Saturday, February 4, 2012

NICU culture: Blessings in disguise

I was talking to my friend Mimi the other day during a beautiful June-uary mid-afternoon walk and she asked me a poignant question: Did I feel resentful about Natalie's labor and delivery story? The answer to that question is no. As I told Mimi, although it didn't happen the way I would have chosen, I knew going into this process that I would have little control over the way everything occurred. I did, however, respond that I feel some resentment regarding Natalie's NICU stay, particularly the 40 hours I was sequestered and not allowed to visit her.

But, as easy as it is to wallow in self pity, basically ever since it finally registered that Natalie was, in fact, going to spend the majority of her first week of life away from us, I tried to look at the good in the NICU experience. Although I am not a religious or even spiritual person, I do believe in the concept of things happening for a reason. I tried to think positively while she was in the NICU. With the clarity that comes with hindsight I've come to terms with all the blessings in disguise that the NICU gave our little family.

Blessing 1: If you can make it here, you can make it anywhere.

In a way, the NICU is a lot like the vision of New York that Sinatra sang about. Neither Matt nor I had any experience with infant care before Natalie entered the world. We had not changed a diaper. So, we learned to change Natalie's diapers through the holes of the incubator she was housed in, with all the IV lines and sensor cords attached to her. We learned to give her a sponge bath with a nurse's assistance. We finally understood how to use the bulb aspirator. We gave her bottles and burped her. Basically, we got eased into parenthood under the supervision of what are no doubt some of the world's greatest medical professionals.
Pictured above, our absolutely favorite nurse. She deserves a medal, but the best we can probably do is bring her bagels and a nice note.

Blessing 2: Breastfeeding support

My nurses up in Family Centered Care, where I was recovering while Natalie was housed in the NICU, knew I wanted to breastfeed. So, just hours after Natalie was whisked away in the early hours of Friday morning they brought me a hospital-grade breast pump (the Ameda Elite) and had me get to work. They knew that I needed to pump if I was going to be successful once Natalie and I were reunited. One bonus is that they gave me all the attachments I'd need (which cost roughly $40) for free since Natalie was in the NICU.

The Ameda Elite hospital pump costs $950 to purchase at the hospital, but I could rent it for $19 a week or $72 a month from my hospital. I'm glad I didn't buy a heavy-duty pump before Natalie was born because I'll continue to rent this one for a while.

Here's the bottom line: breast pumps are no fun but totally necessary. One particularly patient nurse sat with me while I attempted to fill these tiny syringes with colostrum (the yellow stuff women produce before the actual breast milk comes in). To my (and her) shock, she helped me fill three syringes on my first attempt. They are a pain and a half to work with, but sending these syringes of colostrum down to Natalie in the NICU made me feel like I was doing something productive when I couldn't see her.

Of course, the first lactation consultation I met with came into my hospital room as I was in my final minute of pumping, round 2. In an attempt to help she grabbed the breast pump, eh, suction cups (?) off my boobs and spilled everything I'd spent 20 minutes pumping. I started to cry. That was a breast feeding low point.

After I requested that the horrible lactation consultant never visit me again, I met with three different lactation consultants, including one who specifically works with mothers of NICU patients. The NICU consultant was perhaps the most helpful, but all three women were good despite the fact that they literally all gave me very different advice. Finally, as I was sitting in the middle of the NICU bare-chested (lost my shame a long time ago in this process, if you'll recall) with Natalie draped across me, her splinted arm with its IV line across my stomach and various plastic bits from all her tubes poking into me as I tried to keep her off my c-section incision, the NICU lactation consultant asked me if she was latching on and if I was comfortable. I could reply yes to both. She said that's good because the technique I was using she would never recommend to anyone but if it worked for me I should keep going. Yes, in the circumstances, this was working and it was the best I could do.

As with all other aspects of infant care, I knew that if I could learn to breast feed Natalie in this environment we would get home and everything would be fine. That prophecy indeed came true.

Blessing 3: Versatile baby!

