SPECIAL BABY SPECIAL CARE a Guide to Caring for Your Baby in the NICU
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SPECIAL BABY SPECIAL CARE A guide to caring for your baby in the NICU SAMPLE parenthood Joy baby skin-to-skin birth Mother family journey Love communication Mother family baby skin-to-skin breastfeedingSAMPLE SPECIAL BABY SPECIAL CARE A guide to caring for your baby in the NICU Dedication This book is dedicated with love to parents and all who support them. We hope that this book, along with help and guidance from your baby’s caregivers, will help answer many of the questions you have about your baby’s care in the NICU or SCN. Thank you to the many people and organizations that participated in the production of this publication. We are very grateful for their willingness to share their personal experiences with us. SAMPLE CCI Scan + Play App Some topics are best explained in video form. Use the “CCI Scan + Play” app to view videos on corresponding topics for a better understanding of caring for your baby. Follow the instructions below to access this digital enhancement. Download our free app and enjoy the following complementary videos: • Parent Emotions . 5 • Breastfeeding Benefits . .36 • NICU Hygiene . 9 • Breast Physiology . .37 • NICU Equipment . 11 • Milk Production . 38 • Baby Care. 14 • Hand Expression . 40 • Kangaroo Care. 16 • Pumping in the NICU . 41 • NICU Therapies . 17 TO ACCESS AND WATCH VIDEOS: Download Find Scan Play With your mobile device, scan Find the purple Use the Play the corresponding the QR code above or visit “Scan + Play” “CCI Scan + Play” video for an optimal customizedinc.com/ScanAndPlay icons throughout app to scan the learning experience. and download the “CCI Scan + Play” app. the book. purple icons. SAMPLE© 2019 Customized Communications, Inc. Arlington, Texas • 1-800-476-2253 • All Rights Reserved Visit us at: www.customizedinc.com • Email us at: [email protected] Table of Contents Part 1: Part 2: When Your Baby Needs Special Care Breast Milk in the NICU What You May Be Feeling . .5 The Benefits of Breast Milk . 36 Your Baby’s Health Care Team . 6 How Breast Milk is Made . 37 Communicating with the Care Team. 8 Stages of Milk Production . 38 Being with Your Baby . 9 Milk Supply. .39 Who Can Visit . 10 Hand Expression . 40 Monitors and Equipment. 11 Pumping Your Milk . 41 Pain . 13 Cleaning Your Breast Pump Parts. .43 Using a Pacifier . 13 Storing Breast Milk for Use in the NICU . .44 Parenting in the NICU . 14 Choosing a Home Breast Pump. .44 Kangaroo Care. 16 Increasing Your Milk Supply . .45 Comforting Your Baby . 17 Breastfeeding 101 . 46 The Importance of Positioning . 18 Positions for Breastfeeding . 48 Baby Behavior . 19 Latch Guidelines. .50 Sleep Development . .20 Nipple Shields . 51 Developing Senses in a Premature Baby. 21 Fortifying Breast Milk. 51 Communicating with Your Baby . 22 Donor Human Milk . .52 Preemie Development . 23 Challenges . 54 Adjusted / Corrected Age . 24 Safe and Healthy Breast Milk Facts. .59 Screenings / Procedures . 25 Nutrition and Fitness . 60 Safe Sleep . 27 Pumping Log . 62 Shaken Baby Syndrome . 28 Glossary . 63 Child Safety Seats . .29 Bibliography . 64 Look Before You Lock . .30 Infant CPR (Under 1 Year of Age). 31 Infant Choking (Under 1 Year of Age) . 32 Warning Signs of Sickness. 33 GoingSAMPLE Home . 34 PART 1: When Your Baby Needs Special Care Introduction The birth of your baby is one of the most exciting and memorable events of your lifetime. It is a deeply moving experience that can be shared forever with friends and family. Some babies will be born prematurely. Others may have a critical illness or condition that requires highly specialized care. If your baby needs to be in the Neonatal Intensive Care Unit (NICU) or Special Care Nursery (SCN), you may be experiencing a wide range of emotions right now. It is normal for the excitement you feel about the birth of your new baby to quickly change to worry or fear about what lies ahead. It is also true that the more you know about what to expect when your baby is in the NICU, the easier it can be for you and your family to manage these feelings and move forward. We want to help. How to use this book You are your baby’s most important caregiver. To help you understand the people and procedures in the NICU and how we work with you to care for your baby, this book has been divided into two parts: Part 1: When Your Baby Needs Special Care • Introduces the doctors, nurses and therapists on the care team • Offers an overview of the NICU equipment and procedures • Provides insight into your baby’s experience while in the NICU Part 2: Breast Milk in the NICU • Explains how vital your breast milk is to your new baby’s health • Provides key insights into breast milk