Guide to Summer, Part 2: Swim Diapers

A follow-up to Volume 1: Best Baby Sunscreens

[Next edition: sun protective clothing (I know I promised this next last time, but I lied!)]

Heading to the pool or beach this summer? You'll probably need some swim diapers so your kid doesn't shut the pool down with a doodie (thank you, Caddyshack).

Swim diapers are special in that they don't contain "water crystals" (sodium polyacrylate) and therefore, they don't absorb liquid. If they did, they'd puff up immediately (like a normal diaper) once they hit the water and lose their "containment" power.

The sole purpose of swim diapers is to contain poop and prevent the spread of all the nastiness that comes with it. Contrary to what you might think, their job is not to contain pee*.

* While baby is in a swim diaper, you may get pee'd on. Sorry. Be sure to use a towel under your babe's butt while in her car seat - or better yet, just wait until right before you're ready to swim to change.

Pool Rules

You can do whatever you please at the beach, but some pools have special rules about kids in diapers. Again, the main concern is preventing the spread of illness and disease** from accidents. For example, pools on cruise ships completely prohibit children in diapers (of any kind). The pool at our swim school requires a double-up system: a reusable diaper OVER a disposable diaper, whereas our neighborhood pool allows either. You never know.

** A single poop accident can shut a pool down for hours or even days. I would guess that shutting down a pool would be one of the more embarrassing things that could happen in life. Just sayin.

** Always keep babies and children with diarrhea OUT of the pool completely. Far, far away.

That said, there are 2 kinds of swim diapers: disposable and reusable.

Disposable Diapers

The two big disposable swim diaper brands are Pampers Splashers and Huggies Little Swimmers. They are pretty much the same, so just pick whichever one is cheaper.

Disposable diapers start at 16 lbs and come in diaper sizes 3-6 (S, M, L for Huggies). For smaller babies? You're going to have to use reusable swim diapers (see below).

Pros: Easy to remove by tearing the sides, soiled diapers can be tossed in the garbage.

Cons: Somewhat expensive if you're a frequent swimmer (about $.50 - .$60 each), don't always contain poop very well, don't come in smaller sizes; can cause rashes and chafing, can look saggy.

If you don't swim a lot, disposable swim diapers are the most economical way to go. Always bring extras to change into in case of a #2

For added protection, I would highly recommend using a reusable "waterproof pant" over your disposable swim diaper. About $2-$3 each, they are cheap, durable and easy to clean and re-use. Gerber makes them as does Dappi. These are practically impossible to find in stores. Anywhere.

Reusable Swim Diapers

Reusable swim diapers seem to be preferred by most parents and pool operators -- especially by those who live warm climates, swim a lot, etc.

These diapers generally fit better* because they don't stretch out and sag.

* You want them to be fairly tight to contain stuff, so be sure not to order them too big because they won't do their job as well. That said, you don't want them so tight that they cause redness around the thighs.

Reusable swim diapers are more economical if you're a frequent swimmer, as two or three should get you through the summer, 3 or 4 if you swim a lot. Remember, you'll need to buy at least 2 to change your baby after a numeros dos. I always bring 2 extras with me just in case there are TWO poopages to deal with because INEVITABLY, the day you take your baby swimming, she'll have 3 back-to-back poops. Murphy's Law. Note to self: no prunes for breakfast on swim day.

Reusable swim diapers cost about $10-$15 each, the price of just one pack of disposables. Most baby swimsuit bottoms also have a reinforced swim diaper-like bottom, but I wouldn't rely on this alone. I prefer to use a snug-fitting reusable swim diaper under a lined swimsuit for added protection (and for easier changing).

The downside to reusables is that you'll have to wash them out after a #2 (this is par-for-the-course for cloth diapering moms; the rest of us may find it a little icky). Be sure to bring some disposable diaper sacks along to contain the mess.

Here are some favorites:

Bummis Swimmi Cloth Diapers ~ $14

A favorite among cloth diapering moms, this reusable swim diaper has Velcro (sorry, "hook and loop") closures on the sides for easy changing and a snug fit. They start at 9 pounds, so they can be used for the smallest of babes.

---

iPlay $5 - $12

The best-selling iPlay swim diaper is cute and inexpensive. Their plain white diaper has snaps on the side and their cutesie ones pull on like pants.

---

Sun Smarties Swim Diaper by One Step Ahead ~ $10

The Sun Smartie by One Step Ahead is also a crowd favorite. An adjustable diaper with Velcro fasteners, it provides a snug fit, easy changing and UPF 50 protection.

