Parenting in the NICU - a quick look

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Learning about the NICU and ways of helping and bonding with your preemie can help you manage some of the stress and uncertainty associated with a preterm birth.


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Finding special ways to connect & understand preterm birth

The joy of childbirth is often short-lived for parents of preterm babies. Isolation from your newborn, extended hospital stays, and the uncertainty associated with medical procedures, takes a massive emotional and physical toll. This section has been created to help you navigate your way through some tough times. It covers everything from family-centred care, tips on how to bond with your preemie, helping out in the NICU, what to bring, to learning to read your prem's body language

 


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Preemie’s & their Siblings

In the NICU: Preemie’s & their Siblings

When faced with the stress and uncertainty of preterm birth and the experiences of the NICU it can be very difficult to focus on things beyond that, however for parents who have other children it’s important to find ways of explaining what is happening and ensuring they feel loved and secure.

What to tell preemie’s siblings?

It may seem like a catch phrase but, honesty is the best policy in this regard, provide your children with as much information as they want to know, obviously in a capacity that is appropriate for their age and understanding. You will find that younger children ask basic questions and should be responded to with simple answers. It can be helpful to refer to your preemie with their names whenever you are referring to them so that your children are starting to see them as part of the family even if they are still in hospital.

Common reactions of young siblings

Children are very perceptive and will notice that you are sad and that you are likely absent a fair bit due to needing to be at the NICU.

Common reactions include;


Reaction

Sometimes siblings think they may have caused the baby to be sick by thinking or wishing things like, not wanting to share their parents or wishing the baby won’t be born. This is known as “magical thinking” which is believing that thoughts or wishes can make things happen and is very common in children between the ages of 2 and 7 years.

Solution

Assure your child they did not cause the bay to come early or to be unwell.


 

Reaction

They may think that they have said or done something that has made you upset.

Solution

Let them know you are sad and explain that is because your new baby is so tiny and sick, assuring them it is not because of something they did or said.


 

Reaction

Acting out is a common reaction. Change can be unsettling for some children, with changes in routines, changes in who is providing care giving and so on. This can make children feel out of control and insecure which they may express as acting out in order to get some attention.

Solution

Try to find someone they know well and like (i.e. grandparent, close friend, favourite baby sitter) who can provide extra attention both when you’re home and at the hospital. Organise special trips they can take with support people, like to the movies, shopping, beach, gardening etc. Try to stick to their typical routine as much as is possible, like nap times, bedtime, meals, extracurricular activities. For those at kinder or school, inform their teacher so they provide additional support for the child and may help explain acting-out etc. This can help reduce any anxiety they may feel.


 

Reaction

Some siblings may feel insecure, left out or lonely.

Solution

Assure your child that you love them just as much as before the new baby arrived. If the NICU allows it consider bringing them for a visitation and involve them in other preparations for visitations, such as helping you pack a bag for the NICU or choosing a piece of clothing for them.


 

Reaction

Feeling sick and complaining of tummy aches or other pains are common.

Solution

Try some of the above mentioned approaches to increasing attention, cuddles, and kisses, and inclusion in things where appropriate. Set aside special time where you read them a book, visit the playground, go to a movie etc.


 

Reaction

Fear of catching preemie’s sickness. Depending on your child’s age they may know that common illnesses they have experience with, such as colds and chickenpox, are spread by contact with someone who was ill.

Solution

Assure them that they and you can’t get the baby’s illness


 

Reaction

Wonder and worry who will care for them once the new baby comes home.

Solution

Show them and tell them how important they are to you and the family. Encourage them, and help them find special ways of welcoming the new baby to the family. Show how proud you are of things they can do by themselves that babies can’t. Help them make a brag book they can take to school, which could include a photo of their first cuddle with prem, baby’s hand and foot prints, etc.


 

Reaction

Regressing. Emotional distress in children can often lead to regressing, which is a return to less mature behaviour. For example, they may have stop using newly learnt words, refuse to dress themselves, start sucking their thumb again, use a pacifier, use a security blanket, may have more “accidents” or bed wetting.

Solution

Don’t punish, scold, talk negatively, or make a big deal of it. It’s just their way of letting you know that they need more love and attention. This regression will only be temporary; once they are feeling more secure they will return to their former level of development.

 

Visiting the NICU

You should find that most nurseries are happy for siblings to visit their preemie brother or sister. If you are wondering if it is good idea to let your child visit, consider the results of a number of studies that have reported that children who visit the NICU are more responsive to their mothers and to the new preemie than those who do not visit. There were no negative effects identified.

