Special Care

IMG_04421-7115Having multiple babies increases the chances of one or more of your babies having to spend some time in the hospitals Neonatal Intensive Care Unit (NICU). This can be quite upsetting and difficult for parents and knowing what to expect can help to ease some of your concerns.


The best way to prepare yourself for the possibility of having a baby or babies in the NICU, is to familiarise yourself with the NICU in the hospital that you plan to deliver in. As you are having multiples, you will probably have been advised to deliver in a hospital with a level 3 NICU. Most hospital – based antenatal classes will be able to arrange a visit to the NICU for parents of multiples. The NICU is typically divided into several intensive care units with a critical care unit, a high dependency unit and an isolation unit.

In the National Maternity Hospital, approximately 10% of all babies born are admitted to the NICU. Most of these babies have been born premature and may need help with breathing, feeding and controlling their body temperature. Most of them will be put in an incubator for a little while which helps protect them from infections and other illnesses. Depending on how early they were born, babies may need to be kept on a ventilator to help their breathing or they may need to be given supplementary oxygen. Babies that are born before 32 weeks will usually need to be fed through a tube that goes into the babies nose or mouth and then down into their stomach. Many babies are jaundiced, which means that their liver can not break down red blood cells efficiently and this produces bilirubin. Bilirubin causes yellowing of the skin and is treated by placing the baby under bililights, which break down the bilirubin. Blood suger levels will also be monitored to ensure they do not go too low.

Going to see your baby for the first time in the NICU can be a very emotional experience. You will probably be a bundle of emotions, ranging from excitement at seeing your little bundle(s) of joy to nervousness about his/her well-being. The NICU is very warm and mothers will undoubtedly still be recovering from the birth, so they may feel a bit weak. There are lights, alarms and monitors everywhere and even though it sounds serious when these go off, it is usually just that the monitor has slipped off the baby’s pulse or there is a slight change in the baby’s heart rate. Staff are usually very sensitive to parents concerns and will explain the functions of all the equipment to help ease your fears.

At first, you may not be able to hold your baby but you will be able to touch and talk to him/her. Most NICUs will put multiples in the same incubator if possible, as this has been proven to have positive effects. As soon as it is possible, you will be gently encouraged to hold your baby and help with his/her care. Many parents are nervous or afraid of hurting their baby and sometimes feel that their baby’s care is better left to the professionals. This is a common reaction, however, you should try to help care for your baby wherever you can as this will help bonding and make you feel as though you have some control. You will also be encouraged to try “kangaroo care”, which means that you hold your baby on your chest, against your skin, tucked inside your clothes. Apart from the warmth and closeness this also gives your baby the familiarity of the sound of your heartbeat. Many mothers will express milk for their babies until they are strong enough to suckle at the breast or bottle. If babies are not being breast fed they will be given special, fortified milk designed for premature babies.

Sometimes, you may be discharged from the hospital long before your baby and this may be very difficult for you. You can always contact the staff in the NICU by phone, day or night, for a report or simply to get reassurance. Visiting times are usually not restricted for parents and if your baby is very ill the hospital may provide accommodation for one parent. In most hospitals, visiting in the NICU is restricted to parents and grandparents only.

When you are able to take your baby or babies home, it is important to be prepared for all the special care they will continue to need. Staff in the NICU will show you how to care for your delicate little baby and watch for different signs of illness. One advantage of having your baby spend some time in the NICU is that they should be well established on a feeding routine by the time they come home, which makes life much easier with multiples. It is important to look after yourself at a difficult time like this. Try to eat well and sleep wherever possible, even if this means you can’t spend every minute with your babies. Accept any help you are offered and ask for help if it isn’t offered. Most importantly, stay positive and enjoy your babies while they are tiny.


Other Useful Resources:

www.irishprematurebabies.ie group offering support and information about Special Care.