REMEMBER, folks, there are NO guarantees that a swim diaper - disposable or reusable - will contain your baby's poo in every scenario. Many frequent-swimming parents have a horror story (or two) to share. Honestly? Your job is to pray to god that your kid doesn't poop while swimming and if he does - get to it right away before it.... you know... just get to it as soon as you can. Once you see the red, scrunched-up poop-face, declare a Code Brown and evacuate the premises, stat!

*** For babies younger than 6 months old who have not started solids, I would be extra cautious. Not to get too graphic, but the loose-stool situation of a young baby is dicey in a pool. Try the beach instead ;-) There's more water out there. And stuff. You know?

---

Next Issue: Sunglasses and Sun Protective Clothing

Guide to Summer, Part 1: Sunscreens and Such

With so many conflicting recommendations out there about SUN and babies and sunscreen, it's hard to know what to do. Thus: The Official Lucie's List guide to Summer Fun. Holllerrr!

A huge thanks to Carol Collins, Ph.D., for compiling this research!

Protecting Little Skins

Since unprotected sun exposure is the most preventable risk factor for skin cancer, it's something to take very seriously. Heck, I wish someone had given me the memo about this when I was a young'un; maybe I would have reconsidered daily tanning (burning?) contests with my sister. As someone who grew up in the South, LIVING at the pool every day... I am now well on my way to becoming a leathery old hag.

It's not just skin, in fact, "Children under 10 are at a high risk for… eye damage from UV rays. 'And until about age 10, the lens of a child's eye is clear, allowing greater solar penetration and thus greater UVR-induced ocular changes,' explains Adelaide A. Hebert, MD, professor and vice chair of dermatology, University of Houston." [SkinCancer.org] Fab, I'm gonna be blind and all macular degenerate and sh*t too. Sweet!

So I think we can all agree that protecting our baby's [and toddler's] skin is important so they don't grow up looking like Magda in "There's Something about Mary".

Babies 0 - 6 Months old

"I've read I can't use sunscreen until 6 months and I've got a family beach vacation coming up, what should I do?"

It's true that the AAD (American Academy of Dermatology) recommends keeping babies < 6 months out of the sun and using minimal amounts of sunscreen, but don't cancel your beach vacation [oh no]... just bring along an umbrella or a sun tent and use hats, protective clothing and small amounts of sunscreen when you must.

Last summer on our beach trip, baby Alice spent many an afternoon chilling in our beach tent and wiggling around in the sand. I recommend the Schylling Infant UV Play Shade (below).

Baby Sunscreen 101

Sunscreen vs. Sunblock

Technically speaking, sunSCREENS use chemicals to absorb UV rays; SunBLOCKS uses minerals, such as titanium dioxide or zinc oxide to physically deflect rays from the skin. These terms are often used interchangeably by drugstores and such, so it's a little confusing.

Sunblocks are generally recommended for babies and children (over sunscreens) by pediatricians, advocacy groups, environmentalists, etc, for various reasons [read more below in "sunscreen controversies"].

The general sentiment is something like this: "A natural mineral (aka physical) sunblock is, by far, the safest option to get your SPF. The minerals zinc and titanium sit on the skin's surface and reflect sunrays out away from the body like tin foil. Chemical ingredients [found in sunscreens] are absorbed into the skin to deal with sunrays in a chemically reactive process in the skin cell itself, with potentially unintended and harmful consequences to the skin and body," says Kim Walls, M.S.

The downside to sunblocks is that they are generally more expensive because of the cost of the mineral ingredients.

Screens and blocks come in lotions, sprays and sticks. I prefer to use sticks on the face, sprays for toddlers [and other squirmers] and lotion for infants.

So, what's good?

The Best Sunblocks for Babies and Toddlers

* How did I decide? I weighed input from SkinCancer.org, EWR, Consumer Reports, SafeMama.com and Amazon.com

For whatever reason, most of these products can be a bit hard to find (i.e. they are definitely not found at your local Walgreens or Piggly Wiggly. Sorry.)

Lotions

1. Blue Lizard Baby Suncream SPF 30 ~ $19

* Active ingredients ~ 10% Zinc Oxide and 5% Titanium Dioxide [Non-Nano]

This VERY waterproof formula protects skin for up to 4 hours of heavy activity and uses only Zinc Oxide and Titanium Dioxide (as active ingredients), with no irritating chemical absorbers. This has been our go-to sunscreen since Lucie was born.

