NICU Preparation - any advice welcome

[April24baby]

We have found out that baby will need to be admitted straight to NICU for what is hopefully a 'manageable' issue. Currently 34 weeks but baby is likely to have to come out early (via planned c section). Baby is measuring very large so no concerns on size if they do come out soon but they are hoping to get me to 37 weeks. The thought of going straight to NICU and baby having to have a procedure is upsetting but at least we've had advance notice so we're trying to prep for it the best we can. Any advice would be appreciated - anything specific to pack, coping strategies, just anything in general really. TIA and thanks for reading

so sorry you’re having a rough time. Lots of nicus will let you have a tour/get to know us meeting. It helps with fear, understanding and nerves.

nicu seems terrifying but your baby is in very skilled hands and the kindness and care is overwhelming.

worth having a chat with the obs team about the process.

depmeding on the illness situation etc will you get a cuddle in theatre or is it more urgent to whisk the baby up to nicu? Can your partner go with the baby or after?

I'm a nicu nurse. Do you mind sharing why baby needs to go to nicu? Is it a surgical procedure?

@Answersunknown thanks for replying. Until baby is out we don't know if I will get cuddle/skin to skin or if baby will get taken straight away. Husband will be on hand to do whatever I want him to do....

@burntoutnurse yes, baby has fluid on one lung. At the moment it's only a small amount (we're now on weekly scans to monitor it). Baby will have some of it drained before they delivery and then likely need further work when baby is out. Baby also has (mild) ventriculomegaly on one side - this has been stable on last 2 scans so we're hoping this will just nee to be observed. Because 2 things have been identified, I've had an amnio this week. Thankfully all clear on the big 3 trisomies but awaiting the next set of genetic results. Baby is currently 7lb 2 and very active so I'm taking comfort in that. We've been transferred from our lovely local hospital where we know all the staff, to the huge city hospital - which although it has an excellent NICU, it's not got the best reputation for standard maternal aftercare as it's so busy. So I'm dreading that too. Feel like I will just be dumped on the ward and left.

Does the bigger hospital have parents accommodation on site?

Sounds like you're talking about my hospital tbh but that would be a very small world 🙈

Assuming you're under Fetal med in the bigger hospital, if they haven't offered, ask them for a tour of the neonatal unit. Im guessing they've said baby may need a chest drain? Nicu is a very scary place for parents (I've been on the other side before I was a nicu nurse) ask about accommodation too, DH can stay there as well whilst you're waiting to be discharged.

If baby is stable enough they should facilitate delivery room cuddles, we often stabilise baby, get them into breathing support if they need it and then take baby over for a cuddle :) hopefully they will do the same.

Things that will come in handy for you, bonding squares (we also provide these but many parents bring their own)

Have a small teddy to leave with baby too :)

Express milk as soon as you can cos this will be amazing for baby, skin to skin should be facilitated too if baby is able to (may not be able to with chest drain though)

Baby will only need nappies and cotton wool whiilst on nicu and a big blanket to cover incubator over the top. Again nicu will provide these but I think parents feel like they should have their own,

From a parents point of view, as scary as it is, try and get involved with baby's care, nappy changing, repositioning, ask them to show you how to take baby's temp/blood pressure.

Most importantly make sure you get enough rest and eat and drink well, it's a very emotional and draining time on nicu, but the nicu nurses will support you :)

Any more questions please ask :)

I’d go shopping for button down shirts or cardigan that you can completely unbutton to put baby on your chest for skin to skin. I didn’t have any tops like that and had to send MIL to the shops.

Also a really long phone charger so you can charge your phone whilst sitting (and use it while it charges if you’re doing skin to skin).

For the section, I’d get some high waisted underwear so it doesn’t rub your cut. I lived in maternity leggings.

I had a section at midnight but wasn’t allowed to see baby until 10am the next morning. I was in tears it was horrible. We also weren’t allowed to hold him for 4 days as he was too unstable. I wasn’t prepared for the lack of contact and it destroyed me.

You won’t need any nappies or clothes for baby in NICU so that’s one less thing to worry about! They have milk pumps you can use but if your milk hasn’t come in yet then they have premie formula that they supply. They have fridges you can stock your milk in as well so you don’t have to worry about taking it home (but you can also express at home and put it in NICU fridge).

Good luck!

Thank you @Rosiiee and @burntoutnurse . @burntoutnurse I'm in the North West. Yes, baby will need a chest drain, they have said they will do it before delivery and then review again once he's out. There is (limited I think) accommodation but not sure if we'd qualify as we live reasonably close, although journey can take ages as it's via a large city centre. Thanks for the advice, we will definitely ask for a tour. I know it will be scary and upsetting but forewarned is forearmed and all that....

