You’ve barely had time to nest, so many things are still missing in your nursery, maybe you haven’t even had your baby shower yet — and baby is already here!!! Mine came two months early. Lyons Cub’s due date was March 8th, and he arrived in January. Luckily, I had bought two car seats already, one for nanny’s car and one for my car, and we had been to the police station to have them installed professionally and safely. I had a crib, I had diapers size 1 and 2 (he needed preemie size), and I had lots of baby clothes (but none of them fit, because they had been baby shower presents (my baby shower had been THREE DAYS BEFORE he was born!!) and were sizes newborn to 3 months, but who would have known that my son has to stay naked the first week of his life, just wrapped in a red-and-blue striped cloth like they have in the NICU, because nothing fit, and then come home in preemie clothes???).
Thank goodness, I had hired our nanny in November already (I myself had been a 7-months-baby, and I had read somewhere on the Internet that if the mother was premature, her baby might be, too), and since I had been recently widowed, it was important for me to have a second person by my side who could help with my infant, pets, and household, especially in the first two weeks where I recovered from my C-section. I don’t know whether it was the emotional stress after losing my husband or my failing placenta, but Lyons Cub did not only come out two months early, but also weighing only 3 lbs and being 15 and 3/4 inches short (he had IUGR, which had never been diagnosed on our prenatal ultrasounds).
Without Nanny Nancy, I would not have managed. She followed me when I was wheeled into the operating room for my C-section, she took photos of it (without fainting!!), she lived in the NICU with us for a whole week, and she moved into my house for the next week to help me get around. (After a C-section, you cannot get up alone from your nursing chair, and you cannot take off or put on your compression stockings; little did I know…)
Being in the NICU with your premature infant is a new and scary experience. Now, in the aftermath, I have read many articles about it and have learned a lot from preemie and IUGR forums, and I wish I had at least some kind of knowledge before it happend to me personally. Here is an informative, short article from 2014 about how important it is that the doctors and nurses receive and welcome the mothers well: “The voice of the woman-mother of a premature baby in the neonatal unit: a phenomenological approach” by Rita de Cássia de Jesus Melo, Ívis Emília de Oliveira Souza, and Cristiane Cardoso de Paula.
According to this article, moms of preemies experience four different phenomena:
The experience of the woman-mother in the NICU concerning the birth of her premature baby allowed the creation of four units of meaning: being afraid of the environment and initially touching the child; being received in the unit; the chronological period, and; the monitoring of the baby’s improvement (Melo, de Oliveira Souza, & de Paula, p. 201)
Exactly this happened in my case, too. I like this article because it offers the authentic view of NICU mommas who voice their fears and thoughts. Let’s talk about the fear of the environment and initially touching my baby first.
FEAR OF ENVIRONMENT
Actually, I was grateful that my son was in a “safe place” and that we had made it to Vandy, where they knew what they were doing and took great care of him and me. I was scared of the beeping noises, the lines, and the big machines, but my child luckily was only attached to monitors, nothing else. The alarm went off almost every time I burped him, and his heart rate showed “200,” which scared the heck out of me, but the friendly nurse explained to me that this was completely normal and not to worry. I never had a scary moment where he stopped breathing, and he had no heart or lung problems and didn’t get NEC. Other mommies didn’t fare so well with their babies, so I thought of those while staying strong for my child.
The Monroe Carrell Jr. Children’s Hospital had stores on the ground floor where Nanny Nancy and I could get a sleep sack for my son, a plush lion for my mighty lion, and other necessities, since I hadn’t brought much from Clarksville. Also, I had been advised to walk as much as possible, in order to make my C-section scar heal faster, so I walked through the stores when my son was sleeping and turned many rounds, and it really helped; I healed up very well. I had been glued and stapled, and after about two weeks, the staples came out.
I didn’t know how to open the isolette in the beginning. With all this expensive high-tech material around, you kind of worry that something might break if you don’t use it correctly. But I was instructed by the kind nurses how to do it, and it was actually quite simple. In the beginning, I just put my hands through the two big holes in the sides, but when my baby was better and I was allowed to take him out all by myself, I just opened the whole side and let it fold open towards where I was sitting. No big deal. It all looks way more difficult than it is!
I was around my son 24/7. Nanny Nancy and I had received a family room right next to the ward where my son was in ever-changing “pods” (he kept moving from one area to the other, because he improved so much; sometimes, I got scared not finding my baby in the room I thought he would be in, but it always meant he had been “promoted” to the next lowest level of severity). We received free breakfast and lunch because I was nursing, and the Ronald McDonald House gave us free dinner, too. I also got a gift package with a big, green plush frog for my son, chips bags for us to munch on, and other little things like nipple cream, etc. And the most important thing for me back then: I got to use a very high power Medela breast pump! You can’t imagine the relief of getting all that pressure off yourself. Of course, I hadn’t gotten my own pump yet from my insurance. When you’re having a preemie, you’re not prepared for anything and don’t have a pump yet (some insurances only send it out 30 days before the estimated due date).
