Navigating the challenges – neonatal intensive care unit


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When my first daughter was born 6 weeks premature I was thrust into the world of NICU and it was scary.  When I went down for the first time to see my tiny daughter in her incubator it was a shock. I felt lost bewildered and terrified. I was a afraid to touch her, hold her. Her care felt completely out of my hands and I felt helpless. I didn’t understand the machines and why she was under a uv light, why she was on medication or why she had so may wires and tubes. Yes NICU can be a very scary place for parents. What are some of the ways we can not only help our little ones but also ourselves?

Ask

It can be easy to feel unable to ask about the medical side of our babies but we must. Ask about your babies health, why certain medications are being given and ask again if your unsure. Speak to the doctors about your babies progress, be informed and be involved. Ask staff to explain about the machines your baby is connected to, what they do and how they work. Ask about feeding and what feeding schedule your baby is on and if your expressing your breast milk ask about your pumping routine. Ask if you can be part of your babies cares, ask to be shown how to change a nappy, do mouth care, do a tube feed or give a bottle. In short don’t be afraid to ask, in fact the more you ask the better. Don’t feel like you don’t want to bother the staff or they will too busy. Your baby is important and it’s important you know as much as you can. Ask for help, NICU can be overwhelming and scary if you need help ask, seek support from staff, family and friends you cant do this alone. Some NICU’s have Bliss nurses/volunteers you can talk to, to help you feel supported. Also the ‘Small wonders’ DVD by Best beginnings can help you understand more your journey in NICU. Asking will help you feel less anxious, more in control and more able to support your baby.

Touch

Touching and holding your premature baby is so important. Skin to skin or ‘kangaroo care’ provides your baby with contact with you, being close to your skin and your heartbeat has so many benefits such as:

  • Helps to regulate baby’s heart rate and breathing – better oxygenation
  • Reduces apnoea and bradycardia (periods of irregular breathing and heart rate that can occur in preterm babies)
  • Better temperature stability
  • Analgesic (pain relieving) effect
  • Increases time in quiet sleep which may help brain development and growth
  • Enhances mother-baby attachment
  • Improves breastfeeding success and longer breastfeeding duration
  • Babies grow faster and are discharged sooner from hospital
  • Reduces maternal stress / depression.                                            (unicef)

Try to have periods of skin to skin contact as soon as your baby is stable, even if baby is very early. Once your baby is stable, try to have regular periods of kangaroo care with your baby for at least an hour. Many NICU’s have comfy reclining chairs so mums and babies can relax together, cuddles and special moments are so important.

col047If your baby is really sick you may not be able to hold your baby for a while but still touch and stoke your baby. The staff may suggest ‘Comfort holding’. Cradling your baby with still hands can be more comforting than stroking or massage for a very sick baby. It’s so important that premature babies associate touch with comfort and reassurance, not only medical procedures. By touching your baby you can soothe your baby during uncomfortable procedures and help your baby to settle if they are restless. It will help you as parents bond and feel more included in your babies care.

The more you do skin to skin the more confident you will feel with your baby.

Singing and talking to your premature baby also are important. These too help soothe and reassure your baby.

 Be There

One of the most difficult things about having a baby in NICU is being with your baby. This can be especially challenging if you have other children to care for too. Your baby needs you but so does everyone else. Mom you will be recovering from birth and most likely be sore, tired and if you have had a c section then also unable to drive. Dad you may find that you have to return to work while your baby is in hospital thus making visiting or taking mom to the unit difficult. Being with your baby as much as you can of course is so important both for feeding but also things such as regular kangaroo care and bonding. It takes lots of planning, organisation and help to find ways to be with your baby. Ask for help from family and friends, even if its just a lift, picking up your other children or maybe a meal. Have a good routine and get to know your baby’s schedule for cares, doctors rounds and feeding. It will be a challenge and it will take much thought but being there for your baby is one of the best ways to care for your premature baby. Regular contact with you and just hearing your voice will calm your baby and reassure. Some Units have flats on or near the unit that parents can stay in to make being with your baby easier.

Take Time Out

You may be thinking, ‘how on earth am I going to find time to do that?’ Yes this may seem impossible, but its important that you look after you! Caring for a baby in NICU can be exhausting. getting to the hospital, expressing, caring for your baby, caring for other children if you have them and doing everyday life (yes the washing will still be there) leaves little time for you. Its important however that you do make sure that you care for yourself. How?

Adequate rest is important, so making sure that you get as much rest sleep as you can. If expressing then have a routine that allows for an expression in the night but also for you to rest. Have the pump and kit ready so you can pump quickly and with as much ease as possible.

Take time to rest your mind also, take a book/magazine to the unit. Go for a walk and stretch your legs, or ask a friend to meet you at the unit and go have a coffee.

Make sure your well feed and watered. Its easy in NICU to lose track of time and before you know where you are you haven’t eaten or drunk for hours. Its important to keep well hydrated and try to take snacks that you can have regularly. Ask friends and family to help out with meal times, maybe preparing a few in advance you can freeze. Some units have kitchens and rooms where you can have a much needed cup of tea.

As a couple remember each other, communicate and strengthen each other during this difficult time. Talk about how you are both feeling and be each others comfort on the tough days. Look after yourselves and each other as well as your baby.

Take Each Day

When your baby is in NICU days can feel so long, you cant wait to go home and everyday can be spend in the pursuit of progress that may signal a step further in your journey. Days will sometimes be good and sometimes be rough. You may make great leaps one day to find you slip back another. This is your journey.

No two babies will progress the same, no two NICU journeys will be the same. You may see babies around you come and go and wonder when it will be your turn to take your beautiful baby home. So, take each day as it comes.

When the days are good enjoy your small successes. When days are rough remember that tomorrow is a new day. Babies in NICU often make progress slowly but then suddenly things start to fall into place. Try to go with the flow, don’t set unrealistic goals and be prepared for surprises. Things can change from day to day and what your baby was doing yesterday maybe different today. Accept the journey of NICU will be always changing and that you will sometimes feel lost along the way.

Record memories, take pictures and note milestones. When you see your baby everyday you may not see the progress, so recording milestones such as first feeds, first nappies, first skin to skin, and pictures will help you to see the progress your baby is making. There are apps such as ‘baby buddy’ from best beginnings that allow you to store the milestones, pictures, all your precious memories.

Yes your journey in NICU wont be easy, you may find you face many challenges along the way but with help and support you can navigate the bumpy road and reach your destination. HOME.

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