Preparing for premature baby

[Blueroses99]

I'm 23+3 in my second pregnancy. My first pregnancy last year ended suddenly at 21+3 when I went into pre-term labour due to weak cervix, and sadly our son was just too little to survive. The preventative measures to manage the cervix (cervical stitch, progesterone, rest) are failing and I had an emergency second stitch 2 weeks ago to try to buy some more time. I am still at very high risk of pre-term labour and I know my little girl could make an appearance at any time, though I'm trying to keep her in for as long as possible. Every day, every week I know she is getting stronger.

So I'm just looking for support and advice really. What can I do, if anything, to prepare for a premature baby? Has anyone had anything similar?

Have you had a fetal fibronectin test? That should give an idea of whether you are likely to go into labour in the next 2 weeks. Check out the bliss website as they are very helpful. If your baby is before about 28-30 weeks you will need a level 3 NICU. This may mean they transfer you to another hospital. Try to find out which one and try to ensure you give birth there rather than at your local and then the baby is transferred. You may be able to visit the unit to prepare yourself but equally you may prefer to rest at home. Do they have an idea how big your baby is? As it is incompetent cervix rather than e.g. pre eclampsia, she has a better chance of being a decent size. Really hoping she stays put for a while longer.

Thanks for your reply. I am waiting on a transfer to the nearest level 3 hospital St George's, they have a spare neonatal bed but not one for me in antenatal yet. I agree I would rather be there for birth rather than transferred afterwards. I'm also told being in SW that there are a number of nearby hospitals that are level 3 if George's can't take me.

I had a high fFN result 2 weeks ago which was one of the factors resulting in me having a second stitch put in place, a week later it was reduced, but I was tested on Tuesday after coming in with brown discharge/blood and it's high again which is why I was admitted. I'm told that the fFN test isn't supposed to be used with a cervical stitch, after bleeding or before 24 weeks though.

I don't know the baby's size. I just hope she is >500g and otherwise healthy. I believe they would do a more thorough scan tomorrow (if I'm moved) or Saturday (if I'm still here).

I hope she stays put for longer too. They were all set for sending me home until they noticed low fluid on the scan this afternoon. They are worried about a leak in the membrane, possibility of infection and how this impacts baby's growth. I've had my first steroid shot tonight and waiting for a transfer.

If I were you, I'd do everything possible not to get discharged. Once you start labour, it can go so quickly and you cannot predict how quickly you can make it to the hospital. I went into labour on a Friday night (at 29 weeks). We called the hospital and were told to call an ambulance. The ambulance took just over 40 minutes to get to us (despite living in Greater London) because they were so busy with all the drunk people getting into fights and 'suffering' from alcohol poisoning. I was convinced I'd end up having her at home, and if that had happened I'm sure she wouldn't have survived. So, stay in hospital if at all possible, and good luck!

I think they are intending to keep me in for a while. Because I have 2 stitches, they would have to be removed immediately if I went into labour else they could cause major damage to my cervix, bleeding etc. I've been moved to a level 3 hospital where they can look after babies from 23 weeks so the neonatal team are on standby. I live 10 minutes from my local hospital but that isn't a level 3 so best to stay in, I agree!

Ah that's good.
Have you had your second steroid shot yet? They burn like hell, don't they?
Is there a room you can stay in at St George's once your baby is born?
I had dd1 at the PRUH and couldn't stay past the first night. There were a couple of rooms in SCBU for parents but they were being used overnight by parents who, after many weeks of hospital, were about to take their baby home, to have a practice run doing it all by themselves but able to get support from the nurses if needed. A few days after I had dd, one of the rooms was them used by a mum who's baby was very very sick and she never knew how quickly things could deteriorate. You might be entitled to a room too, with such a tiny premie. Is she still sitting tight?

Yes I had the second steroid injection and she is still sitting right for the moment. I have no idea about private rooms to be honest, I've not enquired about all the facilities and options. I'll find out x

Good luck!!!

