Let's talk about NICU and babies

[brownay2]

Just looking for some information. I am not really familiar with the hospitals NICU. I have never had to have one of my babies in there. Unfortunantly we are going dady by day at this point trying to keep her in the womb as long as possiable. Last week my midwife said at my 31 week appointment that it looked like the baby was around 4 lbs. how she could tell I have no clue. That really isn't factually enough for me.

My question is what risks would me baby at almost 32 weeks tommorow face if born at this time? I am really scared, as everyone hopes to have their baby healthy, and be able to not have them in NICU. How long do they keep them in NICU? I would hate to leave the hospital while she is there, it would break my heart. I have had pre-term labor since the day before Thanksgiving, and they have been trying to stop it. I am contracting every 4-5 minutes, with some dialation since Thanksgiving, I am tired, and just so frustrated right now.

One of my selfishness quirks right now is worrying about the breastfeeding, as I was hoping to just have the baby and start breastfeeding, with no help, like my other two, and I have no clue why I am so worried about this. What does a baby at this stage even look like is another thing in my mind, and actually real life picture of a baby already born at this age, not in the womb, or a colored picture, anyone have a link to some premie pictures. I feel like if I would see some pictures I would be a little more bale to cope, at the sight of a tiny baby, then have her and then see her and be emotional distraught.

I have been having so my anxiety, it is unreal. I really hope everything turns out ok.

[Honeybee'smama]

I don't really have any information about NICU, I am sure other mama's will chime in soon. But I just wanted to say to you and your family and congrats to making it to 32 weeks!

I don't think worrying about breastfeeding is a selfish quirk at all! It sounds like breastfeeding went smoothly with your other two, of course you want that for this one as well! Maybe you could talk with some LLL people about your breastfeeding worries, they might have some information and if nothing else support.

[pfamilygal]

My girls were born at 33 and 34 weeks. Anna latched immediately at 34 weeks, fed perfectly and we went home the next day. Abby went to the NICU at 33 wks and I was able to start nursing her at 2 days. We had a lot of problems and the LC at the hospital was absolutely not helpful. I developed a pp infection that made things worse. I pumped for her for 3 months, but never really established good nursing at the breast. I am hoping things go better this time and know that we will be heading straight to LLL as soon as we are dc'd from the hospital.

Woo hoo on making it to 32 wks. At 34 wks you will be even better. My goal is 34. I am taking shots weekly to try and keep Luke in. Have you had the betamethasone (Celestone) shots? It is two shots 24 hrs apart and helps mature the baby's lungs. I had them with Anna and did not with Abby. I really feel like they made a difference. The girls were only 5 ounces different in weight, but Anna's breathing was so much better.

[zavierchick]

hang in there mama! as for the NICU- try to view it positively, it will lessen your anxiety, which I think will help with your overall health too. DD was in ours for 13 days, I was discharged at 4 days- so for 9 days I went to the hospital and was with her when I could be (also recovering from c-section) Because our whole birth experience was everything that I didn't want to have happen, the NICU was actually the least of my worries. They were FANTASTIC, other than really pushing bottle feeding her EBM to keep her from struggling for anything (she desperately needed to gain weight- was born at 3 lbs 6 oz) which resulted in a VERY long struggle with breastfeeding (that's another post!) I pumped like a wild woman because I didn't know how much she would need (ended up donating to milk bank) It depends on the situation as to whether they need an NICU stay...factors that come up frequently are weight (technically Peanut was supposed to stay there until she was 4 1/2 pounds, which would have been nearly a month and a half!!!) we were only allowed to take her home because I have medical training, and we promised to co-sleep (how's that for a change of pace...a hospital making you promise to co-sleep???????) Other factors, for preemies especially, is lung development...a bigger problem at our altitude here than some places. The best thing I could say is, maybe head on up and check it out (your NICU) if it is a worry for you- it will likely help you to feel better about it being a possiblity this go around- and ask exactly what to expect before it comes up (or hopefully, doesn't and all this worry will be for nothing anyway!)

