What You Should Know If You Have a Preterm Baby

I’ve always wanted to do a “What to do if you have a premie” post except I’ve never had a premie; and while I could look stuff up and ask around, I didn’t feel like I could give true insight on it. So when Lucy Williams wrote me and said, “I wanted to offer my experience to you in case you ever decide to do a "having a premie" post."  I jumped at the chance.

I think this is list is a great post to tuck in your mind just in case you pull the premie card.

As aways, PLEASE add any insight, resources or suggestions to help other parents that may be going through this – I always appreciate it!

– Amy

 

If you have just had a preterm baby, welcome.  Welcome to the exclusive club you never wanted to join.  I welcome you because you are my sister now.  Initiation is a bitch, but I promise you at the end of this you will find strength in yourself you never knew you had.  I am not going to tell you everything will be alright – that would only be dismissive of the totally legit worry you have.  This is hard, hard stuff.  But I can tell you that you can do this.  You are strong.


A few things I wish someone would have told me when I became the mother of a premature baby:


1.  

Take all the help you can get.  When people ask if they can help – refer them to the list below.

 

2.  

Be aware you might not make as much breast milk as a full term mommy for a variety of reasons (your body didn’t have as much time to start making milk, you may have had a traumatic birth, your placenta may not have come all the way out on its own, you were probably separated from your babe shortly after delivery, etc).  Lots of people in those first days will tell you it’s your job to make milk for the baby and then your body may not cooperate.  It is one of life’s cruel jokes and it’s not your fault!

 

3.  

Did you hear me when I said “it’s not your fault”.  I want to repeat this again – none of this is your fault.  There are drug addicts that have perfectly healthy full term babies so it is not your fault, or your body’s fault.  There are a million reasons you can go into premature labor and bad luck is one of them.  Treat yourself nicely and get help if like me you felt insanely guilty over something that you logically know wasn’t your fault.

 

4.  

On the other end of the spectrum you may not be feeling guilty.  You may be PISSED!  Pissed at your doctor, pissed at the hospital, pissed at your higher power, pissed at the freaking world.  Why did this happen to your baby!?!?!?  Feel free to get angry – just try and channel it in the right way.  Like try not to focus it ALL on the NICU nurses, they are good peeps and they work hard (that is not to say that you can’t complain to the Charge Nurse if it is warranted).

 

5.  

Don't feel like every mom but you is with the baby 24/7.  They aren’t, or if they are they will pay for it later. Go home and get some sleep.  As the NICU Nurses love to say “You have the most expensive babysitters in the world” - use them!  You aren’t going to make it through this marathon if you run at full speed the whole time.  Pace yourself.

 

6.  

Don’t feel bad if you don’t think your baby is cute.  Seriously, it is hard sometimes to see past the tubes and wires to that cute little earthling underneath. They look different than you are expecting, see through skin and fur were off-putting to me at first and then I felt guilty for not thinking he was the cutest thing in the world (yeah I had a lot of guilt)

 

7.  

Take lots of pictures and journal - you are in shock -you may not remember anything later and may want to know what the heck just happened. 

 

8.  

On that note – take whatever “memorabilia” you can from the hospital – their first pacifier, first diaper (not the ACTUAL first diaper because that is disgusting, but one of the leftovers when they move up a size), anything that will show their tiny size and will help get through to all the people that might want to visit when they go home just how fragile they are.

 

9.  

Decide whether you want to go public on social media or keep things private.  Even if you are keeping it just family and close friends you may want to designate one person to keep everyone updated so you aren’t constantly sending updates.  Sites like caringbridge.com can help you disseminate information or email and Facebook work as well.

 

10. 

NICU moms are more prone to Post Partum Depression (see guilt and anger above).  If you even think that this might be happening then go talk to someone.  Your OB, the NICU Social Worker, a therapist.  Just start talking.

 

11.

Make some premie parent friends.  No one can understand the emotional roller coaster like another parent of a premie.  Although, one word of caution – steer clear of the parent that tries to play the “my baby is getting better faster than your baby” or “my baby is sicker than your baby” game.  All our babies are in the NICU for a reason and we all need support in our lives. I found my tribe through the preemie baby board on inspire.com, handtohold.org and through the NICU social worker who introduced me to other premie parents.

 

Things to help a premie parent:

1.   There are a lot of people who will tell you what to say and not say to a premie parent and lots of people would disagree with those people but here is one that almost never fails:  “Congratulations, your baby is beautiful.  I am so sorry they are in the NICU.  How are you doing?”  And then listen.

