NICU and Divorce

Parents of small, sick  preemies  can, for many reasons, lose each other.

Parents in NICU have a scenario that the normal newborn family, home in 3 days, never has.  Because of the construct of the small space for isolette and chair etc., parents come into the unit and the mom absolutely zeros in on the isolette,  (Reptilian brain again.). Her body completely fills the space at the isolette and there is almost no way around that.  The father sees her back and little else, and again and again, he eventually sits in a chair and reads a book, appearing as uncaring and callous.  Sometimes the mother will hand the wrapped baby to dad but it’s still an offering from her, not ownership by him which is a must in a happy partnership.

I would tell this to all the parents of long term little ones and now, fifteen to twenty years later, I’m learning that the majority of our families are still intact so this may be the core problem.

Now for the bad news.  The divorce rate in families with long term NICU babies is believed to be 97%.  Tulane calls it 100%.

I believe the father as ‘left out’ is the major cause.

There is an easy way around this for fathers and I have seen many do it.  They come in alone, often before work for the 6AM bath and feeding.  It seems that this experience creates a sustained bonding.

We are enculturated to focus on ourselves with such intensity that everyone else is left out.  Intimacy is frightening and humans no longer look each other in the eye.  They don’t even look their pets in the eye.  It’s too much giving up control and allowing vulnerability.  Force yourself to do it.  Begin with a child or maybe the cat.  Talk to this spirit as independent from yourself.  When brave enough, look an adult you love (and trust) in the eyes… it’s a soul to soul experience.

Only the last years in NICU did I begin looking newborns in the eye and talking to them as an adult (and what was looking back at me was very adult… try it.)  I’d say to the boys:  “You are born onto earth and have parents who are going to give you a great childhood.  And you are quite handsome, like your father.”  And they smiled!

The notion that newborns smile is gas is complete nonsense, driven by those who have no experience.  We in NICU see it all the time and a classic example is the photo called  Laughing Premie from Loma Linda.

So, how can parents avoid divorce after NICU:

  • Choose a baby sitter.  Have the person take a CPR class for infants.
  • Include Dad in the daily care of the baby.
  • Do not focus completely on the baby.  It’s hard on the marriage and hard on the baby.
  • Make some feedings by bottle so Dad can see the curve of his baby’s cheek, that beautiful corner of the baby’s mouth where tongue, bottle and cheek meet.  So he can feel how strong the baby’s pull on the bottle is.
  • Don’t always hand the baby to Dad, he must be a full partner, not a participant.  There’s a difference.
  • Do not criticize parenting of the other.  It turns the critic into everyone’s parent, not a nice place to find yourself.
  • Once a month, go to a restaurant with booths (so no one can shout and no one can cry) for a family meeting. Bring notes if you want to.  The agenda is to be objective and to answer the question:  “How’re we doing?”.  This way, gripes don’t ooze out and ruin the time at home.  Just put it into the notes and save it for the family meeting.  Home must be safe for everyone, always.
  • Plan a date.  Once a month, every other week, you each plan something very special that will please the other and make good memories.  Not a dinner and movie date.  Something like sitting on a dock in morning mists, with a thermos of coffee and breakfast treats.  Feeding ducks in a rose garden pond. Visit art galleries on a First Thursday.  Sit on a bench and guess what passerby’s do for a living.  Visit a toy train store. Go to garage sales or a flea market.  It need not cost money.  The upshot of this is that you know your mate is thinking of how to please you and you are thinking of your mate in positive, loving terms.
  • Learn Partner Yoga.  Do it with your mate.  Do it with your children.
  • Become romantic.  Set up candlelight dinners.
  • Look into your partner’s eyes.

Bringing Baby Home to Pets

Bringing  a new baby or preemie home to a family that includes dogs?  Here’s a bonding trick.

Take a clean piece of cloth, a wash cloth, or maybe use a worn out NICU shirt they are going to throw away… one for each dog, and shortly before the baby goes home, ask the nurse to put it in the crib, next to the baby.  If it’s a shirt, put it on the baby.

