A Parent’s Guide to the NICU


300990_10150802984205344_1412243073_n(N.B. This post is for parents who may spend a few hours, a few days, or a few weeks in the NICU with their babies as they recover and grow stronger. I don’t pretend to know what the NICU experience is like for parents of micro-preemies, and I would certainly never speak for them.)

When C was born, she was a tiny 4 lbs 6 oz.  Her gestational age was 37 weeks, which is considered full-term.  But, as I explained in a previous post, she had not had enough nourishment in utero due to placental insufficiency.

C spent two weeks in the NICU, before she was sent home with us. We were extremely lucky.  Our baby came home.

We had advanced notice that C would likely spend time in the NICU, and we were given Parents’ Guides to help us prepare.  Those guidebooks were valuable, in that they prepared us for the equipment we would encounter, for the constant alarms, and explained the roles of each type of medical staff.

But beyond that information, I wish I could go back and give my past, pregnant self some advice.  Here is what I would have told myself:

1) Get some rest:

The nurses at Royal Victoria Hospital in Barrie told us this, many times.  They told us that attending each and every attempted feeding (every three hours, start to start) was wearing us out.  Each attempted feeding and diapering took at least an hour, but usually longer.  Pete and I would then have to go to a room to pump breastmilk and then deliver that milk to the nurses and then wash the pump parts.  After each session, we tried to sleep.  This was Hell on Earth.  It’s nothing like the feedings you do with a newborn at home.  Not even close.

Finally, the nurses and our neonatologist sat us down and insisted we take two night feedings off per night and get a few hours of uninterrupted sleep, or we would be of no use to anyone once C was discharged.  I felt guilty.  I felt like a terrible mother.  I was afraid C would think the nurses were her parents, instead of us.  But those few hours of sleep helped us cope with everything we were going through.

2) Nurses are wonderful, but they are not always right:

The nurses who looked after C at both hospitals were wonderful.  My Dad is a registered nurse, and he is also wonderful.  Nurses usually know best, but not always.

C had very low blood sugar when she was born because she was so deprived of nutrients in utero.  She was give a sugar solution intravenously but we tried to get her to breastfeed as well.  The problem was that she was exhausted.  And the nurses at Mount Sinai in Toronto insisted we try to get her to breastfeed every three hours, for forty-five minutes at a time, even when she couldn’t keep her eyes open.  I know that newborns are sleepy, but this was different.  And Pete and I felt that.  We didn’t speak up, however, because we’re just lay people and didn’t feel we could contradict the nurses.

It turns out that the nurses at the Mount Sinai NICU are less accustomed to full-term babies like C and more at ease with very premature infants.  Once we arrived in Barrie, where the staff are accustomed to less severe cases, the nurses immediately recognized that C needed to rest.  From then on, we would try to get her to breastfeed for five or ten minutes, until she tired out, and then gave her the rest of her milk by feeding tube while she slept on our chests.  She improved dramatically from that point forward.

3) Learn from the nurses:

I have to mention again that Pete and I were very lucky parents.  We got to take our baby home, at a robust 4 lbs 12 oz, after only two weeks in hospital.  And because our baby was fairly healthy and not on a respirator, we were allowed to perform a lot of baby care ourselves.  What we got in the two NICUs/nurseries was a sort of newborn boot camp.

The nurses taught us how to feed her, how to bathe her, how to change her teeny-tiny diapers.  In fact, after you’ve changed dozens of preemie-sized diapers while negotiating all the monitors and wires, through the two little holes in an isolette, regular diaper changes are a breeze.

4) Find some kindred spirits:

If possible, talk to some of the other parents.  They understand what you’re going through.

And although it can be difficult to find parents you “click” with, you might just be surprised.  The other parents in Barrie seemed to be so different from us, but then one day a couple came in and they seemed like kindred spirits.  And then, the next day, the husband half of the couple walked into the nursery wearing a Rad t-shirt.  Pete was so very excited.  Rad is a very cheesy ’80s movie about BMX bikes that all of his biking buddies love.


5) Laugh:

During the hours I spent pumping, Pete often put a DVD on on his computer to amuse us.  We watched I Love You, Man, The Forty-Year-Old Virgin and because it was on TV in our care-by-parent room, Kindergarten Cop.  Pete has a bizarre love for that movie.

6) Spend some quiet time together:

Pete and I made an effort to go for some quiet walks near the hospital together.  It was so nice to step outside the hospital and enjoy the weather outside.  Hospitals can be so oppressive.  It was also nice to reconnect as a couple while going through such an intense experience.  It helped us to feel like “us” again.

7) Spend some time in the “real world”:

This is similar to the last point but the emphasis is to socialize a bit.  After five full days inside the dark and cavernous Mount Sinai, we stepped outside and said “oh, the real world, I forgot about this.”  When Pete and I had a few dinners at my sister and brother-in-law’s house in Barrie, we really started to feel like humans again.  No alarms, no buzzers, no hospital equipment, no medical jargon.  It’s so important to interact with people slightly removed from the NICU world in order to feel normal again.

8) Don’t let specialists scare you:

The neonatologist really, really scared the bejesus out of me.  He told me that because of my placental insufficiency, C was at risk of developmental problems, speech delays, problems with motor skills and that she was at much higher risk of death by SIDS.

The nurses got annoyed at him and told me not to worry about C.  One nurse (thank you, Sandy!) saw me crying after the neonatologist told me C was at risk for cognitive delays, said “I’ve been doing this for more than twenty years, and there is absolutely nothing wrong with that little girl.”  Did I mention that nurses are wonderful?

9) Remember that the situation is temporary:

I should give the specialist-who-scared-me some credit for this one.  He was the one who reminded me that two weeks was a tiny fragment of C’s life and a fragment that she wouldn’t even remember.  Sometimes it’s hard to keep this perspective in mind.  Time goes by so slowly in the NICU, when you’re always awake and always worrying over every monitor, every alarm, every glucose reading, every ounce eaten, every ounce spit up, every drop in heart rate.  My bond with C was not diminished by this experience, no matter how much attachment parenting books terrified me into thinking it would.  She’s a happy, healthy toddler with no recollection of her rough beginnings.

10) Enjoy your baby:

It can be difficult to enjoy your baby when you’re worried sick about her health, when you’re so sleep-deprived you can barely think, and when you’re away from home and living out of a suitcase in a hospital.  It’s easy to feel too afraid to become attached.  It’s normal to be nervous to pick up a tiny, fragile newborn and cuddle her.  And it’s easy to feel that you’ve had what was suppposed to be the most wonderful experience (the birth of your healthy baby) taken away from you.  But try to remember to enjoy that little baby.  Even though time has slowed down, almost to a standstill, it will speed right up again soon and your 4 lb peanut will be an opinionated toddler.  Try to cherish these times, as difficult as they are.