All new parents have a lot to fret about, but for mums and dads whose babies were born prematurely those worries can build to an overwhelming level.
Your baby being born early leaves you with less time than expected to mentally prepare for their arrival, couple that with the additional needs of a premature baby and you’ve got a recipe for anxiety.
To help allay some of your fears, HuffPost UK spoke to Tommy’s midwife Anna Nella, and Zoe Chivers, from premature and sick baby charity Bliss.
Was It My Fault?
The answer here is a resounding “no”.
“The truth is, little is known about the causes of premature birth and for the most part, doctors do not know how to prevent it,” said Chivers.
“Going into early labour can be distressing for new mothers and it may feel like the only person to blame is yourself.
“This state of mind can have a negative impact on your emotional and mental health. It is important to remember to talk your feelings through with health professionals and your partner or family members.”
Nella adds that prevention of premature birth is still in need of extensive research because “without knowing the causes, prevention is difficult”.
Why Is My Baby Being Kept In An Incubator?
“Neonatal wards are full of medical equipment which can seem overwhelming to new parents,” said Chivers.
“Remember – all the equipment is there to help your child have the best possible chance of survival.”
Nella explains that an incubator will keep your baby warm and can administer extra oxygen.
“Incubators are needed for premature babies as it is harder for them to regulate their own temperature and they are nursed without clothes so they can be monitored closely,’ she added.
How Can I Bond With My Baby When They’re In An Incubator?
Nella and Chivers offer the following advice:
Holding: Even if you are not able to pick your baby up, they may find it comforting to hold your finger. Also comfort hold them if they are having a procedure which may be painful.
Stroking: This can be reassuring for your baby. Do it smoothly and very gently, but firmly enough not to tickle.
Cleaning: This can include cleaning your baby with cotton buds regularly and changing your baby’s nappy.
Using your voice: Your baby will recognise your voice from inside the womb, so this familiarity will be music to their ears. Gently sing songs, talk to them, make cooing or kissing noises or read them a story.
Making eye contact: This is crucial for bonding. Look into your baby’s eyes and play with them by showing different expressions, such as smiling or looking surprised. Your baby will be communicating with you in response.
Using objects: Show your baby simple black-and-white striped objects or toys.
Chivers added: “When staff on the neonatal ward say that your baby is well enough, ask whether you can start to be involved in your baby’s daily routine. This will encourage a bond between you and your baby and build your confidence in caring for your little one.
“Be aware that it may be a while before you can hold or care for your baby on your own if they are very small or very sick.”
My Baby Is So Tiny I Don’t Want To Hurt Them, How Should I Hold Them?
“Gently does it,” advises Nella. “Your nurse will be there to support you and guide you on how it is best to hold your little one safely and securely.
“It is extremely normal to feel scared about those first few cuddles.
“Watch carefully to see how they respond and if they start fussing, stop. They probably need some peace and quiet.”
Chivers adds that the first cuddle is usually a “major milestone” for parents of premature babies.
“You could wait weeks to hold your child for the first time,” she explains.
“Be sure to speak openly with the staff on the ward and let them know your fears. They are there to help.”
What Is Kangaroo Care And Should We Try It?
You may have heard the term “kangaroo care” bandied around the neonatal unit. It refers to a way of caring for your baby by placing them skin-to-skin on your chest. Both mums and partners can do this.
“Parents who use this method often say they find it a very satisfying way to nurture and bond with their baby,” says Nella.
“Many also report that their babies seem to love this method of care –because it is likened to life inside the womb.”
Chivers adds: “Ideally a kangaroo care cuddle should be for about two hours.
“Consult directly with your neonatal unit team to find out if kangaroo care is appropriate for your baby.”
What Position Should I Lay My Baby Down In?
Most babies should be positioned on their back, however if your preemie has breathing difficulties requiring support with Continuous Positive Airway Pressure (CPAP) or high flow nasal cannulae, then your healthcare team are likely to recommend your baby stays on their tummy for most of the time in the early days after birth because this helps the bottom of the lungs to stay aerated.
In hospital, it’s safe for your baby to lie on their front, as they are being constantly monitored.
Nella explains that as time goes on the neonatal team will introduce more positions into your baby’s routine.