[spero]

Even if you are physically unable to breastfeed your babe, a good NICU will allow (or, like mine) encourage you to pump breastmilk. If the baby has an OG or NG tube for feeding, they'll put the breastmilk right in there (when they are certain that the baby can digest) and then transition to a bottle and/or breast when the baby is able.

We had a wonderful NICU experience with our daughter. She was full term, but had a chest tube for a collapsed lung and couldn't nurse for several days. The NICU had a very nice pumping room and milk storage area ... I never once saw formula given to a baby while we were there. All the preemie moms were pumping.

Is there a chance you could get info on the NICU in your hospital? Possibly a tour? Ask about their breastfeeding policies, and make your wishes explicitly known (a written care plan wouldn't be a bad idea).

Be proactive, and get information NOW, so that you won't be going in blind on top of being post-partum/emotional/hormonal.

[pfamilygal]

You can click on the Abby's birth album here: www.picturetrail.com/pfamilygal and see some real NICU pics. Abby was 33 wks.

[EllasMama]

Sending you hugs and hoping baby stays in as looooong as possible. I am not personally familiar with NICU, but I know that a good lactation consultant will help you to establish breastfeeding in different ways (depending on baby's abilities). Breastmilk is the best for a preemie just like a newborn, so hospitals should do everything to help you - giving you a hospital grade pump for example. Sometimes you get a great LC in the hospital, but it might be a good idea to look around for a really excellent one in your community right now so you have their number readily available and have a relationship. They can answer your questions to help you feel more secure right now. I know they can help you with how/when to pump, how to start feeding baby partially by breast and partially with a supplementer, that sort of thing.

I think it really depends how big the baby is at the point of birth and what is/isn't fully formed. I think even at say 34-35 weeks, some preemies function essentially like small newborns who just need a little extra help, and some have more issues, but the rate of babies who not just survive but truly thrive is huge after 30 weeks. You're growing your baby so well and just keep taking extra great care of yourself (and making sure plenty of other people help with everything, too!). One thing that you really need is emotional, not just physical, support. Talking to an LC will help; you might also try to make sure you have someone IRL (friend, therapist, mom who's been through having a preemie) to share your worries, feelings, and hopes with. Anything that will help you feel better is great for you and the baby. Hopefully you'll get some great replies here from mamas who've been through this.

Take care and best wishes!

Carol

[rachdoll]

I don't have personal experience with NICU, but I know that every baby's length of stay there varies, depending on how much attention they need. I'll be praying that you have a safe delivery when your baby is ready, and that any stays in the hospital will be brief.

Oh, and I understand wanting to breastfeed without issue! If there is a NICU stay, be adamant with the hospital staff that you are breastfeeding! Some supplementation may be required, but you can absolutely offer your breast every chance you get, and pump, too. It would be a good idea to speak with a LLL leader or a lactation consultant now so you can have assistance as soon as you need it.

[sweetpeasmom]

Just lurking..
Don't worry you are not selfish thinking about breastfeeding at this point. BM is the absolute best thing a preemie could get!! I had mine at 25 weeks and after i was settled back into my room and even though i was very tired and it was the middle of the night I wanted a pump and started my pumping adventure. BM is usually very highly encouraged in NICU's so most likely you will get support there.
As for the stay, that really varies. But each day the baby stays inside you, the shorted the NICU stay is generally. We spent 102 days in the NICU but that was for a 25 weeker. Gnerally a 4 lb baby will pretty much look just like a tiny baby.

here's a few pics of my baby around 4 lbs, this one was a few days before she reached 4 lbs, believe me i remember it like yesterday!
http://img.photobucket.com/albums/v1...an/121704a.jpg

this is actually a week later, she was 4 lbs plus. Notice the big difference
http://img.photobucket.com/albums/v1...an/122404a.jpg

if you want to see one at her lowest weight, it was 1 lb 7 ozs.
http://img.photobucket.com/albums/v1.../000_1621p.jpg

