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Navigating the NICU

Having a baby in the NICU can be a scary and isolating time for parents. While other new parents are snuggling their newborns at home, parents of NICU babies are navigating complex health care systems, monitoring a whole new set of milestones, and managing daily uncertainty, often with little or no support. In addition to worrying about the health of their infant, factors such as travel between home and hospital, work schedules, and caring for other children can add to parents’ stress during this challenging time. Here are some strategies to make it a little bit easier: 

  • Take care of yourself, both physically and emotionally 

  • This might be the hardest advice to follow, but remember that you are healing, too.  

  • Try to eat well and get some sleep. You’re gathering strength for when your baby comes home. 

  • If you catch a cold (or worse) you might not be allowed to visit the NICU, so wash your hands and stay away from anyone showing symptoms. 

  • Say No 

  • Be clear and firm about your needs and boundaries. Well-meaning loved ones don’t always know how to be supportive. Whether it’s visiting or requesting daily updates, if you’re not up for it, say No. 

  • But say Yes to help (actually helpful help) 

  • Childcare, food delivery, transportation…if someone offers you something that makes your life a little easier, say Yes! And don’t even think about sending a thank you card. 

  • Advocate for your baby 

  • Don’t be afraid to ask lots of questions or request a second opinion if something doesn’t feel right. 

  • For those who wish to breastfeed, the NICU presents a number of challenges. Find support from your local La Leche League chapter: https://lllusa.org/locator/ 

  • Find support 

  • Ask the hospital staff if there are any local support groups or other resources. 

  • Join an online support group (searching for ‘NICU parents’ on Facebook returns hundreds of groups…you might even find a local one). 

 
 

Questions to Ask Yor Doctor: For NICU Parents

If your newborn is receiving care in a neonatal intensive care unit (NICU), you will want to learn as much as you can about your baby’s health. Use the questions below to help prepare for the next time you speak with your healthcare provider. Click here for a downloadable copy of the questions.

  • What can you tell me about your NICU?

  • What is my baby’s condition?

  • What is my baby’s treatment and daily care routine?

  • What can I expect in the short term and long term?

  • How often/ how long will I be able to see my baby?

  • Is there a way I can help my baby?

  • Are there ways I can bond with my baby in the NICU? How can I connect with my baby while we are apart?

  • Will I be able to breastfeed or bottle-feed my baby? If so, do you have anyone to help support me or resources?

  • How long do you think my baby will stay in the NICU?

  • What type of support services do you offer to NICU parents?

  • If there are any updates on my baby’s health, how will you contact me?

  • How do you communicate with your patients?

  • What things should I do to avoid infections and protecting my baby?

  • How can I safely introduce my immediate family to my baby while in NICU?

Do you have a non-emergency topic that you'd like more information about?  You can submit a question to our "Ask the Dr.!" team and we'll do our best to include in it our periodic video updates.  If you have an emergency question or concern, please contact your provider.

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Postpartum Period

The period after delivery and up to 42 days is called the postpartum period or the 4th Trimester.  

4th Trimester, What Is it?

Typically, when pregnancy is discussed, three trimesters are mentioned, along with the symptoms of pregnancy or key developmental milestones of the fetus.  

The 4th trimester is a term some in doctors use to describe the needs of a woman who has recently given birth.  This period may last for the first 3 months after delivery as they transition into parenthood. 

 

The needs and care of the birthing person and the family during the postpartum period are often overlooked.  However, it is just as important for families to plan for the 4th trimester as it is for the planning of the first three trimesters!  

What can you do to care for your health during the 4th trimester?  

Mood and Emotional Well Being 

Pay attention to how you feel mentally and emotionally. Perinatal mood disorders including postpartum depression, anxiety, and psychosis are common for new parents and can negatively impact your mood and desire to parent. If you notice signs of sadness, frustration, overly worrying about your baby, or having thoughts that you might hurt your baby, reach out to a provider, support group, or therapist immediately.  

Infant Care & Feeding 

Breastfeeding has important benefits for you and your baby. Whether you breastfeed or formula feed, there can be a lot of barriers that you are experiencing regarding what baby is eating during this time. Resources are available to support you with feeding including WIC, lactation consultants, and your medical provider who all may be able to give you accurate information regarding infant care & feeding. 

 

Sexuality, Contraception, & Birth Spacing 

Giving birth and parenting a newborn is challenging and causes many changes that can make you feel ill-prepared for sexual activity right away. Providers in NJ typically recommend postponing any type of intercourse or insertion of objects into the vagina for 6 weeks. It is important to ask your provider if this in fact is their recommendation based on your treatment and talk to them about contraception if you want to prevent another pregnancy from happening right away. Using birth spacing to wait at least 18 months before beginning another pregnancy can help reduce your risk for having preterm birth and baby with low birth weight. (Link to our birth spacing section) 

Sleep & Fatigue 

As a new parent, you are likely tired! Lack of sleep can significantly impact your mood, coping, health, and safety. During the first few months after having your baby it is important to identify your support system and ask others for help so you can rest. Trying to sleep when the baby sleeps can be difficult but taking naps and practicing safe sleep habits are important.   

