Thursday, September 26, 2013

NICU Survival Guide - Adoption Edition

I might not be a mom yet, but I experienced two months of being a mom to preemie twins in the Neonatal Intensive Care Unit (NICU). Having your baby in the NICU is stressful enough, but adding in adoption brings its own set of challenges. Here are my top 10 tips to get you through the highs and lows.

1.  Find a friend that has been through the NICU experience and listen to everything that they tell you. I had two, let's call them the Bettys*. I work with one Betty and went to high school with the other. I wasn't that close with either, but they embraced me with open arms and prepared me for the fight ahead. They were a wealth of knowledge, knew exactly how I felt and let me lean on them whenever I needed. I would not have made it through without them. There isn't a big enough thank you out there for them. So go find yourself a Betty -- whether it is a Facebook friend, co-worker or another mom at the hospital. You need to have a support system. Hey, I am available!

2.  Make a plan with the hospital staff and birth parents about expectations.  If you have an open adoption, will the birth parents and family be allowed to visit the baby during the hospital stay? Do you want to be there while the birth parents are visiting? Who will make medical decisions? Who will be called in case of an emergency? Who is paying for the hospital stay? The adoption laws in your state may determine what you are legally allowed to do. Are you comfortable with the birth parents holding, caring or doing kangaroo care with the baby? What about breastfeeding or pumping? How do you want everyone to be addressed? Our nurses called both the birth parents and us, Mom and Dad. It made me uncomfortable in the beginning, but I got over it. Discuss whether the birth parents will be at the hospital on discharge day. The staff treated us as their parents, but be prepared for it not exactly going the way you wish. Be flexible and understanding.

3.  Get to know your nurses and doctors, you may be there for awhile. Aside from taking care of your baby everyday, they will ease your fears and tell you what's beeping and why. Our nurses gave us hugs when we needed it and sat and listened when we wanted to talk. When we needed some reassurance about what to expect in the long term, the doctors met with us and answer all of our questions. These are a special group of people that love what they do and it really shows. They rock!

4.  Take pictures of your baby the entire time. It may be hard to see them hooked to machines or look so small and fragile, but you need the pictures to see the progression. This is especially helpful when the baby has a set-back and you feel like it is the end of the world. You can look back to see where they were just days or weeks ago and how far they have come. It was amazing to me 
how resilient and how much a baby can overcome. Set-backs happen and it is OK.

5. Ask! If you don't understand a beep, a number, a term, just ask.  If you are having trouble feeding, diapering, etc. ask the nurses for tips. If you have concerns about something, speak up. If you researched some special formula or procedure online at 3 am, it is okay to ask them about it. Ask if you can decorate the isolette. Ask if you can bring in linens and clothes for the baby to wear (and wash them). Asking questions will help you feel like you have more control of the situation.

6.  Take advantage of learning baby care basics from the staff. When they asked us if we wanted to learn something, we said yes. We fondly called it baby bootcamp. We learned everything - swaddling, temperature taking, bathing, diapering, feeding, burping, soothing techniques. They showed us how to look to the baby for signs of what they needed and let the baby be our guide. Since we were the adoptive parents, we didn't spend the night with the babies. They did offer us to do 24 hours of care before we went home. Boy those 24 hours were an eye opener, but an invaluable experience. I feel 100% confident in my baby care skills.

7.  If someone offers help, take it. I felt like there was no time to do anything. Forget about grocery shopping, laundry, getting ready for baby, etc. In the beginning we were eating out every night or not eating. Life was still happening, but I didn't have any time to address it. My parents got us a hotel room for a long weekend near the hospital. Our distant aunt offered us to stay at her home that was close to the hospital. She fed us a home-cooked meal and packed our lunches for the day. Thank you. I took advantage of convenience services like getting our groceries delivered by Fresh Direct and having the laundromat wash and fold our clothes. These things really made our life a little easier. Your friends and family want to help, so let them.

8.  Take a break.  We wanted to be with the babies as much as we could. You will feel tremendously guilty when you are not there, but you have to take care of yourself so that you can take care of the baby. The nurse reassured us that they don't expect parents to be there all the time. It's easy to get burned out from the stress and long days. An adoption situation is different because you normally don't get maternity leave. I had vacation time saved, but I wanted to use those days for when the babies came home. We could not afford to take unpaid time, so we worked. When we could not be there, we called to check-in. I admit that I called several times a day. We took the first week off to get the rhythm of everything and then after that we hopped in the car every night drove 2 hours to sit with the babies for a few hours. We stayed in the area on the weekends to spend more time with them. After several weeks of 18 hour days, we knew we would not be able to sustain the routine. We started alternating. Once or twice a week, I would stay home and Marlon would go to the hospital by himself and vice-versa. It made a huge difference.

9.  Step aside and give some space to the birth parents. If you have an open adoption, the NICU may prolong that final goodbye between birth parents and baby. If the birth parents are visiting, give them some privacy to say goodbye before the baby goes home. If they want it, let them have some alone time with their baby during the hospital stay. You will have a lifetime with the child. I surprised myself at how relaxed I was with their birth mom. I thought I would be jealous, but I wasn't. I felt secure that she wasn't changing her mind, but just wanted to show her love to the babies. Try honor and include them as much as they need, it will only promote a good relationship later.

10. Celebrate! Celebrate every little milestone, every ounce gained, and every machine taken away. With each day, you are one step closer to taking your baby home.

Ultimately, this adoption did not work out for us. Along with the hospital staff, we gave them the best start possible. They needed us to be their parents and I feel good about the time we spent with them. On the bright side, I no longer have any nerves about caring for an infant. After two months in the NICU, I think I can handle just about anything.

Irish blessing                                                                      Image by Jim Muth

*I changed my NICU friends' names. They have the same name and they know who they are. xo


  1. Good post about NICU parenting. My bio daughter spent 3 weeks in NICU. That pregnancy became complicated very suddenly. Before we knew it we were facing parenting a preemie in the NICU and were not prepared for everything involved. It is a very stressful time, so if adoptive parents or biological that the NICU is likely in the their future, it is a great idea to start reading up on it. Thanks for putting your insights out there.

  2. Great advice! It is so difficult to have a baby in the NICU for extended periods. I can't imagine doing it with an adopted baby. It must be heartbreaking when the adoption does not work out. I admire adoptive parents and their strength and determination. I wrote a memoir about my micro preemie's time in the NICU. My daughter Joy was born at 23 weeks last year. Due to modern medicine and prayers she is doing great today. I hemorrhaged at 17 weeks for the first of 4 times because of 100% placenta previa, which turned into placenta accreta (which I believe was caused by 3 prior c-sections). After she came home from 121 days in the NICU, I wrote a memoir called "From Hope To Joy" about my life-threatening
 pregnancy and my daughter's 4 months in the NICU (with my 3 young sons at 
home), which is now available on Amazon. It was quite a roller 
coaster that I am certain some of you have been on or are currently riding on. My mission is to provide hope to women struggling with
 high-risk pregnancies, encourage expectant mothers to educate themselves before 
electing cesarean deliveries, provide families of premature babies a realistic 
look at what lies ahead in their NICU journey, and show that miracles can 
happen, and hope can turn into joy.
 Please see my website and
Thank you.


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