Then carry it home in a plastic bag to insure the baby’s smell is strong, and one by one, give each dog in the family a treat, pet him, talk lovingly to him and then give him the shirt to smell.  Then put it into the dog’s bed.

Repeat this for each dog.  They will then bond with the baby before it comes home.

Preemies as Genius

Now for some fun. When he’s at the point where he’s held, fed, contented and you sit with him on your lap, position him so he can see the ceiling and watch his eyes…  you can tell what he’s thinking.  Preemies, more so than normal newborns, are very alert and problem solve. (newborns are not that alert until about 4 months. This is because all the while these NICU events have been going on the preemie has been figuring them out.)  The artist’s foundation of IQ is pre-cognition, finding the problem and then solving it and, applying this theory to everything in life, these preemies become masters at it at about 26 weeks. I have hundreds of stories.

While watching hundreds of babies during thousands of feedings over 20 years in NICUs, I’ve come to believe that we are all born genius and what happens to us from birth on determines if it’s supported and nurtured or harmed.

Preemies and newborns focus on straight lines. Watching their eyes as they look at a large square black and white checkerboard you see that they are doing two things, they trace the outline of the shape and then compare one to the other. Always in that order. Then they recognize perspective. If you place the grid so one edge is in their direct vision, they will see the perspective and begin to compare only the closest and furthest. You will also see that their attention span is very long. I would time them and the range was from 18 to 26 minutes.

Our NICU ceiling was about 10 feet above the baby in my arms and it was made of white acoustic tiles set into a white metal framework. After the first intense minutes of sucking, he began tracing the shape of the closest, then the one next to it and kept going… learning that they were smaller each time and continuing to the point they would arch their backs to see further down the line. Then they would compare the very smallest to the one above their head, recognizing perspective White on white, ten feet away. (the warm-nummy theory in America about how life works is that the baby can only see as far as the mother’s face. What nonsense.) The edge of our NICU had a narrow ridge of lights behind white louvers extending 40 feet and with this they saw a bold example of perspective. So their vision extended to at least 40 feet.

Eventually I began to wonder about the socio-economic standing of the family and learned that this brilliance included all babies who were not drug effected.

When you take him home, videotape him as he examines his surroundings. The living room for example. Then watch him every time you bring him into that room. He will reexamine it all, again and again until he knows it all. Then sit in a different place in the room and watch what he does.

Play Mind to Mind Games With Your Preemie

Preemies and infants are bored.  Forget the American adult  bias that infants are blank slates.  They are thinking and problem solving, just as we all do, with all the assessment skills and conclusions we have and probably more because theirs is pure and without the influence, fear and worry acquired during childhood.

You can play silent mind games with them and see that this is true.

The first time I posted this design on the outside of the isolette of a baby who was 2 weeks old and now 29 weeks gestation.  She was not supposed to be born for almost 3 months.  I watched  as her eyes outlined each side and compared it to the other, again and again, over and over.  She would just keep doing it and I had to feed the next baby so I began to time her.  Twenty three minutes.

Then after a few days of this, when she was asleep, I rotated the card 1/3 of a turn and stood, waiting for her to wake up.  She opened her eyes, looked at it, frowned, cocked her head, straightened her head, pulled her neck back, pushed her face closer…  the classic ‘double-take’ sequence.  She had immediately identified the problem, checked her facts, verified what she was seeing and accepted it.  She weighed less than 3 pounds.

So I did this for at least a hundred babies over the years.  Stable feeder /grower babies, all with the same results.  The attention span time was from  18 to 26  minutes.

We are all born genius.

Visual Stimulation Cards for Preemies and Infants

All babies, but preemies especially, are inveterate problem solvers and they are bored. Watching the movement of their eyes, gives clues and strong understanding to what their brains are doing as, at first, they seek out bold and well defined shapes. They outline the shape and then begin to compare it’s parts. Within this framework, you can invent games to interest and challenge them.

