Newborns with symptoms of fetal and neonatal alloimmune thrombocytopenia (FNAIT) often need to spend time in the neonatal intensive care unit (NICU) for urgent care such as platelet transfusions.
The pain and stress of medical interventions in newborns has been shown to affect long-term memory and emotional and cognitive development. Medical trauma can also affect mental and behavioral health in children.
What is FNAIT?
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a rare but serious condition that affects 0.1% of pregnancies in which a pregnant mother’s immune system produces antibodies against the platelets of her fetus. This occurs when a fetus inherits platelet antigens from the father that are not compatible with the mother, typically involving a protein called human platelet antigen (HPA). The mother’s immune system recognizes the fetal platelets as foreign, attacking and destroying them, leading to low platelet levels (thrombocytopenia) in the fetus or newborn.
What is considered medical trauma?
Medical trauma is defined as emotional and physical responses to pain, injury, serious illness, medical procedures and frightening treatment experiences. In babies, pediatric medical trauma can refer to medical intervention in the womb, a traumatic birth experience followed by the stress of acute and prolonged medical care post-delivery.
Other traumatic events for babies include being separated from their parents, pain and discomfort, loud noises, distress of close family members and invasive medical procedures.
What are the potential consequences of medical trauma in children?
Medical intervention does not automatically lead to a trauma response, but in some children social, emotional, behavioral and development issues can be related to medical trauma.
Some short-term consequences of medical trauma observed in infants and children may include:
- Difficulties sleeping and feeding
- Hard to soothe
- Emotional distress
- Separation anxiety
- Reduced social interaction
- Developmental delays
- Resistant to touch or to engage
- Longer-term consequences of pediatric medical trauma to be mindful of are:
- Cognitive development delays
- Emotional distress, such as tantrums, anger, anxiety or depression
- Difficulty in relationships, such as shyness or social anxiety
- Behavioral problems such as aggression and mood changes
- Sleep disturbances, such as nightmares or insomnia
What is play therapy?
Play therapy is used to manage the potential long-term impact of medical trauma experienced by infants and children. It is conducted by a pediatric psychologist or play therapist who assesses the child and then creates a treatment plan to help the child process his or her past trauma.
It allows the child to express residual emotional distress such as fear, pain and anger related to medical procedures and experiences. Children who experience medical intervention as a newborn won’t remember the actual experience, but by explaining or recreating the details of early medical trauma play therapy creates self-awareness.
The benefits of play therapy include:
- Learning to manage emotional triggers
- Providing self-awareness
- Developing self-confidence
- Managing social situations
- Learning about building relationships
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