Surviving the NICU

Today's "PP Guest Post" is brought to you by an incredible mother of three toddlers. We are amazed by how she juggles everything! She has definitely had some unique experiences and we asked her to share one with you. This is her experience in the NICU right after having the twins. 

I grew up surrounded by birthing goddesses.  Women who delivered naturally at home with my mother as the midwife, and it was so magical. A slight moan, a little push and a tilt of the head: Oh, did I have a baby?  I thought I felt a little pressure.” When I got pregnant many years later, I read all the books to prepare myself for my induction into the birthing goddess circle. I read these while imagining myself with my double jogging stroller, hair blowing in the wind as I pushed my perfectly healthy full-term twins, both asleep and full of breast milk. (Important fact—double jogging strollers are so GD heavy that you will pee yourself and leak most of your milk straining just to get them out of the driveway).    

Most of the books I read told me that 1 in 9 babies in the U.S. are born preterm, and with twins it’s a whopping 60%, but I had no concept of what prematurity really meant for a familyNow, looking back after my twins had to be medically evacuated across the ocean and live in the NICU for months, I wish there had been a book on how to survive the microcosm that is the NICU. I vaguely remember the neonatologist speaking to me after the birth and my mind wandering in a futile attempt to distract myself from the severity of the situation, thinking, um, is NICU a word or an acronym? Crap. I should know this, I read all the books.   

So I will give you the condensed version of my Neonatal Intensive Care Unit survival guide, written by someone with no qualifications other than that I am a mowho froze my ass off in the NICU for half a yearleaving only for oh-so-brief hints of sleep at the Ronald McDonald House. Here are 15 survival tips  

  1. No sleeping! This isn’t a hotel! It’s inevitable that at some point, you will fall asleep unintentionally. Perhaps from intensely concentrating on holding your finger through the incubator to touch what little of your baby you can, or from the never-ending sleep deprivation and obsessing over your child’s daily weight gain chart and watching it go down instead of up. Whatever the reasonthe nurses are always required to wake you.   

  2. If you do manage to nod off anyway, amidst all of the alarms that go off every minute, congratulations.  If you had been a cave man, you and your offspring would have died. These alarms are intentionally designed to trigger your adrenaline because they notify the nurse that your baby stopped breathing or there was a sudden HEART RATE drop.   

  3. Heart rate drop?  Oh that’s just a ‘Brady” (short for bradycardia). No big deal.  Happens all the time.   You may hear the term every day, along with “apnea” and “desat.”  You might even watch your child’s heart rate drop to zero and feel like you’re on ER, hoping that George Clooney will run through the door. This site explains each of these terms: 

  4. You’ll freeze your ass off. Bring a hoodie and leave a blanket for yourself next to the incubator. Your hand is already shaking enough because you’re afraid that you’ll break your child, you don’t need to add hypothermia to that.  

  5. Keep a notebook with you at all times. Write down questions as you think of them and the responses you get from the staff.  Advocate for your child(ren).       

  6. Make sure you’re there for rounds each morning so you can hear the latest about your child. The staff walks from room to room and they get briefed about each patient. If a parent is there, they give the briefing anyway. They do this at ungodly hours, I assume hoping that no one will be there. If you are working and cannot get much time off, this would be the time I would choose to go.  

  7. You can page a doctor. Yes. It’s just like the movies. And they’re usually just as good looking. Except that you don’t care because everything is blurry from sleep deprivation and you’ve just aged 10 years in a few months and haven’t washed your hair in 3 weeks. But page away….  

  8. The wipes on the wall? Don’t touch them. They kill cancer. Your skin will peel. At least that’s what the sign says. Use gloves.  

  9. You’ll want to be with your child at all times, but you’ll have to leave for the following: 

    1. To use the restroom 

    2. To eat 

    3. To pop a Xanax 

    4. Twice a day for shift change, so the nurses can brief each other about how cute your children are. At least that’s what you like to imagine because you know they are actually gossiping about how you never leave and how many questions you incessantly ask.    

  10. When you do leave, know that the process for re-entering is so difficult and time consuming that you feel ashamed for even thinking using the bathroom was important. There is a litany of steps you’ll need to take in order to see your child.  Yes, your child that you carried and birthed, who is now on the other side of a well-armed castle (which ultimately you’ll be grateful for after watching too many of those switched at birth films in the 80’s)My fav of these steps has to be the monotonous sanitation video playing at the hand-washing station that you will most certainly want to burn by the time you leave.  

  11. The car seat test. This is a requirement for your child to be released to go home.  We, the very experienced nurses who change a 2 lb baby’s diaper without blinking an eye, are going to watch nervous, shaking, sleep deprived you put your 4 lb baby in a car seat without breaking him and if he stops breathing at any point, then he’ll have to try again tomorrow. He may even become a feeder-grower. 

  12. Feeder-grower? These are babies who are premature with no other conditions, they are simply there to eat and grow. Boooo-ring.  When you walk by these feeder-growers or a 9 lb baby who was admitted because of a small apnea episode, don’t be jealous. No, be jealous. Your hormones are pumping, your breasts are engorged because your preemies can’t latch well yet and the 9 lb baby looks like a total freak to you.  You are blinded by motherly love so much that you can’t see your babies for what they are—naked little squirrels.    

  13. The nurses. We had a different one every day shift. That’s over 60 nurses that I had to get acquainted with every day. Here’s a helpful tip I didn’t know until halfway through—you can request nurses that you like. Maybe they gossip more and it distracts you from the fact that you can’t hold your child all the time or maybe they’re quiet and leave you alone but are good with the babies—whatever the reason, they don’t have to know whyGo to the NICU nurse scheduler and ask them to make that nurse your regular. They can (if the schedule permits and the nurse agreesassign her or him to your child.   

  14. Sometimes the nurses may weigh your child before and after you breastfeed, to calculate how many oz they gained from that feeding and if they need to supplementSo if you are breastfeeding, no pressure!  Luckily our NICU nurses were very pro-breastfeeding and encouraging. If you are not producing enough, you can ask if your hospital has donated breast milk available. The feeding schedule for our twins was every three hours and if you’re not there, they get a bottle. So I recommend that you pump pump pump.  You can ask family to be your breast milk carriers. Believe me, it’s everything they ever hoped being a grandparent would look like. If you are so dedicated that you want to be there for every feeding, then more power to ya! You are insane and will never sleep.   You can also go the (GASP!) formula route. The NICU will provide that 

  15. If the alarm goes off and you see everyone scrubbing in, it can mean they are performing emergency surgery on a child in the NICU and they don’t have time to take him or her to the OR. Run as fast as you can or you will be locked in until they give the all clear.   

As challenging as my time in the NICU was, it gave me perspective and I am grateful for that. When my three toddlers are throwing food on the floor and my daughter takes her diaper off and smears it everywhere when I’m not looking, it doesn’t faze meIt’s in these moments, these sweet, (literally) shitty moments, that I remember looking at my babies through a plastic wall, the startling and constant sound of the alarms, and the CPAP on my son’s face. Most of all, I remember the baby who was also Level 3 like my son, who was released to hospice, and the nurses grieving quietly together. In the end, I may not have been inducted into the birthing circle as I had intended, but every mom I saw there was a NICU goddess. We can all certainly survive the toddler years if we survived the NICU