MaternalMusing

A Personal Adventure Into Parenthood

I Can Kangaroo (Care)…Can You? April 30, 2012

Filed under: Uncategorized — maternalmusing @ 9:36 pm
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Being a new (or at least fairly new at this point) mother…my brain has turned to mush. Every mama can tell you that your usual logical, organized, rational self takes a permanent vacation as soon as your  child receives their womb eviction notice…or sometimes even earlier. My point is that some exact milestone dates escape me now on V’s journey home, but although the specifics are a little short at this time, the emotional memories are still very much alive.

One happy occasion, whose date must be filed somewhere in the ‘lost’ area of my brain, is the day that V was officially respirator free. Sometime before he was two weeks old, we were surprised to see our tiny man minus his scary looking accessory, chillin’ as usual in his little isolette. He seemed unfazed by this momentous occasion but Andrew and I may have shared some tears and a happy dance knowing that holding him just got that much easier.

Holding an infant on a respirator is serious business and you spend most of your time watching the monitor to make sure you’re not crushing or twisting any important wires, and that your kiddo is still taking in the O2 at an appropriate level. It’s also darn near impossible to pick up your own child when they’re attached to a breathing machine and you’re at the mercy of the very busy nurses who have much more experience navigating the technology.

The first day off of the respirator definitely gave us some pause, repeatedly checking the monitors to make sure that, yes, he really was able to do it all on his own. Most parents get excited for the first hand-hold, smile, and spit bubble…and while we got to those eventually Andrew and I celebrated a special ‘preemie’ moment when we could finally say ‘Our son can breathe on his own! Isn’t that cool??’.

One great thing that we were finally able to take part in, now that V was off his respirator, was this amazing practice called ‘Kangaroo Care’. Kangaroo care in the NICU involves a comfy recliner stuffed into your child’s bay for some quality one-on-one snuggle time with your infant. This is the first ‘long term’ cuddling you get to do with your child as a preemie parent (most often the mother)…usually for upwards of an hour, until someone needs to feed, bathe, examine, or weigh the baby and put them back in their little cocoon.

Photographic proof of our first 'Kangaroo Care' experience...before the sloppy cry-fest began!

The first time they asked me if I wanted to do it I was a little unsure. V was still so small (under 3 lbs) and holding him was a scary proposition. I gathered up all of my courage and agreed…at which point I was handed an ugly yellow cover and told to strip down from the waist up while they got the chair. Did I mention that this was all in the middle of the NICU? Modesty is so over-rated. However, as time went on, I did learn to come visiting in a sports bra to help preserve the last remaining shreds of my dignity.

This near-nakedness is necessary for direct skin-to-skin contact with the baby. This is important for preemies so that they get to know Mommy’s smell as well as help keep their body heat up. Preemies are so small and so fragile that they don’t have the ability to regulate their own temperatures and a variety of methods are used to do it for them.

All curled up against Mommy. Just look at how big that Newborn diaper is! This is actually V at 15 days old.

I settled myself down in the chair and V was carefully placed on my chest with his scrawny little limbs tucked underneath him. He preferred to be all curled up with his arms under his chest and legs tucked up against his stomach. The nurse then turned off the light and handed me his soother and a mirror. I lifted the mirror and stared at my sleeping son lying on my chest. Then I quietly went to pieces….it was the first time I really felt like a mother. In the dark corner of our room I finally got to just spend time with my baby, no tubes, respirator or IV attached…and savour it.

There were a lot of tear-filled moments in the NICU, both happy and sad, but this one was really profound for me. V’s slight weight on my chest, face snuggled into my collarbone and tiny, sleepy squeaks were all amazing things I hadn’t even let myself think about yet, and to be actually experiencing them was mind-blowing. For those of you experiencing NICU stays and preemie births…invest in waterproof mascara and don’t be ashamed to cry in public, some things are worth getting that emotional about. For those of you lucky enough to have full term, healthy babies I hope that you never ever take this ability to snuggle with your kids for granted…it truly is a blessing.

It's hard to believe how tiny our little man was. What a miracle he is!!

I actually fell asleep with V on my chest and the hour went by way to quickly but this became a solid routine for us. Every day, or at least when we could steal chair from all those other preemie mommas, I got to hold and bond with my tiny baby and it just got better from there. Andrew was definitely a little jealous of all of this ‘Mommy’ snuggle time and did his best to scam in on chair time when he spent time with V after work. To this day, nothing melts my heart more than seeing V sleeping on his Daddy’s chest…one of his favourite positions.

