Healthcare Forum: Jenn Taylor - NICU Nurse

Here at Nightowl Nursing, we understand that some families do have babies in the NICU. The prospect of having your newborn hooked up to wires, tape all over their skin and sleeping in a plastic box sounds scary. All staff in our NICUs in Edmonton are highly qualified, so passionate about the care they give and want your baby to go home with you as soon as possible.

We had the pleasure of meeting Jenn a few months ago, her passion for helping postpartum families in her role as a NICU nurse is infectious. She loves teaching and education and cares about advocation in our healthcare system. We are so proud to have met and connected with her on this new project of ours.

We want to feature our everyday heroes in our healthcare system: the professionals that we could work with everyday during our postpartum journey. It is important to highlight all the different norms of a new postpartum delivery and sometimes some babies do have to be admitted to the halls of the NICU.

Before we continue on with the most common questions parents have about the NICU, I’d like to tell you a little bit about Jenn.

Jenn has worked as a neonatal nurse for nearly two decades. She has had the opportunity to work in several NICUs throughout the province. Jenn has a passion for teaching parents about developmental care and how they can best support their preterm baby. [She] is currently working toward the completion of her International Board of Lactation Consultants certification, so that she can better serve breastfeeding parents and their little ones.

Now that we have gotten that out of the way, let’s ask Jenn some questions - shall we? Let’s dispel the mystery of a NICU admission together!

Will my baby get taken away right away to the NICU before I can see them?

Sometimes newborns need specialized care when they are born. If your baby is showing any signs of distress during labor or if your baby is premature, the NICU team will be notified of your situation. When it is time for your baby to be born, a small group of specialized healthcare providers will come to your delivery room.

If your baby is active and crying after birth, the doctor will place your baby up onto your chest or stomach. A nurse will dry and stimulate your baby to breathe or cry, and the doctor will cut the umbilical cord. Sometimes the baby is taken to the radiant warmer to be checked over by the NICU team. This can happen right at birth or within the next few minutes after delivery. Your partner can always come over to the radiant warmer to be near the baby while the team provides care. Your baby may be able to stay with you for some skin-to-skin, prior to going to the NICU, as long as the vital signs are good.

If your baby requires more advanced care, the team will take your baby to the NICU after explaining to you what care your baby will need. Your partner is encouraged to come with the baby to the NICU, and you will be able to visit shortly after. If your baby is born by c-section, the process is similar. Your partner will be able to hold the baby skin-to-skin after delivery, as long as the baby is breathing well. The baby will be covered with warm blankets and wear a hat. Some mothers choose to hold the baby skin-to-skin on their chest while the surgery is being completed.

Will the NICU respect my decision to exclusively breastfeed and ask for permission before they give formula?

Absolutely! Health care professionals recommend breastfeeding as the first choice for feeding any baby. Someone will help you breastfeed as soon as possible after birth. If your baby cannot breastfeed, a nurse will show you how to express colostrum for your baby. Many premature infants qualify for donor human milk to supplement your breastmilk until you have produced enough to meet the needs of your baby.

Even if your baby is not well enough to breastfeed initially, breastfeeding will be encouraged and supported as soon as possible. Donor human milk will not be given to your baby without your signed consent. Some babies receiving NICU care require an alternative method of feeding. A small nasogastric tube can be placed through the mouth or nose and directed into the stomach. This tube is secured and used to feed some infants milk until they are strong enough to breastfeed or bottle-feed.

What are the most common things that beep and occur on the machines while my baby is admitted to the NICU?

Sometimes there are many alarms and beeps in the NICU, but don't worry because you will learn what they mean soon enough. Your nurse will teach you about what the different alarms and sounds mean. Your baby will have their breathing and heart rate constantly monitored. The monitor will alarm if it detects a change in vital signs.

Will my baby always be in those boxes? Will I have an opportunity to be able to hold them as much and as long as I wish? Would we need to be supervised?

Some babies are cared for in isolettes. They are heated and humidified environments that help control light and sound in the baby’s environment. In most circumstances, the best place for your baby to be is skin-to-skin. We call this kangaroo care in the NICU.

Studies have shown that kangaroo care helps your baby with their vital signs to grow better and go home sooner. Kangaroo care is very important for you as well because it helps to reduce stress, strengthen your bond with your baby, and aid in milk production.

How long will my baby be in the NICU? Is there any way to tell if we would be there longer or be discharged earlier?

Every baby has to demonstrate their readiness to go home by achieving particular goals. These goals include: taking all feeds by breast or bottle and not with a feeding tube, gaining adequate weight consistently, and maintaining normal oxygen levels at all times. Every baby’s journey to graduating from NICU is unique.

If my baby will be in the NICU for a significant amount of time, what else can I do to help with their developmental growth?

You are already contributing to your baby’s developmental growth if you are holding them skin-to-skin often. The minimum amount of kangaroo care should be at least 1-2 hours per day, but the preferred amount of time should be 6-8 hours per day.

Talking softly to your baby, reading stories, and singing also help with your baby’s development. Your baby enjoys your voice and looking at your face. Gentle and positive feeding experiences are essential. The quality of the feeding session is more important than the quantity of milk the baby can take by breast or bottle.

Participate in multidisciplinary rounds whenever possible. You and your partner know your baby best. Your insight is vitally important in guiding the team to make decisions about your baby’s care plan.

Thank you so much Jenn for answering some of our questions. Trust us, we asked her a lot. She gave detailed, thoughtful and insightful answers to all of them. Want to know the rest of the questions? We will be doing our shameless plug for our Instagram right here. We post great, informational post there too. Check us out!