Premature Baby Archives - The Motherly Heap

Kangaroo Care for NICU Babies

Jordan N. — Thu, 18 Nov 2021 14:44:51 +0000

Babies born prematurely have extensive need for medical interventions. However, what struck me the most was preterm babies’ responses to skin-to-skin experiences with their mothers. This healing and therapeutic experience are called Kangaroo Care or Kangaroo Mother Care for NICU babies. Having gone through a NICU experience when my daughter was born has been a frightening journey for our family. Prematurity had not been on my radar when I became a mom, but life has many surprises. What I loved and looked forward to the most during our stay in the NICU was the Kangaroo Care time. I remember holding my preemie daughter for the very first time. It was scary because of how fragile she was; simultaneous, it was a beautiful moment. First, the nurses helped me get settled on the recliner. Then, they carefully handed her to me on my chest along with the attached wires on her. The happiness I felt when she snuggled around me was incomparable. I grasped the reality of her being born at that time. I know, she was born five days ago. But when we both had that moment together, to be this close with skin-to-skin, I felt blessed – I was her mom. She was mine. Kangaroo care became our daily mommy-me time. I couldn’t imagine not holding her for a day, and my heart ached when I couldn’t as I lay on my bed at home. My husband did kangaroo care with our daughter too. When we visited with our son, he was close by gently putting his hand on her arm or back. We forged our family bond during this difficult NICU time. Our kangaroo care time was sacred to me, to our family. How and When Kangaroo Care Became part of the NICU Developmental Care As soon as kangaroo care is initiated, it can help your premature baby tremendously. However, it also depends on when babies are stable enough to be held by mom/dad per every NICU protocol. Even the tiniest premature babies can benefit from these moments of skin-to-skin contact with their mothers. Two physician-researchers first developed the kangaroo mother program in the late 1970s in Columbia. Back then, premature babies died of respiratory issues, infections and had very high death rates. The moms acted as human incubators and also did exclusive breastfeeding during the study. Conventional incubators were challenging to obtain at that time. Moms who were holding their premature babies most of the day – their babies thrived and survived. A new clinical trial was conducted among 2944 mothers and 3211 infants (2.2 lbs-3.7 lbs birth weight) with two methods: immediate kangaroo care and conventional care (kangaroo care initiated only after premature infant stabilization). The trial found that those infants who received immediate kangaroo care had an improved survival rate of 25% than infants stabilized before kangaroo care. This study involved four different hospitals in Africa and one hospital in India. The Benefits of Kangaroo Care for Premature Babies Stabilize their vital signs (heart rate, respirations) Promote growth and development, such as gaining weight Connection with parents. Keep the baby warm. In deep sleep and more calm wake hours for brain development. Reasons Why Kangaroo Care Helps Mom Too Helps with healing Supports breastfeeding Lowers stress and anxiety Fosters bonding Promotes confidence as you care for your premature baby. What can you expect during Kangaroo Care time? Talking with the NICU healthcare providers when you can do kangaroo care with your premature baby is essential. Once everything is determined that your baby can receive kangaroo care, you will be informed by the NICU staff. The nurses will assist you in getting situated first before they’ll get your baby out of the isolette. Then, the NICU staff will provide a comfortable seat or recliner to you. Wires and equipment are connected to your baby. It will not get in the way, so don’t worry. Make sure you take a bathroom trip ahead of time. Eat your meal, and you can pump your milk before doing kangaroo care. Silent your phone or keep distractions out of the way. Your baby