FEAR OF TOUCHING BABY
After Lyons Cub was born at 9:11 a.m. on that fateful day on a cold January morning (I had driven myself to the hospital at midnight, losing blood and water, and had just barely enough time for one out of two necessary steroid shots and an epidural), I saw him for a few minutes until he was taken by children’s ambulance to Vanderbilt in Nashville, because my local NICU at Tennova in Clarksville, TN could not handle such a tiny baby. I enjoyed a brief moment of interaction (touching his hand with my index finger, and he held onto it so tightly). I was not scared about that yet, because I knew I couldn’t possibly “break him” by letting him hold my finger with his teeny-tiny hand. I did have the crazy thought that hopefully, there were no germs on my finger (it was the time BEFORE Corona, by the way).
The saddest and most touching moment was right before our separation, when I let him hold David’s wedding ring. My husband had passed from suicide due to his bipolar depression a few months before, and I wore his ring during the last weeks of pregnancy, because my own one had become too tight on my swollen fingers. Our son and I both held daddy’s ring together, and it felt for a brief moment as if he were there with us, telling us all would be fine.
Then, my baby was taken away from me. But I knew it was best for him; he went to a better hospital that could take care of him. I had to stay behind one day to recover from my C-section (strictly speaking, it should have been three days, but I left the hospital with my nanny to be with my baby). Thus, my son was already two days old when I was able to touch him for the first time on his body. I watched how the nurse gave him a bath, and then, I was allowed to give him his first bath myself. I was really scared! I knew he couldn’t drown, because the “bath” consisted of carefully touching him with a small piece of moist gauze. He cried like crazy and turned really red, so I wondered if I had hurt him, whether it was too warm or cold, or whether he was afraid of water or of my voice. It was like touching one of those expensive, painted Russian eggs with velvet gloves. At that time, I also thought, “what if he hates bathing for the rest of his childhood now and will always cry when I give him a bath in the baby bathtub?” I know it makes no sense. For some reason, I thought I could change his view on things by giving him a trauma. New mommies, especially first-time mommies, have lots of irrational fears!
The NICU nurse was always next to me, holding my baby, and telling me what to do, which made me feel much safer and relaxed. I wondered why his skin was so red. In fact, he was my orange baby (I was explained his bilirubin levels weren’t bad enough to “go under the lights,” so I was relieved about that). He also had very visible, dark blue veins on his almost transparent belly (turned out to be nothing, but I had never seen that before and worried about it).
As a NICU mom, you worry about everything. POOP! That’s a big reason to worry. Is it the right consistency? Is it the right color? How much is it? Is there any red or black in it? Is it there at all? Sorry, gross, I know. Close your eyes and skip on if you don’t want to see a poopy diaper now.
It was greenish-black. I had never seen anything like this before. My baby’s first diaper. I would have thought that when he drinks milk, it would be yellow. Then, the nurse told me about meconium, and that it’s a very good sign when it gets passed 24-48 hours after birth. I learned that sometimes, baby passes it while still in utero, causing it to swallow meconium and have lung problems. So I learned about a first milestone, passing the meconium. And he had managed! One thing less to worry about. And the diapers were so absolute tiny and cute!
My sister had had “normal” babies (what I now consider “big” babies, 6 lbs or so). And mine wasn’t even the smallest! So on the one side, I was a bit worried something could happen to my 3 lbs infant, while on the other hand, I saw and met moms of 1 lb babies, and I always wondered how they were managing, with all those wires, CPAP, ventilator, feeding tubes, etc. I was so lucky in my misfortune that there was no time to complain or feel sorry for myself (I didn’t. I was grateful that it hadn’t come a whole lot worse for us.). Three and a half years later, our nanny would become grandma of two micro preemies, weighing 1.2 and 1.4 lbs…
What gave me a lot of comfort in this situation, as a widow with a preemie with IUGR, in a hospital in a city I didn’t know, without any friends and in a new job I didn’t want to lose (and that had no maternity leave policy) was the fact that the doctors and nurses were very caring. Of course, I had read before that North America has the highest maternal mortality ratio of all industrial countries, and I was just a little bit worried I might get an infection after the C-section or die of sepsis or hemorrhage, or something like that. But as soon as I was in Nashville, that fear disappeared. In addition, I had a super nice German neonatologist, which gave me a feeling of being home — it provided me with a little bit of extra trust that I could rely on German precision, hard work, and craftsmanship. (Forgive me for boasting.)