This is my personal favorite -- because if it's not majorly waterproof, what's the point? Trust me, you don't want to be re-applying this stuff more than is necessary.

2. Thinkbaby Sunscreen SPF 50+ ~ $17
~ Can also be found at Whole Foods

* Active ingredients Zinc Oxide 20% [Non-nano]

SPF 50+, water resistant, you can actually read and understand every ingredient on this list, yay!

3. Adorable Baby SPF 30+ Sunscreen ~ $25

* Active ingredients ~ Zinc Oxide [Non-Nano] - 24.7%

SafeMama.com Award Winner 2012 - Best Overall

This is an all-natural, high-performance sunscreen that blends clear and is waterproof for 1-2 hours, although [as a practical matter] some complain the bottle is extremely hard to squeeze and the formula is a bit too greasy.

4. Episencial Babytime! Sunny Sunscreen SPF 35 ~ $12

* Active ingredients ~ 10% Titanium Dioxide; 4%, Zinc Oxide [Non-nano]

This highly-rated sunblock is non-greasy and spreads well; water-resistant for up to 80 mins.

Sprrrrray

All Terrain KidSport Sunscreen Spray ~ $12

* Active ingredients ~ 19% Zinc Oxide [Non-nano]

One of the few decent sprays on the market, this one is easy to apply and spreads well; waterproof for 80 minutes; it's non-whitening and non-greasy; we love it!

Stick

Aveeno Baby Natural Protection MineralBlock Face Stick, SPF 50+ ~ $10

* Active ingredients ~ 8.1% Titanium Dioxide; Non-nano 6.8% Zinc Oxide

Water-proof, non-greasy, recommended by dermatologists; works well! Can be a little pasty.

FYI -- There are lots of good sunblocks out there, but many of them are only available through specialty websites [which I tried to avoid]. Other products that deserve honorable mention are: Neutrogena Pure & Free Baby Sunblock Lotion, Aveeno Baby Natural Protection, Honest Sunscreen by the Honest Company (ding'd for frequently being out of stock and waterproof for only 40 mins), Badger All Natural Baby Sunscreen SPF 30 (ding'd for being too thick and hard to spread), and California Baby (ding'd for being REALLLY expensive AND because they won't state whether they use nanoparticles or not).

Remember: sunscreen is just part of the equation that also includes protective clothing [coming next week], hats and eye protection, and staying out of sun when the rays are strongest, between 10am and 2pm.

Sunscreen Controversies (gasp!)

The 3 main controversies (of late) of sunscreens (particularly for children) look something like this:

1. The Nanoparticle debate

Over the past few years, there's been a lot of talk about the safety of "nanoparticles". You see, in the past, mineral sunblocks have consisted of large enough particles so that they always remained white and chalky on the skin. More recently, many products have been formulated to reduce the size of the mineral particles, called nanoparticles, making them less visible on the skin. No more ghosty white-face -- yay, right?

However, there are concerns that nanoparticles may possibly pass THROUGH the skin (especially in pre-term babies and very young babies) and may be photo-reactive, forming free radicals that can cause cell damage. Those espousing this position recommend using only mineral sun blocks that contain "micronized" rather than nanoparticles. [Technically, a nano particle is any particle less than 100 nanometers in diameter, but a particle must actually be less than 50 nanometers to enter skin cells; less than 70 nanometers to enter the lungs, etc] Got it? Ok good.

Essentially, the jury is still out on this, folks. The American Academy of Dermatology [AAD] says "Considerable research on the use of nanoparticles on healthy, undamaged skin has shown that the stratum corneum - the outermost layer of the skin - is an effective barrier to preventing the entry of nanoparticles into the deeper layers of the skin." [AAD 2012]; still, others suggest otherwise. Basically, nobody knows for sure. *All the products I recommend [above] are NON-nano (in case you were wondering what the heck that meant). No she-NANO-gans here, mama ;-)

2. Oxybenzone

The good news is that oxybenzone is one of few FDA-approved ingredients that provides effective broad-spectrum protection (see #3) from UV radiation. The bad news is that oxybenzone is an endocrine disruptor, which can affect the nervous system, has been linked to cancer in some laboratory studies, and creates free-radicals when exposed to the sun. Woohoo!

