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This really isn’t what you expected for your first child. You expected to leave the hospital with stuffed animals, balloons and a new baby in your arms. But instead you are leaving with worry, fear and tears. When your child began life in the Neonatal Intensive Care Unit, you faced different challenges and issues than a “typical” parent. The birth of your child, while a joyful event, was also full of fear and uncertainty. It has been nearly three months since that wonderful day and now your newborn baby girl is home. She still only weighs a mere 5 lbs., 2 ounces, is attached to an apnea monitor and is feeding every three hours day and night. You are chronically sleep-deprived, continuously worried and generally overwhelmed. The future is very bright since NICU graduates do very well, but it seems so distant. The worst is really over. Your child is on her way to Harvard or Stanford or UCLA. Even though you have been discharged from the NICU, neonatologists and neonatal nurses take a certain pride and ownership in their graduates and their families. They will be there for you, especially in those early days after discharge. They have prepared you well but don’t be afraid to call for some advice. They are there 24/7. Develop a relationship with your pediatrician. Your neonatologist can provide a detailed summary of your child’s course as a “Discharge Summary.” Most of the time this is sent directly to your doctor but you may also receive a copy. There is usually enough information in the discharge summary for the pediatrician to assume care. When interviewing a physician for your child, ask how much experience he has with premature infants. An experienced physician will be a great asset over the next few months. Never be afraid to call. How are you going to work through the next few days, weeks and months? You are not alone! Here are some of the problems that your child may have and some suggestions on how to manage them. APNEA Many premature infants are released from the hospital on monitors. The respiratory center is not always completely developed and infants sometimes forget to breathe. Some infants will be on medication as well as the monitor. Most children will stay on the monitor for 3-6 months. Even though most children rarely set off the alarm, it can be frightening. The sound of the alarm usually increases the parents’ heart rate as it stimulates the infant to breathe. Newer monitors store information and can be analyzed in order to determine if a child can be removed from the machine. In addition, apnea clinics run by your neonatologist will guide you in determining when the monitor can be discontinued. GASTROESOPHAGEAL REFLUX Reflux (GER) is very common in premature infants and can cause irritability and fussiness in an infant and interfere with food and weight gain. Most infants outgrow reflux but it can be disturbing for both parents and children. Medications that help heartburn and promote stomach emptying can be prescribed to decrease this discomfort. ANEMIA Because premature infants do not get the advantage of the last few months of pregnancy, they are often deficient in nutrients, especially iron. Therefore, most infants will be on vitamins and iron at least for a few months. A blood count may be needed to monitor therapy and to decide when medication is no longer needed. FEEDING PROBLEMS Premature infants often have difficulty feeding. Breast milk remains the best milk for your infant and therefore breastfeeding is encouraged. Proteins in breast milk are more easily digested. In addition, there are antibodies in the breast milk that help prevent infection. Lactation consultants are available to help you breastfeed your child. Ask about their experience with premature infants. Frequent weigh-ins are a good way to watch your pro-gress and decrease stress. DEVELOPMENT Premature in-fants need to be monitored for normal growth and development. Regular visits to your pediatrician as well as developmental specialists will ensure early intervention. Your child’s first birthday will be a milestone for both you and your child. Take it seriously and celebrate your success and perseverance. Therefore, relax and enjoy and keep your eye on the future. This is the time in your life when you need to ask for help. There are many resources and organizations that can continue to serve you when you are home with your child. Whether you need parent-to-parent support or information on specific conditions that your child has developed as a result of his prematurity or other medical condition, resources are available. So don’t hesitate! “This too shall pass!” Dr. Clyde Wesp is a pediatrician with Southern Orange County Pediatric Associates with offices in Lake Forest, Laguna Hills, Rancho Santa Margarita, Ladera Ranch and San Clemente (Talega). You can email him at askdrwesp@netscape.net. |
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