The second 2 cards, part of the Ross set, were designed by a pediatrician, Dr. julio C. Guerra, and provide preemies with hours of fascination. Watch as the baby outlines each part of the round design and then compares it to the reversed color. Then, when the baby is asleep, turn the card so it’s now slanted and watch his eyes when he wakes and first sees it. We are all born with the same facial expressions and these babies do the classic ‘double take’, frowning, tilting the head, chin out to get closer… Watching hundreds of preemies, (some not supposed to be born for another 3 months). I began to time their concentration and was astonished to find it lasting from 12 to 28 minutes.

Make up your own games with these cards but keep them as simple as you can. Get colored stickers of dots and, while the baby is asleep, put one on the checkerboard card. Later, add another colored dot partially covering the first. Then watch.

It’s important that the cards be positioned straight up and down. Tipping them or turning them to the side will add the element of perspective which would change the experience.

The third and fourth cards below are part of a pack that Ross Labs, makers of Enfamil formulas gave to NICUs long ago. These cards were a huge gift to the  babies, A HUGE GIFT  but were discontinued for some reason.  

Please write to Ross Labs to reinstate their pack of cards, preemies need their intellectual stimulation. They were the very best and should be easily available for all babies.

Why are preemies problem solvers to a greater degree than full term newborns? It’s because they quickly become super alert survivors in extremely complex, annoying and stressful circumstances, and act in their own best interest like all of us, going toward pleasure and away from pain. The full term baby is comforted with basic needs met and soft human connections made and never has to develop skills to mitigate stress.

Open fullsize and print

Open fullsize and print

© Brie Widmeyer, CCRN

Open fullsize and print

Open fullsize and print

© Julio C. Gurrea, MD

Preemies Fail Hearing Tests. Don’t Worry.

The very young, very small preemie is initially put on an open warmer with full exposure to the noises around him.  Observing, one understands that even a 26 weeker quickly learns to tune out external noise, starting with the monitor alarms.  They will react only to sudden, very loud, unexpected noises and these should be avoided at all costs.  They also, with a strong connection, react to the voices of their parents which is the way they recognize them.

I have seen many hundreds of parents being told that their baby failed multiple hearing tests and it was completely wrong information… with disastrous results.  Because she believed that he could not hear, the mother would stop talking to him and because she was not talking to him, she no longer looked at him.

Therefore, the baby was no longer seeing the mother’s face or hearing her voice.  No more twinkling eyes looking at him, no more movement of mama’s head, no more little air kisses from her, no more little love words. He now only sees the bottom of her chin as she sits in silence. And he thought he had done something to cause this.

The young mother of fragile twins was crying and beside herself when I got to work one night.  One of the twins had failed several OAE tests and finally the ABR.  They told her he was deaf.  I told her I’d watch him during the night and to go home and sleep.  I called her at one in the morning and said not only was he not deaf, he knew his name.  I’d fed him twice and did an experiment to test his hearing  at least thirty times.  Each time I’d wait till his eyes were turned away from me and I’d call his name.  He’d look at me.  Nine times out of ten.  He is 13 today and certainly not the least bit deaf.

The medication Gentamycin has a strong hearing loss component as do some infections and very, very extreme jaundice, a rarity.  So why tell hundreds of families that their baby is deaf when it’s not even 3 pounds or verbal yet?  Ask the question:  “Who benefits?”  I believe it’s from lobbying for state laws mandating hearing tests of newborns by an industry that needs money. Certainly multiple hearing tests of these infants is not doing the baby any good or the family.  It’s harming the family for useless information.  Every mother will know if she has a deaf child by the time he’s 3 months old (corrected age). Then it’s time for hearing tests.

Identical Twins

It became fascinating to me to watch twins in NICU, usually  side by side in their own isolettes.  The Oxygen sat monitor would alarm on one for low sats and instantly the other would alarm for the same low sat.  So I’d sit and watch them. Heart rate monitors, respirations and sats would be within a point of each other.  How did they do that?

With mirror twins, one will put his left arm over his head and the other will do it with his right arm.  One would bend his left leg and the other his right leg.

If you doubt me, watch identical twins in the stroller at a shopping mall.  Fascinating.

Very Right Brain behavior.

Life is Good.  Life is Great.