“They will start to focus on getting your baby into a good position through ‘containment’,” she said.
“This means limiting their movement and giving them something to push against so they can practise flexing their muscles, similar to the position that they would naturally have in the womb at this stage of development.
“This is often done using rolled-up bedding, but make sure any fabric cannot get close to her face and impede her breathing. This can be done with your baby on her front or back.
“Another option is to ‘nest’ your baby: building a nest of rolled-up blankets around so they are contained. They may need some cushioning under bony parts of their body, such as their hips and knees.
“Once you take your baby home you will be told to lay them on their back, because sleeping on the front is associated with cot death, also known as sudden infant death syndrome.”
Find more information on how to position your baby on the Tommy’s website here.
How Can I Feed My Baby?
“All babies born prematurely develop at their own pace and are cared for as individuals. The medical team on the neonatal unit will inform you of the best way to feed your baby.” explains Chivers.
“If your baby is very premature or sick, they may be fed intravenously (through a vein). This is called Total Paternal Nutrition.
Nella continues: “Alternatively, the doctors may decide that your baby is mature enough to take milk through a small tube that is passed through the nose into the stomach.
“If you are making milk and your baby is strong enough to suckle, you can breastfeed. If your baby is not ready yet to latch on, you can express milk and this will be given to your baby through a tube.”
More information can be found the Bliss website here.
Will My Child Struggle In School?
“All children develop differently and the same goes for those born premature,” Chivers assures.
She advises that some families decide to have their child start reception a little later.
“One reason you might want to delay your child’s school start is if your child has fallen into the ‘wrong’ year group because of their premature birth,” she explained.
“You may also feel that your child hasn’t reached the developmental level they need to be at to be ready for school.
“No two children born premature will have exactly the same needs and it is important that you think carefully about which option would be best suited to your child.”
Will My Next Baby Be Premature Too?
“If you get pregnant again, there is a good chance you will bring home a healthy, full-term baby,” assures Chivers.
“The risk of a second premature birth is about 10 to 15% - depending on why it happened in the first place.
“Try to seek advice from a consultant before you get pregnant again. Usually you will be monitored closely in your future pregnancies for reassurance.”
Nella adds: “A major factor in assessing your risk the next time around will be the reason for your previous premature birth.
“If there is a known reason, steps can be taken to try to delay it this time around. For example, if your pre-term birth was associated with cervical weakness your healthcare team may give you a cervical stitch.
“We are searching for ways of identifying women likely to have preterm babies. In addition to the research, Tommy’s also runs a clinic in St Thomas’ Hospital in London for women who are at high risk of having a premature baby. The majority of women go on to have a full term pregnancy under our care.”
When Will I Feel Normal Again?
Feeling stress, anxiety, grief and even anger is perfectly normal after a premature birth, so be kind to yourself and try not to feel guilty about any emotions you experience.
“Every parent’s neonatal journey is different,” explains Chivers. “Having a premature baby can be extremely traumatic and can affect some parents for months or years afterwards.
Nella adds that how quickly you find your feet will depend on a whole range of factors, including:
:: Your experiences during pregnancy, delivery and your baby’s early life.
:: Your state of health and that of your baby.
:: How you tend to respond to stress and change.
:: Your personal identity.
:: How much support you have from your partner, friends, family and health professionals.
:: What other pressures you are facing, including work, children and other caring responsibilities.
:: Other factors, such as your baby’s sleeping patterns.
“Because of the interplay between all these factors, every parent will have different levels of resilience, and may respond to the same situation in a very different way,” Nella explains.
“Throughout this period it is important not to have a preconceived idea of how you should be feeling at any given time.
“Even if you feel you are coping, it is worth keeping an eye out for changes in how you are feeling, so that if things start to become unmanageable you can seek advice or support sooner rather than later.”
Where can I get more information and support?
Speak to your GP or health visitor if you need any support. They’ll also be able to advise you about getting more support at home from the community healthcare team.
Visit the Bliss website for more information. The charity also provides a helpline for parents who need guidance and a listening ear on 0808 801 0322.
The Tommy’s website also has plenty of information for parents of preemies and you can keep track of your baby’s feeds and development with their free app My Premature Baby.