2.   If you want to help, here are some ideas:

  • Send a care package with snacks, a water bottle, hand sanitizer, nice lotion, gift card for e-books or paper books
  • Send money for gas, restaurants or lodging if the person lives far away from the NICU so they can see their baby
  • Offer to babysit their other children, watch their dog, water plants, clean their house etc
  • Tell them that they and their baby are in your thoughts and/or prayers as appropriate.  Even though I am not religious, the idea of hundreds of people sending positive energy to our family felt amazing.
  • Offer to bring a meal over – bring it in a disposable container and preferably food that can be frozen and easily reheated. Or better yet, offer to organize all the people who want to help by using a site like www.takethemameal.com
  • Once baby is home, don’t be pushy about visiting. The smallest cold for an adult can be life threatening to a premie.  Trust me, they would love to see you and introduce you to the baby.  And they will as soon as they recover from the trauma and feel comfortable.  If they are ready for visitors, be prepared to sanitize yourself before going near that baby.


I am 14 months out from this life changing event and I still don’t have my head fully wrappe d around it.  I am sure I missed a ton of great resources and advice for a premie parent, so please feel free to share yours in the comments.  I am always looking for new ways to support my friends who are parents of premies.


Lucy Williams isn’t a writer or anything cool like that.  She is a nerdy Data Analyst who enjoys spreadsheets and databases and hopes to one day make use of her Masters in Library Science.  She is mommy to Emrys, her 2 ½ lb 28 weeker who is now too heavy to carry down the street.  Her hubby Richard hails from Wales (not Whales) and is the rock she leaned on during not only a premature baby but the surgery that followed during which the doctors removed a 3 lb benign tumor.  Poor Emrys was the messenger that saved his mommy from her hibernoma, a rare tumor of the brown fat in her abdominal cavity.  This is the fat we all have to keep us warm as babies, but in Lucy it turned out to be the thing that put her baby in harm’s way (oh, the irony!)  She now volunteers to supports parents who have babies in the NICU in her spare time and occasionally enjoys a glass of wine or a good dystopia novel.

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Re-Thinking the Four Month Sleep Regression

I think everyone on the planet knows that most babies are challenging when it comes to sleep. What I do find interesting is the controversy that surrounds it. If I post something about babies not sleeping someone will say that it’s bull because their baby slept well from day one, and if I post something about babies sleeping well, I’m told it’s horse shit because their baby is 18-months old and still not sleeping through the night.

To this I say, “Yep, you’re right.”

Some babies are great sleepers and some aren’t – all of them are awesome. If it works for you, great! Keep doing what you’re doing. But if you’re not in a good place and something needs to change, I just like to throw the occasional suggestion out there.

So when I saw how many people were talking about the 4-month sleep regression (I didn’t know there even was such a thing – I guess I was too tired to notice) I asked Alysa from SleepWell Baby to give a little insight on it.

Sure, she's a sleep consultant so she's going to have some strong feelings about sleep (it's like asking a dentist about teeth) but she knows a lot about the science around sleep and she’s not a dick about it so I value her input.    

With that in mind,  if you have heard about the dreaded ‘4 month sleep regression’ and are looking for ideas on how to minimize it, have a read.

– Amy

 

The dreaded four month sleep regression is a hot topic of discussion for many new parents.  Just when you think you’re in the clear, things are getting easier and WHAMO, your four month old baby is up all night, won’t nap during the day and you’re at a loss for what to do.  Your friends assure you that it’s just the four month sleep regression, every baby goes through it and it won’t last forever.  That’s one way to look at it.  Or, you could dare to be different and try on a new perspective.  The four month sleep regression is not really a regression at all.  In fact, it’s an opportunity to guide your baby down the path to healthy sleep. 

Why does it seem that your baby’s sleep has become a nightmare at the four month mark?  The change is due to your child’s neurological development at four months old.  Day and night sleep is organized which means that if we don’t follow our baby’s biological rhythms in how we offer sleep, our child will become overtired.  Babies who are overtired have a difficult time falling and staying asleep. 

 

Here’s how to re-think regression and opt for opportunity at the four month mark:

 

Follow Your Baby’s Body Clock. 

We all experience the drive to sleep during the day.  Many of us can relate to feeling a little sleepy after lunch and again after 9pm in the evening.  This is a result of our body’s circadian rhythm or body clock.  It’s this internal clock, which is regulated by light that promotes sleep at particular times during the day.  If we sleep at those times we experience the most beneficial, restorative sleep. 

