I just got home from the NICU.... - Page 4

[bec]

Originally posted by LBBmom
Bec...I don't understand why they wouldn't let you breastfeed. If we have a baby who really needs the calories/sugar, we let mom nurse, then either wait and check a blood sugar or follow the breastfeeding with EBM in a bottle or formula. And I'm puzzled by the antibiotics. We only start antibiotics if there is a real reason to suspect infection....hypoglycemia does not fit that criteria.

I'm sorry your experience was so negative. I hope your next one is a very positive one for you.

I never did understand the breastfeeding thing. I pumped, and that was fed to her from a bottle before the formula, but because it was before my milk came in, there wasn't very much (and I've never been a very succesful pumper). We had a lot of problems getting her to nurse after that. If I had been less persistent, it wouldn't have worked. I am happy to say that she is 28 months now and still nursing.

The antibiotics also confused me. It wasn't until the 2nd day of the course of them that we were informed that we would need to bring her back to have her hearing checked, as hearing loss was a possible side effect of them.

I'm mourn mine and my daughter's experience at this hospital. I'm sure my next birth experience will be better, as it will be away from the hospital and the NICU.



Bec

[candiland]

Actually, I did write a letter of complaint. I work in the medical office building attached to the main hospital. I've doula'd for tons of births at this hospital, too. Episiotomy rate is incredibly high, the birth rooms are teeny tiny and full of harsh lights and metal equipment everywhere... it's like something out of a 1970's birth book or something... ah, beside the point...
Again, no reason to get so harsh with me. I totally understand that NICU nurses are very busy, stressed out people. Did I post that all NICUs are like that? That all nurses ignore crying babies? Honestly, some people will go to great lengths to argue and disagree. It was very upsetting to me, and many "mainstreamers" that I talk to don't think ignoring a crying baby is that big a deal. That's why I came to MOTHERING to post how upsetting this was for me. Not to create a huge controversy:
Also, about the hypoglecemia thing... I'm really glad I delivered at home, as both my kids were larger than average and would have been tested for that if they were born in the hospital. My midwife has only had a couple of cases of hypoglecemia in all her years of practice... why is it so common in the hospital? Do they just test so much that they have a bunch of high positives that would have been just fine without treatment?

[Greaseball]

I still don't understand the formula. I was under the impression that a mom produced milk when the baby needed to drink it, and that if she does not make milk in the first week it's because all the baby needs is colostrum.

I also thought human milk alone was the best and only food a preterm baby needs. It sounds like a lot of NICU nurses think most premies need to be supplemented with formula.

Re letters of complaint and other reporting: I think most people who have tried this know how frustrating it is and how usually nothing is done. Most reporting systems are not very reportee-friendly; they are friendly to those who do paperwork about it. In most hospitals the patients are seen as kind of the bottom of the heap. Doctors especially do not see courtesy and kindness as essential parts of healthcare.

(Again, only my exp., I hope there are many people who have had different ones!)

[LBBmom]

Originally posted by candiland
Also, about the hypoglecemia thing... I'm really glad I delivered at home, as both my kids were larger than average and would have been tested for that if they were born in the hospital. My midwife has only had a couple of cases of hypoglecemia in all her years of practice... why is it so common in the hospital? Do they just test so much that they have a bunch of high positives that would have been just fine without treatment?

First of all, I don't really think it was the content of your post, but the way it was presented. I think it's unfair to say that just because you saw some babies crying that these nurses "treat animals better" etc. I just found that a little offensive. But, I did apologize because I know I was a tad harsh and defensive.

The thing is that you really did not know the circumstances surrounding the crying baby, and you lept to a lot of conclusions about the nurses caring for him. Maybe the baby couldn't be picked up for some reason? And maybe they had tried and tried to calm the baby before you came in? Maybe the baby wasn't able to eat for whatever reason...maybe the nurses had done everything they could do to comfort the child, and they had to stop for a while and get caught up on other things. It is really hard to keep a hungry baby who can't be picked up from crying. There really is not a lot you can do. You don't know, yet you said some pretty harsh things. I can totally understand being upset about crying babies...it was the wording of your post that bothered me. Anyway, I think we're all running this into the ground a bit, so I'll move on.

