24 Tips For Parents

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Having a premature baby is by no-one’s standards a “normal” thing to do and once you start on this journey you will find it can be extremely emotional. As parents of premature babies ourselves, we felt that there was a lack of support and information available. We decided to do something about it, and hence 24 Weeks Plus was born.

Our aim is to support anyone affected by a premature birth. Although our name suggest we only offer support to parents of babies born at 24 weeks plus, this couldn’t be further from the truth. We offer support to anyone who has experienced a premature birth regardless of gestation. This is in the form of email communications. If you need to type all your fears and feelings out- there will always be someone available to read your emails and write back to you- if indeed that is what you want.

We understand that Doctors and Nurses can sometimes be intimidating because we’ve all “ been there and done that”. We understand that sometimes you just want to let off steam, and that’s what we’re here for.
A Neonatal Unit is such an alien world. Days merge into weeks, and it is something that we are all totally unprepared for. We understand that and that’s why we would like to help to make that world a little less frightening and a little more welcoming.

Here follows our top 24 tips, that we as parents of premature babies ourselves, thought you might find helpful.

1. Wash your hands.
This is the first thing everyone should do on entering any Special Care Baby Unit.
This will stop the spread of germs to all the babies on the Neonatal Unit.

2. Breast feeding/Expressing your milk.
We know that when your premature baby is born the last thing on your mind is expressing your breast milk. However giving your baby expressed milk is essential even if you don’t intend to breast feed. Breast milk is so precious to your baby we would advise you to start expressing your breast milk as soon as possible, even if your baby is extremely premature and is unable to tolerate feeds. When it is decided to start your baby on feeds, breast milk is the best thing in the world for him or her, as a mothers milk will help to protect the baby from infections.
Most Special Care Baby Units have breast pumps on the unit or know of somewhere you can hire one. You can buy electric or hand pumps (which take a little longer but do the job just as well) from shops such as Boots or Mothercare. A company called Medela who make all types of breast pumps will do a next day delivery service.
The milk that you have expressed will be frozen on the unit ready for when your baby needs it. If you do not label your milk with your baby’s name, the time and date it was expressed it will not be used. Your breast milk is so valuable to your baby, so try not to waste any.
Some Neonatal Units will have facilities available for you to remain at your babies incubator while you express your milk. If this is not possible you may find it easier to express by having a photo of your baby with you (the milk may flow through quicker or more easily). Or alternatively you could try holding something that belongs to your baby, which has your baby’s scent on it. This could be something as simple as a toy which has been in your baby’s incubator.

3. The scent of a Mother
A lot of research has been done by various premature baby charities which suggest that a premature baby knows when its Mother is around and can recognise her voice. In the same way they can also recognise the Mothers scent. Some women have found it helps to keep their baby stable if they put something inside the incubator which has their scent on. Ideally you should boil wash something, say a handkerchief and then carry it around maybe tucked into the strap of your bra, for the day. Then place the handkerchief in the incubator where your baby is able to smell it. Obviously you will have to check with your baby’s nurse to see if this is ok, as sometimes there can be a risk of infection.
But if it is allowed it is yet another way of helping a Mother and Baby bond.
Another cautionary note. It is best for the Parents to avoid wearing strong perfumes or aftershaves.

4. Firm touch not feather.
When your baby is born, your first instinct will probably be that you want to touch him or her. This is completely natural. Your instinct may be to gently stroke the baby. Please fight this urge. An extremely premature baby can be sensitive to touch. Well, when you think that they should still be in the womb for another four months it’s hardly surprising. If your baby is laying prone (on their front) then gently and making sure your hands are not cold, place your hand on the baby’s back. As we said before it should be quite a firm touch. If this is not always something that you feel comfortable doing you could always put your finger in your baby’s hand.

5. Cares
Once your baby has stabilized a nurse will ask you if you would like to do “cares” for your baby. Cares is the term used for nappy changing and washing your baby. When a baby is extremely premature this can look like a daunting task but please try to get involved, as it will make you feel happier to know that you are caring for your baby and any contact for the baby with its Mother or Father is always a bonus.

6. “Kangaroo” Care
“Kangaroo” Care has many benefits and it is difficult to do it justice in so few words.
The sort of babies and at what stage a baby is considered suitable varies greatly from one unit to another. So please talk to your baby’s nurse about the benefits you and your baby can get from “Kangaroo” care.
“Kangaroo” care is skin to skin contact with your baby. Your baby is snuggled down on your chest. This is particularly helpful as your own body heat will warm the baby, and it also creates an atmosphere where the baby can hear the heart beat of its Mother or Father, and therefore the baby can be comforted by this.

7. Dry skin
Again this should only be carried out on a baby once he or she is stabilized and you have the permission of a nurse. Premature babies are extremely sensitive to touch and they can suffer from dry skin. The best thing to use on them is oil. You should put a little oil ( check with your unit which oil they recommend) in a container and stand this in warm water, put the oil on to some cotton wool and apply on to your baby, making sure your touch is firm not feathery.

8. Positioning your baby
You will need to be guided by a nurse. They will not mind talking this through with you. Positioning your baby looks a scary thing to learn but it will help you to get close to your baby which in turn can only be a benefit to both of you. With an extremely premature baby this is invaluable. The correct positioning will help your baby to develop good posture and improve muscle control.