Our four month old babies are no different.  They have developed their own circadian rhythm.  If we overlook their need to sleep during the times when their body temperature dips and melatonin production increases, we see babies who do not settle easily or sleep for long stretches.  Most four month olds can tolerate about 2 hours of awake time.  Babies who take longer naps will naturally fall into a rhythm of napping in the morning, after lunch and again in the late afternoon.

  

Use a Consistent Sleeping Space.

The days of easy napping on the go are over.  Four month old babies are able to recognize their sleeping space and follow social cues.  If you want your baby to settle into a restorative nap, the grocery store, car seat or baby carrier sadly won't cut it.  Our children thrive in consistent environments and your baby’s sleeping space is no exception.   In addition, establishing a regular nap and bedtime routine is a key component of cueing baby that it’s time to sleep.

It’s also important to note that motion naps are not as restorative as stationary naps as we can never reach the deeper stages of sleep while we’re in motion.  This is also the time to ensure your baby’s sleep environment is slightly cooler than room temperature, dark and safe.  A sound machine playing pure white noise, placed away from the crib on a low setting is also a good cue for sleep.

 

See the Benefits of an Early Bedtime. 

All sleep has a purpose.  The morning nap restores our babies mentally, while the afternoon nap offers physical benefits to growing little ones.  It’s during night time sleep, specifically the first half of the night, until approximately midnight, when our babies receive the benefit of the growth hormone.  So it’s important that we are getting our babies as much night time sleep as possible.  We know that night time sleep organizes around the 6-8 week mark when day/night confusion ends.  This means that an earlier bedtime is appropriate at that time and certainly by four months old.  Most well rested babies do well with a bedtime between 6-7pm.  Those who are napping poorly benefit from an even earlier bedtime to make up for sleep that is lost during the day.

 

Take a Look at who is Putting Baby to Sleep. 

Babies who are put to sleep are often more wakeful in the night than those who are able to go to sleep independently.  The reason for this requires an understanding of sleep cycles.  When we fall asleep we enter a sleep cycle which lasts from 45 minutes to 1 hour.  During that time we go through four stages of sleep which are followed by REM.  After REM we have a brief awakening where we scan the surface of our environment.  A person with good sleep skills will not even be aware that this brief awakening has occurred and will transition into the next sleep cycle.  If your baby entered a sleep cycle in your arms, in a car seat, in the living room, with a bottle, at the breast or with a pacifier and has woken to find those circumstances have changed, your baby will likely require that you recreate that situation in order to return to sleep.  Babies who are given the opportunity to fall asleep rather than being put to sleep have an easier time independently transitioning through sleep cycles.

One of the great things about belonging to a community of parents is that there is always support for whichever challenge you’re facing.  From potty training to picky eating you will find someone who tells you they’ve been through it and it will get better.  But if you are the parent to a four month old who has hit the dreaded four month sleep regression, consider a new approach.  Re-think the four month sleep regression and opt for opportunity instead. 

 


So, after all this sleep talk, I asked the folks at SleepWell Baby if they would be up for a little giveaway. They said "sure" and offered up their awesome Save Our Sleep package to one lucky winner.

 

Win a full "SOS" package worth $449

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If you truly feel like you have tried everything and your child still isn’t sleeping, this is the consultation for you. The Save our Sleep package provides the most support including a 90 minute consultation and a 2 week follow up period.

This private consultation will take place either in the comfort of your own home, by phone, or even Skype. Our availability varies, but we can often accommodate a new client within about a week and sometimes even sooner.

This package includes:

  1. A preliminary evaluation. This is a comprehensive questionnaire about your child’s sleep habits and routines that you’ll fill out prior to our meeting. Having this information in advance helps us make the most of our time together.

  2. A private, 90 minute consultation where we’ll discuss strategies and troubleshoot possible problems. You will learn how to address bedtime, naptime, nightwakings, or any other specific issues you might be dealing with.

  3. A detailed, fully customized sleep plan that your consultant will prepare following your meeting and will be sent to you promptly. Your input at the consultation will be essential to developing this easy-to-follow plan that will suit your family’s needs.

  4. Four follow-up telephone calls that will be scheduled throughout the two week consultation. These follow-up calls typically last about 15 minutes, and we’ll use this time to deal with any setbacks you might be having or answer any general questions. As your child’s sleep begins to improve your consultant will also provide you with valuable information that will prepare you for challenges that may arise as you move forward.

  5. Unlimited e-mail support throughout the consultation. You will be provided with your consultant’s email address so you can check in on those days when you don’t have a call scheduled or after your calls have been used. Your consultant will respond to your emails within one business day.

