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World Prematurity Day – Advice from a neonatal nurse

09/11/2020

This World Prematurity Day, WaterWipes has teamed up with Amy Overend, a neonatal intensive care sister and a trustee at Bliss – a leading charity in the UK that supports premature and sick babies. While the Neonatal Intensive Care Unit (NICU) is a familiar environment to healthcare professionals, it can be a daunting place for parents and is somewhere they never expected to be. Amy shares her advice to help neonatal professionals encourage parents to be involved in their baby’s care, celebrate key milestones and provide emotional support.

Helping parents feel more involved

Whether their baby is doing well, ready to go home, or the most critical in intensive care - to that parent their baby is unwell, and they often can’t see anything other than their sick child. That is why involving them in their baby’s care is crucial - not only does it help them to understand their baby better, but it will also help parents to bond and focus on something positive.

There are multiple ways of involving parents in the care of their child throughout their journey on the neonatal unit. Something we as healthcare professionals can often take for granted is feeding a baby. This is one of the most important aspects of care for parents, but it can come in many different forms. Tube feeding, whether via an NG tube or a gastrostomy are skills that can be taught to parents. Most units will have their own documents to help guide you in the teaching process for parents. It’s important that parents know that they can go through the procedure multiple times with you, to help build their confidence. Some parents may feel confident straight away, others may find the entire process quite daunting and may back away from the opportunity. It’s important to continue to offer guidance and support, in case they want to be involved at a later stage.

Breastfeeding and pumping are also new skills for many, and with a sick or premature baby, the landscape of that can look very different. It is important to be a safe and trusted person for a parent to share their worries with, and you can help them by giving advice and guidance and encouraging them to be open and honest about how they are feeling. There is an expectation that breastfeeding, and pumping is natural and an easy thing to do. Being honest with parents that it can be hard work and acknowledging that there will be plenty of times they will feel like they want to quit, is important. It will help to normalise those feelings for already stressed and anxious parents.

Involving both parents in feeding is also important, as often partners can feel helpless or less important to their child because feeding is predominantly done by mum. Giving partners skills to help is a positive way of including them. This can be anything from helping to set up or clean breast pumps, teaching them to tube or bottle feed, or even giving them tips on how to support their partner during breastfeeding.

prematur baby with mum

Healthcare professionals can also support parents with things like changing baby’s nappies. This can seem like an easy thing for neonatal nurses, but for many parents, doing a nappy change through an incubator is a new skill. Not only will they be battling with worrying about which hand goes where, they’ll also be worried about doing anything that might hurt their baby. Your reassurance, guidance and kindness are so important for parents. To make changing their baby’s nappy as simple as possible, WaterWipes are a good choice as they have been validated as being purer than cotton wool and water and are perfect to use on baby’s sensitive skin – they are also less fiddly than using cotton wool and water.

The machines and tubes within the NICU that support premature babies can be alarming for new parents entering the NICU, so it’s a good idea to explain what the equipment does and how it supports their baby.

Helping parents celebrate milestones

Feeding and changing a baby’s nappy may seem simple to us as part of our daily job, but often these are big milestones for parents and their little ones. That’s why helping them to celebrate it is so important. WaterWipes have made wonderful milestone cards in partnership with Bliss to help celebrate and acknowledge these victories and achievements. Celebrating baby milestones is one of the real privileges of my job, I love offering to take photos of parents dressing their baby for the first time or giving them their first bath. These are often the most precious memories for parents!

premature baby with milestone card

Offering support for parents

In a recent survey from Bliss and WaterWipes, 79% of parents with a baby in the NICU said neonatal nurses were a big source of support. Being on hand to offer advice and guidance to parents is an integral part of the care we provide, but it is a skill that has taken years to feel confident in. It’s important to remember that parents can often be on the neonatal unit for long periods of time, and you become like a second family to them.

In the first few days, parents can often feel overwhelmed and may be quite quiet and withdrawn. Research from Bliss and WaterWipes showed that 40% of parents felt like they could not be open with family and friends about how they were feeling and had to put on a brave face, so try to reassure them that it’s ok to talk about their feelings and to show their emotions on the unit. Sometimes, speaking about everyday things rather than just what is going on with their baby can help to build a rapport and trust. Even simple things, like asking if they saw the latest episode of a popular programme can often start a conversation that they may need to have.

Conversations in the NICU aren’t always positive and we often find ourselves facing difficult conversations with parents, which they never expected to have, and these can be devastating. Giving people time to process information is key; sometimes it is ok to not say anything and just hold their hand or sit with them as they process the information. Remind them that even if they have no questions immediately, they can ask at any time. You could encourage parents to write down their questions as they come to them. Often when under pressure, we forget certain things, but if they write them down then parents will have their important questions to hand when they speak to a consultant, or other healthcare professional.

I have always found when discussing complex topics or having difficult conversations, it’s important to ensure that parents fully understand what they are being told as we can use terminology they may not be familiar with. Making sure we minimise technical and medical terms is essential in helping parents, and it’s important to take the time to ask them if they understand. Asking parents to relay the information back means that you can see if they have processed what you have told them. Sometimes this isn’t always appropriate, and again, offering to come back to discuss things a little later is always helpful.

During these first conversations with parents, the information we give sometimes doesn’t go straight in, as all they see is their baby in an incubator and everything else goes fuzzy. That is why the About Neonatal Care guide by Bliss is a brilliant resource to give to parents to help direct and remind them of what may have been discussed in those initial conversations. For World Prematurity Day, WaterWipes are sponsoring these helpful guides to give to parents - visit the Bliss website for more information: www.Bliss.org.uk

WaterWipes have been specifically developed to be so mild and gentle that they can be used on premature babies’ delicate skin. They are made with just two ingredients; 99.9% high purity water and a drop of fruit extract, and have recently been validated by the Skin Health Alliance as being purer than cotton wool and water.