Are you expecting a baby who might need the NICU?
Premature birth is common and birth defects happen unexpectedly.
Moms nowadays like to feel prepared for what comes at them next.
So often in motherhood we cannot be prepared. In the situation in which you are expecting a premature baby, or a baby with a birth defect, there are things you can do, and things for you to know, that will help you to cope.
Risk factors for preterm birth are abundant:
IVF (in vitro fertilization)
expecting twins, triplets, quads
advanced maternal age
diabetes and gestational diabetes
hypertension and pregnancy-induced-hypertension, or preeclampsia
obesity
smoking
drug and/or alcohol abuse
10% of births today are premature and most of these will require ICU care. See my previous posting about preterm birth.
Most premature births occur for unknown reasons. Rarely is preterm birth the fault of any mother (unless you are abusing drugs or alcohol.) Please do not feel guilty if you are expecting a premature infant.
Birth defects occur in 1 out of every 33 babies.
Some of these birth defects, or congenital malformations, are severe. Some are mild, but those that are serious will require NICU care and other subspecialty care, most likely in a children’s hospital.
Serious birth defects include neural tube defects (spina bifida), craniofacial abnormalities (cleft lip and palate), congenital heart defects, gastroschisis and omphalocele, and trisomies. All of these will require NICU care.
Tips to prepare for your NICU journey:
Expect to be feel afraid, worried, and helpless. Shock and fear are normal. Doubts are normal, so is guilt. But it’s not your fault! Premature delivery and birth defects are rarely the mother’s fault.
Anticipate your feelings of helplessness. It’s the worst kind of helplessness you will ever feel - leaving the hospital without your baby after delivery. But helplessness is not hopelessness! The NICU and its subspecialty providers will give you hope.
Plan to express/pump your breastmilk for your baby. It’s something only you can do and provides invaluable support. Your milk is “liquid gold” and better for your baby than any medications the doctors have.
Being fed your breastmilk protects your baby against infection, protects against NEC (necrotizing enterocolitis), and improves your baby’s long term neurodevelopmental outcome significantly!
Be prepared to pump, or express your breastmilk for several weeks, or longer. Ask for help from the hospital or NICU Lactation Consultant. Your baby will most likely need tube feeding of your milk before he or she can begin to breastfeed (nurse directly at your breast).
Ask questions, lots of questions. It’s common to be overwhelmed and forget what the doctor said. Your nurse can help you decipher terms and remember the conversation you just had with the doctor. Write things down. Keep a written list of your questions for the doctors’ rounds.
Try to NOT look things up on the internet. It’s too scary and difficult to know which sources you find are actually reliable. In general, you can trust information posted by medical schools or children’s hospitals.
Ask about sibling visitation. Before Covid, most NICUs allowed children who were fully immunized to visit their new sibling(s).
Ask to take a tour of the NICU before delivery, if possible.
Ask to speak directly with any sub-specialists (other than the neonatologist) that will see your baby. This may require an appointment before delivery or later at your baby’s bedside.
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