Basically, all medical staff always told me that although my boy was one of the smallest babies there, he was one of the healthiest. Lyons Cub was just considered a “grower and feeder,” and he would have caught up by age two (truth is, he reached the normal growth curve at nine months of age already). I was so busy with infant care (they let me take his temperature and change his diapers), pumping, and juggling work and NICU time, that I didn’t even get to worry about long-term problems or disabilities. I was told about Early Intervention, for which my baby qualified as a preemie, and received a referral (later, my son’s pediatrician supported that, too), so I used that service, which proved beneficial in teaching Lyons Cub to sit, crawl, and walk without problems, even if it happened two months later than in a term baby.
The nurses were super nice to my baby AND me, and I felt very well understood and received all the aid I could have asked for. I was called to give him his first bath and his first bottle of my milk (the first three days, he had been on donor milk, before mine came in). The nurses taught me how to bathe my baby, feed my baby, and burp my baby, and they never made fun of the 44-year-old who had no clue about anything, while they were about half my age and “had seen it all.” Instead, they praised me for every little thing I did right and for every drop of colostrum I produced. I was so proud of the first 20ml bottles I filled half way!! Later on, I would mass produce 60 ml bottles and bags full. I didn’t miss any of those “first moments” that other mommies might miss. I got to hold him when he was 2 days old. Kangaroo time was the best time in the NICU! I was scared he might get too cold on me, or the monitors might fall off, or he might choke on my milk, but nothing ever happened.
Then, the lactation consultant came to me and first taught me about pumping correctly and then helped me to introduce my son to the breast. It took him about three weeks to learn to latch and suckle, but it was not necessary, since I had to fortify my breast milk with Similac Sensitive to 24 calories, anyway, so I became an exclusive pumper with the occasional “comfort nursing.”
It worked really well for us, and I loved pumping (I was a big fan of using the Lansinoh pumping app that showed me every pumping session how much I had made on each side in what amount of time). I set a goal to do it for a year and stopped exactly on his first birthday. I was very appreciative of being offered lactation services, which I didn’t even know existed. I learned about different colors and fat content of breast milk. Did you know that your breast milk can turn slightly greenish when you have an infection, and then it contains antibodies for your baby?
The milk that comes out later is called hind milk and is especially fatty; therefore, if you want your baby to gain weight quickly, you can pump and freeze the fore milk and give baby the hind milk. Colostrum is dark yellow in color, is dubbed “liquid gold,” and is the healthiest and most immune-boosting milk you’ll ever have, while my later milk was almost snow white. Cool! Powdered milk cannot do all those things. Still, “fed is best,” so if you cannot nurse or pump for any reason, don’t feel bad. There’s nothing bad about giving a bottle. By the way, there’s also so-called “strawberry milk,” which happens when mommy gets a clogged duct and is bleeding a little. Allegedly, it’s not harmful to baby at all, but the thought of giving my baby bloody milk makes me shudder, argh… If you want to see something truly horrible, read the article “Side-by-Side Bloody Breast Milk Photo Shows the Painful Reality of a Clogged Duct” by cafemom:
A financial advisor came to see me, too, but I basically sent her away again, because as an international green card holder I knew that I wasn’t allowed to receive any benefits, lest I’d become a “charge” to the U.S. and would have to leave the country. I didn’t know what my American son was entitled to, but I didn’t accept any aid and did it all by myself. I had a well paying job and rental income from my husband’s and my houses in Southern Illinois, which helped me to stay over water. The costs of the birth and NICU time were quite hefty, and I still received bills up to a year later. Thank goodness, I had a good insurance through the university I worked at, but in Germany, my home country, it would have been free.
What I liked about the environment was that the nurses decorated his isolette and the door of his room. They had asked me about the theme of his nursery, which was “ocean,” and I told them he had whale bedding in his crib and whale pictures and shelves on the wall, so they cut out a little, blue whale from paper, laminated it, and put it on his isolette! They also cut out the letters for his name and put them on his door when we got to do rooming-in before he was transferred to our home town, Clarksville. They did it for all the children there (72, at the time we stayed there. They had a board hanging on the wall with the number of babies).
CHRONOLOGY AND MONITORING OF IMPROVEMENT
The chronology of events for me consisted in moving from one pod to another. In my son’s case, it was a cause for celebrating a milestone every single time. He never took a step back, and he gained his birth weight back quickly, too. His milestone to get from the isolette to the open bed was to keep his temperature, and his milestone to come home was to take his full feeds. His final two milestones were to pass the hearing test and the car seat test. As long as we were in Vanderbilt, I felt very well informed about everything that went on with my baby. However, when we transferred back to Clarksville, because I had to go back to work the week after, I was held to strict visiting hours in the clinic and could not stay overnight. This time, I felt more anxious; first of all, it was a lower-level NICU, and I could not sleep there over night. However, I had more time to prepare the house, get my work in order, and sleep 1-2 hours a piece between the pumping sessions every three hours — in my own bed!! After having been surrounded by beeping machines, crying babies, and running doctors and nurses, you won’t believe what luxury like that feels like.