will be placed tummy down on your bare chest. Then a soft receiving blanket will cover your baby’s back to keep warm. You can hold your baby for an hour or how long you and the baby can tolerate it. The nurses will check your baby through the monitors, and if sometimes alarms are going off, the nurses will be nearby. Keep your drink close by and the call light close to your chair if you need help from the NICU staff. RELATED POST: Helping a Sibling of a NICU Baby Adjust Kangaroo Time with your Premature Baby You can stay relaxed while holding your baby. You can talk to your baby quietly or sing. Tell your baby the story of your family, siblings. Or you can stay quiet together as your baby sleeps on your chest or listens to your heartbeat closely. These skin-to-skin care helped premature babies thrive in so many ways. In addition, NICU babies are comforted and feel secure when close to their moms and even dads during kangaroo care. There may be times that you aren’t around in the NICU; the nurses and even therapists who work with your baby will hold them for the time being. Knowing these makes your mama heart grateful that someone besides you cares for your baby. But, likewise, you may feel a slight pang of jealousy when you walk into the NICU seeing your baby being held by the NICU staff. There’s nothing to be ashamed of. You’re the mom of your child. Nevertheless, these feelings are surfacing, maybe accompanying some guilt that you can’t be there 24/7 in the NICU. Your feelings may be unsettled right now, which is understandable. However, you can speak with the NICU staff about it if it bothers you the most. They’re there to help you and your baby. Dads can also do kangaroo care. This presents the best opportunity to also bond with baby starting at the hospital. What if you’re not ready to do Kangaroo Care Not all moms are ready to do kangaroo care immediately when able. Moms who have experienced traumatic birth or past difficult birth experiences may delay holding their babies. Some emotions are best-addressed head-on when it comes to these situations. For example, moms are having a hard time connecting with their newborns. Give yourself some time. Sitting beside your premature baby near the isolette may be enough right now. That’s okay. Coping with traumatic birth can sometimes pile on a mom’s mental space. Then seeing your premature baby and having a fear of the unknown can be too much to bear. Talk to your healthcare provider about it. Please don’t bottle it all up inside. Speak with your spouse or trusted friend. Another alternative to kangaroo care is the hand hug. You can place one hand on the baby’s head and the other hand on the baby’s tummy or chest. You may hold the baby’s arm or leg with a gentle touch. It’s natural to be fearful when caring for your premature baby, especially in your baby’s fragile state. RELATED POST: Tips for a Struggling NICU Mom: Surviving the NICU Life Giving Kangaroo Care for Premature Babies in the NICU Holding your baby skin-to-skin is part of caring for your baby. Both baby and mom will benefit from doing kangaroo care when the opportunity presents. The timing as to when this will happen will also depend on your premature baby’s condition. However, this isn’t a hindrance to kangaroo care time. There are ways in which you can still touch or hold your baby even if life-saving equipment such as a ventilator is attached. Being around your premature baby will help with your healing and also boost your confidence as a mom. Your premature baby knows mama is close by and will feel your loving touch through kangaroo care. I hope as you go through NICU time, you’ll be able to have the chance to do kangaroo care. Doing so will pave the way to a smooth transition of your premature baby into the world. Continue kangaroo care time even after babies are discharged from the NICU. You’ll feel closer and bond with your premature baby at home. You’ll remember that first time you held your baby close to your heart – as you do kangaroo care. Share your Kangaroo Care story in the comments. How was your experience? Share this post to any mom who has a baby in the NICU.

