NICU

Mamas on Bedrest: Going Home Without Your Baby

December 8th, 2014
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Me and my daughter the day after her birth. Kangaroo (skin to skin) care is very beneficial to preemies helping them learn to regulate their body temperatures, soothing and comforting them and helping mamas and babies to bond.

Hello Mamas,

We all know bedrest is a beast, but we endure it with the ever pressing hope that at the end of the journey, we’ll end up with a healthy baby. Sometimes the journey ends up not quite how we expected. We deliver and our baby has to be taken into the neonatal intensive care unit (NICU) for special care. Even though all proceeds positively, it’s a tough pill to swallow that after the many weeks on bed rest, you actually have to leave the hospital without your baby. While most mamas on bedrest know that they have a higher than normal risk of delivering a premature infant, few are prepared for the feelings that ensue when they are discharged home from the hospital and their babies must remain. Many mamas describe a feeling of grief, a void and feeling like they didn’t really succeed in having a successful birth outcome. All of these are very valid feelings.

As a mama who had to leave the hospital without her baby, it was really hard to be wheeled down to the pick up circle in front of the hospital, all my personal items and flowers beside me, and no baby in my arms. And I was lucky. My daughter (a late phase preemie born at 36 w, 6d) only remained in the NICU for 5 days beyond my discharge. But it was still hard to walk into my house and to see her room all ready and to see the cradle and changing table in my room and for her not to be there. During those 5 days, I made the most of my time, created a routine with my husband and the order, quite frankly that feeling of control is what got me through.

Structure your days: Every day I got up, dressed and prepared a bag for the day full of snacks and supplies (breast pump tubing, bottles, breast pads, maxi pads and other personal items) and my husband would drive me to the hospital so I could be there by about 9 am. Once I arrived, I assumed most of my daughter’s care. I would weigh her, feed her, change her and weigh her again. Then I’d hold her and rock her, talking to her. My mother had come down to help out, so she would come to the hospital with me and we would take turns holding my daughter. While my mom held my daughter, I’d pump. I pumped every few hours and by the time she came home, we had enough stored breastmilk to take up nearly one quarter of our freezer. Occasionally during the day I’d take a nap in the rocker, but generally I hung out with my baby, holding her and caring for her as much as the nursing staff allowed. My husband would typically pick up my mom and I at about 7pm and he’d bring us home. I’d eat and pump and rest, my mom taking care of me, while my husband would go back to the hospital and hang out with my daughter until about midnight. We repeated this schedule daily until we brought my daughter home.

Now I am sure that many of you are thinking,

“Well that’s just fine for you. Your baby was only in the NICU 5 days beyond your discharge (10 days total). And you didn’t have any other children at home.” 

To this I say, “You are absolutely right!” But the point I want to make is that when your child is in the NICU, it’s stressful. Many mamas feel as if the nurses are bonding more with their babies than they are! Personally, I was kinda pissed at the nurses at first. They held my daughter before I did. Although they had whisked her by me when she was first born, the NICU nurses were the first people my daughter really  “saw”. I knew intellectually that they were doing the best possible for her, but frankly I was jealous. I wanted to be doing everything for her. I WAS HER MAMA!!! And as the days went on, and I was able to do more and more for her myself, those feelings of jealousy gave way to gratitude as I realized those nurses really were doing the best things for her at that time.

Get support: I live in Texas and my family lives in Massachusetts. My mom came down to visit and take care of me. It was a HUGE help. While she really didn’t do much (a few loads of laundry, made sure I ate, helped me move about comfortably), her presence meant more than I can say. She was there when we learned about a lot of my daughter’s lab tests. While most of them were negative and my daugther was progressing nicely, the anxiety that arose each time the neonatologist arrived was stiffling and each day that he said my daughter could not go home, mom was there to comfort me. Also, although I didn’t have other children at home, having my mother present would have enabled me to be with my daughter without having to worry about the care of my older children at home. Do what you can to have folks present to support you. Its invaluable!!!

