This week we got to speak with Adriane Powell who is a level III NICU nurse at Methodist Hospital in Gary Indiana. I know when I was pregnant I was so concerned about my children ending up in the NICU and was actually lucky enough to be in a Lamaze class with a NICU nurse. Just being able to ask her questions totally put me at ease. Hopefully Adriane’s questions will put any MoM’s to be at ease! Feel free to share you experiences at the end of the post!
From your point of view, what is the hardest thing for parents about having their babies in the NICU?
Not being able to be with their baby all the time, plus if they have other kids at home, merely getting to the hospital regularly is hard.
What issues or factors will determine if a baby needs to go to the NICU?
Anything out of the norm… difficulty breathing, eating, maintaining temp (usually any baby born before 35 weeks will have some or all of these problems); along with congenital abnormalities/ disorders.
Is there any one characteristic, or factor about babies that can predict how long a baby will need to stay in the NICU, such as gestational age, weight?
In my experience, babies tend to go home at or around their actual due date, while some will go home around what would have been 35 weeks gestation, it just depends. this is always a question the parents have and one that is so hard to answer as it depends on each individual baby. The baby has to be taking all feedings by bottle, be able to maintain it’s temp in an open crib (usually happens around 4 lbs), so usually babies are near 5 lbs when going home.
Are parents encouraged to take an active role in caring for their babies in the NICU?
Definitely!!! As the baby is stable and can have full baths and is taking bottles, parents are encouraged to learn how to give a bath, to feed the baby. We even let parents hold the syringe when a baby is still being fed through a tube.
Is it beneficial to multiples to be kept in the same crib? At what point are they able to share a crib?
I do believe multiples benefit from sharing a crib, but I have never experienced it where they share a crib the entire time. Multiples I have cared for, when they have no IVs, are breathing without problem (except maybe a little oxygen through a nasal cannula), I have put them in a crib together for a few hour periods at a time between feedings. Other nurses don’t believe it is good because if one is harboring a germ, the others will catch it.
Are there any common misconceptions that you find parents have about what the NICU experience will be like?
Many parents find it hard to believe how long the NICU stay will be. When they hear the baby will probably go home around her actual due date, they don’t understand. Also, they do not understand that the baby won’t be able to take a bottle until about 33-34 weeks gestation even though they may suck on a pacifier. A lot of teaching has to be done to counteract these misconceptions.
When babies are in the NICU, are they able to be breastfed? Is it encouraged for new moms to pump breastmilk while their babies are in the hospital? If the NICU stay is prolonged, will they be able to nurse eventually?
Babies are able to breastfeed once they start taking a bottle. We also put babies to breast sooner not for the point of them eating, but to help mom’s milk come in and stay in high portions. Mothers are always encouraged to pump, especially to the preemies, since it has been shown that preemies in particular handle/ digest mother’s milk best. Most babies will be able to nurse eventually, but usually end up going home doing both because many go home on heightened calorie formula/ fortified breast milk because they are still playing catch up and need the extra calories then a normal term baby would need.
When babies are in the NICU and sleeping most of the time, are they aware that their parents are there with them, talking to them?
I firmly believe that infants know when their parents are there. They have listened to the mother’s voice for the past 6, 7, 8, 9 months and know it! Many times you will see an infant be more stable when the parents are there. I have seen this happen with my own eyes!!!
Are there restrictions about who can visit a baby in the NICU?
It depends on each NICU’s rules. Where I work, parents (or the mother and other person with a matching baby band like her mother, etc) have 24 hour visitation rights. No children under age 12 allowed. Then we have a list of 3 other people (besides the mother) who the mother fills out as “allowable” visitors. Many units, however, only allow parents (2 banded people) 24/7, grandparents during the day, no kids under 12-16.
Do you recommend that multiple-parents-to-be take a NICU tour prior to giving birth? Is there any way to be prepared for the experience?
I think tours of the unit are a good idea for any parent to be, whether expecting one or 5. You are able to take things in and them to not be as scary when you do not have a baby (ies) in the unit. You can take in the whole atmosphere, not just the little bed with your tiny baby in it hooked up to wires and lines. Until you experience it though 1st hand, I don’t think you can be completely prepared. As nurses we try to put ourselves in the parent’s shoes, but it is still hard until you would experience it yourself, and hopefully many won’t have to! I believe tours of the entire labor room to nursery/ NICU to postpartum room are a good idea for many parents.
In the case of multiples, what are the most common reasons for newborns being hospitalized?
Prematurity and all the problems associated with it! The more fetuses fighting for space in one uterus usually can predict how premature they will be born (the more fetuses, the earlier they will be), in my experience at least. You do have some surprising things happen though!
What is the one piece of advice that you would tell all parents of NICU babies?
Visit often, or call if you cannot make it the hospital, and talk to them when you are there. Don’t be afraid to change her diaper or feed her. The nurses are only steps away and if they are going to do something funny (i.e. drop their heart rate while bottle eating) the NICU is where you want those things to happen, not when you are at home.
A big thank you to Adriane! Be sure to visit your fellow MoM’s!