9. Nest
Some hospitals actually have a little “Nest” which is a toweling nest with cotton straps.  The baby lies in the nest and the cotton straps are pulled across the baby so that they feel safe and secure. If you are in a hospital that doesn’t use toweling nests or do not have them, you can make your own by using sheets- preferably soft ones. If you take these and roll them length ways so that they are tubes, this is ideal. These are then placed round the baby so that he or she has got something secure around them on both sides and under his/her feet. This will not only help them to feel safe but it will also encourage good posture and muscle development.

10.  Talk to your baby
Once again research has been carried out by premature baby charities and it has been proven that babies not only recognize their Mothers/Fathers voice but that they also respond to it. This can help to make the baby to feel safe and secure. However if the baby shows signs that all this attention is too much for him/her then you should leave him or her alone for a while and let your baby rest.

11. Your Feelings
During the early days of your baby being on a Special Care Baby Unit. Some Mothers may feel guilty for not having carried their baby to Full Term (for whatever the reason may have been). Feeling extremely stressed out, tired, upset or irritable, are all very normal emotions to be feeling.

12. Too much light
A premature baby really shouldn’t be in the “real world” yet. Try to keep light and sound to a minimum. This in turn will help your baby to feel more secure and settled. If you think there is too much light getting in to your baby’s incubator tell a nurse and they maybe able to adjust the lighting or position your baby away from light.

13. Reducing noise
Try to reducing the number of visitors who visit your baby at any one time. There is evidence that if one person starts talking quietly other people around them will follow and the general noise level will drop.
There are other ways to help reduce the noise level. Like wearing quiet shoes, and having “silencers” on all the metal bins in your Neonatal Unit.

14. Do not use mirrors or visual aids
If a baby is born extremely premature (23 weeks onwards) the chances are that the baby will spend the months until their due date on a Neonatal Unit. Never leave anything in their eye line as this can over stimulate the baby.

15. Do not over stimulate your baby.
Sometimes it’s easy to forget that premature babies shouldn’t actually be around, they should be tucked up snugly in their Mum’s tummy. You have to understand that they are intolerant of being over stimulated. Let your baby have “time out” where you leave them alone so that they can rest and sleep. This may sound like common sense but never wake a sleeping baby. Rest and sleep are the most important things a premature baby needs. So if they are sleeping leave them be.

16. Babies Privacy
Please do not allow any of your visitors to “visit” any other babies on the unit. It is very important to respect the babies and their families’ right to privacy on a Neonatal Unit.

17. Cameras
It is a good idea to keep a camera on the unit so that you can take photos of your baby. You may not want to do this at first and you always think you will never forget how small and vulnerable they are but you do and you will. Having photos is a lovely way of keeping those precious memories. It’s also a good idea to take a photo of your baby with one particular toy every week so that you can see for yourself just how much he/she has grown.  Parents who use video cameras, please do not video any other babies on your unit.

18. Familiarise yourself with the machines.
There are plenty of books available which will tell you in detail about the machines but if you don’t want to leave the hospital you can always ask a nurse to tell you what the machines do. On entering a Neonatal Unit the beep and buzzes of the machines are quite unnerving but once you get to know what they mean you will find that you feel calmer and more in control.

19. If you don’t understand.
Please don’t feel silly for asking questions. Doctors and Nurses understand the pressure parents of premature babies are under and have no problem in repeating themselves ten or even twenty times as long as they know you are happy with the knowledge they have just told you.

20. 10 Minute recap
If you are around just before hand-over to the next shift, ask your baby’s nurse for a quick recap. This is where you can be updated about your baby’s progress and where you can feel free to ask about anything that maybe bothering you.

21. You can leave the room
When the Doctors and Nurses are working on your baby you can leave the room. This does not mean you are a bad parent. Nobody wants to see their child suffer and unfortunately on a Neonatal Unit there are certain procedures which are unpleasant but necessary. If you feel you can’t handle it or don’t want to, that’s fine. You have to think of your baby and if you not being there means that your baby doesn’t become more stressed out then that’s a good thing.

22. Communication
It is quite reasonable to expect a Doctor or Nurse to teach you how to interpret your baby’s cues/behavior. This is one of the ways your baby can communicate with us all.

23. Developmental Therapists in NICU
Availability of therapists working in NICU and their role varies greatly from one unit to another.  It is worth asking if your unit has an Occupational Therapist or Physiotherapist. If so they can often advise on positioning, developmental care, appropriate levels of stimulation and help monitor your baby’s development. They are also often involved in follow up programmes after discharge. The great benefits of seeing an OT or Physio is that as well as having your baby’s development assessed, they are usually also in a position to offer therapy if it is needed.
Some OT’s are also specialists in irritable babies and “difficult to settle” babies. These babies may have sensory or self-regulation difficulties and sometimes if the causes are identified early on it can have a huge impact on helping the baby to become more settled.

24. Maternity and Paternity Leave
Most women will be entitled to some sort of Maternity pay. If you had your baby at 26 weeks or more you should have already been given a MAT B1 form. If your baby was born before you were 26 weeks. You should go to your midwife or GP and ask for a MAT B1 form. In most cases you will not get any maternity pay without a MAT B1 form.
If you receive benefits you should telephone your local benefits office and ask for a Maternity Allowance Benefit form.

Not forgetting you Fathers. Most Fathers are entitled to Paternity leave from work.
You may also be able to claim compassionate leave from work if your baby has been born extremely premature.