About the hypoglecemia problem in the hospital...first, it is probably diagnosed far more often because it is tested for more often. But I also really think that all of the glucose-filled IV's moms receive in labor might contribute to it too. Just think of a mom getting a straight shot of glucose into her veins for the durations of labor. This in turn goes to the baby via the placenta. So during labor, the baby is getting tons of glucose he hadn''t been getting before, so he starts producing tons of insulin to compensate. Then all of a sudden, after delivery, the glucose supply is cut off, but it takes a while for the insulin to shut off....therefore resulting in low blood sugar.

That is merely my hypothesis though.

[LBBmom]

Originally posted by Greaseball
I still don't understand the formula. I was under the impression that a mom produced milk when the baby needed to drink it, and that if she does not make milk in the first week it's because all the baby needs is colostrum.

I also thought human milk alone was the best and only food a preterm baby needs. It sounds like a lot of NICU nurses think most premies need to be supplemented with formula.

Premature babies have very different needs than full-term babies. Preterm babies do not have the fat and reserves to go a whole week with only a few drops of colostrum. And even then, many times we have to fortify the breastmilk because it doesn't have enough calories to allow a small infant to grow.

I never said that preemies need to be supplemented with formula. We do, however, offer a bottle after mom nurses. And if she does not have EBM on hand, the baby will get formula. This is because a premature infant cannot afford to even miss one meal's worth of calories. I'm not saying the baby isn't getting adequate calories, but many times, it is questionable, so the baby gets formula. But if the mom doesn't have EBM on hand, then the baby has been getting formula anyway, so I'm not sure why it matters.

[spero]

Originally posted by Greaseball
It sounds like a lot of NICU nurses think most premies need to be supplemented with formula.

Again, I must say...this was NOT my experience!
In the hospital where my dd was a NICU patient, breastfeeding is highly encouraged. I never once saw formula being used in her nursery. All the babies were fed EBM, either through an NG/OG tube or with a disposable bottle (there was NO bottle washing by nurses...bottle nipples and pumping parts were collected in bins to be sterilized elsewhere in the hospital). As soon as babies were big enough/well enough to breastfeed, moms were urged to nurse them. I witnessed several moms coming in from home with little coolers of EBM for their babies.

Within the NICU was a comfortable "pumping room" and an upright freezer full to overflowing with little labelled jars of EBM. Honestly...I never saw evidence of formula anywhere! I never heard any of the docs or nurses mention it, either...but I did hear them encouraging and supporting all the moms to provide breastmilk for their babies. They all seemed to be big advocates for breastfeeding and it's many benefits.

Please do not generalize based on your own unhappy NICU experience.

[bec]

Originally posted by LBBmom
I'm not saying the baby isn't getting adequate calories, but many times, it is questionable, so the baby gets formula.

If a mother is trying to breastfeed (even and maybe especially her premie), I understand it is frustrating to medical staff that they are unable to measure how much a baby is taking in. Breasts don't come with measurements on them. But it would be possible to weigh the baby before and after nursing to see how much fluid was ingested. Part of the problem with introducing a bottle so early (and this is certainly the case with my daughter, even though she wasn't a premie, underweight, or anything of the sort) is that it can cause nipple confusion, making the baby unable to nurse or nurse effectively. Introducing a bottle only undermines the early breastfeeding relationship.

If the calories are absolutely necessary (and I recognize that there are times when it is, and also that there are times that the mother is unable to nurse her baby if it must not be picked up for whatever reason, etc.), it would be better to use an SNS system to feed the baby. This has the effect of getting the baby the calories it needs, stimulating the mother's milk supply, and promoting the bonding and attachment that are so vital to a baby's well-being.


