Care in the NICU
The first time Darcy Orr saw her newborn twins, they were sleeping in separate plastic incubators filled with monitors and wires. Born 10 weeks too early, Cassie and Caden each weighed less than three pounds and were unable to breathe on their own. Like other newborns in distress, the babies went straight from the delivery room to the neonatal intensive care unit or NICU (pronounced NICK-yoo).
Orr, a registered nurse in Billings, Montana, knew what to expect before she ever set foot in the NICU. Lights blinked, monitors beeped, and doctors and nurses hustled back and forth. "I could sense other moms and dads getting overwhelmed, but I wasn't bothered by it," she says. "My medical background kicked in and I turned off my emotions for the first few days."
The emotions wouldn't stay bottled up for long. Over the next six weeks, Orr went through cycles of panic and joy. One moment she'd worry about brain damage or stunted growth, the next she'd hold one of her babies in her arms and feel boundless love. In that time, she discovered that parenting can begin long before a baby goes home.
If your newborn faces serious challenges -- such as prematurity, low birth weight, or a traumatic delivery -- you'll soon become a vital part of the NICU team. Your baby may not be ready to leave the hospital for several weeks, but it's not too early to start establishing lifelong bonds.
Obviously, you're going to want to know everything you can about your baby's condition. Ask the doctors and nurses to explain why your baby needs to be in the NICU and how long he might have to stay. If he's attached to any wires or tubes, know what they're for. Babies in the NICU are typically attached to monitors that measure their heart rates, oxygen levels, breathing rate, blood pressure, and temperature. Premature babies are especially likely to need feeding tubes in their mouths or IVs in their arms because they aren't ready to swallow yet. They may also need breathing tubes until their lungs have a chance to develop.
In the process of learning about your baby, you'll naturally discover many things about the NICU and its staff. You'll see that each staff member and each piece of equipment has a specific role. Before long, the chaos will begin to make sense, and you'll come to know and appreciate the people who are taking care of your baby.
As soon as you understand your baby's situation, ask how you can help. You may be surprised to discover how much you can do. For instance, many NICUs strongly encourage parents to hold their babies as soon as possible. Orr first held her children four days after their birth. She could only have them for three of four minutes at a time, but she didn't feel shortchanged. "It was the most incredible feeling in the world," she says. "When I finally got to hold Cassie, she calmed right down. She knew mom was there."
As babies become more stable, they can spend more and more time in their parents' arms. Typically, the diaper-clad baby rests against mom or dad's bare chest. The baby is then lightly covered in a blanket or the parent's shirt. This skin-to-skin contact, often called kangaroo care, is a precious time for parents, but it can also do wonders for the baby. According to the March of Dimes, kangaroo care can help babies control their body temperature, maintain healthy heart and breathing rates, gain weight, sleep soundly, and spend less time crying.
Not all babies are ready to be held. If your baby isn't stable or if he just isn't ready for the extra stimulation, you may have to wait. With a doctor's permission, you may still be able to stroke your baby's forehead or hold his hand. Keep in mind that extremely premature babies may not enjoy being touched. After all, nobody would be touching them if they were still in the womb.
Even when you aren't holding your baby, you can be there for him. Many NICUs allow parents to sit with their babies practically 24 hours a day. (They may ask parents to leave the NICU while they do daily rounds.) Other relatives may also be able to visit occasionally, although small children are often kept out to reduce the risk of infection. For her part, Orr visited Cassie and Caden at least three times a day. She'd watch them through the plastic incubator, and she'd hold them when they received their feedings. "I would tell other parents to spend as much time with their babies as possible," she says.
If you have a baby in intensive care, it makes perfect sense to be anxious, perhaps more anxious than you've ever been. But being at the hospital day after day can be an exhausting experience, and it won't help your family or your new baby if you make yourself ill. You're in this for the long term, so pace yourself. Spend an hour or two with your friends or other family members, or take a walk or a long bath while another family member visits. And don't hesitate to ask others to help you with the chores of daily life, like getting your other kids to school or cooking dinner for you.
Orr had her babies long before the COVID-19 pandemic, which has changed NICU care around the world. However, as an integral part of the care team, you should still be able to see your babies. As a February 2021 article in Frontiers in Psychology concluded, there are several ways "to safely support and empower NICU staff and enhance family-centered developmental care practices, without increasing the risk of contagion. Apart from evidence-based training on cutting-edge COVID-19 management tools, high priority should be given to the preservation of family-centered care principles, including parents' presence in the NICU, parent-infant physical and emotional closeness, and parental involvement in the infant's care. Furthermore, NICU systems should implement evidence-based assessment and treatment for parental distress while providing peer support for parents by video and voice calls."
Parenting in the NICU is never easy. Just remember: Every parent has fears, and every baby has a fighting spirit. Orr knows she's fortunate. Cassie and Caden passed their one-year checkup with flying colors. She loves being a mom, a passion that started the first time she saw them, wires and all.
NICU Parents Bill of Rights. NICU Parents Network. https://nicuparentnetwork.org/bill-of-rights/
Interview with Darcy Orr, R.N., mother of premature twins.
Cena, L., Biban, P., Janos, J., Lavelli, M., Langfus, J., Tsai, A., Youngstrom, E. A., & Stefana, A. (2021). The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities. Frontiers in Psychology, 12, 630594. https://doi.org/10.3389/fpsyg.2021.630594
March of Dimes. Parenting in the NICU. http://www.marchofdimes.com/Baby/inthenicu_confide...
Nemours Foundation, Kidshealth.org. When your baby's in the NICU. http://kidshealth.org/parent/system/ill/nicu_carin...
March of Dimes. Holding your baby close: Kangaroo care. August 2009. http://www.marchofdimes.com/baby/inthenicu_kangaro...