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NICU Baby is Ready for Discharge

Jordan N. — Mon, 20 Sep 2021 04:07:06 +0000

Is your NICU (Neonatal Intensive Care Unit) baby ready for discharge? Babies born too early (before 37 weeks) weighing 5 lbs or less are considered premature. Parents celebrate when it’s time to bring a NICU baby home. So what does it take to get ready for discharge with your NICU baby? What developmental milestones do your premature baby need to meet before leaving the hospital? When my premature daughter was admitted to the NICU, I received a checklist of conditions to meet before bringing her home. I want to share some of the discharge standards we’ve encountered and what you can expect in preparation to go home with your premature baby. That was almost six years ago when we took our 28-weeker preemie daughter home from the NICU. A joyous occasion for our family and also laced with concerns regarding taking her home. Today, she’s a five-year-old kindergartener with the same feistiness when she was born. Before this significant milestone happens, there’s plenty to check off from the NICU Discharge list. NICU parents take the lead in getting everything ready for the baby to go home. Thus, seeking education when it comes to caring for their newborn, adjusting from NICU to home life, and keeping a home that’s safe for a premature baby to transition. From feeding, monitoring essential body functions, and passing screening tests, these are the primary basis for your NICU baby’s discharge. What are the discharge criteria for a NICU baby? NICU babies are discharged when these criteria have been met. Parents can be confident that their baby is monitored during this time closely to determine physiological maturity. The healthcare providers will be by your side as your baby undergoes these tests and explain what will happen. It’s important to understand that every baby is not the same with their development, recovery, and even healing from illness. The healthcare team may set the date your baby is for discharge depending on how they adjust to the test, and corresponding results give the best indication that your baby is ready to come home. NICU baby is gaining steady weight with the nutrition the baby is receiving If your premature baby is feeding on their own with breastfeeding or bottle-feeding expressed milk/fortified breast milk/premature formula If your premature baby is gaining weight NICU baby can regulate their temperature in an open crib When your baby is moved to an open crib, their temperature can drop and fluctuate. One criterion for discharge is when your baby can continue to adjust their body temperature without the help of an isolette (incubator). Stable breathing and heart rate of your NICU baby Premature babies can have heart issues such as PDA (patent ductus arteriosus), an opening in their heart structures, and low blood pressure (hypotension). Their breathing may not stabilize; these premature babies may experience what they call the apnea of prematurity (when babies stop breathing). There are other two breathing problems that premature babies may experience: Bronchopulmonary dysplasia (BPD) the lung structures of a premature baby are damaged, destroying the lung tissues inside the air sacs and Respiratory distress syndrome (RDS) a baby’s lungs aren’t producing enough lung surfactant (the substance that keeps the air sacs in the lungs from collapsing. Other discharge criteria for a NICU baby ready to go home include: Able to pass the car seat test The NICU staff are testing your baby’s heart and lungs’ stability at this time. When premature babies aren’t tolerating the car seat challenge for 90-120 minutes, it will be repeated to reassess readiness. Able to pass a hearing test This hearing test is usually done the day or a day before the discharge date. Screening for Retinopathy of Prematurity performed by a pediatric ophthalmologist Your baby will be followed up closely for a year or more after discharge. What are classes or education do NICU parents need to attend before bringing a NICU baby home? It’s great to know how to care for your NICU baby at home. However, it can be intimidating to new parents when their newborns can have health issues added to being a newborn. This time, the purpose of parental education is to ensure the safety and proper care of the premature newborn and the adjustment of parents to the needs of their baby at home. Infant CPR (Cardiopulmonary Resuscitation) Ask your NICU nurse about the schedule and requirements to attend an Infant CPR class. Make sure you and your spouse attend the CPR class intended to educate parents on CPR steps in case of an emergency at home. Safe sleep Your neonatal doctor will recommend a safe sleep method and discuss SIDS (Sudden Infant Death Syndrome). Be certain to clarify any unclear information you received. It’s best to keep babies around your bedroom in their safe bassinet or attached bed at night. Know the precautions for preventing sleep accidents or injury. Make sure everyone is aware of what not to place in your baby’s crib or sleeping space. Proper feeding Suppose you decide to continue breastfeeding your NICU baby. In that case, there may be a need to fortify some of the feedings along with your breastmilk to help the NICU baby gain more weight. It’s important to discuss this with the neonatologist. Familiarize yourself with slow-paced feeding when introducing bottles to your NICU baby. The nurse can guide you through bottle-feeding your NICU baby with the slow-paced feeding technique. The nurse can also stay by your side while you bottle-feed your premature baby and check if everything is good. Car seat fitting and use Premature babies gain weight progressively. However, some infant car seats have weight limitations, and your baby may be weighing less than the required weight. Make sure you purchase the appropriate intended car seat according to your