 

$449 value (Open worldwide)

 


Alysa Dobson is a Certified Child Sleep Consultant with SleepWell Baby.  She works with families to help them get the sleep they need.  Alysa offers support to parents with children ages 4 months- 8 years old through both in home and remote consultations.  She can be contacted at alysa@sleepwellbaby.ca.

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Travelling with a Baby: some tips for flying

Every once in a while I’ll be asked what the tricks are to flying with a baby to which I answer, “I have no idea.” I could barely keep it together in a doctor’s office let alone a four-hour flight, so I never attempted it.

So when I read this post that Gemma had on her site, the sweetest digs, I asked if I could post it here so you guys could get some solid advice instead of me just screaming “Don’t do it!!!” (Just kidding, you'll be awesome.)

Let me know if you have tips too!


So now that we have done our trip to Florida over Christmas when Maya was 3 months, and our recent trip to Puerto Rico for my girlfriend’s wedding when Maya was 6 months (we got lucky with hot vacay’s this winter!), I feel like I can pass on some tips and tricks for flying with a baby. I’m definitely no expert, but both were long enough travel days and used different airlines, so I feel like we had a bit of variety in our experience. Some were nighttime flights, some were daytime ones, and all had connections.

I was definitely nervous before going, but in the end found it not to be too bad. Here was some of the stuff that worked for us.

 

 

Seats

When we booked our tickets, we chose a window and aisle seat fairly close to the back of the plane. We did this because the middle seat is always the last one selected, so we figured if there were by chance some empty seats on the flight, a middle one (especially near the back) is the most likely to be left open. On all the flights we went on we asked when we were checking in if the flight was full – and the answer was always yes. So we assumed that we would have someone sitting in between us and would just ask them if they wanted the window instead (and we would take the middle and aisle). Who’s going to *want* a middle seat over a window anyway, right? But just as a double check measure, when we got to the gate, we would go up and ask again if the flight was full. And you know what? For about half of our flights, it turned out it wasn’t entirely full, and they were able to do a little switcharoos and give us that empty middle seat. The extra room makes such a nice difference to give the baby somewhere to sit and move around. We even got Maya to fall asleep lying down in the seat on a few flights! So lesson learned? Always check again at the gate. Those folks seem to be able to have more control over the seat selection.

 

 

Boarding

This might seem obvious, but board the plane early to ensure that you get enough space in the overhead bins. All flights give priority boarding to first class travellers, but most will also allow families, elderly, and others who require assistance to board early. Take advantage of it. You really don’t want one of your bags in the overhead bin 10 rows behind you or something.

 

Sleep

We tried to get Maya to sleep anytime we were waiting around in the airport — connections, waiting for flight, etc. She is usually able to fall asleep in the stroller or the carrier if you walk around for long enough, so we took that time to just walk walk walk, until she had nodded off. We knew that sleeping on the plane would be more difficult, so it was important to catch as many zzz’s for her in the airport. Any schedule you might have at home for naptime sort of goes out the window when you’re flying, so for us we just tried to get her to sleep whenever we could. The more sleep, the happier the babe.

Once on the plane, we ended up getting her to sleep a few different ways. When we had the empty middle seat we would lie her down with some cozy blankets all around, and then give her a bottle and sing quietly until she nodded off. You obviously need to stay alert when they are sleeping like this though, as you can’t let them roll around! We also used the carrier and had her fall asleep in it, but we found it to be a bit uncomfortable to sit in after a while. Because of that, we would instead hold her facing outwards or inwards (whichever she preferred) and went to the back of the plane to bounce a little. I would just go and stand behind the bathrooms where the hosts/hostesses are. They were always super friendly. This usually made her sleepy and then we would go back to our seats, sit down carefully, and she would stay asleep. It’s not the best because then your arms aren’t really free to do anything else, but if you just want to put your head back and try to doze a little yourself, it’s not bad.

One of the things I totally would’ve used if we had the opportunity are those attachable bassinets that some airlines have. None of our flights had them, but if you are flying with a baby then I would definitely call the airline ahead of time and see if you can swing one of those. You sit up in the first row and the bassinet attaches to the wall in front of the seats. I think the weight limit is pretty limited (15 pounds rings a bell?), but it’s definitely worth checking into.

