The Special Care Nursery
Up to 10% of little Australians are born before 37 weeks of pregnancy. If this is your baby, he or she will probably spend some time in the Special Care Nursery (SCN) or Neonatal Intensive Care Unit (NICU)27. While prematurity is the most common reason for a SCN admission, it is certainly not the only one. While this information leans toward pre-term babies, the information here applies to any baby who needs to spend some time in the nursery.
Whether your baby stays or merely visits the nursery will depend on how many weeks pregnant you were when they made their big (and often unexpected) arrival. It will also depend on how much help your baby needs to go home safely. This point is different for each baby and depends on his or her circumstances.
Having a baby in special care can be an emotional rollercoaster. Some mothers describe feelings of anger, guilt, loneliness, sadness, and fatigue. These feelings are common in new parents; some specific to preterm parenthood. Others are unique to mothers whose babies are having a few challenges to life on the outside. There are a few important points that you need to remember if you find yourself in this situation.
You are not alone
Firstly, congratulations on your new arrival! What a fantastic thing it is to have brought a new person into the world. While they may be a little scrawny (or puffy, or little, or big or attached to wires and monitors right now) this will change when the time is right – and under all that is the little person your baby always was – a little fighter.
You are not alone. The nurses in special care work with families day in and day out, caring for your little one, and to some extent, you. They are very aware of the effect that having a baby in the nursery can have on a mother’s emotional well-being. It also affects parent-infant bonding, the family as a unit, and has social and financial implications (particularly of babies who are under special care for long periods).
They are responsible for helping you nurture the health of your baby on a holistic level. They don’t just attend to their physical needs. Babies are little people who thrive in a low light and noise environment. They also need positioning, skin to skin and bonding with their parents. The nurses in special care will be able to connect you with social support systems; these supports are available to you both while your baby is in hospital and after you go home.
The mother’s role
Most special care nurseries recognise how vital the role of the mother is in the baby’s holistic health. Nurses work very hard to include parents in the care of their baby. This ‘care’ ranges from something as simple as a nappy change to skin to skin contact. It includes informed consent and decision making regarding your baby’s treatment.
Just as with your pregnancy and birth, please do your homework. Ask the questions you need to make an informed decision about the care your baby receives. Other parents with a baby in the nursery are a great resource. You may find that you can provide support to each other as you are walking a similar path.
Baby will go home when they are ready
Regardless of why your baby is in special care nursery, they will all go home at the same time. When they are ready, and it is safe for them to go. Some babies will go home with plans and follow up, and some won’t need either. It’s essential to speak with your baby’s doctor before you head home to find out what your baby requires to stay on track.
Not all babies born before 37 weeks need a full stay in the nursery. If your baby is feeding well and has no other challenges, they may be able to go home earlier. On the other hand, if your baby can’t control his or her blood sugars yet, it would not be safe. Each baby has a unique set of circumstances. Each baby will dictate when it is safe for them to go home.
Life in special care
ife in the nursery can be busy. Monitors are pinging, doctors talking, and discussions underway. Your baby usually has at least one lead attached somewhere under there. But it’s also full of people who just love what they do, care for your baby as if they are their own and step up when you need to step out for a break. If you aren’t sure about what’s happening, just ask. You must be involved with what is happening with your baby. You need to have the confidence to speak up and ask the questions that you need to, so you know what’s happening.
Establishing a routine is an essential step toward normality. Time for yourself and other family is also important, especially if you have other children requiring care. They also want to be a part of your baby’s life, and the demands of the SCN can sometimes get in the way of that. Scheduling time for fathers, siblings and grandparents can give you a break to go and eat or a quick walk, as well as allowing connections between your baby and other family members to develop.
We know how important breastfeeding is – not only for baby’s health but for bonding. However, it can be challenging to get started if your baby is on a monitor, in an isolette, or is not yet strong enough to feed. Special-care nurses are aware of these issues. They will support you to provide your baby with the best nutrition available – first your colostrum, then your breastmilk.
Even if your baby is very early and can’t digest anything via his stomach yet, the time will come that baby will be hungry and ready for milk. When that happens, it essential that you have that supply ready to go. The best way to ensure this is by expressing your breastmilk from the time baby is born. That way, when your baby is ready to breastfeed, your supply is there, and all either of you will need is a bit of a hand to get the hang of it.
Once your baby is ready to feed, the staff in the SCN can help you to get your breastfeeding underway, with support such as attachment and positioning advice. You can start this even if your baby is feeding through a tube. Baby can also have tube feeds while laying skin-to-skin.
Breastfeeding is hard work! Therefore, you must be patient and give your baby to build up to fully breastfeeding. Babies may only have the energy for a short breastfeed once or twice a day at first. However, it won’t be long until they are feeding more frequently. Before you know it, your baby will be breastfeeding like a champion. In the meantime, if he or she needs a day off because she’s tired it won’t hurt her in the long run. There are many tips and tricks for establishing breastfeeding, so please don’t hesitate to ask the nurses to help when the time comes.
Dr Janelle McAlpine (PhD), Clinical Midwife
Photo by OndroM used under license from Shutterstock.com