SILVER SPRING, Md, September 1, 2011 – Very little is more disheartening than being told your newborn won’t be able to room in with you or go home with you once you’re discharged. Most parents don’t have to face this separation, but unfortunately, I was one of those parents. My newborn daughter was whisked away to receive treatment before I had the opportunity to hold her.
Whether it’s because your child has been born prematurely or there is some other reason your infant needs special care, the days in the Neonatal Intensive Care Unit (NICU) can be difficult to handle. Here are a few tips to help manage the stress, sleeplessness and all the different emotions that can assault you while you navigate the days or weeks when your child is away from you.
In most situations, the parents are allowed into the NICU almost immediately following birth. Once the doctors stabilize your child and have set up whatever life-saving equipment may be required, parents are usually allowed right up to the bassinet or incubator. Ask the doctor or attending nurse what kind of interaction you can have with your child. Some children require more intensive care than others and therefore cannot be held. Others simply require an IV or oxygen and can not only be held, but breastfed. Whatever your child’s situation, being able to see your son or daughter for more than a brief moment is the first step to bonding.
This is an important time for nursing mothers as well if you are planning to breastfeed. Ask if you are able to feed your baby or if he or she will need to be fed via IV or bottle. If your child’s caretakers say your infant is not able to breastfeed at the moment, ask that they only give your breast milk and then find out what the hospital’s policy is with regards to receiving, using and storing expressed breast milk.
Your next step is to rent or buy a breast pump to ensure that your milk comes in, you can supply the NICU with expressed milk for your baby and you protect your milk supply until baby comes home and can nurse regularly.
Most of what goes on in the NICU may seem foreign, and the words and terms seem like mumbo-jumbo. As a parent, you are sure to be full of questions, so ask them. Don’t be afraid to ask what the numbers on the monitors mean, why your child is hooked up to different machines, and how long he or she will need certain treatments.
Ask about what medications are being prescribed and why, what they do, any side effects, how long the medication will need to continue, etc.
Often, when a doctor comes to brief you about your child’s condition, you are asked, “do you have any questions.” You have listened to what has been said and tried to process it, but at that moment nothing comes to you.
Inevitably, once you are alone with your baby, or have left the hospital for the evening, you begin to think of new questions, or start thinking of all the things you meant to ask but didn’t. The best way to deal with this is to keep a list. Carry a small notebook and a pen with you so that you can write down questions as they occur to you. Next time, you’ll be able to look though the list when you have the doctor in front of you.
Once you start receiving information about your child’s health, the more you’ll want to know. While asking questions is the first step to understanding how best to care for your child and to understand what’s going on, doing a little further research is also important. The overview that doctors provide is often the basics. Just enough information to explain in a simple fashion what the problem and the treatment is.
But doctors do have limited time to spend with each patient’s parents, and often there is plenty of additional information that can be found.
This is especially helpful if your child is being treated for a condition that will stay with him or her past her discharge and if you will have to take an active part in your baby’s healthcare or medical treatment once you get your infant home.
Extra information can also be helpful in generating questions for your medical team. But be careful about second guessing or coming across like you know better. While you may have spent all night reading articles online, remember the doctors and nurses spent years in school learning how to best care for your child.
Also, be careful not to over worry yourself. Doing your own research and reading can help alleviate fears, but it can also spur them. Don’t dwell on worse case scenarios or horror stories. If you find yourself overly concerned about something you read, ask about it, but ultimately you will have to realize that at some point you will have to live with whatever risk you are concerned about. Trust that the hospital isn’t going to release your child until the doctors feel that your son or daughter is safe to go home.
This is perhaps the most important piece. Make sure you spend some time with your child while he or she in the NICU. This continues the bonding process and ensures that your child recognizes you once released. This may not seem like a big concern, but consider the premature infant who spends the first month of his life in an incubator.
Spending time with your child every day, even if it’s only an hour in the evening after work, will also help you to adjust to the role of being a parent. Going home without the baby you’ve been planning for can be unsettling. But going a week or two, or even more, without the infant in the house and no contact with the child will make the transition when baby does come home all the more difficult and surprising.
Ask the nurse when the baby’s feeding are, and if you can help with any of the general care. Get your practice changing diapers at the hospital, feed your child, and help with any care you might have to continue at home. Aside from giving you practice with an experienced person to assist you, it also gets you used to some of these tiny everyday activities that you will being doing once you get baby home.
Take a Break
It can be mentally, emotionally, and physically exhausting to have a child in the NICU. It becomes even more so if you spend every waking (and sleeping) moment there. Generally, the staff won’t throw you out. They may ask you to step out during a shift change, but they understand the desire of parents wanting to be by their children’s bedside and the importance of having them connect with their child. That being said, you need a break.
Sleeping in a chair is not going to get you the rest you need to stay healthy. Nor is eating meals composed solely of whatever is in the vending machines in the maternity ward waiting room. Depriving yourself of proper rest and nutrition are also great ways of allowing yourself to get sick, and the last thing you want to do is give your infant an illness that could have been avoided. Try to set yourself a schedule of when you plan to arrive, how long you’ll stay and when you’ll leave. This will also help you coordinate with any time requirements for delivery of expressed breast milk, or other care schedules you might want to be present for.
Plan to take breaks for meals if you are staying for more than an hour or two. Even if it’s in the hospital cafeteria, go sit down. Don’t inhale your food, and if someone is there with you, try to have a conversation that doesn’t involve the hospital.
Have a Support System
It is important to have someone that can help you through this tough time. Whether it is a spouse, a partner, a parent, a sibling or a best friend, make sure you have at least one person that you can talk to when things get too much to handle. This should be a person who you can cry in front of, since the post-partum emotional rollercoaster can make even the most level headed people dissolve into a bucket of tears.
It’s also important to have someone that will go to the hospital with you. If there isn’t someone that can go every time, try to rotate through a pool of people so you don’t have to go alone. Having someone else present can help you through the disappointment of being told your child has to stay a few extra days or needs to be put on a new medication.
These tips helped me get through my daughter’s week-long stay and prepared me for the doctor’s appointment and follow-up care she required. Hopefully, you will have your baby home and healthy before too long, but in the meantime, try to remember that he or she is getting the best possible care.
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