What To Expect With A Premature Baby

by Jennifer Swartvagher
Originally Published: 

The plan is to be pregnant for nine months. You need that time to get the nursery ready, to finish up your projects at work, and eat at least a dozen pints of guiltless ice cream that your loving husband goes to get at 2am. My son, Linus, was born when I was only 24 weeks pregnant. Weighing only 1 pound, 8 ounces and measuring 12.5 inches, he resembled a miniature version of the newborns I was accustomed to. All of a sudden I was faced with the reality that I was nowhere near ready and I had no idea what to expect with a premature baby. Here, however, is what you can…

1. After you give birth, you, most likely, will not get to hold your baby. The best part about being pregnant, is you get a baby at the end. When you have a preemie, that “new baby” smell is trapped within the walls of an isolette. Yankee Candle should look into trademarking that scent. In a flash, Linus was whisked away to the Neonatal Intensive Care Unit (NICU) and I was wheeled into a postpartum room, sans bassinet and baby supplies.

2. A nurse/lactation consultant will wake you 3 hours after you give birth and thrust a breast pump into your hands. In your drugged up stupor, you will wake to find a woman fondling your breasts. Be ready to be manhandled as she positions those plastic horns around your nipples. Then, she turns up the suction. You will be able to borrow a pump while you are a patient and the NICU should have a pumping station in the parent lounge. If you are in it for the long haul, look into renting or purchasing a hospital grade pump.

3. Do not feel guilty if you decide to formula feed. You need to do what is best for you and the baby. Don’t be afraid to talk candidly with the NICU Staff about your concerns, they are the most dedicated and caring people I have ever met.

4. The NICU can be a scary place. Linus was so delicate and fragile when he was first born. There were so many wires and tubes attached to him that you could barely see his face. His skin was so thin, it was almost translucent. I wasn’t allowed to pick him up and hold him. Instead, I was instructed how to place my hands on his small body using a firm touch. I often wondered if he was crying, but was too weak to make a sound.

5. You will become jealous of the other moms in the postpartum wing. Every time you hear a baby cry or see another mother cradling her newborn bundle, your arms will start to ache.

6. You will become a walking medical dictionary. In order to advocate for your child and to fully understand each diagnosis, make sure you ask the medical staff all the questions that pop in your head. Stop consulting Doctor Google, because you have plenty of medical professionals at your disposal. Before long, medical terms you have only heard on Grey’s Anatomy will start rolling off your tongue.

7. Most importantly, if you have a concern, or your baby somehow seems to be acting different, say something. Make sure you ask if the feeding schedule has changed or if any new tests were done. If you don’t understand something, don’t be afraid to have the staff explain themselves.

8. The NICU is noisy. There most likely will be a dozen little incubators in the room you are in. Each bed will be attached to several monitors. Loud obnoxious alarms go off, literally, every few seconds. While the constant noise will totally freak you out, I think it comforts the babies. More than once I witnessed a cascade effect, where a relatively quiet room exploded in alarms. It was almost like one baby, said “Hey! Over here!” Only to be met with a reciprocating chorus of “Me too!” and “I want my mama.” I can still hear those monitors beeping and alarming in my sleep.

9. Be mindful of the NICU schedule. I was not allowed to be in the NICU during shift changes, so I had to know what time those changes occurred. Before each shift change, find out which nurse will be in charge of your child. This way, you’ll know whom to address concerns to. It’s a great idea to keep a list of the NICU’s phone numbers handy in case you want to call for updates while you’re away. Once you are familiar with the NICU routine, it will make it so much easier to plan your visits.

If you want to be present during feeding time, bath time or weighing, find out your baby’s schedule and see if you can help with your baby’s care. Once my son was taking a bottle, I would inform the staff when I would be in so that they knew to wait for me to arrive before feeding him.

10. The NICU has rules to protect your baby. The smell of hospital soap and hand sanitizer will be your new perfume. Your hands will be red and raw by the time your baby is discharged. Just the smell of hospital soap brings me right back to sitting next to the isolette with my hand stretched through the porthole, resting firmly on Linus’ back.

11. Your touch is so important. Touch your baby as much and as often as you can. Preemies prefer a firm touch. Place your hand on your baby’s back and cup their head or hold onto their hand. Preemies benefit from kangaroo care. Don’t get down on yourself if your baby cannot tolerate being held for long periods of time.

Every day I asked if it was the day I could hold Linus. Finally, the day came, and the sweet nurses helped untangle all of the wires and tubes. I think he was in my arms for less than 30 seconds before he needed to be put back in his incubator. He was already over one month old, and it was the first time I was able to kiss the top of his tiny head.

I thought my arms ached to hold him before. That 30 seconds was the worst tease ever. It was another two weeks before I was able to attempt to hold him again.

12. Be prepared for a host of follow-up visits, with specialists you never knew existed. Your medical experience will not end with the NICU. You will visit at least a half dozen specialists, in addition to your pediatrician, just about every week for the first year. However, there is only one that I was not ready for. The first visit to the ophthalmologist freaked me out. Preemies need to have their optic nerve checked. This consists of inserting a metal clamp thing into the eye, and tucking the eyelid in somewhere behind the ear. It was like something out of Total Recall. I couldn’t take it. Send your partner instead.

13. It’s okay to go home. You will have a lifetime to raise your baby. While your child is in the NICU, put your trust in the medical team. They are there for your baby. Each shift, your baby will be assigned their own personal nurse. As a 24 weeker, Linus’ nurse was usually strictly dedicated to him, or shared with just one other little friend.

You job, right now is to take care for yourself. Get rest. Get your flu shot. Pump. Finish all the preparations you didn’t get to do while you were pregnant.

14. Better days lie ahead. The time your baby spends in the NICU will seem like an eternity. After 94 days, I was finally able to bring my son home. Now, he is an extremely active and healthy two year old who finds new ways to make our lives interesting every day. As a matter of fact, in the time it took me to write this post, he has managed to swing upside down from the bottom of the highchair, squeeze a juice box in my lap, and wrestle the cat. Rest up while you can.

15. Once your baby is discharged, you can leave the house…and have visitors.The nurses will warn against visitors and germs. Listen to them, the truth is there are a lot of dangers out there, especially ones that are only half-baked.

But you can have visitors as long as no one is ill (not even the sniffles) and practices good handwashing habits. No toddlers or preschoolers outside of the immediate family. No offense to your sister-in-law’s best friend’s third cousin, I’m sure they want to see your baby, after all he or she is the cutest baby in the whole world. However, there is a reason your baby just spent three months in a sterile environment. To your child, everyone else in the the world is a big, festering, pus filled, germbag, and the smaller they are the germier they are.

Use your best judgment. Unless you have an underground tunnel leading from your house to the pediatrician, you’ll need to take the baby out into the world. I know mothers who quarantined themselves and their babies for months, and one for almost a year. I am not sure how they did it, because I would have gone crazy. With seven other kids to care for, quarantine was just not practical, and the reality was my own little germbags brought more icky bugs home off the bus than Linus would have ever picked up in his stroller at the mall.

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