Eyes open and just enjoying his cuddle time with Mommy. So much love for this little boy!!

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A New Parent’s Guide To The NICU: A Cheat Sheet From Someone Who’s Been There April 19, 2012

Before I continue onto V’s journey, I thought this might be a good point to share my list. I actually started this post just over a year ago as a note to a friend and former co-worker who’s pregnancy was at risk for ending in an NICU stay. It was a list of all of the info I wish I’d known going into our experience, questions I wish that I’d asked or things that I wish I’d done. I’ve definitely added a few points but NICU Mommas…please feel free to add any additional suggestions!! These are in no particular order, just written down as I brainstormed!

  • Strike up conversations with other parents. They will look tired, stressed out, and sometimes angry but that doesn’t mean that they don’t want to vent, chat or commiserate with other NICU mamas.

  • Ask about your primary care nurse…and what a primary care nurse is and does! I had no idea what a primary care nurse did (they are the nurse who will be primarily responsible for your child’s care..duh…) until V was about 4 weeks old. We didn’t actually meet our primary care nurse until we were moved to Care By Parent…two days before we were discharged. I definitely regret this and think we could have had a smoother experience if we’d had more contact with her!

  • Set up a routine that works for you and don’t judge your visiting times against those of other families. Everyone has different responsibilities and schedules at home which affects their ability to be a fixture in the NICU. I definitely felt that I wasn’t spending enough time with V while he was there but we went back for night visits and other random times when it was pretty quiet around there. Just because another parent is there from 8am to 8pm and you drag your sorry butt in the doors at 11am doesn’t make you a slacker or negligent! Schedule visits when it works best for you and your family.

  • Make friends with the nurses and make your expectations for involvement in and about your child’s care very clear. When we arrived each day my first priority was to find out who was taking care of V for the day, going over the notes in his file for the past night and letting them know if I planned to nurse, hold him, weight him, bathe him, etc during my visit. This set a plan for the day early on and I could make sure I was there for appointments and  dr visits. It also cut down on conflict if they thought there was too much handling going on for the day.

  • Bring pieces of home with you! Stuffed animals, blankets, outfits, anything you can think of! Just make sure you clearly label them, do the occasional search of the hospital laundry basket and don’t bring anything with huge amounts of sentimental value.

  • Take advantage of you and your significant others’ last few days and weeks alone as a couple. Everyone needs some stress-relief and I highly recommend some epic date nights before you being all-nighters with a hungry newborn. Andrew and I saw some great movies and ate some pretty delicious food before we brought our little man home!

  • Take a tour of the NICU beforehand if possible and learn more about the specific structure of the unit later. Ask as many questions as you can to make yourself more comfortable. I had no idea what a NICU looked like when we entered to see V the first time which definitely added to the anxiety of the moment. It was also good to know what the progression of the NICU was like (back room –> front room –> NPCU –> Care By Parent) and helped us monitor his progress by where he spent his time.

  • Show up every single day unless some emergency keeps you away. I had a cold my second week there and when I called to say I wouldn’t be in that day the nurse told that that’s what the masks were for…and they were expecting me that afternoon.

  • Keep the number for the NICU by your phone, but don’t panic when ‘Private Number’ shows up on your caller ID. My heart hit my stomach the first time I saw that display…and all they wanted to know was if they could feed him with a bottle! Good news comes by phone too, which is hard to remember when you suddenly become the world’s biggest pessimist!

  • Develop a filter when dealing with the nurses. Although they may not always tell you what you want or do what you want them to do…they do have years of education and experience with preemies and as a first time mom I learnt to respect their knowledge. It used to break Andrew’s heart when they’d get on his case about holding V after work, but they just wanted him to get as much sleepy growing time as possible..and the faster he gained the faster we’d take him home and be able to hold him all we wanted. A little trade off, as much as it hurts your heart, does go a long way.

  • Pump and do breastfeeding attempts but don’t rule out the bottle…how soon do you want your baby home?? NICU babies need to be feeding-tube free for 48 hours to go home and nursing takes a lot of energy which is in short supply for those little ones. There are definitely success stories about breastfeeding after the hospital but to get home ‘most’ parents go the bottle route.

  • Spend the night if you can…especially as a first time parent. It was great to get some supervised ‘practice’ with V before we actually took him home.