The jury is out on this one as well: According to the AAD, "Available peer-reviewed scientific literature and regulatory assessments from national and international bodies do not support a link between oxybenzone in sunscreen and hormonal alterations, or other significant health issues in humans," Dr. Siegel. [AAD 2012]

However, many pediatricians warn parents to avoid oxybenzone. So… yeah. *All of the products I recommend [above] are free of oxybenzone. Just in case.

3. Many sunscreens only protect from UVB rays, giving people a false sense of security about spending time in the sun. UVA radiation doesn't cause sunburning per se, but can increase the rate of melanoma and AGEING of the skin (ack!), so many people using sunscreens may be exposed to high UVA levels without realizing it. So... look for sunscreens with broad-spectrum (UVA/UVB) protection (for adults too)!

Natural sunscreen ingredients, including zinc oxide and titanium dioxide, protect from both UVA and UVB overexposure. Do I have your back or what? Pssshh.

So go getcha' some kiddie sunscreen and enjoy the summer!

Stay tuned for: swim diapers and sun protective clothing.

---

Newsflash: The new Chicco NextFit convertible car seat is finally out - and it's fabuloussss!

Pumping at Work

Pumping at work kinda sucks, ladies, not gonna lie... but it's sooooo worth it to be able to provide your babe with the good stuff when you can't do it in person.

The goal here is to make it suck as little as possible. [Thanks to everyone on my Facebook page who contributed to this article -- crowd-sourcing, baby!]

* This article assumes that you have the mechanisms in place to pump at work. For more on pumping-at-work rights and statistics, go here.

Equipment

Unfortunately, pumping at work is a bit equipment-intensive. Here is what veteran pumpers recommend for optimal efficiency:

Pumps

For heavy-duty pumpers, a high-quality pump will make a world of difference. It's imperative that your pump have enough suction (to not diminish your supply) and speed (so you don't get fired) -- just kidding (sort of). Remember, your health insurance company should cover SOME form of pumpage, but many will only cover a hand pump (i.e. a manual pump). A hand pump ain't gonna cut it, y'all, so...

Outside of a hospital-grade pump, the two pumps that consistently get 2 thumbs up from working moms are the Hygeia EnJoye and "Old Faithful", the Medela Pump in Style Advanced (a.k.a "PISA"). Armed with one of these pumps, you'll be well equipped for battle.

Here and There

While not feasible for everyone, multiple women suggested buying two pumps: one for the home and one for the office -- especially if you're in it for the long-haul. "This is one less thing you'll have to carry back and forth each day, especially if you're riding the subway or bus. I hate being loaded down like a pack-mule," said one mom.

If you're not pumping a lot at home, another recommendation is to keep your electric pump at the office and a manual one at home. Also, multiple moms suggested to keep a manual pump at work, too, in case your electric pump fails you.

A great manual pump is the Medela Harmony or the Philips Avent Manual Pump. [Now I'm having flashbacks on hiding in the supply closet at work with my manual pump because there were no outlets. HELLLLL! I think I got carpel tunnel (could I have gotten Worker's Comp for that??) I digress...]

Breast Shield Flanges

There are few different strategies for cleaning flanges. One mom suggested, "if you don't want to bother washing your flanges at work each time, buy as many sets as the number of times you pump each day, then simply throw them all in the dishwasher when you get home each night." Another common suggestion is to refrigerate (and re-use) your flanges in between pumping sessions instead of washing them at work. Still others recommend bringing some dish soap and washing them between each use. Your call.

Remember: frequent pumping can make your nipples REALLY sore. Did you know there are five different sizes? It's imperative to use the the correct size flanges to fit you. Flanges that are too big won't allow it to seal properly around your breast; flanges that are too small will cause excessive squeezing and irritation. I also recommend you smear Lansinoh (or some other lanolin-based cream) around the rim of the flange in order to decrease friction. It's amazing what a difference a little lubrication can make!

Pumpin Pals

Many moms rave about Pumpin Pals (below), which are adapters that allow you to sit back in a reclining position while pumping and are supposed to be much more comfortable than regular flanges.

Hands-free Pumping Bra

Most agreed that a hands-free pumping bra is imperative. The crowd-favorite is the Simple Wishes handsfree bra. One mom added, "I actually have two: one at home and one always in my work pump bag so I never risk forgetting it."

Nursing Cover

Many suggested wearing a nursing cover while pumping, especially if you don't have access to your own private space with a locking door. One mom said, "I can't tell you how many people walk in while I'm pumping. Thank god for my nursing cover!"

