Instruction Manual Not Included

I remember sitting in the chair enjoying kangaroo time with my daughter when rounds happened. They asked me “how does Monday sound?” and I naturally responded, “for what?” Poppy still had a feeding tube in at that point so I thought their response would be for that to be removed since everything seemed to happen in steps while we were in the NICU. Instead they said to go home and the lengthy to-do list of what has to be done before she could actually be discharged was being rattled off to me and all I kept thinking was that my shirt is currently off, I am snuggling with my daughter under a blanket, and I do not have a pen to take notes. In that moment I felt lost and since I wasn’t able to write things down I felt I was going to miss something important or forget something I had to do since I am the queen of lists and post-it notes. Then I started to make the phone calls to my husband and our parents to let them know that Poppy was coming home on Monday and instead of taking it as the happy news it was, I got a million questions being asked whether or not this was too soon and more things thrown my way like where are we taking her since our house was still going through some renovations and since we didn’t have everything we needed yet to care for her at home. The realization that I felt unprepared and that I wasn’t able to bring my daughter home to our house was very overwhelming and I broke down. The moment we have waited 48 days for, to hear our daughter is finally going home, was both the happiest moment and the most terrifying at the same time.

NICU baby or not, children do not come with an instruction manual. Yes there are classes you can sign up for and we did, but our baby came before the classes occurred so we never went. There are books you can read and I bought them, but I thought I still had another trimester to read them. Yes I have babysat throughout the years and cared for younger siblings and cousins enough to know the basics, but that was a stretch of hours not 24/7. There are books and studies out there on sleep training and feeding and different rules of thought on everything in between and then it seems everyone you know is the “expert” and that their way of caring for a baby is the only way to go or assume you will do it their way and seem shocked when you don’t. The schools of thought also varied greatly from one generation to another; set schedule vs. eating and sleeping on demand. Even though I am a first time parent, I am older and didn’t feel some of the millennial school of thought would work best in my scenario. You get a lot of advice, but you have to remember it isn’t tailored to your child, but what worked best for them. My husband and I did go to the post partum class offered during your hospital stay after your baby is born, but the class seemed pointless to us because our baby was not there with us, she was much smaller than the full-term babies that the class referred to, and the changes my body would be going through to get back to “normal” would happen while she was in the NICU and not while caring for an infant at home. So again, more information that was not overly useful.

So day 51 came. It is as though you officially become your child’s parent the moment you walk out of the NICU doors. You are responsible now for every aspect of their life including changing all of the diapers. The beeping to let you know they are breathing has officially stopped. We dressed her in her little outfit and brought her “home”.  Here comes the “now what?” I knew what my daughter was like in that window of time when I was present in the NICU, but what about afterhours? I had my list of upcoming doctor appointments for her, but that was really my only parting gift from the NICU other than iron, vitamin D, and fortifier. Again, that instruction manual did not exist. However, where the NICU parents have an advantage in the world is the fact that our babies are on a very strict schedule. They are fed and changed every three hours. This schedule can be easily maintained when you go home and during the adjustment phase for a few weeks at least thereafter. Nothing in the world can prepare you for that first night though. The beeping that lets you know your child is breathing as they should be is no longer there. It is silent so you are constantly wondering if your baby is ok. I cannot remember how many times I woke up that night just to make sure Poppy was still breathing. That paired with the routine feeds at night equaled not a lot of sleep. I did have help, but all of the help in the world did not let me know if my daughter was still breathing or not. Once that fear subsided, I was able to focus on Poppy and figuring out the method of feeding and sleeping that would work best for our family. My husband and I felt that the feeding and sleeping on demand schedule was best. I know I would not be happy if someone tried to force-feed me when I was not hungry or let me go hungry until we hit a certain time. Babies can get hangry too! The same goes with sleep. Why would you want to keep a baby awake that is tired because it is not your scheduled time for their nap or to go to sleep or how can you be successful trying to put a baby asleep that is not tired? I am not saying that school of thought is wrong by any means and if that works for you great, but to us that just did not make sense. Since this was the path we chose and it worked, I was able to get things done around the house, take naps when I could, ride my exercise bike and shower regularly since naps would last longer because she was actually tired and wanted to sleep. I would also take her with me when I had to run an errand and this got her used to her car seat and going places which has helped when we do that with her now.

There are obviously a lot of other things that goes into caring for a baby where an instruction manual would have come in handy. Like if the baby has consistent blowouts it is time to move up a size in diapers. When it came to diapers, I thought you went by the weight on the box. Thank goodness for Google! Then there was always the question if I was giving her enough milk. I did get to nurse her for some feeds, but how do you know if they are getting enough then? When it comes to bottles, how much is enough or when do I increase the amount of milk? I was used to the NICU nurses timing how long she nursed and supplementing with milk in her feeding tube if they felt she didn’t get enough or the doctors increasing how much milk went into feeding tubes/bottles per their feeding schedule taking her weight into consideration. A lot of this ended up being trial and error at home. I would nurse her until she was done, but if she was hungry an hour later I would give her a bottle so I would know how much she still needed. With a bottle, we would start with a certain amount and if she was still trying to eat when nothing was left, we would give her more.

Then there are other little things an instruction manual could have helped with like how often to bathe them, when to call the doctor or not, how much medicine to give if we have to, how to change a blowout when they have poop all over themselves and you do not want to get poop on everything else, or what to do when you run out of things to do with your infant to entertain them. When you do not know what to do, just ask. Ask other parents whether family or a friend first if it is something minor. For more important things, I always have my list of questions for whichever doctor Poppy has an appointment for and if the question cannot wait, I would contact the office and get an answer that way. Overall, we have been lucky when it comes to caring for Poppy. She is a happy baby, so when she cries, she is either hungry or wet and that can be easily fixed.

With all that being said, the moral of this blog is to trust your instincts as a parent. Yes, taking a baby home, let alone a preemie, is a scary thing. Even the most well read parent would not know what to do in every situation. You have to realize that you will not “break” your child if you have a misstep somewhere along the way or if you don’t know what to do in that exact moment. You will figure out what works best for your baby, your family, and most importantly you.