Anticipating the Birth of a Premature Infant
Congratulations! You are about to start the most wonderful, terrifying, exhilarating and rewarding experience of your life - becoming a parent! Parenting a "preemie" will bring a new set of challenges that many other parents won't face, but there will also be joys and rewards that most other parents don't get to experience. Whether your new baby is a few weeks or a few months early, there will be ups and downs, decisions to make, and technology that will be difficult to understand. We hope that this Web site will help you make sense of everything you and your baby are experiencing, answer some of the questions you will have, and prepare you for the challenges that lie ahead!
The birth of a premature infant is rarely expected. You may be forewarned by weeks or days, but sometimes only hours or minutes. Carefully constructed birth plans often go by the wayside and whatever you may have envisioned as the ideal birth is replaced by medications, monitors, countless medical professionals, sometimes surgery, and sometimes immediate transport of your infant to another hospital without you. While your questions will eventually center around the complications of prematurity and your NICU experience, most parents have more immediate questions:
Who will be in the delivery room?
There are usually many more people present for the birth of a preterm baby than a full term baby. There will be nurses there to care for you as you give birth and nurses to assist in the delivery and care of the infant. There will be medical personnel in the room to care for your baby after delivery and provide any immediate medical interventions your infant may need.
The size and location of the hospital where you are delivering your baby will determine whether there are family practitioners, pediatricians, neonatologists, medical students or residents present at your delivery. It in not uncommon for a premature infant to need extra oxygen, help breathing with a hand ventilator or a "bag and mask," or placement of a breathing tube into the airway. Regardless of whether you are at a small community hospital or a large regional teaching hospital, medical personnel will be trained in neonatal resuscitation and will take necessary steps to ensure that your new baby is safely transported to a Neonatal Intensive Care Unit (NICU).
What will my baby look like?
Most parents do not know how their premature baby will look. Regardless of how early your baby arrives, he or she will be fully formed with all the tiny fingers and toes. The biggest difference you will notice in addition to smaller size is the lack of body fat in preterm babies. Although every baby looks different (even at this early age!) The following three pictures can give you an idea of what to expect:
Who will take care of my baby?
NICU nurses will provide the day-to-day care of your baby until he or she is stable enough for you to take over. NICU nurses will be your biggest support and your best resource for learning to care for your new baby. In addition to NICU nurses, your medical team may include nurse practitioners, neonatologists, Neonatology Fellows, pediatric residents, and medical students.
When can I see my baby?
As soon as you are able to come to the NICU you will always be welcome. Fathers, family members or partners of new mothers often accompany the infant and medical team from the delivery room to the NICU. New mothers may or may not need recovery time after delivery and are brought to the NICU by wheelchair when they are stable. If your infant is transported to a NICU at another hospital you will be discharged from your hospital as soon as medically safe so you can join your infant. Social workers will be available to ensure that you are able to stay near your baby.
Can I breast feed?
Providing breast milk for your baby is the best thing, and sometimes the only thing, that you can do for your infant in the first weeks of life. Some premature babies are able to breastfeed right away and your nurses will work with you to coordinate feedings with your presence in the NICU. Some premature infants are unable to breast feed for several weeks to months, and a pump is needed to express breast milk which can then be fed to the infant through a tube or bottle. Most NICUs have nurses specially trained in breastfeeding called Lactation Consultants, who will help you with this process. Having a baby in the NICU may make breastfeeding a little more difficult but should not interfere with plans to breastfeed your baby.
What happens when I go home?
You may be discharged from the hospital before your baby is ready to go home. There are often parent rooms in the NICU where you can stay, or you may be in a NICU with private rooms. If you live far from the hospital where your baby is being cared for, a social worker will help provide options for staying near your baby. You will be allowed to visit your baby at any time of the day or night. You will always be welcome to be near your baby in the NICU.
What next?
Whether your stay in the NICU is for days, weeks or months, you will settle into the daily routine of the NICU. This will include daily rounds, feedings, caring for your infant as much as possible, and a lot of sitting next to your infant's isolette. It is impossible to know what challenges lie ahead for you and your baby. There will be awful moments, wonderful moments, and everything in between. Accept whatever help your friends and family member can offer, ask for help when you need it, and even if it doesn't always feel life congratulations are in order - Congratulations! You deserve it - you have a new baby!
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