How to Participate in the Physical Care of Your Premature Baby in the NICU
By Susan L. Madden
Providing basic physical care for your premature baby in the NICU - taking temperature, diapering, mouth care and bathing.
In most NICU's, the nurses try to concentrate their care into discrete sessions and otherwise allow your baby to sleep undisturbed. IF you time your visits to coincide with these activity periods, you will have more opportunities to help care for your baby. You may want to call your baby's nurse before your visit; she can tell you when she expects your baby to be awake, or she may be able to adjust his schedule so that you can provide his care when you get there.
All preemies need to have the following tasks done regularly. Your baby's nurse can teach you how to do them and help you until you feel comfortable on your own.
Taking Your Baby's Temperature
This is often of the first tasks that parents feel comfortable performing. When you take your baby out of the incubator to hold or feed him, his nurse will want you to take his temperature to make sure he is not losing too much body heat. IF you are using a traditional glass thermometer, you will probably take your baby's axillary temperature by placing the end of the thermometer in his armpit with this arm down at this side and leaving it in place for three to five minutes. If you have never used a glass thermometer before, the nurse will show you how to use and read it. Some hospitals use thermometers that give instant digital read-outs.
Although diapering is not an inherently difficult task, it can be challenging to work with a tiny baby who is inside an incubator and connected to IV tubes, monitoring wires, and /or respiratory equipment. In addition, preemies who are less than about 32 weeks old are weak and floppy. If your baby is lying on his stomach or side, you must turn him over on his back to change his diaper. Unlike a full-term baby who feels like a compact, connected bundle when you handle him, your preemie is floppy and his bottom half may feel only loosely connected to his top half. You'll need to scoop both of your hands under your baby to support his whole body and head as you turn him. This can take some practice, particularly if you are a new parent.
If you are uncomfortable moving your baby, have the nurse get your baby into position first and then take over. And if working through the portholes is very difficult, ask your baby's nurse if you may open the front of the incubator and slide the bed out to give you a platform that is easier to work on. She may place warming lights above your baby so he doesn't become chilled while you work. The nurse will want to look at your baby's diaper and weigh it in order to keep track of his output of urine and feces, so leave it on top of the incubator when you have finished.
If your baby is on a respirator with an endotracheal tube in his mouth, you can help keep him comfortable by wiping away secretions that accumulate around the tube and applying glycerin ointment to his lips to keep them from getting chapped. This is a simple task that you can do very early in your child's hospitalization when you may be able to do little else. Some parents also learn how to suction mucous and other secretions from their baby's nose and mouth if he must remain on respiratory equipment for an extended period of time.
At first, your baby will only be given sponge baths inside the incubator or on the warming table. Because preemies tend to have very thin and sensitive skin, they are usually just wiped with a soft wash cloth and plain warm water. As your baby gets older and bigger, you will be able to give him tub baths. In some hospitals, baths are given during the night shift when the nursery is generally less busy. If you want to start bathing your own baby, talk to the staff and try to rearrange the schedule so that you can do it yourself. Your baby's nurse will get you set up and teach you how to bathe your baby.
Susan L. Madden is the author of The Preemie Parents' Companion : The Essential Guide to Caring for Your Premature Baby in the Hospital, at Home, and Through the First Years. The parent of a child born 12 weeks premature, Susan Madden has written about health and health care policy for more than 15 years. In her informative book, Susan L. Madden guides you from your earliest meeting with your child in the NICU through the transition of your child's first year at home.
© Copyright 2000 Susan L. Madden, from 'The Preemie Parents' Companion.' Reprinted by permission of the publisher, The Harvard Common Press. All rights reserved.
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