  • Ask about parents support groups set up with the hospital. I wish that we’d gone to the coffee meetings for NICU parents while we were there and am considering volunteering to share our experiences now that we’re a ‘success story’. It would have been nice to hear from parents who had been there, done that, and now had healthy, active kiddos.

  • Take advantage of any professional support offered: physio, respiratory therapists, dr meetings, lactation consultants. They are free professional services that are there to help you adjust to preemie parenthood and keep you informed!

  • Stockpile diapers, soothers, etc provided by the NICU…we felt like chumps when we left and took half a pack of diapers with us and the nurse had to force us to take the soother V was using. Other parents had been stocking up for weeks and nobody cared…

  • Don’t compare your post-baby body to other NICU Mommies…you will only be depressed if you were whale-like like me!! However, I definitely applaud all of those who were able to fit back into their pre-pregnancy jeans by the time their bundles were discharged.

  • Beware of ‘student’ nurses and dr’s….they tend to want to do everything and get flustered easily…at least in our experience. Experienced nurses will let you do the diaper changes, hold the feeding syringe, and bathe your little one. Student nurses tend to take over, not maliciously, but because they want more practice and experience, which is definitely annoying when you’ve developed a solid routine of ‘doing it yourself’.

  • Take many, many, many pictures. Just because your baby isn’t at home doesn’t mean that you can’t wallpaper your Facebook page with adorable cuteness. Also you have more support than you know and others want to cheer right along with you when major milestones are met!

  • Encourage family visits so long as the visitors are healthy.

  • Ask about post-discharge support like feeding studies or pediatrician follow up. We got involved in an amazing nutrition study that lasted until V was 8 months old. The support I got from the dietician, lactation consultant and pediatrician involved was invaluable and fingers crossed that it becomes a regular support program for preemie mamas after the paper is released. V was actually the last graduate from the study (a whole other post I assure you) and a big fuss was made over him…how can you not be happy about that!

  • Get a good day-timer or app to keep track of your kid’s many many many appointments. There will be scheduled eye exams, physio, respiratory therapy and developmental appointments. You will want to be there for them!

  • Start a diary or blog to help you get your frustrations and worries out. I wish I’d actually started this while V was a patient rather than almost a year old!!

  • Wear comfortable clothing…the NICU isn’t a fashion show and the chairs are not comfortable. No one is going to judge you for bring back the university look of PJs in public at 2 in the afternoon…in fact they may tell you that they look comfortable and ask where you got them.

  • When meeting with the NICU dr. before delivery ask about the side effects of ANY medications they will be giving your child. If we ever do this again Andrew and I will hands-down decline surfactant unless it is 100% life-savingly necessary (which it wasn’t in V’s case).

  • Get a really really really good hand-cream. With all of the washing and sanitizing you will do as a NICU parent your hands will be so dry they will crack and bleed…true story.

  • Take some time to feel sorry for yourself…this situation sucks and you have the right to the occasional pity party…just don’t let the negativity overshadow all of the great progress your baby is making.

  • Spend your time at home ‘nesting’ if you can. Chances are that if you have a preemie you have absolutely nothing ready at home and the time spent in the NICU will allow you to get your act together. It will also help you feel closer to your child and more useful as a mother to fold tiny onesies and fight with your partner over crib construction.

As I mentioned before, I’m sure this list in incomplete and I sincerely hope that no-one needs to use any of these little pearls of wisdom, but I definitely do find some satisfaction in sharing my would-haves/should-haves with others. Wishing you all healthy, happy and NICU-free deliveries!!

Ps.  I should probably mention in the context of the info and experiences that we had…we live in Ontario and our healthcare experiences and costs are both public and covered by our provincial OHIP. I imagine that some of the general points will definitely apply to NICUs across the globe but in terms of appointments and specialists I’m not sure what is provided in other countries.

What better way to end a post than with adorable tiny baby feet? Squeeee! If this doesn't make you feel mushy inside you need to go and watch some sappy movies...

 

Who Says Roommates Start In College?? V’s First Friend! April 18, 2012

Filed under: Uncategorized — maternalmusing @ 8:53 pm
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After those first few days, as a new parent in the NICU and if you’re very lucky, you settle in to a somewhat uneasy routine. Your baby is stable, growing slowly, and you just show up every day and wait…and wait….and wait…

V had his umbilical line removed, was being fed lipids through his regular IV and had stopped receiving jaundice treatments. Basically we were just sitting by his bedside and watching him sleep. Preemies sleep a lot, more than regular newborns, and V would be awake for maybe 2 hrs a day. He was still on his ventilator, although the sprints were getting longer, and holding was kept to a couple of times a day to help minimize disturbances to the growing boy. To keep myself occupied I napped (sitting on a stool and leaning my head on my arms on top of a bedside table…thank you boring university classes for teaching me how to uncomfortably catnap anywhere!), read many trashy magazines since my mental capacities weren’t up for any extended or intellectual masterpieces, and just sat and stared at the baby. I made small talk with the nurses when they stopped in to check on V but the isolation made for some long, stressful days and I was always happy to see Andrew when he showed up after work.