It's good that you are getting prepared in a way just in case. I didn't have that and honestly had no idea what to expect and totally freaked when i first saw her. Even though your baby will be bigger, the NICU is still pretty tough place to be in. You'll see babies just like mine, you can't help it, they just may be right next to yours. It is difficut seeing them so small and tiny with wires and tubes everywhere. Often you'll see moms crying next to their babies or running out in tears, having a breakdown outside etc... There will be so much you will hear, see, experience that it's just hard to describe. But hopefully you won't have to and that baby will stay nice and snug inside and come out a big and healthy baby!!

Hugs to you and hang in there

[danav]

I don't have any experience with a preemie, but I did have a full term NICU baby (Noah was there for 4 days after being born depressed, not breathing with a very low heart rate, at the birth center). As awful and overwhelming as it was to have my baby in intensive care rather than home with me, I do have to say that I had a good experience there with regard to breastfeeding at least.

I had pleaded with the neonatologist who came to the birth center about not letting anyone give Noah any supplements or bottles, and he ended up writing orders on the chart in big bold letters about "breastfeed or cup/finger feed only". I wasn't allowed to try to nurse him for over 36 hrs (until they had determined that his system could handle it), so he only had IV fluids until then. They had a LC come see me the first morning and she gave me the set up to use the electric breast pump they kept in the breastfeeding room so I could start pumping right away, and showed me how to use everything.

Overall they were pretty supportive of breastfeeding. I slept on the chairs in the waiting room to get a little sleep, and the nurses would come out and wake me to nurse him every few hours. They had a breastfeeding room (two, actually) so I had a place I could go and sit in a comfy chair in private, away from all the chaos of the unit, and nurse for a while. They had a special refrigerator that they could keep pumped breastmilk in, in case a mom wasn't able to be there for a feeding - I was able to be there for every feeding so Noah never got anything but the breast, but for a baby who has to be in NICU longer and a mom who just can't be there around the clock every day, that would be really helpful.

Someone did give Noah a paci when I was gone briefly once, even though I had expressly told them not to. So you do have to be vigilant about things like that...but aside from that (and the fact that they shoved a paper grocery bag FULL of prefilled formula bottles at me when we were finally leaving : ), they were on the whole supportive of breastfeeding.

Wanting to exclusively and successfully breastfeed your baby is NOT a selfish quirk - please don't feel that way! I'm so sorry that you are facing such a stressful situation - I will pray that your baby will be able to stay put for several more weeks and you are able to avoid any problems altogether! Lots of s to you...

[FancyD]

Originally Posted by skellbelle

Even if you are physically unable to breastfeed your babe, a good NICU will allow (or, like mine) encourage you to pump breastmilk. If the baby has an OG or NG tube for feeding, they'll put the breastmilk right in there (when they are certain that the baby can digest) and then transition to a bottle and/or breast when the baby is able.

We had a wonderful NICU experience with our daughter. She was full term, but had a chest tube for a collapsed lung and couldn't nurse for several days. The NICU had a very nice pumping room and milk storage area ... I never once saw formula given to a baby while we were there. All the preemie moms were pumping.

Is there a chance you could get info on the NICU in your hospital? Possibly a tour? Ask about their breastfeeding policies, and make your wishes explicitly known (a written care plan wouldn't be a bad idea).

Be proactive, and get information NOW, so that you won't be going in blind on top of being post-partum/emotional/hormonal.

A big "yeah that" to skellebelle's post. I had a full-term NICU baby and they were very encouraging wrt pumping. The bolded part is very important. DS went in the NICU unexpectedly (hypoxic) and I was in a tail-spin. Our nursing relationship suffered not only due to the NICU stay (and his subsequent issues), but also because of my massive depression and ptsd.
Good luck to you!

