Family Centered Care

fcc

 

Partnering with Families in the NICU

As a parent, you can help your baby’s healthcare team learn and understand what your baby likes and dislikes by observing your baby’s specific behaviors. Your baby’s behaviors tell us what is stressful to them and what is comforting. Through these observations, you will learn how your baby responds to their environment. You will also learn how your baby reacts to being handled and touched and how to comfort and console your baby through the journey. With time, you will come to know your baby’s own special language, their strengths and challenges, and how to respond to give your baby the very best start possible.

 

You have a very import role in helping your preemie develop in the early days and weeks in the NICU. Even if all you can do in the beginning is offer a gentle touch and reassuring voice, your baby will find comfort and contentment in your presence. As your preemie grows, you will assume more and more of their care, and by the time your baby is ready to go home you will be doing almost everything for you baby!

 

Empowering yourself with the information and knowledge needed to feel comfortable and confident is an essential aspect of parenting in the NICU. Don't be afraid to ask questions. YOU are an important and crucial part of your baby's healthcare team.

 

 

Things you can do to help your baby grow in the NICU:

 

 

23- 25 Weeks Gestation

  • Your baby can only tolerate a small amount of touching at this time. Lay your hand on your baby’s back with firm but gentle pressure. Do not stroke or rub the skin because it may be painful for your baby. Your baby cannot differentiate between pain and touch at this time because of their undeveloped neurological system.
  • Help to keep your baby “nested” in the fetal position. This means bringing your baby’s legs and arms close to their stomach and chest so that they are “organized."
  • Allow your baby to have uninterrupted rest time. Your baby needs a lot of sleep to grow and gain weight.
  • It is very important for your baby to hear your voice. Talk to your baby in a low, quiet, soft voice for short periods of time.
  • Ask the nurses if you can decorate your baby’s space. Bring pictures from home or a small stuffed animal to keep at the bedside to help personalize the environment.
  • Refer to your baby by their name!
  • Leave a cloth or small blanket with your scent for your baby. Make sure to rotate it out every couple of days.
  • At this gestational age, your baby needs to be in a dark environment. You can help by bringing a special blanket or a quilt from home to cover the incubator.
  • Start a journal to record your baby’s journey through the NICU and to keep track of milestones and important events.
  • Begin to pump! You can provide the only nutrition that is made specifically for your baby. Your breast milk is very important for your baby’s immune system and will not only help your baby grow but will act as an important medication to help your baby thrive. Ask your nurse to help you get started.

 

26-27 Weeks Gestation

  • Help keep your baby “nested” while in the incubator. This gives the baby boundaries helping them to stay in a tucked and flexed position. This means bringing your baby’s legs and arms close to their stomach and chest. Have your baby’s nurse help you learn how to do this.
  • Position your baby’s hands up close to their mouth or face. This allows your baby to feel calm and comfortable.
  • Touch your baby with a firm caress rather than soft stroking movements. Your baby cannot differentiate between pain and touch at this time because of their undeveloped neurological system.
  • It is if important for your baby to hear your voice. Talk to your baby in a low, quiet, soft voice for short periods of time.
  • Refer to your baby by their name!
  • You may be able to take your baby’s temperature and perform a diaper change. Please ask your baby’s nurse to show you how.
  • Learn about the importance of Kangaroo Care and ask if your baby is stable enough to have some skin- to-skin time with you.
  • Allow your baby to have uninterrupted rest time. Your baby needs a lot of sleep to grow and gain weight.
  • Bring a special blanket or quilt from home to cover your baby’s incubator. Your baby needs to be in a dark environment just like when your baby was growing inside of you.
  • Start a journal to record your baby’s journey through the NICU and to keep track of milestones and important events.
  • Continue to pump for your baby. Your milk is specifically designed just for your baby’s developing immune system.

 

 

28-30 Weeks Gestation

  • Help to keep your baby feeling safe and secure by “nesting” your baby in the incubator. This is called containment. This gives your baby boundaries and helps to keep them in a tucked and flexed position.
  • Ask your baby’s nurse or therapist to show you different positions that your baby may like. Position your baby’s hands up close to their mouth or face. This helps your baby feel calm and comfortable.
  • Learn about the importance Kangaroo Care and ask if your baby is stable enough to have some skin- to-skin time with you.
  • Once your baby can open their eyes, allow some quiet time to just focus. Shield your baby’s eyes from bright lights whenever possible and keep their space dimly lit.
  • Preemies have a hard time handling several things going on at once. Use only one form of interaction at a time with your baby. (Speaking, rocking, touching)
  • Refer to your baby by their name!
  • You may be able to do some hands on care for your baby- taking a temperature or changing a diaper are two things you can do for your baby. Ask your baby’s healthcare team to help you at first until you begin to feel comfortable.
  • Bring in a special blanket or quilt from home to cover your baby’s incubator. Your baby needs to be in a dark environment when sleeping and have periods of light during awake times.
  • Let your baby hear your voice! Talk or read to your baby in a low quiet voice for short periods of time.
  • Your baby may be able to wear clothes now! Bring in a special outfit or two and remember to take some pictures.
  • You may be able to help bathe your baby. Ask your baby’s nurse to guide you through the special techniques used for premature babies.
  • If you notice your baby beginning to have feeding cues, offer a pacifier during tube feeding times.
  • Keep in mind the importance of sleep cycles and rest periods. Your baby needs sleep in order to grow and thrive.
  • Continue to journal and record your baby’s journey through the NICU and to keep track of milestones and important events.
  • Continue to pump for your baby. Your milk is specifically designed just for your baby’s developing immune system.