 

Take off/Landing

So funnily enough I was told by the stewardesses that I couldn’t wear the carrier during take-off, and then that wearing the carrier is a great position, and then getting absolutely no instruction – all depending on which airline I flew with. There clearly aren’t any hard and fast rules on this. For the most part, I think that holding the baby in an upright position (like a burping position) is the way to go – so wearing the carrier is actually perfect for this. Only once was I asked to take off the carrier — so I just undid the arm straps, but kept the middle all done up. Then during take off and landing I would just sing quietly to Maya in her ear. This seemed to distract her enough and she was happy as a clam. If your baby is a soother baby, I would pop one in as a distraction, and in case it helped with the ear popping. I also had a bottle at the ready, and wouldn’t have hesitated to adjust my holding position with her a bit to be able to pop it in, had she started to fuss. If you are breastfeeding, I would be ready to quickly get out a boob! The flight staff are going to be sitting down themselves during take off and landing and won’t actually be able to see you. I would do whatever works to calm your baby, as long as you are holding them securely in case of turbulence.

 

What to pack

In terms of what to have in your diaper bag, we kept it pretty simple: diapers + wipes with a portable changing pad, 1 big muslin blanket, 2 changes of clothes (layers so it was easy to put on/remove if the plane was hot or cold, or if things got messy), a couple of favourite toys, a soother, a couple of bibs, and several bottles (however many were required for the length of travel). We always put Maya in a clean diaper before boarding each flight, to try to minimize having to change her on the plane. Changing on the flight is do-able, but not the easiest in those small bathrooms.

We had the diaper bag with most of those things in it, plus the things that I wanted for myself on the plane (it doubled as my purse), so it was all at-the-ready. Then we had a small suitcase as the other carry-on with other things that we didn’t think we would need on the flight: one of the change of clothes, all of my pumping gear, extra formula, extra diapers, etc. That way you can have the diaper bag on the floor where you are sitting, and the other in the overhead bin, and don’t need to mess about on the flight trying to get things.

 

 

Bottle Feeding and Baby Food

Breastfeeding is obviously a lot easier if you’re travelling, but if that isn’t an option for you like it wasn’t for me, you’ll be happy to hear that with a bit of planning it really wasn’t a big deal to bottle feed during our travel. It wasn’t a problem in any airport we went through to have bottles that were already full with water, or to bring liquid formula. For when we did water, we just measured out the right amount of water in each bottle and sealed it. Don’t do bottles that are too huge, because you need to throw out what the baby doesn’t drink — no fridge to put it in and save for next time. Then we had pre-measured amounts of powdered formula in a plastic container (like this one) that were ready to mix in and shake. We didn’t want to have to rely on getting water from the hostesses during flights just in case we were in a pinch. If it were a long flight though, we could’ve done that. Since the water had been sitting out, it was at room temperature, which is how Maya drinks her bottles. If you needed to warm them up, I’m sure you could ask the hostess for some warm water to dunk the bottle into.

We also had some jars of baby food with us, and again this wasn’t a problem to take through security. Just get it out when you are going through the conveyor and the guards will run in through a test thing. No biggie. We tried to feed Maya actual food before boarding – we would just hit up an airport restaurant with a high chair. We figured it would just be too messy on the plane.

[Note: Mixie also has these bottles if you want to skip the separate formula containers. – Amy]

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One of my best tips? Travel with grandparents. Man those two can seriously help a girl out. I even got to read a gossip magazine or two like the BB (“before baby”) travel days. The best!


So I think that’s about it for tips and tricks on flying with a baby. I’ll do a part 2 travel post with our “go to” packing list, and other lessons learned. Stay tuned for that one!


Note: While the FAA doesn’t require a seat for your child, they do strongly recommend one. If there is turbulence or a runway emergency your arms just aren’t going to cut it so it’s recommended that all children use a child restraint from birth to 40 pounds. This can be an approved car seat (it needs to have “This restraint is certified for use in motor vehicles and aircraft" printed on it) or a safety harness if your child is over 22lbs.

Listen, I totally recognize this is a large cost implication here. I know there are people that will squawk “well, then just don’t fly if you can’t afford the extra seat” but we all know that it's rarely that simple.

It’s just worth noting and something worth checking out. You can find some more information here and here.


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Gemma Bonham-Carter, author of ‘the sweetest digs’, is a crafty, flea market loving, DIY and interior design junkie and mama of one, based in Ottawa, Canada.  Join her as she chronicles her family's adventures (and misadventures...!) as they fix up their first house on a shoestring budget, and the life that happens in between projects. From DIY tutorials, crafts, decorating inspiration, room makeovers, and tales of raising her baby daughter, the blog is a one stop shop for great ideas and a laugh.

Check her out:

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