Here are some stark facts from WHO (World Health Organization). They aren’t meant to scare you but to put into specific relief the importance of neonatal care.
- Every year nearly 41% of all under-five child deaths are among newborn infants, babies in their first 28 days of life or the neonatal period.
- Three quarters of all newborn deaths occur in the first week of life.
Now, WHO also stated that: “More than half the neonatal deaths occur after a home birth and without any health care.” They also state that part of the problem is a lack of continuity of care from maternal to child. As a result, babies fall through the health care cracks.
What’s the cause of these deaths? “The three major causes of neonatal deaths worldwide are infections (36%, which includes sepsis/pneumonia, tetanus and diarrhoea), preterm (28%), and birth asphyxia (23%).” We’re going to address premature babies in a future post but for now, let’s take a look at caring for a baby who is ill, at home.
So let’s say you’ve had a hospital birth, but because of low birth weight, jaundice, infection (respiratory, like pneumonia), congenital issues (birth defects) or others, your baby might not be 100% healthy on day 1. A trip to the NICU (Neonatal Intensive Care Unit) will likely have been warranted. The duration of baby’s time in the NICU will depend on a lot of factors but if all goes well, you’ll get the green light to go home at some point.
The day you’re told that you can finally take baby home is a day to celebrate! And it’s also a day where many parents are even more scared. They realize that suddenly, they’re going to be at home, without any nurses or doctors around, without any of the equipment that brought baby back to a state of stable health. It’s scary, to be sure, but there is a lot parents can do to make sure that they have a successful return home, with baby.
Don’t leave without a plan
I’d be hard pressed to imagine a medical NICU team that would release a baby without going over a solid care plan with the parents first, but just so that you know what to expect, this is the first step.
What’s included in a care plan?
- Feeding needs
- Sleep requirements
- Any medicines required
- The use of any devices to supplement their healing
- Infant CPR (if respiratory issues were part of the problem)
- What signs warrant concern and what signs and symptoms warrant a return trip to the ER.
You also need to make sure that you have a follow up appointment set up with a pediatrician, within two days of discharge, as well as all the paperwork that goes along with baby’s stay in the NICU. Like what?
- Test results
- Lists of medications, including dosages
- Names and numbers for specialists
- Any information about devices required
- A copy of the plan
Getting help at home
Having a postpartum doula who is trained to deal with and care for medical devices—a G-tube, for example, for feeding baby—can provide a major safety net for you and your baby. After all, they have seen many babies and will give you the comfort of knowing what’s okay and what needs to be investigated medically. Your mother-in-law, though you love her, can’t do that.
Since babies with health concerns require even more care than a healthy baby, what others can do is help you with the things you don’t have time for in the weeks following your return home. Dishes, laundry, shopping, cooking, caring for and giving attention to elder siblings who, temporarily at least, won’t get a lot!
That said, healthy babies are already at risk of exposure to disease that they can’t fight off: they haven’t developed the natural immunity that the rest of us have. Babies with health issues are even more at risk. Visitors should be kept away from baby if they themselves are sick, just getting over an illness, or live with or are school aged children. Make sure you have clear rules about hand washing on arrival and before touching the baby, for example.
A baby that is immunocompromised, more than a normal level of compromise, really shouldn’t be exposed to any visitors. A quarantine is hard on you more than anyone, but you can still leverage resources like postpartum doulas, so long as they are properly equipped with face masks and gloves. And there’s always social media to keep you up to date with what’s going on with your friends and family!
Look into early intervention services
Babies born with health issues are at risk of experiencing developmental delays so getting on top of that from day one is possible with early intervention services. All babies who spend time in the NICU are evaluated to see what care services they might be eligible for, and some of these are designed for the family too, including counselling, therapy, and education.
This is the hardest piece of advice, but perhaps the most important. You can’t be a good caregiver if you’re in panic mode all the time. You will need to rest, hydrate, eat a little something and, most importantly, try and relax a little. If your idea of relaxing is binge watching a Netflix series, this is the time to indulge! The first weeks are the longest with any baby and even more so with a baby who had a rougher start in life, so give yourself plenty of leeway. Remember too that it will get better and you’ll be able to see the forest for the trees, soon enough!
If you are feeling overwhelmed and in need of an extra pair of hands, please don’t hesitate to reach out to us @ www.mothershelpinghandsatlanta.com