Preterm Premature Rupture Of Membranes

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Bonding with your baby

Anthony and dad You and your partner or spouse may feel some detachment from your baby at first. This is not unusual. Some parents find that postpartum depression, post-traumatic stress disorder, or feelings of anxiety, guilt, shock, or anger impair their ability to bond with their babies. Other parents are so afraid of losing their babies that they intentionally distance themselves, either physically by avoiding or minimizing time in the NICU, or symbolically by holding off naming their babies or sharing the news of the babies' births.

Your NICU team can work with you to show you ways to connect with your baby physically and emotionally by involving you in your baby's care and encouraging you to participate in decisionmaking.

Bonding with siblings and other family members

The members of the PROM list encourage you and your partner or spouse to bring your baby's siblings to the NICU so they, too, can begin to bond with their new brother or sister. Visiting the NICU will help your baby's siblings understand and handle the NICU experience, by being able to be a part of caring for and getting to know their new little sister or brother.

Grandparents and other family members should also be encouraged to visit and bond with your baby.

When to visit

Some PROM preemie parents have found that they were given more opportunities to participate in their babies' care during certain shifts, often late evening or very early morning. Talk with your NICU nurses about whether there are certain time periods when your NICU is less busy and the nurses generally have more time to answer questions about your baby's progress, and help with bathing and kangaroo care.

What to bring
You may be allowed to bring pictures, blankets, stuffed animals, or other mementos for your baby. Items other than blankets or isolette covers may not be allowed on top of the isolette, but you can tape decorations such as family photos or spiritual pictures to the isolette. Ask your NICU nurses for specific guidance on what can be placed in the isolette.

Make sure you label any blankets or clothing with your baby's name so they don't get put in with the NICU's laundry.

Watch for overstimulation
Your NICU team will show you how to handle your baby sensitively, without overstimulating him or her. For example, you will need to keep your voice soft and the lights dim, and avoid excess noise. You can avoid overstimulation by introducing only one stimulus at a time. For example, if you are touching your baby, you shouldn't also stroke him or her or talk. When touching your baby, use firm, constant pressure rather than feather-touching or lightly stroking.

Signs that your baby is becoming overstimulated include desaturation of oxygen (ask your NICU nurses how to identify this on your baby's monitors), grimacing, turning away, or a heart rate that is either too fast or too slow. Keep in mind that sometimes your baby may need to be left alone.

Kangaroo care
In kangaroo care, the baby is placed on the parent's chest with the baby's ear against the parent's heart. The baby wears only a diaper and cap so that the baby's bare skin is touching the parent's bare skin. Talk with your NICU caregivers about what their policy on kangaroo care is. Most hospitals will allow kangaroo care even if babies are on a ventilator. "Rooing" is believed to enhance babies' long-term development and can have a powerful impact on parents.

Hope and Jen rooing

Kangaroo care was first used in hospitals with insufficient technical equipment where no isolettes were available. After years of studying the positive effects for both baby and parents, some well developed hospitals (such as the Uppsala University hospital in Sweden, starting summer 2005) have been using kangaroo care as the first and preferred care, rather than isolettes. Families are offered a room of their own where one of the parents can carry the baby close to the body all day and night with a special kangaroo blanket. Studies show that the babies that are "rooed" this way need less medication and progress faster, and that the parents bond with the baby much better.

When not to visit the NICU
People who are sick, have a fever, or have a rash, or have been exposed to certain illnesses such as chicken pox, measles, mumps, meningitis, are unlikely to be allowed into the NICU. Washing and disinfecting your hands as well as wearing a hospital robe or gown before entering the restricted NICU area will most likely be the standard procedure and the most powerful way to prevent infection.

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Article by Jodi Donnelly, Mommy to Anthony PROM @ 16 weeks, born in 2004 @ 31.5 weeks, 41 days in NICU and now thriving
and Kay Squires, september 2005
Special thanks to Inkan, Jen, Jody, Lise, Sonya, Valerie, Beth and the members of the PROM list



		Preparing for a PROM Preemie

• Preapring for a
PROM Preemie

• Advice

• Meet your new
health care team

• Preparing for
delivery

• The first 48 hours

• The first week:

- Your baby

- Taking care of
Yourself

- Your partner, older
children, and others

• Bonding with
your baby

• Loss in the NICU

• Remember

• Resources

• Appendix A:
Creating a Preemie
Birth Plan

• Show all