Tag Archives: NICU Nurse

Helping Mum to be Mum: Life in NICU

You’re a new mum, getting to know your new baby.

Sleep deprived you wrestle wriggling limbs into a baby-grow, changing yet another sicky item of clothing, wondering if any milk is staying down at all!  How perfect they look in their new sleep suit, the cute one your friend brought round the other day.  Then their cheeks flush red and you smell that smell… off to the changing table again!  Dressing your baby, feeding and changing nappies are all part of being mum.

Yet for mothers of premature babies these everyday tasks, so synonymous with parenthood, are undertaken in the most clinical of environments.

Parent’s often wait days, if not weeks to dress their baby.

Nappy changes happen through incubator portholes and are all done to pre-determined times dictated by your baby’s daily chart.

smallest thingsAnd to hold your baby…mothers can wait hours, days or even weeks after birth for that first precious hold.

Parents of premature babies will tell you, there is a lot of watching and waiting in NICU. Hours can be spent beside incubators, mothers and fathers watching their new babies, yet not able to do those seemingly basic tasks.

A mother will always remember the nurses who helped her to be a mum on NICU.

The nurse who helps you with that first touch; the one who shows you how to hold and cradle your baby in their incubator.

The nurse who shows you not only how to change their nappy, but who understands how nervous you are; how scary it can be to move your own babies limbs so small and fragile, and how the sound of alarms and buzzers can terrify you as you contend with a host of wires and tubes.

The nurse who asks if you’d like to dress your baby for the first time, the one who helps you to manoeuvre limbs and lines into tiny sleeves.

The nurse who tells you that you are doing just fine.

Nothing can be more important than helping a mum to be mum or a dad to be dad when a baby’s life is short.  Still just as precious, still just as loved and parents still parents.

seeing our son for the first time

 

In neonatal intensive care the small things matter, particularly when you are unable to hold your baby. Simple acts such as wiping tiny eyes or cleaning tiny fingers can leave lasting memories, create bonds and fulfil a mothers need to care; the importance of these acts must not be underestimated for all parents, no matter the length of their NICU stay – days, weeks or months.

Neonatal care is a medical world, a hidden world alien to most parents. Incubators housing tiny lives, monitors, machines, tubes and wire…. For medical staff the sound of alarms and buzzers are part of everyday and moving tubes and tiny babies becomes second nature, but for parents whose worlds may have be turned upside down in just a few hours it can be a scary, isolating and depowering place.

It is a NICU nurse who can give you back that power; a NICU nurse who can give you meaning in a world which can suddenly seem empty.

It is a NICU nurse who can help you to be the most important person to your baby – mum.

Smallest Things

30ml Mum

No one had spoken to me about expressing before.

I guess I’d never thought of it before and at 30 weeks pregnant preparing to feed my baby seemed like a long way off.

seeing our son for the first time

seeing our son for the first time

And now here he was; covered in lines and tubes. Monitors beeping and in a pespex box so far removed from me.

My waters had broken with little warning and he’d arrived soon after. The labour was straightforward and I was discharged from the ward. And there he was, in NICU. And there I was, getting ready to go home.

I was exhausted, numb and in shock. We’d spent the afternoon sitting by his side – watching, waiting – taking everything and yet nothing in. The nurse looking after us suggested we went home to get some rest. She knew we had a long road ahead of us. Leaving the unit the breastfeeding nurse caught up with us – had I started expressing she wanted to know. The blank look on my face told her all she needed to know. I was taken into the expressing room. Had I not been so emotionally and physically shattered the site of tubes, machines and buckets of sterilising equipment could have been enough to terrify me. “We’ll just start with a small syringe” she said. That was the image that terrified me until I realised she didn’t mean needles! I was taught how to hand express and produced just a few drops. Then off I went with a brown paper bag full of 1ml syringes and sticky labels, leaving our new born son for the first time.

