Giving birth to a premature baby who will need to spend time in the neonatal intensive care unit (NICU) isn’t exactly how many people imagine childbirth will go, but it isn’t uncommon. In fact, premature birth occurs in about 11 to 13% of pregnancies. Many preemies—babies born prematurely before 37 weeks of pregnancy—need to spend a few weeks in the NICU, though babies with more severe complications could be there longer.
Having a NICU baby can be an overwhelming and frightening experience but you aren’t alone. Here are some ways to cope if you give birth to a preemie and what you can expect.
What Exactly is a Preemie Baby?
A baby born more than three weeks earlier than its predicted due date is considered premature. These babies have not had enough time to grow and develop, meaning some of their organs may not work on their own. This can increase the risk of health problems, including:
- Difficulty regulating body temperature. Preterm babies may not have enough body fat to regulate their body temperature and need to be cared for with warmers or incubators until they get bigger.
- Breathing issues due to an immature respiratory system.
- Feeding issues. Many preemies need assistance with eating.
- Heart problems, including low blood pressure and a heart defect known as patent ductus arteriosus (PDA)
Preemies may also experience more long-term complications, including developmental milestone delays, such as hearing or vision problems. However, not all babies born prematurely will experience complications, and advancements in medical care and technology have vastly improved outcomes for preemies. Babies born after the 28th week of pregnancy have almost a full chance of survival and eight out of ten babies born after the 30th week of pregnancy have minimal long-term health problems, according to the American Academy of Pediatrics. Your preemie baby will be closely followed by their pediatrician after birth and following hospital discharge to monitor development and assess for any possible delays.
What to Expect in the NICU
Not all premature babies will need to spend time in the NICU, but some do require the kind of intensive care and support the NICU provides.
If your baby does need to spend time in the NICU, many different health care providers will make up your baby’s health care team, including registered nurses, nurse practitioners and a NICU doctor known as a neonatologist with special medical training on how to care for sick newborns.
Upon arrival in the NICU, you’ll meet your baby’s healthcare team and find out more about your baby’s status and plans for treatment. The providers on your team may change during your time there. This varies by hospital and length of NICU stay.
The time your baby spends in the NICU will depend on the severity of their condition. Some spend a couple weeks in the NICU, while others may need to be there longer. Your baby will be ready to come home when they are stable, meaning they are eating and breathing on their own, regulating their body temperature and gaining weight steadily.
Some babies may continue to need special care after being released. Your baby’s healthcare team will talk with you about follow-up visits and whether or not your baby needs continued care under a specialist.
How to Get Involved with Your Preemie Baby’s Care
The NICU can be an overwhelming place, and you may not know what to do, but there are ways to get involved in your baby’s care. Ask questions about your baby’s treatment and how they are doing. If you are unable to go to the NICU yourself due to your own treatment and recovery, you can call and request to speak to a provider on your baby’s NICU team. Your baby will be assigned their own individual NICU nurse too and those nurses are more than willing to call and give you updates at intervals you ask for as well, day or night.
Ask the nurses about when you can hold and feed your baby. If you aren’t able to hold your baby (yet!), ask how you can touch and comfort them. Even if your baby is hooked up to medical equipment, you still should be able to hold them once the doctor says it’s ok. You may even be able to change your baby’s diaper or clothes. The nurses can guide you and show you how. And of course, if you decide to breastfeed your baby, the NICU staff can help you get set up with a breast pump and instruct you on how to store your milk and provide it to your baby. In the NICU, breast milk is treated like medication, especially for critical babies, so pumping can be a wonderful way to help with your baby’s care if you are able. Many hospitals also arrange for donor breast milk too, so you can ask if that is an option for your little one.
How to Cope with NICU Stress
Having a preemie can be a stressful experience, compounded by the difficulty of recovering and healing from birth on your end. Mothers with NICU babies are at an increased risk for developing postpartum mood disorders compared to the general population, so it’s important to find ways to care for yourself during this time. Here are some ways to cope:
- Give yourself permission to feel a range of emotions. You may feel many emotions after the birth of your baby — excitement and joy over welcoming a new family member, fear and anxiety over their health, or doubt, guilt and even jealousy when you see other parents with healthy babies. There is no right way to feel, and you are allowed to celebrate and grieve all at the same time. Give yourself space and time to process your emotions.
- Find support. Giving birth to a preemie can feel isolating, but finding a community of parents who have been through the same thing can help. Your hospital may have a support group for parents with babies in the NICU, or if you feel comfortable, you can gently approach another parent you see. Online communities are another great place to find support. Some organizations that provide parent support groups include:
- Tend to your own needs. This is a hard lesson for any new mom to learn, whether or not their baby spends time in the NICU, but taking care of yourself is one of the best ways you can care for your baby. Pack healthy snacks, make sure you’re drinking plenty of water and get as much sleep as you are able to. As temping as it can be to spend every second at your baby’s side, I promise they are in good hands at the NICU and that you catching up on your sleep so your body can heal is important too. This will help you manage stress and allow you to participate as fully as you can in your baby’s care.
Giving birth to a premature baby and spending time in the NICU can be stressful and overwhelming, but advancements in medicine have drastically improved outcomes for babies born early. If your baby does spend time in the NICU, don’t be afraid to speak up, ask questions and get involved in your baby’s care. Take care of yourself as much as you can and lean on others for support.
Frequently Asked Questions
What percentage of babies end up in NICU?
How much does my baby need to weigh to leave the NICU?
Premature babies are generally released from the NICU when they can breathe and eat on their own, are gaining weight steadily and can regulate their own body temperature.
Do I need to account for a possible NICU stay in my birth plan?
Spending time in the NICU is certainly not something parents plan for, but it is always a possibility, especially if you have certain risk factors for preterm birth, including a pregnancy with twins or other multiples, or you’ve had a premature baby before. Talk with your doctor about whether or not you are at risk for preterm labor and how to prepare.
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Reviewed by Chaunie Brusie, RN, BSN…