 

 

31-33 Weeks Gestation

  • Position or hold your baby with arms and legs tucked close to chest and abdomen. Make sure you support your baby’s head.
  • Learn about the importance of Kangaroo Care and ask if your baby is stable enough to have some skin-to- skin time with you.
  • Keep in mind the importance of sleep cycles and rest to grow and thrive.
  • Position your baby’s hands up close to the mouth or face in an organized state.
  • Continue to nest your baby and provide important boundaries while your baby is in the incubator. This helps your baby feel safe and secure while helping to develop their muscle tone.
  • Hold your baby 8-12 inches away in a face-to-face position when stable.
  • Remember to shield your baby’s eyes from the bright environmental lights.
  • Talk or read stories in a low, quiet voice. Keep in mind your baby’s stress and stable behavior cues. Use only one form of interaction at a time with your baby, like speaking, rocking or touching. If your baby becomes tired or irritable, stop the interaction time and give your baby a rest period.
  • Refer to your baby by their name!
  • You may be able to do some hands on care for your baby- taking a temperature or changing a diaper are two things you can do for your baby. Ask your healthcare team to help you at first until you begin to feel comfortable.
  • Your baby may be able to wear clothes now! Bring in a special outfit or two and remember to take some pictures.
  • You may be able to help bathe your baby. Ask your baby’s nurse to guide you through the special techniques used for premature babies.
  •  If you notice your baby beginning to have feeding cues, offer a pacifier during tube feedings.
  • Keep in mind the importance of sleep cycles and rest periods. Your baby needs sleep in order to grow and thrive.
  • Continue to journal and record your baby’s journey through the NICU and to keep track of milestones and important events.
  • Continue to pump for your baby. Your milk is specifically designed just for your baby’s developing immune system.

 

34-36 Weeks Gestation

  • Hold your baby with arms and legs pulled up close to face and abdomen. This flexed position allows for your baby to stay organized and content.
  • Encourage your baby to bring their hands to mouth. This helps your baby to feel content and organized. Let your baby grasp your finger.
  • Position your baby so eyes are shaded from bright lights to encourage eye opening. Dim the lights whenever possible. Talk, sing, or read stories to your baby in a soft voice. But remember, preemies have a hard time handling several things going on at a time. Use only one form of interaction at a time so that your baby does not get overwhelmed or overstimulated.
  • Refer to your baby by their name!
  • You may be able to do some hands on care for your baby- taking a temperature or changing a diaper are two things you can do for your baby. Ask your healthcare team to help you at first until you begin to feel comfortable.
  • You may be able to help bathe your baby. Ask your baby’s nurse to guide you through the special techniques used for premature babies.
  • Continue to do skin-to-skin care with your baby. Your baby may be ready to breast or bottle-feed. Ask your baby’s nurse to show you how to begin this important developmental milestone with your baby.
  • Continue to offer a pacifier while your baby is being tube fed.
  • Keep in mind the importance of sleep cycles and rest periods.Your baby needs sleep in order to grow and thrive.
  • Your baby may be ready for a car seat test/study soon. If you haven’t already, it may be time to buy or bring in your baby’s seat to get ready for this important milestone. Make sure you read the instructions on proper positioning of the straps and how to install it safely in your car.
  • If you haven’t picked out your baby’s pediatrician, it may be time to do so. Your baby will have an appointment soon after discharge and often to follow your baby’s growth and development.

 

Growing Bigger

  • Talk, sing, or read stories to your baby in a soft voice.  Remember that growing preemies have a hard time handling several things going on at one time. Use only one form of interaction at a time so that your baby does not get overwhelmed or overstimulated.
  • You may be able to do some hands-on care. Taking a temperature, changing a diaper, dressing your baby, and giving a bath are some things you can do. Ask your baby’s healthcare team to help you at first until you begin to feel comfortable.
  • Keep in mind the importance of sleep cycles and rest periods.Your baby needs sleep in order to grow and thrive.
  • Now that your baby is in an open crib, it’s time to practice safe sleep. Always place your baby on their back and keep sleeping space free of loose blankets and stuffed animals. Ask your baby’s nurse to discuss with you the importance of safe sleep as you begin your transition to home.
  • In order to plan for discharge, you may be asked to take a class or watch a video about CPR. You will want to pay special attention and take notes in you need to. Knowing what to do can be a lifesaver and make all the difference in the world in an emergency situation.
  • Your baby may be ready for a car seat study/test soon. If you haven’t already, it may be time to buy or bring in your baby’s seat to get ready for this important milestone. Make sure you read the instructions on proper positioning of the straps and how to install it safely in your car.
  • If you haven’t picked out your baby’s pediatrician, it may be time to do so. Your baby will have an appointment soon after discharge and often to follow your baby’s growth and development.
  • Your baby may also need special appointments after discharge. Possibly including a follow-up developmental clinic, physical, occupational, or speech therapy, eye appointments, as well as other special medical referrals. Start thinking about your schedule and don’t be afraid to ask for help from family and friends as you begin to navigate life outside the NICU.
  • If your baby is going to be discharged with special home equipment (such as a monitor) or on special medication, familiarize yourself with it. Ask questions until you become fully informed and comfortable taking care of these special devices and medications.
  • Your baby may be discharged soon! Do you have everything you need to take care of your baby at home? If not, speak up and let the healthcare team know. The NICU social worker is available to help you find the resources you may need.