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What to Expect From a NICU Stay

Expectant mothers rarely include a stay in the NICU in their birthing plans. But, for ten to fifteen percent of all babies born in the United States, spending anywhere from a few days, to a few months in the NICU is a reality.

One in eight babies are born before 37 weeks, the benchmark for reaching full term. Because these precious little ones are often born with feeding and breathing issues, along with a host of other possible complications, premature infants make up the majority of NICU candidates.

Some babies are born with heart defects, infections, breathing issues, or other birth issues that make a NICU stay necessary.

One NICU parent summed up their family’s NICU experience like this, “ Being a NICU parent is something no one ever wants to be, but we learned quickly a new world of being in a NICU, and that in the end, it is an honor to be one, because you get to experience miracles every day.”

The NICU can be a scary place, but being informed can help ease your fears.

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7 Common Factors in NICU Mothers and Babies

No one can completely predict whether or not a pregnancy will end with a NICU stay for baby, but there are some common factors that can make a pregnancy high risk for mothers and babies. Pregnancies where one or more of these factors are present are more likely to end in a NICU stay for baby.

Mothers with NICU babies often have one or more of these factors in common:

  • under the age of 16 or over 40
  • to little or too much amniotic fluid
  • premature rupture of membranes
  • sexually transmitted diseases
  • diabetes, either pregestational or gestational
  • hypertension(chronic or gestational) or pre eclampsia
  • drug, alcohol, or tobacco use during pregnancy
  • carrying multiples
  • unusual bleeding

Babies who spend time in the NICU generally have one or more of these factors present:

  • premature birth or an overdue baby
  • low birth weight, baby being small for it’s gestational age
  • breathing assistance given in the delivery room
  • medicine given in the delivery room
  • birth defects
  • herpes, chlamydia, Group B Strep, or other infections
  • low blood sugar
  • the need for oxygen or other monitoring
  • seizures
  • respiratory issues
  • seizures
  • other birth anomalies

Issues during delivery can factor in to whether or not your baby will need to spend some time in the NICU. Here are some common delivery complications that can contribute to a NICU stay:

  • cord around baby’s neck or knots in the cord
  • fetal distress or lack of oxygen during labor and delivery
  • breech or other unusual presentation during delivery
  • baby passing meconium (first stool) during labor or delivery
  • c- section or forceps delivery

Your healthcare provider will perform a thorough evaluation if one or more of these factors are present to determine if your baby would benefit from additional testing and observation, or the skilled care in the NICU. 

6 What You Can Expect After Delivery

If your pregnancy involves any of the risk factors listed above, it’s likely that you will have had extensive testing done to determine your baby’s condition prior to labor and delivery. The results of these tests will help determine the course of action that will provide your baby with the best possible outcome after delivery.

Depending on baby’s condition, there are many different scenarios that can take place after delivery. Your healthcare provider will go over a high risk birth plan with you before delivery. You may have the chance to visit the NICU, meet the specialists who will be involved in your baby’s care, and any support services staff the hospital offers.

If baby’s trip to the NICU is an unforeseen event, you will learn as the situation progresses. Your healthcare provider will do his or her best to answer questions and address any concerns that you may have. In an emergency, things may move quickly, and the health of your baby is the staff’s primary concern.

A high risk delivery is very different from a normal delivery. Your doctor will be present, as well as a separate doctor for baby.There will be NICU nurses present, along with any equipment that may be needed to assist baby after delivery. There will also be OB nurses on hand, as with a normal delivery.

During delivery it is important that you follow any instructions that the medical staff give you, or your support persons. After delivery, things will move very fast as the staff evaluates your baby’s condition. The staff will make every effort for you to hold and/or see baby after assessing him or her. However, baby’s condition will dictate whether or not that is possible.

The NICU staff and neonatal specialist will give baby any immediate support necessary to stabilize him or her for transport to the NICU. The presence of tons of equipment and staff can be overwhelming and even scary, rest assured that they are all there to help your baby have the best outcome possible.

5 The NICU

Once baby is stable, he or she will be transported to the NICU for further observation and treatment. Your baby’s doctor and the NICU staff will get baby settled in while you are in recovery.

Staff

The NICU is a very busy place. Besides the constant sound of buzzers and monitors, there are quite a few people on staff to make the NICU run efficiently, and offer support to the babies and their families during their NICU journey.

Besides your baby’s main doctor, he or she will be attended by any specialists that are necessary to address the unique conditions that your baby is dealing with. A charge nurse will be present to oversee the nurses and provide the doctors with needed information. Your baby will have his or her own nurse each shift who is specially trained in neonatal medicine.

You will probably meet with support staff as well. Social workers, lactation consultants, and clergy are available in most hospitals for patient and family support.

Care

Nothing can prepare you for seeing your baby in the NICU for the first time. The sterile environment of the NICU isn’t exactly what parents imagine when they picture baby’s first accommodations.

The nurses can help explain any of the support equipment or monitors that are used in your baby’s treatment. Knowing what these things are makes them less intimidating.

Here are some things you may see during your NICU stay:

  • Your baby may be in an infant warmer to help regulate his or her temperature
  • Isolettes are used when baby needs a climate controlled environment.
  • Ivs are used to deliver fluids and medication quickly.
  • Arterial lines are used to monitor blood pressure and oxygen levels. Alternatively, your baby may have a blood pressure cuff and oxygen monitor in place externally.
  • Phototherapy is used to treat jaundice, a common ailment among NICU babies.
  • Monitors will record baby’s vitals.
  • Ventilators are used to give respiratory support.