Physical Recovery from Childbirth 

After birth, you may experience pain from tearing or having a c-section. You may also experience new physical ailments such as hemorrhoids, breast tenderness, painful sex, heavy bleeding, backaches, bowel, or urinary problems. It is just as important for you as a new parent to attend your 6 weeks follow up appointment as it is for you to bring your infant to their “well-baby” exams. Be honest about the pain you are feeling and call 911 or your medical provider immediately if you begin experiencing any of the postpartum warning signs.

 

Medications, Substances & Exposures 

Be mindful of the medications you are prescribed, substance use, and exposures during the first few months after pregnancy. Especially if you are breastfeeding. Ask your provider before taking any medications or substances to ensure there will be no harmful effects for you or baby. Also, be mindful of lead prevention and consider having the drinking water or paint in your home tested as high levels of lead can cause lead poisoning in you or your infant. For more information.

 
 

Bereavement

There are five types of perinatal loss: 

Pregnancy is considered one of the most exciting times in the life of a woman, couple, and family unit.  The pregnancy's announcement sets in motion the immediate planning for the arrival of a healthy bundle of joy.  However, rarely are parents prepared for the unfortunate experience of the untimely death of a baby.  Loss during pregnancy or immediately following delivery is commonly referred to as a perinatal loss. Regardless of the cause of the loss, grief often accompanies it.

Molar Pregnancy

Chronic Conditions

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Mental Health

Mental Health  

  • Mental Health affects the way we think, act, make decisions, and handle stressors. 

  • Becoming a parent makes many people feel different about themselves, priorities, and how they perceive the world. 

  • If stress, anxious thoughts, or sadness is becoming overwhelming and too much to manage it is important to get help.

Resources for Mental Health: 

 

 

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Postpartum Depression (PPD) is a mood disorder that can affect women who have just given birth. 

 

  • Crucial to Understanding PPD: 

    • Every woman might experience PPD symptoms differently. 

    • A woman affected by PPD might experience feelings of intense sadness, anxiety, and exhaustion that make it extremely difficult to carry out daily activities such as caring for themselves or others. 

  • PPD symptoms a woman might experience are:

    • Feeling deeply sad, empty, or hopeless. 

    • Feeling overwhelmed by the responsibilities of being a new mom. 

    • Feeling extremely worried or anxious. 

    • Feeling irritable, moody, or more easily frustrated than usual. 

    • Feeling rage or anger. 

    • Having feelings of physical discomfort, including headaches, stomachaches, and muscle pain. 

    • Being unable to sleep when her baby is sleeping. 

    • Oversleeping or having a hard time getting out of bed. 

    • Not eating enough or overeating. 

    • Trouble remembering details, making daily choices, and concentrating. 

    • Losing interest in activities you typically enjoy. 

    • Losing interest in meaningful relationships with family, friends, and loved ones..

    • Struggling to connect or build an emotional attachment with your new baby.

    • Doubt in your ability to care for the baby.

    • Thoughts of harming yourself or your baby.

The “Baby Blues” 

  • The “Baby Blues” is a term used to describe the feelings of worry, sadness, and/or exhaustion that up to 80% of mothers experience.5 

  • Caring for a new baby is very difficult, and new moms might feel overwhelmed, isolated, or frustrated in their new roles. 

  • These feelings are often mild, and they tend to go away within a week or two.   

  • It can be hard to tell the difference between PPD and the “Baby Blues.”  

  • If a woman is wondering if the symptoms she is experiencing are PPD, the “Baby Blues,” or something else, she should visit a healthcare provider right away. 

PPD Causes 

  • PPD does not have anything to do with what a woman did or did not do during her pregnancy.

  • There are likely many combining factors that cause PPD including:

    • After a woman gives birth, she often experiences a quick and drastic drop in her hormone levels, including estrogen and progesterone. This drop in hormone levels might create chemical changes in her brain and body that affect her mood8. 

    • Losing a large amount of sleep can lead to exhaustion and contribute to PPD symptoms9  

PPD Risk Factors 

  • Certain factors can contribute to a higher risk of PPD for some women, though PPD can occur for anyone10,11 

  • Preterm birth (before 37 weeks) 

  • Complications with pregnancy, labor, delivery, and/or birth 

  • Receiving little to no support from family or friends to help care for the new baby 

  • Unplanned pregnancy 

  • Being a teen mom 

  • History of depression 

  • Family history of depression 

  • Ongoing stress in day to day life related to issues such as  

  • Violence in the home or community 

  • Poverty, financial difficulties, or an ongoing struggle to “make ends meet”  

  • Housing instability, or an ongoing struggle to find a safe and comfortable place to live  

  • Giving birth to a baby who needs to be hospitalized 

  • Giving birth to twins or triplets