They weren't private rooms as such, just there to be used for whatever. One of the rooms at the PRUH was stuffed full with spare equipment, for example (which I thought was such a waste, as I would have LOVED to be able to stay rather than driving back and forth for 7 weeks having to leave my baby over and over) Of course it might be different wherever you'll have her.
Have you thought about kangaroo care? I found myself scrambling around for loose clothing (loose cardigans work well) that would allow me to have her on my bare chest and still be covered enough to not feel too exposed with the other parents about, once she was well enough to be out of the incubator for cuddles. Maybe something to bear in mind.

Good luck OP

Don't worry about buying clothes: SCBU will have a couple of baby gros you can borrow for the first day or so, and Mothercare offer free next day delivery on preemie baby clothes (details here) so you can buy when you know what size you will need.

Look into buying a long term parking ticket at the hospital rather than paying the hourly rates

The steroid shots really hurt, sorry. But they are worth it to help your LO's lungs develop even a little bit more

Oh I'm so glad you've been transferred and they are keeping you in. Every day counts and you are very close to 24 weeks now. Excellent about the steroids too. Is it St Georges in sw London or in sw of England?

I second the poster about the Mother care preemie stuff, it's very good. You may find she doesn't need clothes for a while anyway. They often like them in just a nappy in the incubator so they can see them properly and also the incubators are humidified at first which would make clothes damp. For kangaroo care, I really recommend VIJA preemie top with the poppers. Google them and if you email the company they will give you a discount. The tops are great for making your baby feel cradled against you and the poppers allow all the leads to be passed through.

I also hated going back and forth to the hospital and leaving my baby but you can usually phone any time and get an update. Also the NICU is open 24 hours a day for parents so you don't have to limit yourself to daytime. When she is old enough they will usually transfer you back to your local hospital which makes things much easier.

Girls often do better than boys when born prematurely. I was in hospital with the mum of a 24+5 baby girl who only weighed 465 grams. She is now home on oxygen and doing well. Have you had another scan yet? I hope she sits tight for a bit longer. Wishing you both well. Xx

So many things I haven't thought of! Thanks for the advice. I'm in SW London. Naively I didn't think about having to leave baby here and go home. I love the sound of kangaroo care. I most wear dresses so I'll have to find out whether I have anything suitable. I love the sound of the VIJA top. I hadn't thought about clothes but I suspect that little one won't need any straight away. It is a good idea to order them as needed however. I think my husband has wangled a weekly parking permit to visit me so I hope we would be able to continue with those. It's £25 per day otherwise! She has sat tight for a few more days and I am 23+6 today. I know she is getting stronger everyday.

Hello OP. No real advice here but just wanted to hand hold.

I was admitted to hospital at 23 weeks with ds1, I had complications and was warned that he might have to be delivered at any point. I remember how unnerving it was, waking up every morning not knowing if that day was going to be THE day he would have to be delivered. It was 20 years ago, so before mobile phones, tvs on wards, no internet etc therefore nothing to do every day except worry about having a prem baby.

What I found really helpful was being shown round the NICU and having all the equipment and machinery explained to me, so that it didn't seem so daunting.

In the end, they managed to keep ds inside me until 34 weeks, and he was born small but healthy, and only needed SCBU not NICU. My issues were very different to yours and I realise that is very unlikely to happen in your case, but I hope your little girl can stay inside you for as long as possible.

In the meantime, if possible try to take your mind off it. I'm sure that the 10 weeks I had in hospital, bored out of my mind and with nothing to do except worry about what was going to happen were not healthy for me mentally. I know it's easier said than done though.

Hi Blue,
Just seen your post. Have you received the small wonders DVD by better beginnings? It's very informative and I found it very reassuring. I still have it so could always post it to you? Thinking of you.

Blue I'm much further north than you, but once our baby was born we got lots more information. Our hospital gives a free parking permit to parents, and 2 meal vouchers per day for the mum (I only found out yesterday tho, so haven't used that yet), DD was born at 29+1 and is 13 days old now and they've said she may be able to wear a vest in about a week so clothes aren't an issue for us yet. We do provide our own nappies but there was no rush for that. We also bought a few nice blankets and a couple of teddies, it was nice having a few personal things for her and we use the blankets during skin to skin.

