“On the day our baby came home from the hospital, we showered most of the attention on his big sister. She wore her “big sister” shirt to day care and took cupcakes to celebrate. She had her dinner on a special new plate just for big sisters. She felt very important, and that helped her adjust to having a new baby in the house.”
As your baby grows and heals in the intermediate care nursery, you will have a lot to do. It can be overwhelming at times. Go slowly, but don’t procrastinate. Preparation gives you a chance to mobilize some of your anxious energy to make a difference in your child’s future.
Preparing for an Emergency
Graduates of NICUs have a higher rate of re-hospitalization than the average newborn population. Common reasons for unexpected readmission are dehydration because of vomiting or diarrhea, upper respiratory infections, hernia complications, persistent or increased apnea, or shunt repair.
Now is the time to prepare for an emergency, before one arises. Before your baby is discharged, go to the hospital where your baby is most likely to be readmitted. Know the fastest route from your house, and an alternate route, as well as the locations of the hospital’s emergency entrance, parking, and admitting office. Be prepared to call the EMS system for an ambulance if you believe your baby’s condition is critical, however. Post 911 or your community’s EMS number on all of your phones and program your baby’s care providers’ numbers in your cell phones as well. Being ready will prevent panic in case of an emergency.
If you know your baby will come home with a cardiac monitor, a ventilator, or oxygen, you also need to contact public services to ensure that you will receive priority help in community emergencies. The EMS system (or nearest fire station) and your utility providers (water, electric, and gas) should all be aware that you have a baby with special needs in your home. Ask your baby’s nurse, case manager, or discharge planner for this letter to send to your utility companies. Be sure to notify them when your child is no longer technology dependent or if you move.
Many parents feel they must “sterilize” their home with industrial-type cleaning products to eliminate germs and dust before their baby’s homecoming. The family pet may be permanently banished outdoors or given to a new owner. Although the intent behind these precautions is admirable, they often are not necessary and generally are impossible to keep up. Few families can maintain such high standards of cleanliness while giving baby care and normal living the priorities they must have. Rely on common sense as you prepare—and maintain—your home. A thorough cleaning is enough. Harsh cleaning solutions and insecticidal sprays can leave residual odors that may irritate or even harm your baby.
Babies—especially those who have had or are having breathing difficulties—are at risk for a number of problems from exposure to tobacco smoke. No one should smoke in the home, around your baby, or anyplace where your baby spends time, such as in the car.
The AAP Committee on Environmental Health has identified these problems with secondhand smoke exposure: decreased lung growth, decreased lung function, and increased frequency of lower respiratory tract infections and respiratory symptoms. Research also clearly shows that exposure to smoke can cause ear infections and related hearing problems, increased incidence of hospitalization related to bronchitis or pneumonia, and increased risk for SIDS. If you need more information or literature—for example, to convince family or close friends of the dangers of secondhand smoke to your baby—contact the American Lung Association or the AAP Julius B. Richmond Center of Excellence.
Pets are important members of the family. Banishing a beloved companion may cause resentment. Instead, prepare your pet for your baby’s arrival. Bring home clothing or a blanket with your baby’s scent on it before your baby is discharged. Siblings can help by spending extra time with the pet. Be alert for signs of aggression or jealousy when your baby comes home, and never leave your dog or cat unsupervised near your new baby.
Extra attention and discipline will solve most problems. Keeping your pet out of your baby’s sleeping area may help reduce the risk of fur or dander irritating the baby’s breathing passages. When your baby is developmentally mature enough to lie outside the crib, place a clean blanket or mat under the baby to keep fur, dander, dust, and carpet fibers from irritating the baby’s airway during playtime. Carefully assess all of the factors involved in having a pet, and talk with your health care provider as you decide on a reasonable approach.
Prepare your older children for what life may be like when their baby brother or sister comes home. Plan to spend special time alone with each of your other children a short time after your baby comes home and repeat this daily. Encourage and allow them to talk about their feelings. This should reduce episodes of acting out. Most parenting books include information on helping siblings adjust to a new baby.
You’ll need a traffic control plan for visitors. Start thinking about this before your baby’s discharge, and set up a visiting schedule. Don’t turn down offers of help, but use your calendar to keep track of who is planning to visit. Place limits on the number of visitors to your home. Your needs deserve top priority, and entertaining others is probably not at the top of your list right now. Let friends and extended family know that you’ll need some time to adjust to this new baby at home and that you’ll let them know when you’re ready for visitors. Caring family and friends will respect your need for privacy and give you the time you need to make this adjustment.