother, just like a marsupial. It’s thought that this type of closeness can help regulate the preemie’s heartbeat and body temperature, giving the baby a better chance of survival.


In typical kangaroo care, the baby wears only a diaper and is secured to the mother’s chest in a head-up position with a piece of cloth (example top left). The cloth wraps around under the baby’s bottom to create a tight bundle — like a kangaroo pouch.


Dr. Mitchell Goldstein, who practices neonatal-perinatal medicine and pediatrics in West Covina, Calif., tells AOL Health that it is possible that this baby was saved by kangaroo care. “This story is intriguing. I’m not saying that in all cases kangaroo care will resuscitate every preterm baby, but there are certain cues moms provide for babies — it’s something that’s a testimony to the maternal instinct bond,” he says.


“In the NICU, we’re applying chest compression and respiration that are much more vigorous. Medications and fluids were probably given, and then when these things did not make a difference, they gave up. Would I advocate using kangaroo care before vigorous resuscitation? No. But after trying it, yes,” says Goldstein.


But kangaroo care isn’t for all preemies. If a baby is so small that his skin hasn’t had a chance to fully developed, the skin could stick to the mother’s body, causing more harm than good, Goldstein says.


Kangaroo care widely is used in developing countries where hospital crowding is common and there is a shortage of caregivers. If there aren’t enough incubators available, skin-to-skin contact can regulate the baby’s temperature. The method also allows for easy access for breast feeding and bonding opportunities between parent and baby (dads can do it, too).


Other benefits of kangaroo care include less stress for the parent and baby and lower hospital costs. But for the Oggs, the proof that kangaroo care works comes from the fact that their son Jamie is now very much alive and thriving. Now 5 months old, he and his twin sister have been taken to the United States on a media tour with their parents.


“Studies have shown that in third world countries kangaroo care improves survival rates by 90 percent,” says Goldstein. “Moms are nature’s incubators — and not only to warm a baby. If a baby’s temperature gets too high the mom will cool down. Kangaroo care also improves breast feeding. It can have a tremendous benefit for all babies, whether or not they are in distress or preterm.”



 

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‘Kangaroo’ cuddle saves her baby

AFP/Sydney

An Australian couple yesterday spoke of how they believe the skin-to-skin “kangaroo” cuddle they gave their newborn baby saved the infant’s life after their doctor had given him up for dead.

Speaking to Australian television, Kate and David Ogg said medical staff told them that tiny Jamie – delivered prematurely at just 27 weeks and weighing only 1kg – could not be saved.

They said their doctor, who was not named in the Channel Seven report, spent 20 minutes trying to resuscitate the child before giving them the bad news.

“He turned to look at me while his hands were still on the bed and said, ‘Have you chosen a name for your son?’ And we said his name was going to be Jamie. He turned around and said, ‘We’ve lost Jamie. Jamie didn’t make it.’”

Given the tiny baby to hold, Kate gently placed him on her bare chest and cuddled him in what is known as the “kangaroo” care method, named after the hopping Australian marsupial which carries its young in a pouch.

In this position, Jamie would have been able to hear his mother’s heartbeat and feel the warmth of her skin.

“He started gasping more and more regularly and I’m like, ‘Oh my God what is going on? Then a short time later he opened his eyes,” Kate said of the two-hour experience, which Channel Seven said was backed by hospital reports. “Coming back from the dead sounds pretty miraculous.”

Kate and David said they sent a message to the doctor that Jamie seemed to be showing signs of life but were informed that his movements were natural reflexes and there was no way he could be alive.

“I would say that we would have been the only two people in the hospital that believed the possibility of him coming back after he started showing signs of life,” David said.

The couple, who are about to take their thriving five-month-old son and his twin sister to the US for media appearances, said they were astonished at the interest their story had generated around the world.

“Kangaroo care, it sounds cute, it sounds fun. It helped bring our baby boy around,” Kate said.


 

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Kangaroo Care for premature babies

Neonatal Intensive Care Units in Southern Oregon are embracing the term ‘Kangaroo Care’.

Kangaroo Care is a practice that has been researched for about a decade. 10-years-ago, parents were advised to cuddle skin-to-skin for 30 minutes at a time. Just recently, researchers have upped-that to two to four hours at a time. This can have a huge impact, considering how much time babies are in isolation.

“The theory of Kangaroo Care is to promote not only bonding for mom and baby, or dad, but also, many studies have shown a lot of health benefits for Kangaroo Care,” Children’s Services Clinical Manager Michelle Strickland said.

“He was born about five weeks early,” Mother Megan Dunn said
“They rushed him right back here. Tubes hooked up to him and IV’s, and I didn’t really get to touch him or hold him. It was really hard,” Father Austin McCarty said.

Baby Quentin’s early arrival brought a number of questions and concerns for his parents.
“First, we were kind of nervous to hold him, because all the tubes, so we asked if we could hold him. They’re like ‘yeah, the more you hold him the better.’ They’re like, ‘have you thought about taking your shirt off? We cover everything up so no body can be in here’,” McCarty said.

“It increases weight gain for babies, increases mom’s milk supply. It can also decrease infection because studies have shown that mom has antibodies on their skin, and the babies get that too. And it decreases the risk for infection,” Strickland said.

“He benefits from it because he does so much better. And I benefit because it gives me so much more hope that he’s gonna be out of here soon,” McCarty said.

While Kangaroo Care is used mostly with the premature babies, all babies can benefit from it. Doctors say it not only helps with growth and development, it also helps parents and babies bond.

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Kangaroo cuddle ‘saves’ Australian baby

An Australian couple Wednesday spoke of how they believe the skin-to-skin “kangaroo” cuddle they gave their newborn baby saved the infant’s life after their doctor had given him up for dead.

Speaking to Australian television, Kate and David Ogg said medical staff told them that tiny Jamie – delivered prematurely at just 27 weeks and weighing only one kilogram (2.2 pounds) – could not be saved.

They said their doctor, who was not named in the Channel Seven report, spent 20 minutes trying to resuscitate the child before giving them the bad news.

“He turned to look at me while his hands were still on the bed and said, ‘Have you chosen a name for your son?’ And we said his name was going to be Jamie. He turned around and said, ‘We’ve lost Jamie. Jamie didn’t make it.’”

Given the tiny baby to hold, Kate gently placed him on her bare chest and cuddled him in what is known as the “kangaroo” care method, named after the hopping Australian marsupial which carries its young in a pouch.

In this position, Jamie would have been able to hear his mother’s heartbeat and feel the warmth of her skin.

“He started gasping more and more regularly and I’m like, ‘Oh my God what is going on? Then a short time later he opened his eyes,” Kate said of the two-hour experience, which Channel Seven said was backed by hospital reports.

“Coming back from the dead sounds pretty miraculous,” she added.

Kate and David said they sent a message to the doctor that Jamie seemed to be showing signs of life but were informed that his movements were natural reflexes and there was no way he could be alive.

“I would say that we would have been the only two people in the hospital that believed the possibility of him coming back after he started showing signs of life,” David said.

The couple, who are about to take their thriving five-month-old son and his twin sister to the United States for media appearances, said they were astonished at the interest their story had generated around the world.

“Kangaroo care, it sounds cute, it sounds fun. It helped bring our baby boy around,” Kate said.

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