what to expect/tips/ any info appreciated....

hi everyone....

well a quick run down to start with...

im currently 28w2d preg with our bbay girl.... i also have cervical imcompetance which caused us to loose our first bub at 22w1d...

so i had a stitch put in at 15w and up until now we have had smooth sailing, and expected to hit 37w when they would remove the stitch.

but now it looks like we wont be getting that far and are basically preparing ourselfs for a premmie....

my OB seems to think we will hit 30 to 34 weeks but has said that if i dont rest enough it could be sooner....

so im just looking for tips/advice/info/ anything you think will help prepare us for what could be a NICU stay if not a SCU stay....

im hoping to hold her in for another 4 weeks min but as we all know u cant predict these things....

please feel free to PM me if u dont want to share anything on the open forum, any info is much appreciated!!

:hug: Hun! As you know i have worked in a NICU but never faced one as a mum! If there is practical questions you have id be happy to give it a go but i also hope that there are some mums on here that can help you too!

Well DS was a full- term but he was in there for 18 days so i now a little, your health is just as important as bubs. Your need to look after yourself aswell, rest, drink pleanty of water (hospitals drain you). Ask lots of questions, hold bub as much as you can well that goes without saying lol. Will post more later, ds just woke up.

Hope you get to 37 weeks crumpet.

Dd was a 34 weeker, she was on the humidicrib for 24 hours and had phototherapy for 48. The nicu and scn were in the same room. She then spent 2 and a half weeks learning to do all suck feeds and gain weight.

The unexpected thing for us was that visitors were not supposed to hold her as it stressed her out and she lost weight.(didn't find this out until a bit later).

Make sure you talk to the midwives about what doing as much as you can, nappy changes, temperatures etc as part of the bonding process since you can't be with them 24/7.
Leaving dd was always hard, but the MW's were all fantastic with her.

Can't think of much right now too tired but will come back later I'd I think of anything else.

My experience was the same with Black rose with both my premmies. I have a premmie breastfeeding booklet here somewhere that I could post to you from the ABA. I would make sure the nurses on the post natal ward help you with expressing asap, I was ignored at first as they were all busy with the mums with the bubs with them ans wasted 24hours when I could have been expressing the precious colostrum for dd1.

:hug: I have all my fingers crossed that you have at least 9 weeks left.

My advice comes from having Brendan at 30+1 and Tristan 34+3.
* Ask to be shown the NICU, it will make it slightly less of a shock to you.
* Investigate the pump options NOW, see if and how much it costs to hire one or look into buying one, go electric too!
* Keep a diary and take lots of photos.
* Don't be afraid of asking questions, you are your child advocate!
* My rule was; when in NICU and still in humidircrib special moments such as cuddles, are left to Mum and Dad ONLY no exceptions.
* Speak to one of the neonatologists (NICU Dr) or at very least a NICU Nurse, about what is likely to happen at certain gestations, I had one visit me when my waters broke and explained the chances of survival, some of the equipment and what to expect.
* Have your hospital bag packed now, one thing most prem mums have in common is no personal items after birth (simple things like a hair brush can make a difference!)

I have more, will be back soon :hug:

Ok a bit more about my boys journey...
Brendan 30+1
Was ventilated at birth and moved to CPAP at around 2days old
I didn't get to cuddle him until 5 days old, he wasn't even placed on my chest at birth.
He spent 3 weeks in an isolette, for 4 days I wasn't allowed to even touch him at all.
He was tube fed for 39 days. He had an IV in for a few weeks.
His journey was very much a one step forward two steps back for the first 2-3 weeks.
He was in NICU for 6 days and SCN for 35 days and was discharged at 5wk6d (36 weeks gestation)

Tristan 34+3
Was ventilated at birth and then cpap by 8 hours old.
Was placed on my chest at birth and first real cuddle was on day 2, along with breastfeed attempt.
He spent 1-2days in an isolette.
He was tube fed for 3 days and had an IV for 3 days too.
His journey was on the up and up from day 2.
He was in NICU for just over 24 hours and SCN for 5 days then on ward with me for 2 days. discharged at 8 days old (35+4 weeks gestation)

Both my boys were discharged earlier than the Drs in SCN wanted them to be, I put up a very strong fight to get them home when I did. Trust your gut instinct, it's usually right.

Every single day/week you give bub the better, you can hang on you do have the strength and will power to do this. I believe in you.

All the best xx

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:hug: Hun! As you know i have worked in a NICU but never faced one as a mum! If there is practical questions you have id be happy to give it a go but i also hope that there are some mums on here that can help you too!

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totally forgot about that!!! :wall:

thank you everyone all of ur stories have helped me realise what we could be in for and when with certain gestations.....

i had no idea of what would happen if she came at certain points so u have all helped grately!!

we have spoke to a NICU dr in my last preg but that was when i delivered at 22w so the focus was on 24weeker not 28plus....

im not booked into the public hospy at this point, my OB has delivery rights there so i know ill be accepted, but do i call them and explain my stituation and ask to be shown around or do i speak to my OB to help me organise it??

its not going to be a fun trip as its in the hospital i delivered G at so im kinda avoiding it at all costs atm, well until i know i HAVE to go there....