Feeding tubes help to provide needed nutrition.

4 Bonding With Baby

During a normal birth, bonding occurs quite naturally. Bonding in the NICU is a different experience, but you can still develop a bond with your baby, in spite of the monitors and support equipment.

Feeding and snuggling baby are two of the ways parents initially bond with their babies. But what if you aren’t allowed to touch, let alone nurse your baby? Here are a few ideas on how you can create a bond with baby:

  • If baby is unable to nurse, pump breastmilk. Providing nutrient rich breast milk and colostrum gives baby a nutritional advantage.
  • Spend time talking and singing to baby. The sound of your voice is comforting to baby. If you are unable to stay at the NICU record your voice and the voices of baby’s other family members to play when you can’t be there.
  • Doctors often encourage mothers, fathers, and siblings to “tag” a blanket with their scent so baby can get used to their scent. One of the easiest ways to do this is to have family members sleep with a blanket or burp cloth.
  • As much as possible, make baby’s NICU room homey. Bring pictures of family, friends and pets to display. Put up pictures drawn by siblings and other young relatives. Stuffed animals and colorful blankets can be used to decorate as well. If you are able to do so, play peaceful music in the room.
  • As soon as you are able, dress baby in his or her own clothes.
  • Take pictures, your baby’s NICU journey is an important part of your family’s history. Some parents keep a NICU journal to record milestones.
  • Hold or touch your baby whenever possible. The nurses can tell you if baby is stable enough to be touched or held. Learn everything you can about the support equipment and monitors that are being used to care for your baby to make them less intimidating. Touch is a powerful thing, and as soon as he or she is able, skin to skin contact will do wonders for your tiny miracle.

3 The Emotional Impact of a NICU Stay

The emotional impact of a NICU stay can be significant for all members of the baby’s family. Having a little one in the NICU is an emotional rollercoaster. One NICU mom I spoke with said that the daily “one step forward, two steps back” that often occurs on baby’s road to recovery is one of the hardest parts of the NICU experience. Financial stresses can add to the mix.

As the days wear on into weeks, you may experience a myriad of emotions. This is a normal part of having a baby in the NICU.

Many mothers blame themselves for their baby’s condition. They feel that they could have done something to prevent this from happening. This is rarely the case, most of the factors that cause a high risk pregnancy or delivery are completely out of the mother’s control.

Parents often grieve the loss of the labor and delivery experience that they’ve dreamed about. Every parent dreams of the day when they hold their precious little one in their arms for the first time, the stark reality of a NICU experience dashes any hope of a “normal” delivery and postpartum period.

Sometimes the stress of a NICU stay can cause issues in your marriage or family. Dealing with the illness of a child is never easy, and the touch and go condition of a NICU baby is even harder to process. Make sure that your family is taking advantage of the support that friends, family, and clergy can offer.

Many NICU moms report having increased anxiety and irrational fears. Facing your baby’s health issues and even the possibility of losing your baby can cause anxiety or depression to manifest itself in the form of irrational fears. This is perfectly normal, and should be discussed with your healthcare provider or the hospital’s social worker.Some hospitals offer a support group for NICU families during their stay.

Some parents find that they suffer from PTSD after a NICU experience. Completely healing after a NICU experience can take months, or even years. Don’t be afraid to get professional help to process your NICU experience.

2 When Will My Baby Be Allowed to Go Home?

There is no surefire way to predict when your baby will be allowed to go home. However, there are certain milestones that will have to be passed before going home can even be considered.

A few of the most common hurdles baby has to get past before going home:

  • Most babies are unable to go home until they are breathing completely on their own. Some babies are released while still on occasional oxygen. Any respiratory issues need to be treated or resolved before baby comes home.
  • Baby’s breathing and heart rate have to be stable. Some babies are sent home with an apnea monitor to monitor baby’s breathing patterns and heart rate.
  • Baby needs to take all his or her feedings by mouth and be gaining weight.
  • Baby will have to be able to maintain normal body temperature on his or her own.

Any other issues your baby has will be addressed before your baby is dismissed.You will be educated as to how to care for any ongoing issues that your baby may have.

It’s normal to feel fearful and a little overwhelmed when the time comes to take your baby home. Following your doctor’s instructions and keeping scheduled appointments will help your baby’s doctor to monitor his or her progress and address any issues that may come up along the way.

1 What Can I Expect After Baby is Home?

Finally being able to bring baby home is just one step on your NICU journey. Babies who have spent time in the NICU are different from other newborns.

Your NICU baby will be more susceptible to illness. This means that thorough handwashing or dousing with hand sanitizer before holding baby is a must for everyone that comes into contact with baby. From older siblings, to the well meaning ladies at church, everyone has the possibility of passing on illness that may be a huge setback for your baby.

Your need to plan for any treatments or medicine your baby requires. This means scheduling outings around baby’s needs. If you plan on hiring childcare, you have to make sure that your provider is aware of the special needs your baby may have, and has experience in dealing with NICU babies.

If your child has ongoing special needs or disabilities, you and your family may want to seek out support. Support groups, special needs play groups, or professional counseling may benefit your family as you adjust to caring for your child. Home health care and respite care can provide much needed breaks for caregivers.

Having a baby in the NICU is an experience that most parents would choose to do without. But the families who have gone through a NICU stay will all tell you that even though it was one of the hardest experiences in their lives, that it was also a time of growth, realizing great strength they never knew they possessed, and witnessing miracles on a daily basis. 

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