Take Advantage of Available Services: Many hospitals offer a wide range of services to families with infants in the NICU (Social service consultations, assistance at home, getting medical devices and equipment for home if they are needed, counseling for parents if needed and so much more!). While I didn’t need many of the services offered, I did take advantage of the lactation consultations. My daughter had trouble breathing and that is why she was in the NICU in the first place. But she had difficulty breathing while nursing. The lactation consultant gave me tips on good positions in which to hold her comfortably, how to make sure enough of my breast was in her mouth to stimulate the milk let down reflex, and how to best help my daughter to be able to breathe while nursing.

Be present for all tests and ask questions about the results: There are a million and one tests done to make sure that your preemie is progressing and developing. As much as possible, BE PRESENT WHILE ALL OF THEM ARE ADMINISTERED!! There were a couple that they tried to tell me that I had to leave the room to have done. I refused. You have the right to refuse and be with your baby provided it poses no health risk to her or compromises the test. Speak up! And be sure to get full reports on all the tests and ask questions of the neonatologists when they do their rounds and present the test results to you.

Be patient: All babies go home. Some, like my daughter only spend a few days in the NICU. Other babies spend weeks to months. Whatever the duration of your baby’s hospital stay, know that they are getting the best possible care. And know that each day that they stay in the NICU is further preparing them to be home with you. One of the worst things that can happen is to get your baby home and for them to have some sort of complication that causes you to rush them back to the hospital. Be patient, allow the NICU staff to do what they do, and with time and grace, your little one will be home to stay!

Mamas on Bedrest: What to Expect if Your Baby Arrives Early

November 4th, 2013
Newborn Vanessa

My Daughter one day old in the NICU

Mamas,

November is Prematurity Awareness Month and November 17th is World Prematurity Day. These times have been designated by the March of Dimes to raise awareness about the worldwide problem of preterm birth and infant prematurity. Each year 15 million babies worldwide are born too soon. In the United States alone, over 500,000 babies are born too soon annually. When a baby is born too soon, its risk of death before its first birthday is significantly increased. According to the March of Dimes, a premature baby dies every 30 seconds somewhere in the world. The March of Dimes is at the forefront to the battle with research and programs designed to help every baby “have its 39 weeks.” For more information on the scope of the problem, take a look at this very inforamtive infographic put together by the March Of Dimes. Please take a moment to learn about this very significant problem-one that likely disproportionately strikes Mamas on Bedrest. 

Now that we’ve addressed the statistics regarding preterm births, what exactly should mamas know? How many of you have had frank discussions with your obstetricians or midwives about what would happen if your baby were born too soon? In my case, the issue of having a premature infant was never brought up-despite the fact that I spotted and had some contractions early in my second trimester, had Braxton Hicks vs preterm contractions in my third trimester and finally delivered my daughter at 36 weeks and 6 days. Even though we were discussing putting me on bed rest, my OB never said to me, “If your baby were born today, we would expect_____”. I had no idea my child could end up in the NICU and I was completely blindsided when she was taken there. Likewise, I was ill equipped for seeing her all hooked up and with an IV in her little hand when I first saw her in the NICU. While I am completely in favor of trying to prevent preterm labor and prematurity, I think that parents should be educated about what to expect if their baby does in fact arrive too soon. And since the NICU is not on the hospital tour, and if your OB is like mine, they are not taking about a preterm birth (probably don’t want to jinx things!!), Here is what I think you need to know in the event your baby arrives early.

 

You won’t be rooming with your baby

Everyone kept telling me how awesome it was when you first have your baby and they put him/her to your breast. They talked about how you could hold them instantly and how you would room together. This is not the case if you have a premature infant. Most likely, the minute your baby is delivered, he/she will be whisked over to a warming bed and huddled over by a neonatal team. I was frantic because when my daughter was first born, she didn’t cry initially. They had to clear out her airway and tap on her little chest and soon she let out a wail. I didn’t get to hold my daughter when she was born. She was wafted by my face like a bouquet of flowers before being whisked to the nursery for more care. It was a full 12 hours before I held my little girl for the first time and that was because they were taking her by isolette up to the 9th floor to the NICU (My room was on the 2nd floor!). We never roomed together and she was eventually discharged 5 days after I was from the NICU.