Our hospital also has a sick children's trust house next door, same as a Ronald McDonald one and as we arnt local we got a room there so we don't have to leave, but the nurses on neonatal are all very busy so make sure you ask if any help is available as they may just assume you already know.

Our hospital don't like to tell you what the machines mean as they say they just want you to concentrate on enjoying the baby, but I couldn't relax not knowing as there is so much beeping so I kept asking until one nurse explained them all to me, it's much less scary once you no.

Don't have much other advice as we are still figuring it all out ourselves, but I hope your baby stays put for a good while longer for you, hope everything goes well

Usedtobe thanks for sharing your story. I have been on reduced activity for 10 weeks already, and almost full bedrest for the last 4 weeks so I know what you mean about the mental impact. I'm managing OK with that, I have books, internet, visitors etc and I've been so anxious throughout the pregnancy that its not actually possible to be any more anxious now. I hope I can hold on as long as you. Thanks for the hand hold.

Friends thanks for pointing me to those resources, that sounds very useful actually. I know you have a lot going on at the moment so I'll see whether the hospital has a copy first.

Alb congrats on your DD. It makes sense that there's more info available once baby is here, thanks also for the tip about asking for info in case they assume that we know. We live 5 miles/30 minutes away and we have support nearby too. I would definitely find it less scary to know what's going on too.

Wishing you all the best OP

Hope everything works out OP

If you are planning to pump them it might be worth asking about that (whether they can provide one/you can rent one etc). Even if your dd can't use it straight away you only have a few days post birth to prime your body to make milk so it helps to be prepared. Also ask about donor milk as it's usually saved for the smallest preemies. I found that pumping gave me a purpose when my ds was in the NICU and I couldn't do a lot of his care.

I agree with asking about what support can be provided. You can't predict how long preemies will need to be in hospital and costs (parking/food/accommodation) can really add up.

I had 26 weeker twins last April...they were in NICU for 16 weeks before coming home on oxygen.
Its a pretty scary time and until you get used to it, NICU is a scary place.
Your baby probably won't need clothes for a while - they will be in a heated, humidified incubator. The nappies are teeny and will be provided by the unit until they are in size 0 ones.
I bought loads of cheap, stretchy vests - perfect for sticking a baby down! However, don't be surprised if you aren't able to hold baby for a while. They may be too small/poorly/unstable in the beginning. My bigger girl was 780g at birth and we had to wait 2 weeks to hold her, and my little twin was 650g and we got to hold her at 3 weeks old.

Please feel free to ask me as many questions as you need to!

24 weeks today blue.

I thought of a couple of things but please say if it's overwhelming to get too much info. I felt completely overwhelmed for my first few weeks in hospital and just wanted to retreat into myself and be left alone.

You can hire the hospital grade breast pumps for home use as you need to pump at home too. Either from the Medela website or there is a pharmacy in Fulham which keeps them in stock. It should cost £35 a month as you get a discount if you have a baby in the NICU.

If you are able to walk to the NICU or if a relative can, you should be able to pick up some Bliss booklets that give you lots of information.

I can send you my ds incubator cover if you would like it? Little babies should have covers over their incubators to muffle noise and keep out light so they are not stimulated but sometimes the NICUs don't have enough. You want to keep it as womb like as possible so you could use a thick blanket or towel.

There were some websites I found useful. Bliss was good and I also liked the australian website 'raising children'.

Hi Blue how is it going? Hope that she is still safe inside you - every day is a bonus.

I went into labour yesterday and the stitches had to be removed before I damaged my cervix by contracting against the resistance or more importantly before the baby was affected by possible infection. I've had steroids, magnesium sulphate and antibiotics.

Baby Aviana Rose was born at 19.45 yesterday at 24 weeks. She is tiny but stable in NICU xx

Ah that's wonderful she is stable. Huge congratulations. What a pretty name. Not all hospitals give magnesium sulphate but I know a 26 weeker that had it and he is doing really well, better than others of later gestation. What was her weight?

Congratulations! That is a beautiful name for your little girl!

There is a FB group for Preemie Parents which is great for support. It's called Parents of Preemies Support UK.
Full of people who have been through what you are going through and who understand how you are feeling.