August 11, 2014

FIAO 6.2 - Navigating the N.I.C.U. - 7 Tips To Help You Get Through Baby's Extended Hospital Stay

Oh the NICU. What a place. For most people it's mysterious and scary but really it's where miracles happen and it's been our home away from home for the last two weeks. I knew a little about it before, from my boss's son's stay a few years ago but knowing what I know now has completely changed my perspective on them. A lot of people have had bad experiences or don't agree with the way things are done but every hospital is different and our experience has been so positive and I think the girls are growing so well because of it.

That said, I am happy to report that this morning we received word that the girls would be discharged Wednesday, August 15th at exactly two weeks old!!! This is much better than the Sept. 3rd original estimate so we are over the moon.  Relief, happiness, fear, anticipation, so many feelings are passing over us right now. It's quite incredible.

We've definitely learned a few tricks to help make a NICU stay more bearable. If you find yourself facing NICU time try some of these and I hope they can help make an easier stay for everyone!

1. Bring items from home to make your babies (and you!) more comfortable. 

We brought pictures of our cats and put one in each girls' bed, all the preemie clothes we received as gifts, their Aden and Anais swaddling blankets and Dad's good luck charm, a tiny Buddha figurine that we taped to the window next to Jules' bed. I highly suggest a good luck charm, no matter how ridiculous it seems. Jules got off oxygen the night we put him up. Coincidence or not I don't know but I do know that Dad bought the Buddha in Bermuda while on a cruise and then he helped us clean up at the roulette table that night. One of the nurses added some index cards with inspirational quotes next to him. It always lightens up the mood in the room and he's a great conversation starter.

2. Learn the equipment. 

Those are some spiffy first digs!
Know what it does, what to watch out for, what the alarms mean and when to worry. Know your wires, what goes where and which ones to really be careful of. You don't want to unplug the oxygen, NG/Feeding tubes and IVs but the monitors are temperamental and can alarm over slight changes like burping, bouncing and crying. They also fall off. Remember to look at the heart rate before freaking out when your baby's respiration flatlines. It probably means a patch came off, not that baby is not breathing. Don't panic when your baby's monitor flashes tachycardia while you are burping baby unless a nurse starts to panic too. After a few days you'll know what's a big deal and what's not so you're not spending the day as a bundle of nerves.

3. Don't be afraid to ask questions and be involved in your child's care.

Some nurses will be very encouraging and helpful, stopping to explain things and keep you informed. Others will be very by the book or matter of fact and just kind of do their work around you. I found that older nurses want to help but sometimes you need to ask for it. We were really struggling with getting Jules to take her bottle and two nurses just kind watched us suck at it (no pun intended) and then took over to make her finish. We finally asked one of them to show us how she does it and now we're master feeders just like her. She warmed up after that too, helping us understand why her methods work and advising me on pumping. Take advantage of their expertise while you have access to it and be sure to thank the ones who help make your time more comfortable and less stressful. 

4. Embrace the little blessings of the NICU. 

It's not a picnic and I would never say we're lucky that our girls didn't come home with us but there are tiny benefits to NICU time. For instance, the established schedule, the time you get to rest and recover after surgery/childbirth, and the ability to learn the basics like feeding, diaper changing and burping from the pros. It's like having a safety net while you're figuring out how your new baby works, which is important as preemies or sick babies can be extremely daunting to care for. I will never forget how fragile Viv felt in my hands that first afternoon or how terrifying it was when they simply would not eat for us. It was so helpful to have a nurse show me exactly how to provide all aspects of their care and for a doctor to assure me of all my concerns every day. I am confident going in to motherhood and that's definitely the shiniest silver lining of NICU time.

5. Bring your carseat ASAP!

If your hospital requires a carseat challenge before going home and baby is doing well you should bring the carseat as soon as possible. Odds are, if the carseat is there, then they will perform the test as soon as the baby is ready, whether you're there or not. This can sometimes speed up discharge and it can also provide you some peace of mind! In our case it was the morning after a particularly rough afternoon during which Jules fought her feedings and Viv wasn't awake most of the time we were there so it wasn't as satisfying. I just wanted them home and when we got there we got the news that Jules had passed her carseat and congenital heart disease tests the night before. It was the perfect way to start a day and her discharge papers were being drawn up that afternoon for the following Wednesday. Viv took hers a day later and passed too. I am so glad I just brought it in (on the suggestion of a nurse) and the next day it was done!

The girls new beds after they both maintained their temps!

6. Help baby get home ASAP!

Learn what your baby needs to do to leave and how you can help it along. Our NICU doesn't have a weight requirement, as long as baby is eating every feeding from the bottle/breast, consistently gaining weight and able to maintain their body temperature, heart rate and breathing on their own. I now know that they will hold them for three days of observation once all of these milestones are achieved and as much as I wish they were here I'm glad for this as it's just extra precaution. I would also suggest you allow interventions that they think are necessary such as supplements or pacifiers. The pacifiers helped my girls learn the suck-swallow-breathe reflex which allowed them to eat more and I really think the milk fortifier helped them gain so quickly. Not to mention I know that having my breast milk and skin-to-skin time as much as possible are definitely helping! Our original estimate was September 3rd and *fingers crossed* we're breaking out on August 13th!

7. Be positive. 

Above all else, seriously, BE POSITIVE. We sing, talk to and dance with our girls. We don't allow tears or what-if talks in their room and we are constantly praising them for their "small victories" like getting milliliters added to their minimum feedings or a temp reading above 36.5c.  Even after moving to the open cribs I still get nervous taking their temps. I have a mini panic attack with each bottle just praying they finish it and won't need the feeding tube again. But I never let them, or the nurses, know. I am super confident in my babies and even when I'm worried I fake it 'til I (or they) make it. It's helpful that my girls are so strong and I get my strength from them. And it's easy to be strong though when you're surrounded by positivity!

Every families' NICU experience, like the birthing experience, is different from the next. I can only say what's worked for me but I hope you consider trying them out if you ever (hopefully not) find yourself in one of these mysterious places with your strange new tiny human like we have.

Do you have experience with the NICU? What did you learn?


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