production and nutritional value • Includes illustrated guides on how to breastfeed, pump and store your milk See a word in blue text? You’ll find it defined in the Glossary section at the back of the book. We hope this information is helpful and answers many of your questions. But the book is just the beginning. Every person on your care team is here to help you and your baby get the best possible start in life. Remember: • If you have a question, just ask • If you feel afraid or uncertain, reach out to us • If youSAMPLE need anything, please let us know 4 Part 1: When Your Baby Needs Special Care What You May Be Feeling Some parents describe the early days of having their baby in the NICU as “fuzzy.” You are recovering from the birth, you may feel exhausted, and your baby is in the nursery instead of in the room with you. How you feel can also depend on whether you were expecting your baby to need NICU care after birth, your baby’s condition, your own condition, and if you have had experience with the NICU before. You are your baby’s most important caregiver. Take care In addition to excitement and love for of yourself so you can actively your new baby, it is normal for parents take care of your new baby. to experience a wide range of other emotions, including: • Fear • Anger • Guilt • Worry • Loss • Helplessness Taking Care of Yourself In order to be strong for your baby, you need to take care of yourself—emotionally and physically. Remember that you are not going through this experience alone. Reach out to a trusted member of the care team, your partner, friends and/or family members and talk about what you are feeling. Ask for help if you need it. Also take care of yourself physically. You’ll need to be healthy so you can spend time with your baby in the NICU. Get as much sleep as possible, eat healthy foods, drink lots of water, and exercise when you can to lower your stress levels. Looking Forward It is going to take time for you, your baby, your friends, and your family to recover from this experience. But you will get through it. Accept that what you may be feeling is normal. Take care of your emotional and physical health. Reach outSAMPLE for support if you need it. Part 1: When Your Baby Needs Special Care 5 Your Baby’s Health Care Team Your baby’s care team includes specially- trained professionals who are dedicated, experienced, and deeply committed to providing the highest levels of medical care. You can count on them to work closely with you to develop a plan of care for your baby. MEDICAL TEAM NURSING TEAM • Neonatologist: Physician with specialized • Registered Nurse (RN): Works closely with training in caring for premature babies and you and the neonatologist to plan your baby’s infants who need extra attention at birth care. Monitors your baby closely, directs and beyond. Oversees your baby’s care and feedings, and gives medications. Members of examines them daily. the care team that you will see the most. • Resident: Physician who is receiving • Neonatal Nurse Practitioner (NNP): Registered additional specialized medical training in a nurse with specialized training in caring for hospital setting. babies who require extra attention at birth and beyond. Works closely with neonatologists to • Pediatrician: Physician specializing in the diagnose and treat illness. health care of infants and children. You’ll choose a pediatrician to be your baby’s • Charge Nurse: Oversees the daily care and doctor after you go home from the hospital. operations of the unit during each shift. Answers questions and helps with any • Consulting Physician: Specialist in a specific concerns when you visit your baby. area of medicine: heart, lungs, bowels, eyes, brain or infection. May be brought in to help • Nurse Manager: Oversees nursing operations with your baby’s care. and unit processes. Spends time in the unit speaking with staff, physicians and parents. • Physician Assistant (PA): Medical professional who works with the doctors on • Clinical Educator: Works with staff to make the medical team. Nationally-certified and sure that all patients receive the best quality state-licensed to practice medicine under the care. Also handles patient care standards, supervision of a physician. new staff orientation, and continuing staff SAMPLEeducation. 6 Part 1: When Your Baby Needs Special Care SUPPORT TEAM • Developmental Specialists: Team includes • Unit Secretary: Handles administrative duties a physical therapist, occupational therapist to keep the unit running smoothly. Welcomes and/or speech therapist. Works with the and helps you, answers questions about hand medical team to help babies with specific washing, cell phone cleaning, where to secure developmental and medical needs. your belongings, and breast milk storage.