Bec

[LBBmom]

Bec, I agree with all you've said. I know the NICU isn't perfect, but we do promote breastfeeding 100%. The fact is that most babies in our unit will get bottles at some point because the moms aren't there for every feed. It's just not possible.

For term or near term babies with just minor problems, we do promote the mom coming in with every feed and nursing, since she's usually still in the hospital. A bottle is not offered for term babies and bigger premies, just the small ones who need every calorie they can get. And like I've said, they've all had bottles anyway. Despite that, we have sent many preemies home who were nursing full time at discharge and doing well.

I appreciated reading everyone's experiences. I'll definitely keep them in mind when I'm at work and dealing with the very issues that you all dealt with. It's been good having some parents' points of view.

[Greaseball]

Since preemies have no immune systems, I think it's that much more important for them to get only breastmilk. Formula contains known contaminants and hydrogenated fats. Adults don't even have the ability to process hydrogenated fats - why give them to a 2-lb baby?

Formula sets up the baby for the worst start possible. I find it hard to believe that mom can't be there for every feeding. Perhaps if she knew that her baby would not get any formula, she would be there for it.

If supply really is an issue, NICU's should be buying milk from a milk bank. And instead of measuring the intake, why not do what other moms do - count wet diapers and monitor weight gain?

[jtraynham]

Can I jump in with my input? (long)

Well, I have seen both sides to the fence at the same NICU. I rotated through there in my residency and then my DS had a stay in there. I knew most of the regular NICU nurses from my rotation and had a good relationship with them. The ones I did not know very well (or at all) were the only ones I had a gripe with while my DS was there. - MY DH said that throughout my hospitalization, he could tell the nurses I had worked with from the ones who just know who I was because the ones I worked with were very friendly and comfortable with me, while the other ones were either defensive when asked a question or just very uncomfortable. This applied to the NICU as well. Well, back to the subject.

My main 2 gripes were with the same nurse (one who just new I was a doctor, but did not know me.) and they were trivial. I had been very realistic, yet optomistic, about when DS would graduate from the NICU. He was 7 weeks early and on the vent for 5 days. I knew the requirements about graduation (at my hospital they were completion of antibiotic course or negative cultures - done on all babies actually admitted to NICU, not those transitioned there - able to maintain temperature, able to maintain weight on bottle or breast, and able to breathe on his own) I had witnessed 32 weekers go home after 1 week and new it was possible, thus my optimism. I also knew that it was not routine to go home that early. I knew they had determied that DS would get a full 7 days because of his age, but was hopeful everything else would go quickly.

My gripes - 1. When my mom was talking to DS and telling him to hurry up and do the things they needed so he could come home while she was in town (she came when he was 5 days old and was to leave a week later and she knew that the chances were not good that it would happen), the nurse told her that there was no way that was going to happen. 2. The doctor's orders for that first day off the vent were to let me BF once, she wouldn't let me because she didn't see the point of that order and the BFnurse was not around to help (only the second reason makes sense to me). That being said, they were minor. (BTW, I only got to nurse 1 time the next day and the doctor was questioning why I didn't nurse the first day) She was a temp from the other NICU in town, which was temporarily closed because they did not have a doctor at that time causing an overflo in ours. Thus she was not familiar with our doctors as I was. The doctor she had been working with did not allow babies to go home until they were 5 pounds.

Good news is he did go home that Friday, while my mom was in town still. And I have the nurses to thank for that because they worked hard to wean him from the intubator to room temperature and they allowed him to pull his own tube when the NP said to leave it out if he pulled it (and he did and did great). They worked hard to help me get him home as quick as possible.

I think some of the issues have been dealt with completely, but I can say the baby I saw born at 24 weeks in early April was still in the hospital in Sept when my son was. That mom would have been hard pressed to stay there full time all 5+ months with 2 other kids at home and living 1 1/2 hours away.

Julie

[georgia]

I know that at least one hospital in Austin, TX only allows human milk for its NICU thanks to the Mothers Milk Bank. Yeah!!! If they can do it......