Keeping it Cold

For getting your milk home every night -- and especially if you don't have a fridge at work, get a small cooler like the Ameda Cool 'N Carry Milk Tote. Many pumps also come with an insulated bag with ice packs. Storing your milk in the cooler inside a shared refrigerator will also help with privacy concerns ("that's not coffee creamer!").

A Sharpie

For labeling everything.

A Water Jug

For you. Because you can NEVER drink enough water while nursing.

In the Car

For those who have to pump on go, the car adapter is key, "I'm in sales and I pump in my office, which is my car. Thank god for the car adapter!"

Logistics

A real let-down

Getting your milk to let-down is one of the biggest challenges for pumping moms at work -- the cold, sterile office environment isn't exactly reminiscent of your soft, snuggly baby. The Hygeia EnJoye pump has a feature that allows you to record a clip of your baby crying [or cooing] in order to help out in this arena.

Other suggestions include bringing a photo of your baby to look at and/or a piece of clothing that smells like your baby. One mom added, "I used to smell my baby's lovey while I pumped. My daughter had one at home too and at the end of the day we would trade and I would get hers and she would get mine; it helped me feel closer to her".

Remember: you need to trick your body into thinking you have a hungry babe in arms; not always easily done.

Pumping Schedule

If possible, try to mimic your feeding schedule at home. If you typically feed baby at 11am and 2pm, for example, this is when you want to pump. If not, get as close to your regular times as possible. Try to schedule meetings outside of pumping times. The more you stick to your normal routine, the better.

No Pressure

Veteran pumpers agree that one of the hardest things is to not fret about how much milk they're producing, "try to just... zone out and relax as much as possible. Don't focus on how much milk you are getting; once I see the milk flowing I don't look again until my time is up. The more I am watching, the less I produce, it seems". Another added, "set a timer so you aren't worried about how long you've been gone and when you need to get back. Look at pictures or videos of your baby, listen to music, whatever you need to do to relax and not think about pumping." "Whatever you do, don't work," added another. Hey, I like that advice!

Many moms experienced a decrease in supply after going back to work; try not to stress about it. "Make pumping a priority or else your supply will dry up and you'll feel defeated," added one mom. To boost your supply, try a galactogogue, like MotherLove More Milk supplements, tea (like Mother's Milk) or even cookies. One mom added, "I find that compression and massage towards the end of the pump session seems to help me maximize my supply."

"Do the best you can", said one mom, "even if you're only able to pump 10 minutes at a time, it's better than skipping a session altogether and it will really help maintain your supply."

EAT

Sounds obvious, but with all the time being sucked up from pumping [god, I'm funny], it's really hard to find time to eat and drink. Remember: nursing moms are eating for two (sort of), so skimping on food and water will negatively affect your supply. Make a habit out of bringing your snack and water jug with you top pump -- you'll need something to do anyway.

Privacy

Look, you can't NOT feel ridiculous while hooked up to a machine like a diary cow, but try to maintain a sense of humor about the whole thing. The beloved Milk It Kit includes cute door hanger privacy signs and "Be back in 20" signs.

"Don't try to hide it or feel ashamed of pumping at work. I find that if I joke about it, it helps disarm my co-workers," said one mom. Another suggested, "Don't be all hostile about your right to pump, this will just make everyone mad. People will resent you because they think you're getting all this extra 'break time', so try to explain how important it is to you and just be nice." Another said, "Men will automatically be uncomfortable about the thought of you pumping near them -- take full advantage of this." Ha!

Keep the Faith

"Set small goals for yourself, like... I just need to make it one more month or two more months, rather than thinking about how far away one year seems (depending on how long you want to aim for); with each milestone you reach, you will feel that much more accomplished and relaxed.

In closing, a message from all my Facebook pumping moms to you:

"Feel proud that you are working and providing for your family; try to enjoy the time away from home when you can use your adult brain."

It's hard work but you can do it!! Good luck!!!

Pumping Articles and Resources:
- The Milk Memos: How Real Moms Learned to Mix Business with Babies-and How You Can, Too
- Pumping at Work: a Legal Right?
- Why I breastfeed, even if it totally sucks
- workandpump.com
- Pumping from Kelly Mom

The Hardest Year

Written 2-18-13

I'm sitting at the ski resort bar writing on the back of a napkin. Lucie is here taking her first ski lesson, so I'm staying close in case it doesn't go well. Meanwhile, I'm praying that baby Alice is okay back at our rental cabin with a local-babysitter-I've-never-met-before.