I would talk with your OB who should be able to organise a trip to the NICU for you x

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its not going to be a fun trip as its in the hospital i delivered G at so im kinda avoiding it at all costs atm, well until i know i HAVE to go there....

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It will be hard but it would be worth having a look before hand to see whats what.

Also the hospital you ARE booked into...What gestational age will they let bub stay there??

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I would talk with your OB who should be able to organise a trip to the NICU for you x

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thanks sally ill speak to him at my next appt...

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It will be hard but it would be worth having a look before hand to see whats what.

Also the hospital you ARE booked into...What gestational age will they let bub stay there??

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yep i see what u mean, im better of seeing it before she ends up there....just incase.

34weeks i have to be for them to accept us....
but if she comes at say 31 we go to the other hospital and as far as i know they wont transfer her to our private one when she can go to that level of special care coz we are close to both if that makes sense....is that even how it would work? im happy for her to stay at the hospy with the NICU and SCU if we deliver there till she comes home

Depends on the hospital and how full the NICU/SCN is at the time. Both times we were in they were virtually pushing bubs out the door to another hospital because the NICU was so full of babies. Doesn't help that's it's the only hospital in the state that takes babies less than 34 weeks gestation either (except for the Children's Hospital which generally only takes the really sick and surgery bubs). It's best to ask your private hospital of the what if, ask them what criteria they have for a transfer. For instance my local hospital will only take babies after 2kg, with no tubes or monitors, when they are ready to go home anyway.

we are in melb and there is the mercy ( where we will go) the royal womens, monash medical center and the royal childrens all with NICU's so hopefully if we need it they will have room at the mercy...

is it the same with special care? being less.... well intensive as such?

ill add these to my list of Q's for my OB when i see him.....

and ill ask the middie at ante natal classes on tuesday what the criteria is for her to be transfered there if need be.....

thank you again so much for all the information

Intensive care babies have one nurse to two babies, they are generally on some sort of breathing support.
Special Care babies have one nurse to 5-6 babies.

There is also a HDU (High Dependency Unit) I'm not entirely sure on the criteria for that unit, I *thought* that it was for those who were on breathing support for ages. But a couple of my friends babies went to HDU and they were on less support than Brendan was so then I *thought* it might have been based on weight, but then a friends baby born heavier and on less breathing support went there! So Im not really sure on that at all any more!

At KEMH in Perth, all the units are together in one nursery, there's 4 rooms, one for each level of care all in one big unit. However when we were there June 09 they were doing renovations to move the SCN, I believe it is now the NICU is seperate from the SCN but I could be wrong.

Crumpet, I was going to post something similar hun. JIC. Yet I am hoping that bub wont need to come early, but I think it is better to be prepared. Hoping and praying that your little princess stays in until after 34wks, that would be so wonderful. Just behave yourself..... Im going to send lots of sticky sticky vibes and for those stitches to stay tight and your cervix lots of keep closed vibes too. Hang in there hun, you really are doing a wonderful job. hugs

Sally - that was really interesting. I know when Little V was in ICU at the childrens hospital she was on high dependancy ventilators and was isolated from all others. The nurse that was assigned to her only looked after her. So only ever one bub / child at a time. when she was able to be moved from isolation and placed on the less high dependancy ventilator, she was then assigned to a nurse that looked after 2 bubs.

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Intensive care babies have one nurse to two babies, they are generally on some sort of breathing support.
Special Care babies have one nurse to 5-6 babies.

There is also a HDU (High Dependency Unit) I'm not entirely sure on the criteria for that unit, I *thought* that it was for those who were on breathing support for ages. But a couple of my friends babies went to HDU and they were on less support than Brendan was so then I *thought* it might have been based on weight, but then a friends baby born heavier and on less breathing support went there! So Im not really sure on that at all any more!

At KEMH in Perth, all the units are together in one nursery, there's 4 rooms, one for each level of care all in one big unit. However when we were there June 09 they were doing renovations to move the SCN, I believe it is now the NICU is seperate from the SCN but I could be wrong.

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wow another section thanks for that info as well sally....
i *think* at the mercy the NICU and SCU are on different levels, ill have to really sus it all out.....

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Crumpet, I was going to post something similar hun. JIC. Yet I am hoping that bub wont need to come early, but I think it is better to be prepared. Hoping and praying that your little princess stays in until after 34wks, that would be so wonderful. Just behave yourself..... Im going to send lots of sticky sticky vibes and for those stitches to stay tight and your cervix lots of keep closed vibes too. Hang in there hun, you really are doing a wonderful job. hugs

Sally - that was really interesting. I know when Little V was in ICU at the childrens hospital she was on high dependancy ventilators and was isolated from all others. The nurse that was assigned to her only looked after her. So only ever one bub / child at a time. when she was able to be moved from isolation and placed on the less high dependancy ventilator, she was then assigned to a nurse that looked after 2 bubs.