Like most mothers-to-be out there I read a bunch of baby books and talked to lots of friends who'd given birth over the years and soaked up all the information I could. I had heard enough about seemingly classic conundrums such as nipple confusion that I was determined to follow a regimented schedule: Natalie would not use a pacifier; she would get a bottle between 2-3 weeks of life after my breast milk supply was established and a breast feeding routine was well under way.

All these plans went out the window the moment Natalie was admitted to the NICU.

To soothe babies in the NICU, who, like Natalie, can't be held for long because they need to be in their incubators and/or underneath the bilirubin lights (or in her case underneath an oxygen hood for her pneumonia treatment), the nurses use pacifiers (the Philips Avent Soothies kind).

Because Natalie was separated from me, we obviously could not breast feed on a normal schedule, so she immediately needed not only an IV line but also supplemental formula (the NICU uses Enfamil Ready to Use newborn formula).

She was released from her incubator every three hours for a temperature check, diaper change, and feeding. Matt and I tried to get to as many of these feedings as we could, but inevitably we couldn't go to every single one, so Natalie was often handled by the awesome nurses.

The point of all this is that even though we were not caring for Natalie ourselves the way we would have chosen had she been with us at home, at least partially as a result of her NICU care Natalie is incredibly versatile. She takes a pacifier but isn't reliant on it. She takes a bottle of my breast milk about once a day from Matt. I love the freedom this gives me to run an errand or meet a friend for a few hours. But neither the pacifier nor the bottle created "nipple confusion" (a concept all our nurses essentially described as a crock). She doesn't need to be held by me to be soothed -- she will gladly fall asleep on anyone. And because she learned to sleep in a loud environment with beeping machines, crying babies and sirens blaring often, she can sleep anywhere. She is not the kind of baby who is woken up by barking dogs, ringing phones, door bells, the TV, loud voices....basically anything. You do not need to adjust your volume around Natalie. I have to attribute at least some of these qualities to her NICU experience.

Blessing 4: Free stuff

This may sound ridiculous, seeing as the NICU is a very serious place, but while receiving what the nurses aptly described as "the most expensive babysitting in the world" we also got a lot of free stuff. All my breast pumping supplies were free, which was great, and we received double portions of all the baby care items the hospital hands out for free to take home, such as diapers, wipes, and formula starter packs, but the most noteworthy free items would be the classes NICU parents can take.

The NICU has social workers who visit all the parents and inform parents of available classes and other services. Although our stay was so short we only participated in one class, I really like the fact that there are even classes such as scrapbooking that help parents bond with each other and take their minds off the heartache they are dealing with (while documenting their child's early weeks, or sadly, months of life).

We expressed interest in taking Infant CPR, and the two days later we were in the class. This was a class we were going to shell out $150 for through our hospital's parent education classes. (To put this in perspective, you may recall that we paid $100 for Natalie's labor and delivery, my extended hospital stay, and Natalie's week in the NICU -- thank you, health insurance.)

Everything we learned in our Infant CPR class will be subject of a future blog post, but for now I'll give you this little preview with the infant blow-up dummy we brought home from the class (which Matt has determined will somehow get worked into Natalie's first Halloween costume, perhaps as her evil twin).

In the Infant CPR class, we interacted with other NICU parents. We were by far the ones with the shortest stay. One mother who was there gave birth to twin boys January 1. One twin was transported to our hospital (because it's known for having a NICU so advanced it's like it's on steroids) and the other remained about 30 minutes away in the NICU of the hospital where they were born. This single mother (who also didn't speak English) expected for her babies to be released from the NICU in April. Sitting beside her we felt like absolute frauds, getting out of jail free, as the case may be. One of our nurses told us that the shortest NICU stay she's seen is five days and the longest is 250. We are indeed lucky.

As I learn to increasingly accept the things I cannot control, looking at all the hidden benefits of our NICU experience has been a great exercise.


  1. I can't imagine a 250 NICU stay...our littlest was their 25 days and that was enough. They are an awesome group of people who work there.

  2. Jess, I know! I cannot imagine the strength of those parents who must spend the majority of their baby's first year visiting the NICU. So sorry you had a 25-day stay -- hope everyone is healthy now!