Thursday, May 17, 2012

9-5 NICU Mom

Here she is!

I'm settling into my new gig of being Poppy's NICU Mom. Every morning I drive through rush hour traffic into the city, scramble to find a spot in the parking garage, rush to Poppy's bedside, then start the routine of feed, pump, and eat that cycles in three hour increments throughout the day. It's quite enjoyable, actually (minus the commute), but I should really bring my phone charger; my poor phone's battery can't handle being my sole source of entertainment all day!

I've got to say, I feel like an old hand at this. Senpai feels it, too. We've got a "been there, done that" nonchalant attitude about Poppy being in the NICU (we earned our stripes with Rosemary after all). I was not thrilled with the spinal tap, but otherwise, Poppy's development as a preemie is right on track. Since I've got experience to share, I figured I'd put together some pointers for new NICU parents.


When it comes to premature babies, the goal of the NICU is as follows: intervene as medically required, and then slowly remove those interventions until baby can thrive on his own. The three things that all babies must be able to do before they will be sent home are:

1. Control their own temperature.
A baby should do well to be lightly dressed in a 70ยบ room. Preemie babies initially need help holding their temperatures, especially in their hands and feet. They will be put on warming beds or into isolettes until they've got it down.

2. "Nipple" all feedings.
Nipple in this case is used as a verb. Whether the baby takes her food from a breast or a bottle, she must consume enough calories around the clock to meet the final goal.

Eating and controlling temperature use calories. The baby must have enough food in his tummy to do both those things, and still have plenty to spare to grow big and strong.

Here are some tips that will help you feel more involved in your baby's stay.

1. Know Your Nurse
So what do you do while in the NICU... just stare at your baby? Well, yes, depending on baby's level of prematurity. Even if baby is in an isolette, you may be able to at least change her diaper. Just ask the nurse. The worst she can say is no, but she might even say yes. And guess what? Every nurse is different. Just because yesterday's nurse said no, doesn't mean today's nurse will, too. Doctors make the orders, and it's up to the nurses to follow those directions, but not everything (such as being able to hold your baby) is set in stone.

2. Know What You Want and Tell Everyone
Let's say that it is very important to you that baby learns to breastfeed. If you're a regular reader on this blog, you know that to be true for me. What am I doing about it? I am telling everyone. Every nurse, doctor, and lactation consultant in this NICU knows about my struggles with breastfeeding Rosemary, and my desire to get it right this time with Poppy. I may sound like a broken record to myself, when I think of all the times I've had the same conversation with a different person (Poppy hasn't had the same nurse twice yet!), but I would much rather that than the alternative of nobody knowing and my wishes not being granted.

3. Talk to the Doctors
This point seems obvious, but I'll be honest with you, I did not do this so much with Rosemary. I would hear the doctor's orders from the nurses and then leave it at that. I assumed that the doctors' wills were set in stone, and nothing I could say would change that. That is not at all the case. In this NICU stay, I have already convinced the doctors to not add a mandatory bottle after a breastfeeding session, have increased the number of breastfeeding sessions, and turned down a spinal tap. They ended up talking my husband and I into the spinal tap anyway, but at first I said no. Do you see the pull you can have in your baby's growth and development? All of this is possible because I am there for the morning rounds (see below), I put a sticky note with my contact information on Poppy's bed, and I give every opportunity for these dialogues to happen. You should, too.

4. Attend Morning Rounds
This is when the doctor goes over the notes from each baby and determines their plan of action for the day, such as administering which medicines and removing what aid. If the parents are present, the doctor gives them the opportunity to ask questions and ADD THEIR INPUT. The second part of that sentence is very important. You may not be a medical professional, but you are absolutely just as much a member of your baby's care team as everyone on staff. You have a say in how your baby is handled, so say it.

There you go. I know being a NICU Parent is not a job anyone would willingly apply for, but you don't have to feel helpless or out of control. He's still your baby, and you're still Mom (or Dad). Much love and strength to you.



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