I'm wondering about the volunteering admonishment to the OP. My mother (RN) wasn't initially "allowed" into the NICU where my son was. I wonder if they'd let a non-relative?? My midwife's granddaughter has been in the NICU since Feb. A family member has been with the baby 24 hrs a day. Isn't that awesome???? I wish every baby had that. I was off pumping, since I wasn't able to pump in the NICU---I mourn for the time I was away from him.

My complaints about our NICU stay are way too long to put here, and honestly, I would be afraid of the replies. Fear is something I usually don't feel on this board. Please realize that this forum is meant to help us work for positive change toward natural family living and all that entails! Some of us will generalize (which is human nature), but we are all doing the best we can with the time we have at the keyboard.

To the NICU workers, thank you for your dedication. I wish we had met you when we needed you most.

Most times what is easiest/fastest/most convenient for the hospital isn't in the patient's best interest. I'm pretty sure in the homebirth forum, we can agree on that! I wish that, on the whole, institutions did a better job meeting the needs of society's tiniest members and their families!

Amy

[spero]

Originally posted by Greaseball
I find it hard to believe that mom can't be there for every feeding. Perhaps if she knew that her baby would not get any formula, she would be there for it.

Oh, please do not say that unless you have walked a NICU mile in the shoes of a mother who has had to make that heart-wrenching decision...it's cruel, unfair, and an insult.

[Greaseball]

Well, I am here on this thread to learn more and to ask questions. I don't think one has to have personal experience with an issue to post on a certain thread. I don't see how the choice between breastmilk and formula, or staying with your baby in the hospital and going home without it, is a difficult one. If anyone else thinks these choices are difficult, I'm always glad to listen to the other side.

No, I have not experienced any of what most of the people here have. I'm not claiming to know anything about medical treatment of pre-term babies; I just have lots of questions about it.

I definitely do not mean to insult anyone here, and I am not as anti-medicine as some people think I am. There is definitely a place for it.

[mama2mygirls]

Can i just say i am sorry that some of you have had bad experiences with NICU. i'm a nurse in a NICU/SCN, and i have Never just let a baby scream and scream, nor has any of my fellow rn's i work with, most or all of us are mothers and see these babies as our own, who need love and attention to grow to go home with their loving parents



MY goal is to get every infant home to their parents as quickly and as Healthy as possible.
NOT every parent can stay 24 hrs a day if their little one is in the NICU, some babies are there for MONTHS.
Parents and visitors need to leave at shift change so report can be given, That means CONFIDENTIAL information is being shared between ongoing RN and offgoing RN and is not meant for any other parent there to hear.
i hope if you were so offended by your experience that you at least wrote a letter to the hospital to voice your concerns, those letters do make a difference.


I do not mean to Offend, i am just Hurt, i've been a nurse for 13 years, and i take my job, my life choice seriously/provide as much comfort as i possibly can to my patients and their families.

[owensmom]

I just had to jump in here. I had a pretty good experience with NICU nurses - esp considering there was a nurses strike going on so most nurses were there just to fill in.

DS - at 2 days old - starting vomiting bile, so we had to take him in to make sure that he didn't have any kinks in his system. Most nurses were awesome.

One started him on a special bottle that wouldn't make him lazy once we started to breastfeed. They gave me a pump and I used their pumping rooms every two hours round the clock. We could sign up and sleep in these rooms if they were available... if not, we slept in the waiting room (and why they make the NICU waiting room and the birthing waiting room the same I'll never know... full of people excited and people oh so sad..).

They always fed him breastmilk, but maybe formula wasn't an issue because they had him on an IV as well.

The nurses complained (jokingly) because he was so big (9#) compared to the other babes. When they had trouble getting IV's in him (he knocked his out in his arm, they had to put one in his head and it took ALL NIGHT) they took breaks and held him and rocked him. I could hold him whenever I wanted. A great LC taught me how to breastfeed- and while they encouraged it they wanted to see how much he was eating so I pumped and he was fed by bottle so he could go home sooner.

