Four-day old Avalie was critically unwell with life-threatening sepsis due to infection.
Born via an unplanned caesarean on 16 July 2023 at Hornsby Ku-ring-gai Hospital (HKH), Avalie had a healthy birthweight of 3.14 kgs and there were no concerns for her health.
Twenty-four hours after leaving hospital, her mother Gemma, who is an emergency nurse, noticed her daughter’s breathing wasn’t stable.
Avalie looked like a normal sleepy newborn baby, but she showed subtle signs that she wasn’t breathing properly. It is normal for newborns to have irregular breathing, however Gemma was concerned and monitored Avalie through the night. The next morning, Avalie had developed a high temperature, so Gemma called her midwife who advised her to bring Avalie into the emergency department (ED) at HKH.
With her professional experience, Gemma advocates that hospitals are a safe space, and the healthcare staff are always there to help them. So, if you’re unsure of the health of your child, she recommends you don’t delay a trip to the ED.
Avalie was immediately admitted to the Special Care Nursery and treated for a presumed infection; however, she quickly deteriorated despite usual treatment.
The first 24 hours in hospital were a whirlwind for Gemma and her husband Dillan, as the doctors ran a series of tests trying to understand what was causing her daughter to become progressively unwell.
Avalie had difficulties with her breathing and required respiratory support, her blood stopped clotting due to the infection and she started to have seizures due to inflammation around her brain. Her heart became inflamed, and there was evidence of damage to the heart muscle in her blood tests.
“The healthcare staff were open with Dillan and I the whole time and kept us informed of test results straight away and what was going on,” said Gemma. “It makes a huge difference as I know what it’s like to be on the nursing side, but as a mother of a newborn you feel helpless and out of control.”
Dr Joshua Steadson, Staff Specialist Paediatrician and Head of the Paediatrics Department at HKH, confirmed that Avalie tested positive to the common enterovirus. The virus often causes Hand Foot and Mouth disease in older children which is a much milder illness that they recover from within a few days.
Ultimately Avalie developed sepsis, a potentially fatal complication due to infection from a rare but dangerous strain of the virus.
As she was critically unwell, Avalie was transferred to the Royal North Shore Hospital (RNSH) Neonatal Intensive Care Unit (NICU) for specialist support via the Neonatal and Paediatric Emergency Transfer Service (NETS).
Gemma recalls the NETS team being impressed at how thorough HKH was in stabilising and preparing Avalie for the transfer to RNSH NICU who were waiting to receive Avalie, with a full brief on her condition from Dr Steadson.
Gemma admired how diligent the nursing staff were and the tender care they took when handling Avalie.
Avalie was closely monitored, and her condition grew progressively worse before she turned the corner. Gemma remembers there were some incredibly distressing times when she couldn’t see the potential of Avalie getting better.
After a few weeks in NICU before being transferred to the paediatric ward, Avalie finally returned home under the Hospital in the Home (HITH) program, which offers post-acute hospital level care in the comfort of the patient’s home. While it was a stressful time, Gemma felt it was a great stepping stone which allowed Avalie to go home earlier, however the resources and medical reviews made available through telehealth made the transition easier.
“Ongoing follow up in clinic has been such a heart-warming experience as I have watched her improve so rapidly to the point that she is no longer recognisable as the same incredibly unwell newborn baby,” said Dr Steadson. “Her heart has recovered; all her blood tests have normalised, and she is growing beautifully. There is a risk of longer-term neurological difficulties for Avalie due to the episode of inflammation in her brain, but so far there is no evidence of any problems, and she is developing normally and is the happiest (and cutest!) little girl and a real favourite amongst the clinic staff! I look forward to watching her grow and leave this most rocky of starts behind her.”
Avalie’s parents think she is a miracle baby to have survived such a frightening ordeal and are eternally grateful to everyone who looked after Avalie. They believe that she was in the right place and treated quickly and efficiently by the healthcare staff which made a huge impact in her recovery.
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