I should be skiing right now but I'm not*. I mean, that was the whole point of coming up here, right?

You see, I was up the ENTIRE night last night. I haven't pulled an all-nighter since... I dunno, college?

The four of us are packed into one room in a cabin full of friends. Blame the insomnia on a mixture of travel anxiety, too much caffeine, altitude (eh?) and OH YEAH -- because one of the kids was up just about every hour last night *crying*, waking up the other one. It put me into my neurotic why-even-bother-to-sleep mode. I was just praying for the sun to rise -- that way, I wouldn't have to pretend to try to sleep anymore.

I feel so defeated right now. Like... what exactly were we thinking trying to take a ski trip with a bunch of friends with a baby and a 3 year old? I'm a serial try-to-do-too-much'er. It's an illness. 

------------

About a month after Alice (babe #2) was born, I met a friend at a park for a picnic. She could tell right away I was struggling. She said, "Meg, give yourself a break. Last year (i.e. the year her 2nd was born) was the hardest year of my life".

As though someone had confirmed my worst fear, those words caused a visceral reaction. As my eyes welled with tears, I said, "but it can't be this hard, can it? I think I'm doing something wrong." 

Seven months later, I will tell you: oh yes, it CAN be this hard**. 

Don't get me wrong, I know that most people on the planet Earth have more than one child; this isn't some strange anomaly or uncharted territory for mankind. But I REALLY didn't know how challenging it would be to add babe number two to our lives. 

There's a point to this [I promise]: having young kids is hard, y'all. People don't talk about this stuff, but my girls bring me to my knees... more often than I care to admit. Sometimes I feel like I'm drowning and I don't even know when I'll be able to come up for air. Like everything is really blurry and I'm just wading through it.

My friends-who-also-had-baby-number-2-around-the-same-time and I keep reminding each other "it will get better"-- in about a year, I'm guessing. Between now and then, it's just gonna be kinda shitty***. And that's okay.

Doing the things you normally do with 1 kid was totally doable; throw a second kid into the mix and you JUST have to scale it all back. Do less. Lower your expectations. Don't make big plans. And for the love of God, get 2 rooms when you travel.

A childless friend called last week and said "hey, let's hit Tahoe this weekend! Just bring the kids." My Response, "fuckkkk no."

Maybe in a year. Or two.

---------

* I realize this is a 1st world problem (poor me, I can't ski today - wah wah)

** I have a nasty little "anxiety problem" and apparently I lack some "coping skills" (whateverrrr), so take what I say with a grain of salt. I'm sure all of you a-holes who have a properly-functioning amygdala will be just fine ;-)

*** I'm very grateful to have Baby Alice in my life. I have lots of friends with secondary infertility, so please don't think I take it for granted.

7 Important Tips for NICU Parents

By: Guest Blogger Elana H.

At my 35-week ultrasound, they discovered my baby had IUGR, intra-uterine growth restriction. She was 4lbs, which put her in the 4^th percentile for weight. Essentially, my placenta was like a clogged pipe and she wasn’t getting the nutrients she needed. They began twice-a-week fetal monitoring and told me I’d likely be induced early, because in these cases, it’s better for babies to grow on the outside rather than struggle on the inside. 

At my 36-week appointment, they took my blood pressure: no good. It had been high all along and now it was over 140. I had to go to the ER immediately to have some more testing. Gulp.  I was nervous but my OB reminded me that even if they had to induce me that day, the baby was over 36 weeks old and should be fine.

At the ER, my blood pressure was over 160 and the same blood tests were repeated and came back worse, so they decided to do an emergency C-section that afternoon. By that point, I just wanted the baby out!  If they had sent me home, I would have been a wreck. A few hours later, my otherwise-healthy little daughter was born at 4 lbs 3 oz, which in metric/hospital terms translates to 1899 grams. At our hospital, all babies born under 2000 grams (2 kg) go straight to the NICU, so… there we were.

The NICU [pronounced NICK-you]: Neonatal Intensive Care Unit

Because I’d just had a C-section, I wasn’t allowed to follow my baby to the NICU immediately. In fact, I wasn’t allowed to leave recovery until I could feel my legs, and at that point, they were nowhere to be found. 

