Monday, March 24, 2008

Going Home, Part 2

As your baby's discharge/going home date gets closer, you will want to make sure that you know how to take care of your baby. The NICU staff is there to help you so take advantage of them while you can. They will have specific things they want to make sure you know how to do and will often start teaching you as soon as possible. I've included a list of basic care items that you will want to know as well as things you can do to ensure that you are going home loaded with as much experience and knowledge as you can.

Before your baby goes home, at a basic level the NICU staff will want to make sure that you know how to do the following:

1) Give your baby a bath. Depending on how long your baby is there, you will probably have already given your baby a bath during his/her NICU stay. They usually like to see you do it at least twice to make sure your comfortable and that your baby is safely handled during the process.
2) Take care of his/her umbilical cord - this will only apply if your baby is in the NICU a short time. Both of my kids were in the NICU for a long time so I never had to worry about this.
3) Feed your baby. The nurses will want to make sure that you are comfortable and familiar with your baby. They want to make sure you know to breastfeed properly and/or give a bottle correctly. You should get a lot of practice while your there and don't be afraid to ask questions. If your baby is coming home with an NG or G-tube than you will be trained in other feeding aspects as well.
4) Give your baby medicine. If your baby has to take any medicine, the NICU will make sure you have the right prescription(s) filled, know how to draw up the medicine, get rid of air bubbles, and give the medicine. Make sure you know what your baby’s medicine schedule is and if there are any side effects or issues to watch out for.
5) Take a temperature. One of the first things that you get to do as a parent is take your baby's temperature under his/her arm. Beyond giving you a chance to take care of your baby, the nurses want to make sure you can do this at home too.
6) Use a bulb syringe. This can be an important tool for you - I have to use it on my daughter almost daily. Even though kids usually don’t like the bulb syringe and they can be hard to use, they really do work. If you have never used one, ask the nurse to show you how.

Overnight stay
Many hospitals offer parents the opportunity to stay at the hospital overnight and take care of their baby by themselves. If your hospital offers this program and you can do it - take advantage of it! Sometimes you don't realize that you have a question or that you don't know how to do something until you are faced with the issue. If you aren’t able to stay overnight, another good option is to come in for a whole day and take charge of your baby’s feedings, diaper changes, etc. We had to do this with our daughter and it was a valuable learning experience.

Follow-up appointments
Before your baby is discharged from the NICU, the staff will let you know what follow-up appointments your baby needs to have and when they should occur. Some hospitals will even schedule these appointments for you. At the very least you should see your pediatrician 2-3 days after you come home so that he/she can examine your baby and begin taking charge of his/her ongoing medical care. If your baby has other medical needs then you will need to see other doctors as well. Make sure you know who the doctors are, what their specialty is and where their office is located.

If your baby has to come home on oxygen, a nebulizer, apnea monitor, feeding tube or other equipment, make sure you get the equipment ahead of time and are trained on how to use it before your baby comes home. Normally the company that is providing the equipment will send out someone to train you on proper handling and usage. It’s a good idea to have both parents and/or all care providers be trained on the equipment at the same time so that everyone has a basic knowledge of how to use it and how to troubleshoot any problems that may occur.

This is general tip for all parents but an important one if your baby has any breathing/lung issues. I would highly advise that before your baby comes home (or soon after), you watch him/her breathe without any clothes or blankets on for a minute. This will tell you what their “baseline” is so that you will know if they are having trouble breathing or are in repertory distress. We didn’t do this with our daughter and ended up in the ER a few days after she came home because she looked like she was having trouble. Turns out that she normally “pulls in” and breathes fast but we didn’t know that prior to her going home. It’s also a good idea to have the nurse go over basic signs of distress and what to do in those situations.

If your baby is coming home on oxygen, make sure that you are trained on how to use the equipment and what settings your baby needs. Tip: ask the RT to show you how to change the nasal canulla before you go home. The first time I had to do it I realized that I had no idea if the prongs were supposed to be facing up or down. Ask the RT what other information you should know so that you can be prepared. Find out the best ways to tape the nasal canulla to your babies face as well.

Feeding Tubes
The nurses will make sure that you know how to give your baby feedings through the tube. Make sure you ask them any and all of your questions. Try and take part in as many feedings as possible so that you are comfortable with the whole process from start to finish.

Most NICUs have a discharge coordinator who will help you through this process. As I’ve said above, don’t be afraid to ask questions. This is your best opportunity to get information from the people who have been taking care of your baby.

1 comment:

aline said...

I really like your site, I've tried posting several times but i'm really not sure if they're going through. It does not seem like it. if you've received several posts from me then go ahead and delete the duplicates. i'll be checking back with you.
i'm a mom of a former preemie, 32 weeker.