If you decide to have them visit make sure you plan the visit taking into consideration the age of your child. The length of visit is important, don’t make it too long, consider your child’s attention span. Be prepared that some children may only want to stay a few minutes, while others need more time to feel comfortable and familiarise themselves with the environment. Encourage them and show them how they can interact with the baby.

Preparing Your Children for the Visit

  • Give the sibling an idea of how small your preemie is, maybe show them a photo first. Sometimes children expect a life-sized play-mate.
  • Describe a little about the environment of the NICU, such as in a room with many other babies and people and sounds, including alarms and peeping. It can be helpful to show a photo first and point out all the different things helping your baby survive, like isolettes to keep the baby warm; wires attached to the baby’s chest makes sure they are breathing ok, patches over the eyes helps keep out bright light and so on.
  • Assure your child that these bits of equipment are to help the baby and that it doesn’t hurt them.
  • Let them know how they can interact, like talking to the baby, perhaps encourage them to share a story or an event that’s happened recently, if touching is ok, have them practice first so they know to be gentle.
  • Encourage your child to bring something for the baby, like a picture of themselves, or help them make a special welcome card, or a small toy for the isolette.

Common Concerns Children Have While Visiting?

Keep an eye on your child’s reactions during the visit and provide feedback and reassurance as needed.

  • Why are the baby’s eyes covered?
  • Why are the baby’s eyes shut? Can they see?
  • Does that hurt the baby (monitors, IVs, eye patches, catheters etc.)?
  • Will they ever get out of hospital?
  • How will they get out of the hospital?
  • Will the baby grow more hair?
  • How does the baby eat? Can I feed the baby?
  • Can I hold the baby, or, why can’t I hold the baby?
  • After the visit, ask them if they have questions about the baby, about the nursery and how they feel about their baby brother/ sister. Make them feel that their visit was important for the baby, that how they feel is important to you, and that they are as important to you as the baby is.

Most nurseries have a set of guidelines for sibling visits, common NICU rules include:

  • Children should be healthy and should NOT come in if they have a fever, cold, diarrhoea, vomiting, coughing or sneezing.
  • Children should not have recent exposure to communicable diseases such as chicken pox, whooping cough.
  • Children should their wash hands and follow other procedures for visitors in the nursery.
  • Children should be supervised during the visit. It is best to have two adults when a child is visiting, so one can supervise the child once he/she is through visiting.
    • Children should remain at the bedside of their own sibling, and not be allowed to go from bed to bed or run around the nursery.

What to tell Siblings about a preemie who is dying

Again, it is important to be honest with your child. You don’t have to hide everything you’re feeling from them because they will notice how upset you are. It is important to explain why you are sad and that they are not the cause of this sadness. You could explain that it is ok to be sad and offer lots of hugs and support.

Do NOT use the following terms for death:

  • “Baby just went to sleep”
    Why: They will fear dying during naps and at night.
  • “It was God’s will”, or “God took the baby because they were so good or so special”.
    Why: They may fear God will decide to take them too.
  • “Baby went on a trip”
    Why: They will fear travel, for themselves or others.
  • “Baby just went to sleep”
    Why: They will fear dying during naps and at night.

Other Considerations

  • Assure them they will not die. The baby died because they were so small but you are big.
  • Assure them that they did not cause the baby to die.
  • It can be confusing and disturbing for children to see the baby just before or after death. Your child may be old even to be given a choice, especially those children that feel they need proof that the baby is dead.
  • You may want to help your child choose a good-bye gift, which may help them accept the baby’s death or make a scrap book to remember the baby.
  • Explain that most people who go to the hospital get better and are able to go home, use examples from your own experiences.

 


Technical Reference List

252. Rose, S. A., & Feldman, J. F. (1996). Memory and processing speed in preterm children at eleven years: a comparison with full-terms. Child Development, 67(5).
Wechsler Linden, D., Trenti Paroli, E., & Wechsler Doron, M. (2000). Preemies: The essential guide for parents of premature babies. New York: Pocket Book.
Zaichkin, J. (2009). Newborn Intensive Care: what every parent needs to know (3rd ed.). MI: Sheridan Books.
Meriter Foundation: http://www.meriter.com/

 

 



AlbertEinstein_iconOne of the greatest minds in history, Albert Einstein was born preterm.

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Preemie, Premmie, or Prem?

Most babies spend between 38 and 42 weeks in their mother’s uterus. So, technically a preterm birth, preemie, premmie, or prem, is an infant who is born less than 37 completed gestational weeks. 


Read More: Defining Preterm birth


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