Welcome back! We’re discussing what parents can expect during a NICU stay and are interviewing a couple of wonderful nurses our babies had during our stay. If you missed Part 1 of this interview, you can catch up really quickly here. All caught up? Great! Ok, let’s jump back in:
Laura is above. Mandy is below, with the newest addition to their family: Ainsley!
So how beneficial is kangaroo-care, really?
Mandy: Very beneficial! It can contribute to a decrease in hospital stay for your baby(ies). Just ask the nurse if it is a good day to hold your baby. There are some days where it is not the best day or time to hold the baby due to medical reasons, such as excessive apnea/bradycardia spells, recent work up for infection, general instability, blood transfusion, etc., so it is important to ask the nurse caring for your baby if it is appropriate to hold your baby that day.
What do parents do if the nurses say they can’t touch or hold their baby(ies)?
Laura helping me give Noah a bath for the first time – under the warming lights!
Laura: There will be times this request is made, occasionally after a stressful day for the babies, due to a medical procedure or situation. Your baby may need a period of rest. Ask when it will be advisable to hold the baby again. And if you feel the current situation doesn’t warrant a no-touch time, feel free to ask the charge nurse for another RN to check into the situation. This way, even though you may really want to hold your baby, you can feel confident that for the time being it is best that the baby rest undisturbed. While touch can be SO beneficial, there are times when it can physically evoke stress responses, visible through the baby’s increase in heart rate, respiratory rate, blood pressure, and oxygen saturation.
Mandy: I agree – usually there is a good reason if the nurse asks you to not hold your baby that day. Most times it is still ok to touch your baby. There are ways to touch a preemie without disturbing them (talking very quietly, minimal stroking or “petting”, etcc) and your nurse can teach you how to appropriately touch. It is important to remember that they might look tiny and cute, but they are very sick and this should be respected.
If a mom plans to breastfeed, what can she do if the baby is too early to breastfeed?
David giving a bottle – before we knew what we were doing!
Laura: A lactation consultant and/or your bedside nurse will work with you to facilitate education regarding pumping breast milk. Breast milk will always be a first choice. Initially it may be through a feeding tube that is inserted through the nose or mouth that leads to the stomach. This may look and sound scary but this is very common early on in the NICU. As the baby grows, a nipple can then be introduced, typically a bottle and then the breast, as the baby is ready.
Mandy: Breast milk is crucial for premature babies to receive. In fact, if the baby is born less than 1500 grams (or less than 30 weeks) and the mom is unable to provide breast milk, we use donated breast milk for the babies! Early feedings are very important for the babies, and breast milk helps them to tolerate these early feedings much better. There are antibodies in breast milk that cannot be found anywhere else. These antibodies help premature babies, who have a very lowered immune system (think: chemotherapy patient), to fight off infections. Infections are one of a premature baby’s most common complications.
But the babies are so tiny sometimes. What can a mom do if she can’t figure out breastfeeding?
One of the nurses feeding one of the babies while David and I fed two others – it took all of us!
Laura: Breastfeeding a tiny baby is going to be a journey! Together with your nurse and lactation, we will help as much as we can, based on the baby’s abilities at the time. As the baby grows and you become more comfortable, the process should become increasingly more successful. This may take months. Pump as you can to maintain your supply, and practice frequently with the babies. Lactation appointments after discharge (NICU baby or not) can be very helpful in supporting this oh so wonderful, but delicate process.
Mandy: We are here to help! Premature babies have the added challenge of not having the innate process of sucking, swallowing, and breathing in proper order yet, and must also learn how to complete this task. Breastfeeding can be harder for a premature baby initially, because it is more work to learn how to latch, and they have to produce more negative pressure with their suck to extract the milk, whereas the milk from a bottle comes out much more easily. However, it is much easier for a premature infant to breastfeed, once these tasks are learned, due to the fact that they are able to regulate the flow of milk coming out much easier while breastfeeding. I have found that it is a much slower start, but breastfed babies tend to learn how to eat faster than all bottle fed babies, due to the positive experience they get from it. Be available for feedings as often as possible, as the more time at the breast, the sooner it will be learned. Initially, the baby will only be eating once a day, then twice a day, etc. as they do better with it, so be sure to tell the nurse you are interested in breastfeeding for those sessions. Bottles will be used to supplement afterward, and for any feedings where the mother is unavailable. But again, any time at the breast is a learning experience, and the more, the better.