Do you mind me asking if this is your first? I had a baby in the NICU for 4 weeks and I always remember the mums who were trying to be there for other children to found it the hardest. My baby was just small, otherwise well. I was encouraged to be there and get involved in cares as much as possible. First baby, I didn't have a clue what I was doing but all of the staff were amazingly supportive.

@Northernsoul72 makes a good point. I know some parents were there all day long. We went for a morning visit and an afternoon visit each day as we also had a 6 yr old at home who needed us. Don’t feel bad if you can’t always be there. The team knows it’s hard for some parents to be there all day as they live far away or have other kids. If there ever was a change they’d give us a call to let us know what was happening.

DTs were in NICU / SCBU for seven weeks. First off in a hospital miles away as it was the only one with space for sub 32-weekers, I discharged myself as soon as possible, it was around 48 hours.

When they were transferred to our local hospital we were visiting twice a day but it was exhausting so swapped to a once a day longer visit.

There was no accommodation available. Parking was hideously expensive and restricted. I don't know if all hospitals do this but we had vouchers via PALS that were £2 per day rather than £15.

Thanks everyone. 2nd baby, but eldest is a teenager so we don't need to be around all the time for them, and we have Grandparents close by to help

If you want to breastfeed then make sure the midwives tell you how to handpump into syringes. This will help stimulate supply and baby can be fed the colostrum through their gastrointestinal tube.

My eldest had a two week NICU / SCBU stay. She was allowed to wear clothes once she was promoted from NICU to SCBU, but she still needed the foot monitor, so some footless sleepsuits would be a really good idea so you dont have to worry about buying them once baby moves. DD ended up just in a vest most of the time so her sleepsuit didn't affect the wires.

Check if the Neonatal unit has a dedicated charity - ours did and they provided lunch vouchers for the onsite canteen, free tea / coffees / snacks in the parent lounge etc. They were a brilliant source of support. The unit should also have a specialist breastfeeding support / nurse - if you want to bf, try and get as much support from them as soon as possible as it makes such a difference. Once I'd had some proper help, i was able to hand express and then pump once my milk came in so that baby could still get the benefit of my milk (although i will forever be grateful to mums who donate milk to the milk bank as that saved my baby's life in those first couple of days).

Our NICU also had a special link you could log into and they would upload photos of your baby every day. So even if you cant be there all the time (and it is important that you look after yourself in terms of shower / sleep etc), you can still get photo updates.

Good luck for baby's procedures. As pp have said, NICUs seem so scary at the start, but the staff are amazing and will always try and answer your questions. I found it helpful to keep a note on my phone for when questions popped into my head at random times of the day / night and then i could ask the Dr when they next came round.

My 4th child was born at 24 weeks so we spent a long time in NICU.

The noise! Alarms bleeping/going off pretty much all the time. You do get used to it. If they offer you a tour before you have your baby, then go. It can be overwhelming if you're not used to it.

Get some nice hand cream. Constant washing and sanitising whilst on the unit made my hands really dry.

Open front tops so you can do skin to skin and express.
Hope all goes well for you 💐

Bless you OP. I think knowing it will happen will hopefully make it easier for you. It was a complete shock with DD2 and Covid was happening which made it harder as DP could only visit for 1 hour a day.

If you're planning on breastfeeding try and express colostrum. If you're not, be very clear that you won't be. Bonding squares are great. Get a couple and wear one in your bra when the other is with baby so they have your smell with them. Lots of tissues for your bag. Handcrean is good too- my hands got very sore with all the hand washing. I also really liked warm slippers and a big water bottle so I didn't have to leave her too regularly. I'd also take your own pain relief as they won't give you paracetamol and will send you back to your ward (I was terrible if I had to leave the baby) Prepare yourself to wear noise cancelling headphones during rounds- they still make me feel a bit claustrophobic. Finally, they will try and send you back to your ward to sleep. You don't have to go but make sure you get your rest.

OP I think the best bit of advice I can give you is not to panic when you first see your baby in NICU.

DD was in for 12 weeks and I didn't get to see her until 24 hours after birth as I had to have emergency surgery.

When DP took me through to see her all I could think of was how scary all the tubes and machines were and how I couldn't see her properly because she was on a ventilator. I was having a major panic when any of the monitors started bleeping. The staff were so sympathetic and I also second what another pp said about not feeing guilty if you can't be there all the time.

I had DD abroad and all parents had to leave for a while during staff changeovers so, once I was discharged I used to go home for a bit and then come back for the evening. One evening I was so exhausted, recovering from major surgery and all the worry about DD so didn't get to the hospital that evening. I felt so guilty but was reassured by the staff that it was more important for DD to have a healthy mother than worry about not being there occasionally.