[Sleepymama]

I don't have experience with a preemie, but my 39 weeker was in the NICU for 3 weeks due to a heart defect. He also had low birth weight and many of the same issues with feeding that preemies have.

You are not selfish to think about BF at all!! What you should do now:

1) find a lactation consultant that has experience with preemies. If the hospital's LC staff doesn't know, call around.

2) make sure your hospital is level III NICU and that you'll be delivering somewhere that is equipped to handle preemies (you've probably already done this)

3) as soon as possible after delivery, have a hospital grade breastpump brought to your room--medela classic or lactina. Start pumping as soon as you can and make sure to pump every 3 hours at a minimum. Every 2 hours is better (during the day, you can go 3 hours at night). This routine is brutal, depending on how long you have to do it. At home set up your pump and supplies right next to the bed so that you barely have to wake to pump.

4) Start taking fenugreek and drinking mother's milk tea ASAP after the birth (this is less important if it's your 2nd or more baby, but if it's your first you want to ensure a good supply)

5) here is some good info on BFing in the NICU & preemies
http://www.kellymom.com/bf/preemie/preemie-links.html
The best book about BFing preemies is Dr. Mom's Guide to Breastfeeding--there is a chapter on special needs in there that is very realistic and has good advice.

Good luck, and the farther you get past 32 weeks the better! I won't lie to you--our time in the NICU was about the worst in my life, but it was a bit of a shock to find out that we had a severe birth defect. I think I would have been better off with a little warning. Make sure your family & friends are there to help--you will need people to do household chores, grocery shopping, etc. Being at the hospital 16 hours a day after giving birth is just exhausting. Watching out for ptsd/ppd is also important--the more people you have around to help you, the better. I didn't have anyone except DH (who had to work during that time) and I think that really precipitated my severe depression in the months afterwards.

Also, is there any way you can tour the NICU and find out their policies? Like, visiting hours, shift changes, policies about eating, what aspects of baby care you can do, etc.? This was really hard for us--we had no idea what was going on and were just thrown into it.

As far as I know, they like to keep preemies in the NICU until their due date (ish) or until they are gaining weight normally and can eat and breathe without assistance. This depends on a lot of factors, so there isn't really any solid answer on how long they'd keep her. Girl preemies do better than boys though, or so I've heard, so that's something to be relieved about!

[Lousli]

I had a 33 weeker, and we had a lot of trouble with nursing. But if you are committed, you can usually make it work. I had to pump every 3 hours around the clock for her to keep up my supply (plus her older sister helped a lot). She was fed by IV for a day or two, and then tube fed for a while. Her intake was so small compared to my supply that I filled 3 freezers with breastmilk by the time she came home! I strongly suggest getting a good LC to work with, and spening as much time in the NICU as possible so you can be there for feedings. (This was one of the main problems for us as I was trying to spend time with Hazel's big sister as well.) I will be honest with you and tell you that it took nearly 3 months for her to learn to be a good nurser, but she hasn't looked back since!

As far as what she will look like, she won't have the extremely tiny micro-preemie look any more. She will look like a finished newborn, but smaller, and lacking body fat. My daughter, for example, had very skinny legs and no butt! Her belly may seem big by comparison. She may be very red, or jaundiced. She may still have a lot of lanugo hair on her. She will seem like the most beautiful baby in the world to you, truly.

Four pounds is about right for weight. Mine was 4 lbs 1 ounce, and my 36 weeker was 5 lbs. 4 ounces. I'll link to some pictures for you:
about 10 min after birth:
http://i13.photobucket.com/albums/a2...Firstnight.jpg
3 days later:
http://i13.photobucket.com/albums/a2...proutsmall.jpg
23 days later, ready to come home:
http://i13.photobucket.com/albums/a2.../readytogo.jpg

[5xmom]

Everyone has given great advice - I would just add that it's a good idea to tour the NICU - it can make it less scary if you end up having a baby that has to be there. I had 31 and 32 weekers and they needed help with breathing initially and were not able to breastfeed right away. I pumped and in time was able to bring them home totally breastfed. My experience is that NICU preemies 32 weeks and earlier generally come home near their due date - maybe a couple of weeks before.