I absolutely hated the feeling of the epidural; I didn’t want one at all during the delivery. The fact that I couldn’t feel my legs was scary enough, but the idea of my tiny, helpless daughter being taken alone to the NICU made me want to cry. What if she were scared? What if she wanted to hear the voices she’d heard for 36 weeks? I made a decision which turned out to be a good one: I sent my husband with the baby. This might not be the choice for everyone, but my only concern at that point was what would happen to our baby.

I knew I’d be fine, and what could my husband really do for me at that point anyway? My husband followed the nurse to the NICU, with their permission, and was able to stay with the baby.

It was almost laughable to me that all our Lamaze training had completely gone out the window, as we were planning to have a drug-free and pain-free (I know, ha!) birth. Instead, here I was with an IV in my hand, a catheter in my you-know-where, and completely unable to feel the lower half of my body.  

Non-critical NICU admissions seem to follow the same pattern: The babies are cleaned, assessed and put on little warming trays. Then, in most cases, they are put into the ever-present incubators (below). 

After about two hours, I could move my legs (yay!), and I was technically allowed to see my baby. Unfortunately in my case, I had what they called “positional nausea” as a reaction to the C-section epidural. What this means in plain English is, “throw up when you sit up.” They wheeled me to the NICU on a stretcher to get a quick look at the baby, I sat up and…  yeah, you get the idea. I came back much later that night when my anti-nausea meds kicked in.

My daughter was in the NICU for 10 days, four of which I was in the hospital with her. Her 10-day stay also included a bout with newborn jaundice, which is extremely common and even more so for small babies.

Thankfully our NICU story has a very happy ending, as she’s home with us now and weighs almost 8 lbs at 6 weeks. However, the NICU road is always bumpy, whether your baby is in critical condition or just needs to grow a bit more. 

I compiled this list of what I hope are helpful hints, in case any of you find yourselves in the same boat.

NICU Survival Tips

1. Be a presence. Make yourself known. Introduce yourself to the doctors and nurses and even to the orderlies and desk attendants. Make sure they know which baby is yours. It’s human nature to feel more accountable if one is feeling accountable to a tangible being (i.e., you). You want the medical staff to know that “Baby Girl H.” has actual parents who will want to keep up on her progress. The best decision we made was to have one of us there for the doctors’ rounds each morning so we could meet with the actual doctors and discuss our daughter’s progress. But, that said… 


2. Do not move into the NICU.  Your baby is likely in an incubator, which presumably reminds him/her of exactly one place: the womb. The temperature in an incubator mimics that of the womb, and smaller babies are even given eye coverings. YOUR BABY WILL NOT KNOW IF YOU SLEEP AT HOME OR KEEP BEDSIDE VIGIL. So please, go sleep in your own bed, whether during the day or at night. If you’re still in the hospital, return to your room. Trade off shifts with your spouse if you wish, or go there together a few times a day. But make sure to ground yourself in your own house or room.
   
   Look at it this way, you are getting something few postpartum mothers get: time in your own home, your own shower, your own bed, and with someone else caring for your baby. Spending at least a few hours a day on your own turf will make you feel like yourself again. After all, you’re not the patient anymore, your baby is. He needs you to be strong and clear-headed, whether to relate to him or to advocate for his care. If you let yourself get run down during this week (especially after a C-section), you’ll be in no position to care for him when you need to.
   
   Some mothers resist this because they don’t want their babies to bond with the nurses instead of them. Admittedly, I was one of these mothers at first. Trust me, it won’t happen. First of all, your voice and smell are intimately familiar to your baby; he’ll know who you are. Second, there are many people who get ‘night nurses’ for their babies at home; this is no different. Third, and most important, if you’re sleeping at the hospital, how are you bonding with your baby at that moment? You’re not. You’ll be there when you’re awake, and if your baby needs care in the meantime, he’ll have a world-class staff available.


3. Eat.  Sounds simple, right? But between shuttling back and forth to the hospital and sleeping, or not liking the hospital food, eating may fall by the wayside. Bring your own food to the NICU if you need to. Ours had lounges and a “no food in the rooms” policy… but let’s just say the nurses always looked the other way when I took out my bagged breakfasts and lunches in the baby’s room. If you’re nursing or pumping, you’ll need the calories even more.


4. Accept offers of help.  If friends offer to make dinner, say yes. Don’t have friends offering? Perhaps your church or synagogue has a group that does this. Retract the orders for your mom to wait to visit until the baby comes home. If you have other children, send them to a friend or relative’s house if you need to. Accept rides to the hospital if you can’t yet drive. I was surprised that many of my friends didn’t even know my baby wasn’t home with me; if none of your friends has offered to help, perhaps they just don’t know what to offer. So tell them.