Always ask if there is something you don't understand or are not sure about. It makes it so much easier if you know what's going on. Even if you think it's a stupid question.

Wishing you all the best and remember your baby will be in the right place.

Hey @April24baby two of mine were in NICU, big hugs it is terrifying to know that they are poorly.

With DS2 I knew from early on that he was likely to need to go to NICU and would be prem as I had extremely high antibody levels and he had fluid on his brain/chest/everywhere. Like you I had to have a section although I had my son at 32 weeks and he was huge (water swelled him up) he was 5lb 12oz!!

I really did myself an injury after my section as I insisted on going to NICU as soon as I was physically able to stand and for some reason no one thought that walking all the way to NICU would be a bad idea! I was in agony from over exertion. So try to make sure that you are getting rest!! Use a wheelchair if needed.

I addition, look after yourself, it is horrible being away from your baby but you can't be there all the time, you need a break. Have one.

Pump, all the time. You won't produce anything hardly at all but as the staff told me, even 1ml is worth giving to baby.

Lots of skin to skin as soon as you are able to.

Don't worry too much about the alarms. They go off all the time, I had to remind myself it was more likely that he had knocked one off rather than he had stopped breathing.

Don't compare how your baby is doing to others, each baby has its own challenges and there is no comparison. Don't worry if a smaller baby appears to be doing better or worse.

Now, 17 years later, I think back fondly of my time with my babies in the NICU. I was super supported and made close friends with other parents.

Most of all enjoy your baby.

I'd think about having someone in the hospital to support you after the birth, so that if your DH goes with baby to NICU you still have someone to be with you. I'd also agree with the handcream recommendations - my hands became very dry and painful with all the handwashing. And lastly - don't expect to produce much colostrum at first. I was given a large syringe after the birth and thought I was expected to fill it but at first I found I could only produce small amounts. That increased rapidly over the first week though.

I’m really sorry I can’t read all your thread, but please take eye mask and noise cancelling Earbuds. A hand fan is good. Also bottle that keeps water properly cold. Cold packs and face and hand cream. If you are allowed your own pillow take it.

all the very best. Your baby will be in good hands and you will be stronger thank you knew for you all. It’ll pass and you will go home.

My baby had an unplanned admission at term to NICU but only for a week so I'll let others give most of the wonderful advice.
My tips are about pumping as I started doing it in NICU and ended up exclusively pumping for 9 months.
First - if you want to breastfeed, I'd definitely recommend antenatal colostrum harvesting if your obstetrician says it's ok, usually from 36 weeks but best to check given your specific issues. Then once baby is delivered, hand express every 2-3 hours for first 24 hours then start using the pumps they'll have there, 8-12 times in 24 hours. Many places will only have the standard 24mm flange size to give out which might be wrong for you. Using the wrong size will be less comfortable and lead to less milk being produced. So I'd take the time now to find out what make of pump it is (often Medela Symphony) and order what you think might be the right size flange to take in, all Medela flanges are interchangeable with that pump.
Have a look at https://www.medela.co.uk/breastfeeding/mums-journey/breast-shield-sizes.
I found lubricating the flange with coconut oil helped my comfort and thus feeling relaxed enough to get letdowns massively but probably best to check that's ok for your baby in case there is some medical reason not to.

We had accommodation in our NICU.

If you plan to breastfeed, prior to delivery i made some syringes of colostrum. After they had pumps for milk, bottles and labels to store in fridge for the nurses to feed. (Mine was tubefed)
They also had various formulas if not, sometimes certain formulas are stomached better depending on how your baby is.

They did a walk around beforehand too and the manager came to explain and so we could ask any questions.

There were support groups online to link in with other parents that were at NICU past, present and volunteers to pop in and give advice, support and help.

Good luck to you all, it does feel quite scary :( its all a blur i was quite emotional when i was there.

My little girl spent 19 days in the NICU and SCBU and she is now a healthy and happy 4 month old. It will be fucking difficult but I promise you can do it. You will probably feel all kinds of emotions as your hormones settle too. Try to rest as much as you can.

What helped me was having some home comforts with me in a little bag. Lip balm, hair scrunchies, fresh socks, paracetamol, lavender oil, and lots of food! I got through loads of croissants and brownies. Great for comfort and an energy boost. I also made sure I had some fruit or a smoothie every day.

My advice is to get out of the ward for fresh air and maybe a walk depending on your c section recovery. Don’t feel like you have to stay 24/7. Your baby needs you to be rested and healthy.

The nurses might pressure you to express milk, or more milk than you are already. This wound me up so much. I was doing my best. Stand firm whatever your decision re feeding.

Wishing you all the best of luck, you’ve got this!