When Preemies Need to Stay in NICU

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by Jennifer Nelson

Most parents dream of the day they come home from the hospital with Baby in tow. They have waited nearly nine months, readied the nursery and home for the arrival. But sometimes things don’t go as planned. When Baby arrives prematurely or has a medical problem requiring treatment, dreams are often shattered when Mom and Dad find themselves going home — alone.

“It was the most devastating moment of my life to leave without my baby,” says Marla Hardee Milling, a director of public information in North Carolina. Milling’s baby was born at 38 weeks gestation and although he weighed in at more than 7 pounds, he was lethargic and diagnosed with dangerously low blood sugar, which kept him in the Neonatal Intensive Care Unit (NICU) on antibiotics for a week after birth.

The NICU is the world of infant intensive care, where babies receive treatment for a host of medical problems, generally related to prematurity. Various circumstances may require an infant’s stay. Babies with jaundice or low birth weight may need simple treatment and observation while other, more serious complications associated with premature birth — such as heart, lung and stomach disorders; infections; diseases; and spells of apnea and brachycardia (the stoppage of breathing) — may require a lengthy stay in the NICU.

Milling’s experience is typical of the emotional shock that hits parents who leave an infant in the hospital. It’s not what they’ve planned or expected, and it’s often difficult to go home without Baby. Below, experts — both medical professionals and parents who have been there — offer some inspiring ways to ease the various burdens parents face during an infant’s stay in the NICU.

Bonding
Julia Rosien of Ontario, Canada understands the issues of bonding with an infant in the NICU firsthand. A decade ago Rosien’s first child swallowed the meconium during delivery, and was hospitalized.

“The whole experience was devastating to our entire family,” says Rosien. “He was the first grandchild on both sides and no one was prepared for this.” On top of that Rosien says the medical profession at that time didn’t recognize the benefits of a mother’s close contact during the first few days of an infant’s life.

“I don’t feel the nurses at the time respected mothers the way they do now,” says Rosien. “I was constantly told not to touch Nelson or pick him up as he was too sick and needed time to heal. I was told that my touching would tire him out.”

Things have changed considerably over the years. Hospitals today realize the importance of parent interaction and utilize a concept called “cluster care,” in which all of the baby’s care is clustered at time intervals around vital signs or feedings, allowing a parent to bond while Baby still receives uninterrupted sleep time, necessary for healing and recovery.

At the University of California, San Francisco and University of California, Davis, husband and wife neonatal duo and Jan Wheeler-Sherman, RN, NNP, Ph.D. and Michael P. Sherman, MD, Chief, Division of Neonatology think that the quality of time is more important than the quantity of time spent.

“At both UCSF and UCD we facilitate nurturing behavior by encouraging parent/family interactions with the baby,” says Wheeler-Sherman. As the baby stabilizes, parents are able to hold their infant more and provide care such as feeding, diapering and rubbing on lotion. These “skin to skin care” activities promote bonding and help parents feel connected, which is important during their baby’s stay — a time when parents often feel helpless in caring for their infant.

Juggling Work
Lee Hauser, whose youngest son, Jonathan, was born seven weeks early at Tacoma General Hospital in 1994, learned the meaning of juggling. Jonathan, a victim of his mom’s elevated blood pressure and toxemia, didn’t have any physical problems — he was just too early. He spent three weeks in NICU, incurring standard incubator care and tube feeding.

“I was fortunate in having a very understanding employer,” says Hauser. Hauser arranged to come in early and stay late three days a week, so he could take the other two days off to spend at the hospital. This arrangement gave his wife, Marilyn, a break while allowing one of them to be present every day.

“The only demand my employer made on me was that I keep everyone closely informed of Jonathan’s progress,” Hauser says. “Each day I printed out a copy of ‘The Jon Report’ with events, statistics and even a Polaroid photo and posted it on my door.” The Hausers are thankful Lee’s employer was so understanding. Working out an acceptable arrangement during an infant’s NICU stay is a top priority, especially for dads. While Mom is usually still on maternity leave, Dad usually has to go back to work. Employers are often extremely accommodating during a child’s hospital stay. Some offer the employee a modified arrangement, like Hauser’s; others offer vacation or leave time. Employees also may be eligible for the FMLA (Family and Medical Leave Act), a federal law that entitles eligible employees up to 12 weeks unpaid leave of absence for the birth of a child or serious illness of a family member.

Family & Friends
When the baby in NICU is not the first born, there are sometimes one or more children at home in need of care — a complex situation for parents.

“Because we were able to alternate days, caring for our older son was not a problem,” says Hauser. “He was often left with grandparents or the spouse at home.”

Alternating visiting times between parents is one way of coping. Using relatives is also a great strategy. Most close friends and family want to know what they can do to help. This isn’t a time to be shy. Tell them that caring for older children will be a tremendous service. “The extended family provides a wonderful support,” says Wheeler-Sherman.

UCSF and UCD’s policy permits three visitors to see the baby in NICU when the parents are not in attendance. “This allows grandparents and other family members to visit and provide care when the parents cannot,” says Wheeler-Sherman. They also allow sibling visitation. These kinds of benefits can often be a huge support for easing the load of emotionally and physically exhausted parents.

Other Parents
Another source of support for parents is other families in the NICU. These families, finding themselves in a strange and unexpected situation, quickly form relationships with each other.

“Parents of infants who have been in the unit longer show the new parents ‘the ropes,'” says Wheeler-Sherman. It can be an enormous comfort to speak with other parents who have already gone through what you are experiencing. Parents can draw important information and strength from developing relationships with these families.

Leaving the hospital without Baby is never what parents plan or dream. But with improved bonding techniques, an understanding employer, the help of friends and family, along with the support of other NICU parents and staff, parents of preemies can make it through the NICU experience until Baby’s much anticipated and joyful homecoming.

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