Life After the NICU

6 tip to transition from the NICU to home.

The day you bring your baby home is a happy one. But what if baby had to spend time in the NICU (neonatal intensive care unit)? Though you’re probably excited to finally take your little one home, having to walk away from all the security of the hospital nursery can be daunting.

As a postpartum doula, I have had the pleasure of meeting many new families and have especially loved helping those who have had babies in the NICU. Infants who go to the unit are usually admitted right after birth — whether it is because they were born prematurely, experienced complications during delivery or showed signs of sickness within the first few days of life. The length of a NICU stay  depends on the severity of baby’s condition. It may be days, weeks or even months before you get to take him home, and while you wait, you can prepare for the journey that is life after the NICU. Since I know how nerve-wracking it can be, I want to help you adjust to your post-NICU life and share a few tips.

Here are 6 things you can do to keep the transition from the NICU to home as smooth as possible.

  1. Create a safe, slow transition to home. If you are going home with a premature baby, you may find that you still have a lot left to do to prepare the house for baby. And that’s ok. You first need to be easy on yourself: don’t try to do everything at once, and don’t rush. Get help.  For example, have someone clean your house and get groceries before you get home, in preparation for your new family. I accompany clients during this transition and serve as an extra set of hands to help strap in the car seat and get all the discharge paperwork together. Once they are home, I do everything I can to help them feel ready to start their new journey. This first-day support is key.
  2. Feed your baby AND yourself. This sounds simple, but there can be so much going on, and feeding yourself can end up being really stressful. So for this as well, take it easy and get the help you need to prep your food while you focus on feeding your baby. If your little one is a preemie and you want to exclusively breastfeed him or her, you may need a little scaffolding — additional tools, like nipple shields, hospital-grade pump and supplemental nursing system — to help your little one latch. But remember that “fed [not breast] is best,” and your baby loves you whether you nurse or bottle feed. During the first few post-NICU days, an overnight postpartum doula can be a great support for nighttime feeds, when parents are too tired to wash pump parts or assemble feeding tools.
  3. Get emotional backup. As many parents who have NICU babies focus on keeping it together while their infants are at the hospital, a lot of the emotions surrounding the birth or the intensive care experience do not surface until they’re home. And when they do surface, they can take them by surprise. So it’s important to have a few friends, family members or a counselor to help you navigate the transition and your emotions. To take it even one step further, surround yourself with “yes people,” and avoid those who aren’t supportive and helpful. One thing that my clients appreciate about my being there with them is that I reassure them. I tell them that everything is ok and normal and encourage them to trust themselves. As with most things in life, it doesn’t hurt to have someone saying ‘yes, you can!’ on your team.
  4. Say “yes” to help… But only on your terms. There are many times in life when you just need to suck it up and get on with it. This is not one of those times. If someone wants to come and do your laundry and make dinner, let them. Getting the help you need is important and necessary. However, if the people who are supposed to help start stressing and burdening you, make sure to set boundaries. What’s more, the help shouldn’t come at the expense of your bonding time or routine. Being in the NICU can be overwhelming for babies, and as they are being manipulated for medical interventions, they often miss out on that bonding touch they so desperately need. So don’t let anyone overstep his or her role, and don’t let anyone hold your baby if you don’t want them to or if you feel you need more time to bond. Which brings me to my next point…
  5. Make bonding your priority. Babies who are getting out of the NICU need to reconnect with their parents. So for the first couple of days or weeks, you and your partner should spend as much time as possible in skin-to-skin contact with baby. Baby massage and slow gentle baths are a really good way to use intentional gentle touch. I’m also a firm believer of the concept of, “a relaxed parent equals a relaxed baby” and often encourage parents of NICU babies to sing  and play music. It’s not just that music is beneficial for the brain development of preemies. Singing relaxes your body, as your breathing needs to regulate in order to create a sound, and your baby takes their cues from you.
  6. Trust Your Instincts. When they are in the NICU, babies are often on a strict feeding schedule to gain weight. Once at home, parents usually have to keep up with the schedule, so it’s easy for everything to feel very measured and controlled. Parents who rely on such rigorous timetable can forget how to trust their instincts. Once your pediatrician advised you that you no longer have to frequently wake your baby for feedings, do your best to veer away from your strict routine. This will allow you to tune in with your baby’s cues and needs, as well as with your instincts as a new parent — all of this without being interrupted by all the NICU procedures, finally!

Written by Emily Varnam, a birth and postpartum doula. Emily is co founder of The Fifth Vital Sign. A birth and postpartum doula, midwive’s assistant, birth control doula, placenta encapsulation specialist, and holds a degree in counseling and mentoring. She has been working with newborns and families since age seven and her goal is to be able to take people’s hands during puberty and walk with them through every stage of reproductive health. Learn more about her work here.

Photography by Laura Vladimirova of Natural Birth Bebe.

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