When you think of a newborn, what comes to mind? I’m talking about a brand newborn, straight out of the womb. I think of a bundle, a baby quickly wrapped and brought to mum, of cuddles, that little kiss on the top of the head. I think of a baby being cradled by mum and dad. To be able to hold your baby is a basic human right.
When a baby is born too soon, they cannot be held, usually. In some circumstances they can be bundled up for a quick look and a kiss but in lots of cases, they can’t see their mum and dad, and have to be whisked away to be worked on and to be stabilised.
In some cases the mother is too sick to be moved, and cannot see their baby. My baby was born on a Friday. I was told to expect to see him on the Monday. I died inside. I tried to be brave, as I knew I was sick and so was he, and was grateful we were both still here, but not to be able to see him for this length of time seemed impossible to me. Like any mum, I sobbed as soon as the doctor had left. I did see my baby, when he was 8 hours old.
Handling Joseph was impossible. He had to stay inside his incubator. To help others to understand why we can’t hold our babies I wanted to outline the reasons, although they seem obvious, a lot of people outside the world of premature babies do not understand why this is the case.
Vulnerability – The premature baby’s skin is not developed, as you probably know, skin is multiple layers to prevent infection. Imagine the worst sunburn you’ve ever had, the skin peels off in layers. A premature baby has a very thin skin mantle, therefore nothing much to protect it from the outside world and infection. An infection that lays dormant on your skin or on your clothing could kill a premature baby.
Breathing – Whilst being on breathing support does not preclude being held, it is very difficult to maintain a baby on a ventilator outside the incubator. It is not impossible, and babies on long term ventilator support may sometimes be held. CPAP is easier, but an unstable baby with breathing issues may be safer and more comfortable within the confines of the incubator. (in the picture above, Joseph is wearing CPAP - I call it his spaceman outfit!)
Temperature Control – Coupled with the breathing issues and the skin mantle, premature babies are lacking fat stores, coupled with immature body systems, so controlling temperature is very difficult. If a premature baby’s temperature is not stable, it can be life threatening. Once the baby is stronger kangaroo care will be encouraged, where the baby is placed on the mother or father’s chest, skin on skin, which helps keep them warm and snug. Different hospitals will vary on when kangaroo care is considered appropriate.
Overstimulation – Premature babies are very prone to becoming over-stimulated, and as a result they can become stressed, keeping them in their incubators prevents this, however calm, gentle kangaroo care can help too.
For the above reasons, handling needs to be kept to a minimum, however even inside a plastic box, there is a lot you can do to maintain contact with your baby.
Baby massage is very powerful, even if you can only manage a foot or a hand, just gentle strokes, and once the baby is bigger, the staff may be happy for you to do more techniques. You must always be guided by the staff and doctors, in some babies massage may not be a good idea, particularly if they have had surgery.
Comfort holding is a very good technique and the nurses should be able to demonstrate this, but basically you curl one hand around the head and the other around the feet. Joseph’s feet were under a lot of stress with heel pricks and with monitors, so I used to cup his bottom and head, when he was on his side or belly.
Even once you are able to hold or touch your baby on a regular basis, there may be times when this is not possible. Your baby may be have trouble with bradycardias (slow heartbeat) or desaturation (maintaining good oxygen levels in the blood). Your baby might be poorly with infection, or have required surgery. It is difficult, especially if you have had the freedom to get your baby in and out of the incubator yourself.
Sometimes it is difficult to understand why decisions have been made, and you should be involved in the decisions regarding your baby’s care, but it is not always possible.
Remember that one day, this time will be in the past, and you can pick up and snuggle your baby whenever you desire.
Now is not forever.