Welcoming a Premature Baby
Welcoming a premature baby can feel incredibly overwhelming and scary, even as you are joyful to be meeting your child. The clash of emotions, the postpartum hormones, and the stress of NICU life has a huge impact on your postpartum experience. But it doesn’t have to mean the end of your hopes for your postpartum or motherhood journey.
Let’s Talk “Premature”
It is important to remember that there is a huge range of what premature is – from 24 weeks to 36 weeks. The experiences for both parents and baby vary widely within that range. After all, the needs of a 24 weeker are significant compared to most 36 weekers. And even then, each individual baby will be different.
Any baby born before 35weeks+0days will be looking at an automatic admission to the special care nursery or NICU (neonatal intensive care unit). This is a specialized care unit whose focus is entirely on newborns with medical needs. Not all of the babies there will be premature, but prematurity is the number one cause of NICU admissions.
How long your baby is in the NICU will depend on a number of factors including how well they are eating, gaining weight, maintaining their temperature, and breathing.
Welcoming a Premature Baby
When your baby comes early, you may feel like you were cheated out of some of the joys of pregnancy. A premature baby may come before you were able to have a baby shower or do maternity pictures. They may arrive before you have filled the freezer with meals or decorated the nursery. Grandparents may not be ready to visit and your maternity leave paperwork is rarely ready to go. But there are still ways to welcome your baby with joy.
Things to Do
Sending out a birth announcement can feel overwhelming (especially if you haven’t put together the mailing list yet) but it is still a wonderful way to introduce your baby to the world. It also updates friends and family who might not be immediately aware, without you having to answer a million questions or reach out to everyone individually. Use this as a chance to introduce your baby, acknowledge the fact that they came early, and gently request what you need from those who care about you the most. This could mean privacy or support, whatever you need.
Take pictures – the NICU is overwhelming and scary and taking pictures may be the very last thing on your mind. You might even be thinking that the suggestion is absolutely bananas because this is not something you want to remember! But these are the first days and weeks of your baby’s life and they are worth documenting just as much as if you were taking pictures at home of a peacefully sleeping baby. This is part of your child’s story and you will want to remember it, even if it doesn’t feel like it now.
Ask for lactation support early in your journey. Every GTA hospital NICU has lactation support available for families with babies in special care. We know that premature infants do best on human milk. It is the easiest on stomachs and bodies that weren’t really meant to be digesting yet. A hospital lactation consultant can help set you up with a hospital grade pump which is the best way to encourage your milk supply and provide for baby. Even if your baby is not ready to be put to the breast, breastmilk is still the best thing. If pumping is not working or you aren’t pumping as much as baby needs, do not stress. Pasteurized donor milk is available for babies who need it, and older preemies may thrive on formula.
Hospital Transfers
This part of the process is often a surprise to families. But not all NICU‘s are the same and they support different levels of patient needs. Level 3 NICU’s are the highest level of care and are often reserved for the highest need babies. In Ontario we have eight level 3 NICU’s (London Children’s, McMaster Children’s, Mount Sinai Hospital, Sick Kids, Sunnybrook, Kingston Health Sciences, Children’s Hospital of Eastern Ontario, and the Ottawa General). The babies at these hospitals were born before 30 weeks or have more significant medical needs. They may also have been born at that hospital.
Once your baby is improving they may be transferred to a Level 2 or “step-down” unit. These special care nurseries are for babies who do not typically require breathing assistance and are considered stable. We often refer to these babies as “feeders and growers”. This means they are there to gain weight and learn how to feed well. Some of these step-down units have beds or rooms where parents can spend the night with their baby in anticipation of being discharged. This change can be stressful but it also means your baby is closer to being home.
Doula Care
While your doula won’t be giving much hands-on help while in the NICU, we are still there for you! If you had a birth doula, they can help you to process the birth experience. They can also help you to find resources for while baby is in hospital. If you have a postpartum doula, they are a great help once baby is home! It is a big adjustment to bring a NICU grad home. Your postpartum doula can help you to process being home, all the changes, and all the stresses. She can also help you to feel confident in caring for your baby away from the nurses.
Welcoming a premature baby is scary. The statistics and numbers and warnings are enough to make anyone afraid. But there is also so much support and care available to help you with the experience. And even in the hardest moments, you will find joy.