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thanks hun!! u rest up as well we both need to keep baking a bit longer!

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Intensive care babies have one nurse to two babies, they are generally on some sort of breathing support.
Special Care babies have one nurse to 5-6 babies.

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The babies start off being one on one and as they get better it can go to more babies. The most a RN would have in a NICU is 4 babies! Can you imagine what its like to have 4 babies due to be fed at the same time hehe!

The most i have ever had on my own in a SCN is 4 and as a professional i would nurse any more than that. It depends on if you are in a state or private hospital as to the guide lines!

As I pointed out before I can only go on my own experiences with KEMH in Perth, in which NICU was 1 nurse to two babies (there were a couple of babies that came through which needed more intense care and they were assigned one nurse only - there are always exceptions). The HDU in KEMH had babies on oxygen (or not) they had to be off the ventilator AND/OR CPAP before they were moved from NICU to SCN or HDU (again there were some exceptions to this).

NICU had 2 main parts, the main room and an overflow which was in the back of SCN. SCN had 3 areas, the main room (where they went after NICU) and then an 'almost home' room which also had an overflow. The 'almost home' part of the SCN was 1 nurse to 5-6 babies, we were in a room with about 12-14 babies and there was often only 2 nurses and the co-ordinator. Again this was back in June 2009 and they have done renovations since and I have not been back.

It really is worth sussing out the hospital you are going to, because in my experience from talking to other NICU mums, each and every NICU is different. Even some of the equipment was slightly different.

Having worked at KEMH NICU (probably looked after Brendan Sally, I was working there then). You are right, there it is generally 1 nurse to 2 babies unless they are very sick or more intensive forms of ventilatory support other then normal ventilators or CPAP. The place has been so busy the overflows have become normal part of life unfortunately (another disadvantage of being the ONLY NICU in the state apart from the children's hospital which only takes surgical and babies born over 32 weeks in outlying hospitals.) Other parts of the SCN the ration is always 1 nurse to 4 babies. Very very rarely anymore then that.

If you have any questions please feel free to ask as where your bub will go and the treatment and equipment to expect will differ depending on the gestation.

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Having worked at KEMH NICU (probably looked after Brendan Sally, I was working there then).

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hehe probably, he had a lot of different nurses come through, he was a yo-yo baby, went straight to NICU and then back and forth between NICU, SCN and NICU overflow. He spent his last 2ish weeks in Satellite.

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Other parts of the SCN the ration is always 1 nurse to 4 babies. Very very rarely anymore then that.

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I do remember when we were there they got very busy... so the nurses were stretched pretty thin. Most of my memories of nurse ratio came from Satellite, when Brendan was there, they opened it up and he was one of the first babies moved up there (3wks old), (you might remember) there was a huge influx of NICU babies that they even had CPAP babes in the back of SCN (but not in the overflow part) For a couple of days there was 2 babies in one cot space (INSANE!) which is when they opened Satellite. They were literally pushing babies out to other hospitals. I also remember some of the nurses talking about not being able to get hours because the budget was pretty thin or something like that, I spent A LOT of my time in the NICU/SCN after hours (as I stayed in Agnes Walsh) I definitely remember a higher nurse to baby ratio for Tristan's stay though (he was in Satellite from day 3-6) there was 3 nurses + the co-ordinator for about 14 babies.

Basically my memories span only a few weeks of SCN, which obviously isn't the best for knowing all the finer details :)

I have nothing to add to this thread, but I just wanted to say how much I appreciate it.
It's really helped me, because I know that my bubs will be in Royal Children's for 3-6 weeks when he/she comes.
At least now, I know what to expect and some of the tips has helped, too.

Thanks again!!
--Charlotte.

only going off my experience we all know each is different.
But well done on getting so far along, i am guessing you are around 30 weeks now?

Nixon was born at 33+3 weeks.
he weighed 2296g or 5lb 1 oz which is quiet a good weight. They estimated between 1.8kg and 2.2kg so he was a big boy!
He was on hospital for 27 days
NICU for 5 days, SCN the rest.
He was on CPAP within his first hour and ventillated after that until day 5
Our first cuddle was on day 5
He had a few hiccups which required a lumbar puncture, catheter and brain ultrasound.
However when he turned a corner he never looked back and just got stronger and stronger
First bf attempt was at 35weeks, for the first 4-5 days it was more of liking then actually latching on.

Like Sally said having a tour of NICU/SCN was very helpful for us just understand how babys a simialr gestation and size do and to also see your not alone, we were so surprised to see almost 60 bays FULL. (we were at the Mercy Melbourne which was fantastic)

thansk everyone for sharing!

kickers- we will be at mercy in melb if she comes before 34 weeks, if after that my private hospy has the level of special care that can take her.

OB appt on monday showed things have settled a lot from a week ago so OB is more hopefuly of getting to 34weeks now. still a week by week thing but things are looking a little bit better in terms of her baking a bit longer.