Express every 3 hours I was told – so sobbing for the baby who was no longer with me I climbed into bed and set my alarm. It was a long night. It was a surreal night. I put on the TV to try to keep me awake as I chased rolling droplets of milk around my boobs, try to catch them into the syringe. It was tricky, almost like some sort of bizarre game! I changed to expressing into a bottle, but the tiny droplets took up such a pitiful amount of space that I reverted back to the trusty syringe.

There’s not much on TV at that time of night and I switched over to news 24. I expected that to be quiet too, but instead I found myself watching rolling news of riots breaking out across London. I knew I was exhausted; I knew I was probably in shock – but really?! My whole world was turning upside down!

NG tubes

NG tubes

Over the next few days I continued to hand express and would proudly present increasing sized syringes of my milk. I would watch as tiny amounts – 1ml / 2ml would be given to our baby through his naso-gastric tube. Day 3 came and I was told it was time for the pump! The machine whirred as it pumped. Your milk should be coming in around now I was told.

10mls, 20mls – sometimes 30mls. It wasn’t enough to keep up with my babies increasing demands. “Don’t focus too much on it”, one nurse told me – stress won’t help your milk come in. Then another nurse would tell me “You need to be producing more, we won’t have enough for your baby.”

Everything revolved around expressing. Was I doing something wrong? Why couldn’t I produce more? Other mums would enter the expressing room and fill bottle after bottle – I couldn’t even get half way.

“Are you producing anymore?” I was constantly asked. My answer was always the same.

“How about expressing by the cot side – that might make you feel closer to your baby”. It had the opposite effect and instead reinforced the distance that there was between me and my baby.

And then came the day I was told there wasn’t enough of my milk left – they would need to top up with donor milk. I was devastated. I had failed.

But then it became a relief. My baby wouldn’t go hungry. He wouldn’t be left without milk. I was producing what I could and would continue to do so, but in some way the pressure slowly lifted. I never produced much. On good days I would get 60mls, occasionally 70mls, but generally my expressing number was 30mls.

first breastfeed

first breastfeed

Breastfeeds were introduced slowly as he grew – giving him a chance to just ‘practice’ to start with. “Putting him to your breast will help with your milk supply,” I was told.

My expressing number stayed at 30ml.

“Domperidone may help” – I stayed at 30ml.

“Are you drinking enough water”, “Are you getting enough rest” (seriously!), “Are you eating well?” (Hospital canteen sandwiches that were grabbed during a quick break from the ward…)

I stayed at 30ml.

Then one day things started to change. I didn’t produced masses, but just enough to see that all NG feeds were from my expressed breast milk with no top ups. It had happened by surprise and although I knew that his demand would go up again, I felt like I’d achieved a small victory in finally meeting his needs.

My victory was short lived. My increasing milk supply was short lived.

The SCBU nurses had watched as my confidence along with my increasing milk supply had grown. They were letting me room-in to establish breastfeeding. We were about to go home. The moses basket was ready and waiting. Then came the worst day of my life. My tiny baby stopped breathing in front of me. We were rushed via resus straight back into intensive care.

We were right back at the beginning and so was my milk supply. It never recovered. My expressing number wasn’t even 30mls any more. More like a pitiful 15ml.

All important cuddlesThe event made me realise though that it isn’t down to whether you are doing things right or wrong. So much of it is to do with the alien environment in which you find yourself. To do with your own emotional and physical needs as you process the trauma of your early delivery.  You are sometimes made to feel like expressing breast milk is the best and only thing you can do for your early baby. I found that the best thing I could do for my baby was to hold him and to be close to him. The nurses in SCBU would say that he would get too clingy, that he would want holding all the time.

But how could he? He’d waited so long for that first cuddle and now still spent so much time in his cot by himself.

And afterwards – He didn’t turn into that clingy baby, instead he grew into content and settled baby. I continued to breastfeed on discharge, but always topped up with a bottle. It was tiring for him though, so the breastfeeds gradually reduced.

Looking back now I realised that in total I had expressed and breastfed, as well as topping up with formula for a total of 5 months. I guess that’s not bad for a 30ml mum!