Updated October 2018
By: Guest Blogger & Subscriber Elana H.
At my 35-week ultrasound, they discovered my baby had IUGR, intra-uterine growth restriction. She was 4 lbs, which put her in the 4th 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.
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 spinal anesthesia; 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 anesthesia. 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 ten 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 your 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.
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.
7. 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.
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 three hours. She’s hungry every two 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.