What happens when the parents aren’t there?
Laura: This is a hard thought, I’m sure. Having to walk away from your tiny babe will be one of the hardest things, every.single.time. But my, oh my, your baby has a skilled set of caregivers…the best baby sitters you will ever have! Your baby will continue to feed every 3-4 hours, receive needed therapies, treatments, and medications. Most hospitals also have volunteers whose job is to cuddle babies when they are in need of some TLC. You are also welcome to call at any time of day for an update on your baby!
Mandy: Also, assessments are completed every six hours on your baby (blood pressure, temperature, etc.). We change diapers every 3-6 hours, depending on how stable the baby is (the less stable the baby, the less frequently we will be touching them, in order to provide rest). If anything extremely out of the ordinary is going on with your baby, we will contact you.
As a NICU mom, I think one of the biggest unspoken questions I had was “do you enjoy taking care of my babies?
My NICU Visitor stickers for nearly a month!
Laura: YES! So much. As mentioned above, this is a common thread among NICU nurses. We love our babies, and even become protective over them and their well-being. We want to see them grow and thrive! NICU staff turnover is the lowest in the hospital; it’s said once you go NICU you never go back. This is not to say you will love all of your nurses, or feel everyone is super friendly, all the time. I hope that’s your experience, but know that even nurses I didn’t care for personally as coworkers— are still people I would still trust with my baby.
Mandy: Most all of the nurses in NICU have a true passion for what we do, and love our job (or we wouldn’t be there!). Take comfort in knowing that we treat your baby just as we would our own, and really invest our hearts and souls into the care of your baby…and you. Your bad days are our bad days (even if we have our professional mask on). Yes, we go home and cry – we feel your emotions, too. We laugh with you, cry with you, worry with you. We feel these things because we love what we do!
Lastly, what is one thing you wish you could broadcast to every parent going into the NICU?
Our First Family Picture! The babies were one week old!
Laura: Ok it’s more than one thing… (1) Pray hard. This is a time where you will quickly realize that any control you thought you had is totally gone. Trust your baby to the Lord. (2) I am always encouraged when I see families on the other side of the NICU, with toddlers running around. It warms my heart so much, and reminds me why I do what I do. The NICU experience can be intense, and life changing – for sure—but it is a season. It will not last forever. (3) Be cautious of what you research online and whose stories you listen to. Every experience is SO different, every baby comes with unique circumstances— and, chances are, the way things played out for someone else’s baby is not going to be your story. Work closely with your caregivers to receive the most accurate information about your baby’s specific circumstances. Family meetings are available for further discussion and education—you can get good one on one time with the provider this way.
Mandy: Take it ONE day at a time! It is going to be the wildest rollercoaster ride of your life, but taking each day as it comes helps to deal with it better. The nurses and doctors are here for you, and it’s important to remember that we are on your side. Please ask lots of questions (write them down as you think of them) if you don’t understand anything, instead of keeping it inside and letting it upset you. We are here to help, and want to help! Be there for your baby any way you can, but also try to get away to keep yourself emotionally centered.
Wow! I hope this interview is helpful to you (feel free to share with others who are in the NICU or may be entering a NICU stay!). This has brought back a flood of memories, some good and some bad. But they are parts of our babies’ lives – parts of our lives as we learned to trust God in new ways. Mandy and Laura were two of many wonderful nurses who made our month-long stay just that much easier.
Thank you so much, ladies, for serving countless families by taking the time to do this!
The babies at Easter – 18 months old!
Were/are you a NICU parent? How did a nurse affect your stay? I’d love to hear your NICU stories!!! Or do you have a question for Mandy and Laura?
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