V rocking the newborn cap and sleeping. His usual MO while in the NICU!

Luckily that week we were thrust into the unofficial NICU parent support system when V got his first of many roommates. A little girl in a ‘big girl’ crib (picture an ugly, white metal institutional type thing) took up the back corner of the front room and, although her parents were very quiet, it was nice to see other babies who were getting bigger and thriving under the nurses’ care.

The real surprise came the next day when I arrived in the NICU and received one heck of a shock. There was a baby in a plexiglass bassinet in the bay in the middle of the room! His tiny head was covered in the standard newborn cap and he was sleeping peacefully. Brand new mother that I was, I did a double take, was that my kiddo?? He looked an awful lot like him and so I actually had to check the name plate attached to the bassinet. Nope…not mine! Another new roommate for V! I guess swaddled and covered up babies all look pretty similar especially when they’re all about 3 lbs, wrinkly and sleeping. V was still in his full-on isolette next door, sleeping like a log.

The new baby’s name was Lucas and I had the pleasure of meeting his Mommy, Nicola, later that day. Suddenly my days in the NICU became a little more relaxed as we struck up a friendship based on our shared experiences with our boys. Nothing helps new Momma bonding like sharing birth stories, breastfeeding and sleep deprivation!

Actually, I had ‘heard’ about Nicola when I’d been admitted to Antenatal during the drama of my pregnancy. I had brought the book ‘Outlander’ with me to read and had struck up a conversation with my day nurse about it when she’d seen it in my bag. She had told me she’d recommended that very book to the Scottish lady in the room next door. Well, now I was on a first name basis with that same ‘Scottish lady’ and wishing I’d made her acquaintance earlier! We still keep in touch to this day and this past winter she has been doubly blessed as a Mommy with the birth of a healthy, full term baby girl!

Lucas was and still is an adorable and sweet-natured boy who was also dealt a rough hand in the beginning. He’s an incredible trooper and if I can convince his busy Mama (hint hint Nicola!) to share his story I will definitely put it as a separate entry. Their whole family continues to inspire me and I really hope they are able to share it with you!!

Talking with Nicola was a great stress-relief for me and helped us stay grounded throughout our time in the NICU. V and L kept to very similar milestones/sleeping and feeding patterns during their stay in the NICU which I think helped settle both of our minds that they were staying on the right curve. In the NICU you never want your kiddo to be the ‘special’ one….usually it’s not a good thing when they’re that fragile!

Even thought we haven’t been able to meet up as much as we’d like (or at least I’d like!) V and L are both thriving and adventurous little guys who still have remarkably similar taste in toys and food (if Facebook pics are anything to go by!). As horrible as the NICU experience was I do feel that it enriched our lives with the addition of a first buddy for V and a lasting friendship for a couple of first-time Mommies.

Now to wrap up this posting, Preemie Mommas everywhere can attest that, as soon as you start developing a support system of other NICU parents, your days get a little better. As nice as it is to talk to family and friends, unless they’ve been where you are it’s hard to really get a handle on what’s going on. I always got ‘So he’s just small?’ as the reply when explaining to others where V was. Ugh!

What those other NICU Mommies understood was that being a preemie encompasses so much more than size…it covers poor lung development, inability to regulate body temperature and oxygen levels, jaundice, susceptibility to life-threatening infections, hearing/sight/development delays, as well as the inability to summon enough energy to feed themselves. Each of these presents a world of possible complications and talking them over with other parents who know where your head is at makes them a little less scary. Think about it as similar to talking about a nightmare after you wake up in a cold sweat, it slays a few of the demons and lets you get back to sleep. Getting my frustrations and worries out to people who understood let me sit back and enjoy more of the time spent with my son, rather than spending my time thinking about all of the ‘what ifs’ that circle in your head. I can never thank those other Mommas enough for all of the generous support and giggles the provided during our experience even when their own little ones took up so much of their thoughts.