[forkids100]

My baby was born right before 33 weeks. I thought she was going to be born at 30 weeks in a hospital that isn't able to handle babies born before 35 weeks. Luckily I was put on a life flight helicopter to a larger hospital 160 miles away, was under the care of a perinatologist, and was able to keep my baby in until nearly 33 weeks by being on bed rest at the hospital. I too had a TON of anxiety about what my baby would look like, what her condition would be, and how long she would be in the NICU.
I would highly encourage you to visit the NICU if you have a chance. I wasn't able to because the NICU was so busy and didn't even have enough spaces for the babies being born at the time. It would have been much less overwhelming if I knew where my baby would be going after she was born.

I was surprised to hear that at the hospital my baby was born at, there was a 98% survival rate for babies born at 29 weeks...so I felt pretty good about where I was. Having the steroid shots to help develop my baby's lungs was the best thing that could have happened, as she didn't need a respirator and was only on oxygen for 2 hours.

As for her appearance, she was very tiny (3 lbs 2 oz), but looked like a miniature of a term baby. None of the scary things I had imagined. She was very healthy (apgars of 8 and 9) and very strong. I can only hope that your baby will be the same. I can't imagine what it would have been like if my baby would have had complications, as it broke my heart seeing the other babies in the NICU who were not as healthy as my baby.

I encourage anyone to be the best advocate you can be for your baby in the NICU. You will see MANY different nurses with different opinions and ways of doing things, and this can set your baby back a few days if you don't stand up for what you want for your baby. I was lucky to have a couple of nurses who were lactation consultants and helped me out A LOT. I pumped and my baby never had to have formula because I was able to keep my supply up. My baby continues to need 2 bottles a day so that she can get some extra calories from a milk fortifier, BUT, one of the lactation consultants had the Neonatologist write an order that my baby was only to be bottle fed with the Playtex Natural Latch nipple (slow flow), which is more like a mother's nipple and helps with breastfeeding. The good thing about the bottle is that it helped strengthen my babies suck so that she picked up breastfeeding a lot more quickly.
After 3 weeks in the NICU she got to come home and has been home for 2 weeks. My baby's lenghth of stay in the NICU depended on steady weight gain (not necessarily the actual weight, as my baby came home right at 4 lbs), ability to maintain temperature, and ability to take full nipple feedings for 48 hours straight without needing supplements from a feeding tube.
Good luck to you and I hope that things turn out okay.

[lilgsmommy]

My twins were born at 32w2days and are a week old right now.

The main thing with the NICU is not to allow it to overwhelm you. Easier said than done.

My sons were vented for 19 hours and required no oxygen. This isnt always the case with 32 weekers. They havent had any issues cept slight jaundice. Right now they are classified as feeders and growers. They have an NG tube and an IV right now.

There is another 32 weeker in the NICU who is vented and has been for 2 weeks and is requiring alot more assistance. And then theres a 34 weeker that just came in and is on CPAP and needs lots of assistance. But we have a 27 weeker who is now 6 weeks old 2 issolets over from the boys who still cant hold his temp, but is on only oxygen and getting NG tube feedings.

If youd liek to know more, just let me know by pm or email. I plan on posting an update in the next 24 hours on my boys, with pics of them being a week old.

[RedOakMomma]

s, mama.

I don't have much info to add to all these incredible experiences, but this stuff has been on my mind, too. My best friend is a NICU nurse in Denver, and she told me something that was _very_ comforting. She said, in her experience, almost all the babies born after 32 weeks went home (with some NICU stay) with no complications. So, even if you have to face the challenges of a NICU stay, congratulations on reaching the 32-week milestone. Pat yourself on the back and remember--you're baby will be healthy and strong.