My problem was with the ER doc that said ds was "fine when he came in but was going downhill fast and was dehydrated" (all a lie, my medically trained friend that went with us bickered with him, they had the equipment set for adult stuff, not baby stuff, etc). Then they let everybody and their brother try to put the IV in him, bruising him all up, before they called a NICU nurse to do it.

Finally, when we were like a day past being ready to go (he had to stay until all his cultures were done, even though all the nurses said he was just fine), I swear the dr visited everyone else first before coming to see us. The nurse even told her earier that day that we lived over an hour away... He had just sucked down a huge bottle of milk and was in a milk coma, so he didn't have a fantastic latch on her finger and she wanted to keep him in! We said we are taking our baby.

Anyway, our NICU exp wasn't fun, he was there for 4 long days and by day 3 we felt he was fine, can't they call us if a culture comes back bad?

[SarahGuinn]

If you haven't been through the experience of having your baby in the NICU, Greaseball, please please refrain from any judgements or ideals. Difficult choices often lead to difficult realities. Things to be dealt with. Your world may have stopped but the rest of the world doesn't.

Also, my hospital was another that supported breastfeeding. My nurse manhandled my boob until we had a good latch. She wasn't a lactation nurse either, just a bfing supporter.

[Greaseball]

Sorry I keep going a little OT but I think everyone has opinions - sometimes very strong ones - on certain issues. I have strong opinions on the treatment of babies and of hospital patients in general. And I am judgemental, although I don't think against any individual.

Some examples - I don't think one has to have had a c/s to think things like "too many are being done" and "VBAC is totally safe and should be at home." Another example; I have not had a home birth yet I am strongly in favor of it and against hospital birth for non-medical reasons. I'm sure everyone else here could think of things they feel strongly about but have not experienced.

I think on a discussion board, all opinions of the issue being discussed are welcome, even if they stem from ignorance.

More about OP (sort of): I think most nurses are very dedicated to their jobs; I don't think it's a career that one goes into "just because it was there." However, I have seen some job descriptions for newborn nurses and they say things like "Must be able to tolerate crying infants" rather than "Must have a reverence for new life and a sincere love of children."

[munkeesmama]

Originally Posted by LBBmom

I am an RN in a NICU. I read all of your replies with great interest.

First of all, I want to say, that the primary reason an infant is in the NICU is to keep it from dying. Infants who are brought to the NICU are sick, many of them would die if it were not for the capable hands of many RN's and doctors who look after them around the clock.

I have NEVER, in the 11 years I have been a NICU nurse, seen a baby purposely left to cry. I challenge anyone when they see a crying infant to look around and see what the nursing staff is doing. I can bet they are actively engaged in caring for another infant at the time. I have never seen a baby cry for more than a minute or so before somebody goes and tries to comfort them.

Someone also mentioned that nurses spend a lot of time washing bottles, etc. That is not true. We use pre-sterilized volu-feeders and prepared formula.

We actively encourage all moms to breastfeed. We even have a breastfeeding committee to help promote breastfeeding awareness among our clientele.

Sorry, it just got me a little off-kilter to read some of these responses. I'm sure there are some bad NICU's and nurses here and there, but for the most part, those nurses are busting their asses to make sure those babies are well taken care of and given tons of TLC. The NICU is not a place where nurses work just to get a paycheck. It is a heart-wrenching, extremely stressful, and busy place to work.

It just seems a little harsh to me to be so critical and condeming of nurses who helped to save your babies lives!

Like I said before, a NICU is not home. It is a critical care environment. If anyone has a problem with neonates being poked and prodded, maybe your energy would better be spent trying to find ways to avoid prematurity and illness in infants than to spend it griping about the care that is required to keep a sick infant alive. We have no choice but to "poke and prod" these infants. It is for their safety and well-being that we have to do it, hard as that is to believe.