premature baby’s weight when the time comes. The NICU nurse will do a car seat test (tolerance test) in days before discharge. This test will also be the perfect time to ask for other precautions to safely strapping your premature baby in the car seat. Signs and Symptoms to watch out at home The nurse will also go over all the signs and symptoms your premature baby may experience at home and what to watch out for. Don’t hesitate to ask a question from the NICU doctor (neonatologist) about your baby’s health conditions. Oxygen use: Premature babies may require supplemental oxygen when they are discharged from the NICU. Your assigned nurse will instruct you on how to manage oxygen use with your baby at home. List down the precautions and what not to do when oxygen is used around the home. List down the settings, prepare the oxygen accessories and tank. You may also ask for a direct number to order the next oxygen tank to replenish your supply. Again, the social worker will let you know about resources on this, or they may have set it up for you already. Preparing to take your NICU baby home can bring up anxieties and worries typical of your experience. You may be doubting yourself if you’ll be able to care for your premature baby. Unfortunately, it’s common for parents to feel this way. Seek additional support when you think everything becomes overwhelming. The parental classes/ programs are set to help NICU parents prepare for an easy discharge and transition from NICU life. This post may contain some affiliate links. When you purchase from any of the links provided – I may earn a small commission at no cost to you. Please read the complete disclosure here. RELATED POST: Tips for a Struggling NICU Mom: Surviving the NICU Life What can you do to prepare and get ready for discharge with your NICU baby? 1. Prepare the home for your premature baby – safe environment/ purchase the essentials. You may want to change the air filters on all vents in the house. Procure a room HEPA air portable A humidifier A white sound machine Getting a bassinet or safe sleeping space for your baby Make sure no smoking around the baby and in the home (shower if you do before getting close to the baby) Purchase a first-aid baby kit for your premature infant, apnea monitor/oxygen monitor (if baby uses oxygen), and thermometer. Newborn Clothing and accessories Baby Caddy for Essentials or Baby Roller Organizer. With this in mind, I couldn’t get everything ready beforehand as I did with my son’s full-term birth. I could only shop for a few outfits and a homecoming outfit closer to the discharge date for my daughter. We used the items listed above to make our home as ready as possible for the baby. You may be wondering why the white sound machine. You already know there are plenty of beeps and alarms buzzing 24 hours a day in the NICU. My daughter has been used to these hospital sounds. So, I made sure that what she hears besides our voices is a soothing sound that can calm her. 2. Confirm you have a proper car seat fit for your baby – current safety standards. Make sure you purchase the appropriate car seat for your premature infant. In addition, you may need to buy a travel system that goes with the car seat for ease of baby transport in and out of the home and clinic visits. Always double-check the car seat expiration date. The car seat must be a rear-facing one and has no extra things around it. 3. Arranging a leave from work to support the critical transition of your baby at home If you happen to work outside the home, you may request several days off or officially apply for an FMLA (Family Medical Leave of Act) extension to care for your newborn. Back when I was still working as a nurse, and I got approved for extended leave to bond with my premature daughter for an additional one month at home. That was very much needed and helpful as our family transitioned with her being home with us. Contact your human resource department and your boss on what you can avail yourself of at this time of transition. This arrangement will also depend on the type of work you have, so check with upper management what benefits you can avail. 4. Setting up follow-up appointments for your NICU baby with their doctors and therapists. Planning your routine includes appointments with your baby’s pediatrician to check for growth, development, and overall health. Your premature baby may be at risk for any developmental delays. Your baby may also see therapists the same as when they were still in the NICU. The home routine will include visits to these early intervention sessions. 5. Prepare your other children for the homecoming of their premature sibling(s). Your other children will have a big transition once the baby is home. Let them know that they can bond with the baby, and they also need to be gentle around the baby. Talk openly and let them understand why they need reminders about washing hands regularly and keeping hands away from the baby’s face and hands (baby puts hands in their mouth all the time). It’s helpful to answer your children’s questions about the birth/NICU time of the baby and have age-appropriate answers. Not knowing all the answers are okay. Then, you and your children can look them up and learn together. There’s also a program in NICU about sibling’s experiences; check with your nurse. This resource prepares your children to visit the NICU. However, they can also talk about strategies in helping your children with their questions when their premature sibling is coming home. Have them make something special to welcome their baby sibling. Also, let them participate in the preparation, like putting the baby things in order in the bedroom/baby room. Read books about Premature Baby and Siblings: Our New Baby is in the NICU by Lindsey Lucky or Waiting for A Baby: A Sibling Visits the NICU by Jennifer Bracci RELATED POST: Helping a...

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