As we observe Prematurity Awareness Month, one of our nurse case managers shares her tips for parents whose babies are admitted to a Neonatal Intensive Care Unit (NICU) or special care nursery as a result of their premature birth or medically complex condition.
Natalie has been a Registered Nurse for 22 years and 16 of those years were spent in the NICU. Her job was to care for babies that should have been safe and growing in their mother’s womb. Natalie recalls some preterm babies being so small that they could fit in the palm of your hand. Natalie said that it is so rewarding to help a baby born this small survive, and months later see them go home with their parents. She not only helped tiny premature and medically complex babies survive, but she also supported their families during their child’s NICU stay. It was her passion to help these families that brought her to ProgenyHealth as a NICU Case Manager. The NICU is a challenging, very fast paced environment making it difficult for many parents. Here are some things that Natalie learned through her many years in the NICU that she shares with families during what can be one of the most stressful times in their life:
Premature infants are very sensitive to noise, lights and sensory stimulation. A firm touch, with one hand on their head and the other cupping their lower body, is calming to them. If the infant was still in the uterus it would be surrounded by warmth and have boundaries. Your hands can be the boundaries they so crave. Stroking or rubbing is not a touch their underdeveloped brains and nerves can handle at this time.
Keep a journal. It can be helpful and rewarding to keep a record of all the things you and your baby are experiencing. Realize that milestones can be a bit different for a NICU baby. Milestones such as first bath, first day off oxygen and graduation from an incubator to an open crib will help to keep you feeling positive during the long journey until your baby can go home.
Don’t be afraid to touch your baby. Preemies need lots of sleep to conserve calories and grow. Care times are usually every three or four hours. Ask the nurse when care times are so you can be there to help care for them by taking their temperature, changing their diaper, and possibly holding your baby if he/she is medically stable. Many mothers have reported a feeling of bonding when they do something called Kangaroo care. This is when the infant is tucked in the mother’s gown or shirt, skin to skin. Even the tiniest baby can stay warm with their mother’s body heat. Even babies on ventilators can be held this way with the assistance of the nurse and respiratory therapist to get the baby situated and tubes secured. Kangaroo care is not just for mothers, fathers can also hold their baby this way.
Try to be present during rounds. Multidisciplinary rounds in the NICU typically occur in the morning hours between 8am and 11am. Most NICUs have bedside rounds to include the family in the discussion of the infant’s current medical status and the plan of care. Have your journal handy to jot down questions that you may have or information you would like explained further. Families are often overwhelmed by the NICU setting and medical jargon. When I talk to families on the phone I encourage them to ask me any questions that they may have about their baby’s diagnosis, medications or treatments so I can help them understand every part of their baby’s medical care.
Parents often have other children that need their time and attention or some parents may need to return to work. Many families struggle with the guilt they feel when they are not able to spend extended time visiting daily. If parents are unable to visit, I encourage them to call the NICU and ask to speak to their baby’s nurse to get an update. I discourage families from calling during the following times: care times, change of shift, and during rounds. The nurse will be busy at these times and may not be able to give you the time you need to ask questions.
A family’s experience while their newborn is in the NICU can be frightening and overwhelming, which is why ProgenyHealth’s case managers are available 24 hours/day – 7 days/week as a resource for parents. We know the importance of educating and empowering parents. Having managed more than 10,000 babies, ProgenyHealth is an expert in Neonatal Care Management.