I want to say kudos for this post. while I understand how heartbreaking it is to see a baby left to cry. There are lots of babies in the nicu. I'm saying this as a preemie mom of a micro preemie who went through lots off stuff. Some of these babies are not stable enough to be held, rocked, and coohed at. it's too much stimulation. While I understand how it would be hard to see, if you spend a LOT of time in the nicu you truly learn what goes on. As for parents visiting. Most nicus are open 24/7 and close during shift change for confidentiality. So while you may not ever see other parents they may not be there when you are. Look at when you go. You might find that you go at typical times. So back to your post. KUDOS!

[BethLS]

Yeah I just got home from the nicu too

Actually, it will be two weeks tomorrow since I brought my baby home from her 61 day stay in the NICU.

To say that "Wouldn't most moms be willing to stay in the hospital however long their baby was there? Don't most insist on it?" (your quote) is ridiculous.

In a perfect world the mom wouldn't HAVE to work, so therefor she could be with her baby 24/7 during the NICU stay and afterwards while at home. In a perfect world there would be no need for hospital births. In a perfect world there would be no premature babies.

But guess what? It ISN'T a perfect world, and some moms HAVE to work. Myself included. I could not be at my baby's bedside all the time! I had an emergecny cs for my 27 weeker, and after three weeks of recovery, I had to go back to work! It sucks and isn't fair, but that's the way life is sometimes. I wish I could stay at home and not leave my dd, but that isn't the way it is for us.

It is irrisponsible, and almost sounds like homicidal, to say that babies in the nicu are better off at home. MOST of the babies in the worlds nicu's are very very sick, micro-preemie infants. Mine was born at 2lbs 2 ounces, and dropped to 14 ounces before gaining weight! With all of her medical problems, do you honestly think that she would have been 'better off?'

YES touching, nurturing, breastfeeding, KC, everything, is helpful. BUT it should, and does, come second to medical care that is keeping your child alive so that maybe one day you can take them home when they're healthy enough to do those things.

It is just too expensive, and detrimental to your childs care to have each LD room 'specialized' with all of this equiptment. Like an OP said, hospitals are already under-staffed as it is, and having to go from one room to another to care for several very sick babies is ludacris. You cannot expect two (or even one!) nurse to be assigned to you for just that reason. It isn't fair for your baby, or someone elses baby, the nurse herself, nor is it cost effective.

Sure money isn't everything, especially when it comes to your childs life. HOWEVER, my hospital bill just came in (and mind you I had THREE HOSPITALS, before finally delivering in the one my dd was in) for just my babies hospital bed. (Now keep in mind this was JUST to be in the nicu stay.) $315,000. That's not even all of it. And Guess what? My insurance wont cover a thing.

I apologize if I am coming off as a *beep*. But I am truly passionate on this subject as I lived it for a long time, and the images there will always haunt me. But I am truly greatful because I know without them I wouldn't be looking at my precious 5lb3ounce baby girl right now.

I would have KILLED to have been in your shoes. I would have KILLED to just have my baby in the nicu just for a couple of days for 'just in case' monitoring. To know that, 'yes my baby might be a little problematic, but you know what? I KNOW she will come out of here alive.' And I promise you, the moms on this board that also had micropreemie babies will say the same. The uncertainty you get from having a preemie in severe touch and go condition in the nicu is heart-wrenching. I understand that you feel like you shouldn't have been there. But I promise they had their reasons for keeping your baby there, whether it was 'policy' or because they felt it was nessisary, not to be just 'money hungry'.

Off my soap-box now

[spero]

For all you have been through, mama!

Originally Posted by BethLS

$315,000. That's not even all of it. And Guess what? My insurance wont cover a thing.

HUH?!? Please tell me that you have a good lawyer who is fighting that.

Our insurance co denied the claim for my husband's MedFlight. He would have DIED in an ambulance ride (over an hour), for heaven's sake - he had a ruptured aorta! I went around and around with them on the issue, and finally they paid.