Spend as much time as you can with your baby

I gave birth to my daughter at 8:03pm and finally got to “hang out with her” at 3pm the following day. I held her for the first time 12 hours after her birth, then she was taken to the NICU and I was told that I couldn’t see her or be with her because they were running tests. This made me crazy!!! Everyone kept telling me to relax and to get some rest (I had had a c-section) but all I could think about was my baby. I wanted her in MY arms!! I kept going to the nurses’ station and they kept telling me no, not now, it’s change of shift, etc….Finally at just before 3pm I shuffled my way down the hall to the elevators. My husband came runnning after me asking where I was going. “To see my baby!” I said. Everyone tried to hold me back, but I put my very achy foot down and said, “I am seeing my daughter now!” So a kind nurse got a wheelchair and up we went.  In the NICU, you must scrub as if in preparation for surgery because any germs could be lethal for many of the wee ones there. Also, avoid wearing extraneous clothing and jewelry like hats, dangling necklaces and earrings (this is more for guests, but just an FYI) and such which can carry unknown germs. Most NICU’s have lots of rockers, at least one beside every little bed, so plunk yourself down with your little one and stay as long as they will let you. I was fortunate in that my daughter was a “late phase preemie” meaning she was very near term. She weighed 5 lbs 3 oz an was never in an isolette in the NICU. So whenever I went into the NICU, I held her. For the very little ones, this may not be possible. But put your hands in those glove things and stroke your baby, talk to your baby and let them know you are near. This is critical for the little ones to be able to calm down and feel secure. They had all that womb-time hearing your voice and feeling your heartbeat. Do whatever you can to replicate that soothing environment including finding as quiet a space to spend with your baby as possible. Reducing the bells and whistles also helps your little one be calm and to self regulate their breathing, their temperature and to self soothe.

Remember, You are The Mama!

The NICU can be an intimidating place! All the machinery and the staff can be a bit overwhelming. You may feel like everyone knows more about your baby than you do, but YOU ARE THE MAMA!!! Take your rightful place at your baby’s side. Ask questions about tests being run, procedures being performed and make sure you know about any changes in your baby’s status. If you need to, keep your own little log of information in a notebook or on your phone/tablet. Be an active part of your babies care team because quite frankly, you are the

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Kangaroo Care with my daughter

As soon as you are able, practice kangaroo care with your baby. This is where your baby is wearing only a diaper and perhaps a little cap and is placed on your (or their daddy’s) bare chest. This helps the babies regulate their temperature, soothe from your touch, soothe from the sound of your voice, and soothe from the rhythm of your heartbeat.

Breastfeed As Soon As Possible

Breastmilk is the best food for a premature infant. Depending on how premature your baby is, you may not be able to breastfeed initially, or your milk may not be in. As soon as possible, get a hold of a breast pump and begin pumping. Even a few drops is beneficial for your baby. The more you pump, the sooner your milk will come in and the more milk you will make. If its availalable, have a consultation with a lactation consultant to get tips on maximizing your breastmilk production. If you cannot produce enough milk, know that you can request donor breast milk. Also, because premature infants need many more nutrients for growth and development than term infants, you may need to consider a breastmilk enhancement. Learn more about this here.

Decorate Your Baby’s Space

While your infant may not be able to see much beyond his/her isolette, it is very soothing to the family to decorate the baby’s space. Bring pictures of the family and allow older siblings to make pictures. Bring in a Name plate to hang over your baby’s bed. When allowed, bring in clothes and blankets from home to begin acclimating your baby to his/her home surroundings.

 

Having a preterm infant is not easy. By all accounts, I was extremely lucky in that my daughter only stayed in the NICU for 10 days. I know families whose infants are in the NICU for 60 and even 90 days. It’s not easy, but you can do it. Knowing what to expect is half the battle, so I hope these tips will help you feel more prepared. I don’t wish a preterm infant on anyone. But being blindsided as I was is no fun either. Take this information and tuck it away. Hopefully you’ll never need it, but if you do, you’ll know, at least in part, what to expect.