5. Familiarize yourself with your baby’s care and don’t be afraid to ask questions.  If you have no medical background at all, the array of monitors and medical terms can be confusing. If the nurse tells you that “his pulse ox is 96” and this sounds like a foreign language, stop the nurse and ask what this means. What’s pulse ox? What’s normal? Don’t be afraid to advocate for your child. “I know you’re telling me that my baby needs formula tonight, but I always thought breast milk was best. Is there any way we can try nursing too? Or is this just temporary?” Along with this is…


6. Don’t be afraid of the baby.  Many new mothers are afraid they’ll ‘break’ their little ones; this anxiety increases tenfold when your little one is tiny and/or hooked up to monitors. Be assured that the nurses would not let you handle your baby or leave the room if they didn’t think she could handle it. In fact, most NICUs encourage “kangaroo care”, which consists of putting your undressed baby on your bare chest for skin time. This is of great benefit to the baby, and again, you would not be given the opportunity to do this if the baby were not well enough.

  

7. On a touchier subject, I know some NICU parents hesitate to talk to, sing to, or otherwise bond with their baby because they’re worried things won’t work out. But even if your baby is in critical condition, the talking and singing will help him.  It will help you as well; you’ll feel more connected to your little one and you’ll both be in a better position to fight and struggle as you need to. Look at it this way:  if you distance yourself from the baby at this time, you may end up regretting it no matter what happens. 


8. Take advantage of the education offered.  At our NICU, the nurses were extremely focused on parent education. We learned how to feed, burp, change and bathe our little one. We took her temperature each hour and (sorry) learned what normal stools looked like. Everything. I’m very grateful for this; sometimes I even wish I’d taken some phone videos! The nurses are there to show you what to do; don’t be afraid to ask them.

Back at Home

When my baby came finally home, I expected my NICU experience to be a thing of the past. Strangely, though, several elements followed me home. I’ve given these trendy faux-medical names:

1. Post-NICU guilt.  Here’s how this one will turn up in your head: you’ll find yourself thinking things like, “Since I didn’t hold my baby much during the first ten days of her life, I must now pick her up at every whimper.” Resist this. This might be enjoyable at first, but trust me: it becomes less and less enjoyable. Your baby is now home with you; anytime he needs something, you’ll be there. But if he needs to learn to sleep on his own or suck on a pacifier, now is the time for that too.  Your baby is now able to have a normal home-life, and that should come with sleeping in a crib/bassinet/whatever you’ve chosen.



Going Home!

2. Post-NICU monitor anxiety. Some babies come home on monitors; if this is your case, skip to the next tip or apply this to the non-monitored functions. But if your baby does not come home on monitors, this one presents as follows: “My baby has been hooked up to monitors since he was born; now, how will I know if anything is wrong?” You’ll know just as mothers throughout the ages have known: crying, a fever, or something just not seeming right. Here’s a fun fact: did you know we all have to catch our breath after we sneeze? Do you want something beeping and flashing red every time your baby sneezes with no nurses around to explain things? Right.


3. Post-NICU medical worry.  Here’s this one: “Her temp went down .1 degree one night in the NICU and they gave her an extra blanket. Maybe she’s not ok enough to sleep in this new onesie my sister sent.” Repeat after me: teams of doctors have unequivocally determined that your baby is ok enough to be home. If the hospital has given you discharge instructions, of course you will follow those; but in general, babies will not be home if they can’t maintain their body temperature in a different onesie, for example.


4. Lack of faith in your “regular” pediatrician. “In the NICU, they told me to give 30 ml of formula every 3 hours. She’s hungry every 2 hours now and my pediatrician said it’s fine. But I mean, he wasn’t there, so maybe he doesn’t know..?” Part of medical care, and especially critical care, is physician follow-up. Your pediatrician likely visited your baby in the NICU, and if not, he’s spoken to the doctors there. The NICU medical staff was giving you instructions for your baby at that moment. Now your baby’s doctor is his normal pediatrician, and his advice now is just as appropriate as theirs was then.

In short – your baby has started his life as a critical care patient. If he’s still there, he’s in very good hands and is receiving the best care possible. If he’s home, he’s now well enough to follow the track of non-critical babies. Now, he can grow, eat and sleep in your house. Either way, keep yourself healthy and clear-headed enough to take care of him, and you’ll both be better off.

Happy at Home