While bringing your baby home is exciting, it can also be overwhelming and a little bit scary! The neonatal unit is a relatively safe space, no-one is sick, visitors are limited, and everyone and everything is super clean and sanitised constantly - if you’ve ever been in NICU you instantly know that smell! You have a whole medical unit backing you up, with the monitors, routines, nurses and a paeds team 24/7. So when graduation day is getting close it's normal to feel anxious, and to wonder how you can keep your baby as safe and healthy as possible while settling in at home.
Don’t get me wrong, it is an amazing feeling walking out of those doors like any other parent with their newborn (although you might be lugging an O2 bottle out the doors as well!). But this is where there’s a crucial difference - our NICU grads aren’t like full term newborns.
If you’ve been through a high risk pregnancy, or gone into labour much too early, you’ll be well aware that every day longer a baby spends in-utero makes a huge difference to their lung development and means they’ll probably cope a little better after birth. Full term babies make a lot of progress during the last trimester of pregnancy, whereas premature babies have spent all this time on the outside, working on things like strengthening their lungs, learning how to breathe (and later how to coordinate that with feeding), as well as possibly needing medical treatments for infections or surgery. Even for the ‘feeders and growers’ of the NICU, that early start to life has an impact for years. When discharge day finally comes we don’t pass by a fairy at the hospital doors, who waves their magic wand and *BOOM!* congratulations, now your baby is a healthy newborn! We wish it could be that easy, but it really isn’t.
Compared to a healthy baby born at term, a preemie simply hasn’t had the same development. They tend to have weaker lungs and immune systems, and it takes quite a while to build that up (research suggests at least two years for preterm infants). It’s similar for a full termer with medical conditions or who had complications at birth. During the first couple of years they’re more likely to become seriously ill - a little cough or cold in an adult or older sibling can be a virus like RSV* which could send them back to hospital pretty quickly. Our babies have already fought damn hard to get out of the unit, and I’m 100% sure none of us ever want to go through it again!
Obviously the number one way that you can reduce the chances of your baby catching something is to avoid being around sick people. Crowds and large gatherings aren’t great places to be, and everyone needs to be aware that if they have a cold they can’t visit until they’re well. It doesn’t matter if they’ve been planning to visit for months or travelled a huge distance, it’s honestly not worth it. In case you have friends or family that like to stop by unannounced, print one of our medically fragile front door signs and stick it in a really obvious spot.
Now if you’ve got older children it’s not as if they can stay home full time - it's not fair on either them or you! You’ll know that they’re likely to pick up all sorts of bugs from their daycare, kindy or school, which makes it almost inevitable that your baby will get sick at some point. If you do manage to get through a winter unscathed please let the rest of us know how you did it! Kids will be kids and there’s going to be plenty of days where they’re coughing and sneezing around the house, please, please go easy on yourself if baby does catch something from their siblings.
For keeping your family healthy (particularly other children), start with nutrition and making sure your home is smokefree, warm and dry. Teaching your children good hygiene will help them to avoid colds and viruses, the basic reminders are to sneeze or cough into a tissue or their arm, and always wash their hands before they eat. You can look at adding immunity boosters like daily vitamin C, getting everyone the annual flu vaccine, etc, and if your kids have asthma they need to use their preventer inhaler every day. A 24 hour hand sanitiser might be helpful for minimising the amount of germs your family comes into contact with during the week – we love the New Edition sanitiser range.
When your premmie is your first baby it’s a little easier to stay isolated, we’d go for walks around the neighbourhood or to the beach, out for groceries and occasionally catch up with small groups of friends. But hibernating from the world isn’t exactly practical or easy when there are things you have to get done or older children to care for. It’s all about minimising the risk and avoiding situations like large gatherings of people as much as possible - basically treat anyone with symptoms of a cold as if they’re contagious! When you’re out with baby use a cover over their capsule or pram, a sign reminding strangers to keep their distance, or if it’s an option keep your baby close in a wrap or sling.
Adjusting to life back at home can be difficult, especially getting through the first couple of winters. Although your baby is no longer in the hospital they’re still vulnerable, they’re doing their best to grow stronger but it does take time! Remember it’s ok to decline invites and play it safe when you’re not comfortable, you need to do what feels right for your family.
If baby does get sick you can try some of these suggestions for relief:
- Immunity products, usually containing Vitamin C and Echinacea (check with your pharmacist that it’s age appropriate, and able to be taken with your baby’s other medicines)
- Probiotics. Studies suggest that using probiotics can assist the immune system, reducing the incidence and duration of respiratory infections.
- Vaporiser/Humidifier. Please bear in mind that very humid air is heavy and harder to breathe, high humidity can make asthma or a respiratory infection worse so don’t let it run nonstop. Always make sure your humidifier is clean to avoid spreading bacteria and mould spores.
- Saline Drops
- Nasal Aspirator
- Raising the head of the bed/cot. Sleeping upright always makes it easier to breathe, so if you can sit and cuddle them for naps they'll be more comfortable.
- Remember you can always ask Healthline or PlunketLine for advice or take your baby to your GP. For urgent care call an ambulance or go straight to your local emergency clinic.
You might notice there’s no mention of essential oils, Vicks or Olbas Oil above, and that’s because they need to be used with caution. Products containing eucalyptus can be very dangerous for babies, so do your research and check that they will be safe for your family, especially if you have a history of allergies. Personally, one of my sons really struggles with bronchiolitis and asthma, and the first time I placed a couple of drops of Olbas Oil on a cloth in his bedroom his breathing quickly deteriorated. Turns out it was the eucalyptus, and my premmie reacts to lavender, so between the two of them it rules out a lot of the inhalation-type products. That said, some people swear by rubbing Baby Vicks onto the soles of the feet – if you want to give things like that a try please keep a close eye on your baby if it’s your first time using a new product.
Do you have any other tips we should add to the list? Drop us a message or send a quick note via the Contact Us page!
*For more information on RSV, see our previous blog What Is RSV?
The content on www.smallbabies.co.nz is not intend or recommended as a substitute for medical advice, diagnosis or treatment. Always seek the advice of your GP or other qualified healthcare professional regarding any medical questions or conditions. To speak to a registered nurse at any time (day or night, 7 days a week), you can free call Healthline on 0800 611 116 or PlunketLine on 0800 933 922
Posted: Friday 23 April 2021