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She answers the most commonly asked questions from parents…
Zoe is a Registered Nurse and Midwife with over 10 years of post-registration experience. Zoe has worked in various settings, from a specialist homebirth team to a high-risk delivery suite and, most recently, at a community birth centre. Zoe is passionate about maintaining her professional development to enhance her support to families in her care. She has completed courses in neonatal life support, perineal surgical skills, managing acutely ill adults and has recently qualified as a hypnobirthing teacher.
Zoe has two young daughters. As a mum, she has direct experience of water birth, home birth, breastfeeding, breastfeeding through pregnancy, tandem nursing and weaning.
Caring for your premature baby
Caring for families who find themselves at the start of a journey with a premature baby is something I have frequently encountered as a midwife. Sometimes expected, but more commonly unexpected, new parents must navigate through unfamiliar territory and team this with physical and emotional recovery; it's certainly no easy feat! So allow me to guide you through my most frequently asked questions to help you on your way.
Is skin to skin contact still important for my baby?
Absolutely! Skin to skin contact is often referred to as 'kangaroo care' on the neonatal unit. Kangaroo care is when your baby is taken out of the incubator or cot and placed directly against your skin in a chest-to-chest position. It helps your baby adjust to life outside of the womb. Not only does it calm and relax both mother and baby, but it also helps your little one to regulate their heart rate, breathing and temperature. Kangaroo care isn't suitable for all babies straight away; if their condition is not stable, it may be advisable to wait a little longer. If this is the case, talk to the team caring for your baby and ask them to show you alternative ways to connect with your baby. When your baby is ready to receive kangaroo care, it may be that it is done in short periods initially and slowly building up; this is to ensure that any new changes to their routine occur very gradually.
Can I still breastfeed?
Yes, you can still breastfeed. However, not all babies in the neonatal unit can have milk straight away; these babies receive all the nutrients they need through a thin tube into a vein; this is called parental nutrition. Regardless of the circumstances, your breastmilk still plays a vital role in your baby's nutrition, growth, and development. So the first step is to speak to the team caring for your baby. Ask them to talk to you about your baby's feeding requirements and to show you where you can breastfeed, express, and store your breastmilk whilst your baby is in hospital. If your baby isn't ready to take your breastmilk initially, it can be stored, so it is there for them when they are. When your baby is ready to be put to your breast, they may only nuzzle or have a few gentle sucks at first; this is completely normal as they are just learning. If you struggle to get your baby to latch on or they come off after a short period, speak to a nurse about using nipple shields. These are helpful breastfeeding tools that may give your baby a greater stimulus to suck and help with milk transfer from the breast. Please remember that breastfeeding may not be possible sometimes due to the circumstances surrounding the arrival of a premature baby. However, there are still many things you can do to make feeding your baby a precious and bonding experience. Seek plenty of support from the team around you; they're there to help!
Self-care is also of utmost importance; when all your focus is on your baby, you must also check in with your own needs; caring for you is caring for your baby!
What will help my baby & me to bond?
Caring for your baby on the neonatal unit can feel like a daunting experience, and parents often wonder where they fit in. However, I cannot stress enough; your baby needs you more than anyone else. Simply hearing your familiar voice will stimulate the release of the hormone oxytocin, otherwise known as the love hormone, which is essential for brain development. If your baby has been taken to the neonatal unit immediately following delivery and you are recovering from birth, you can ask your partner to take lots of photos of your baby to show you. Many neonatal units will take pictures to give to you too. Looking at their picture will help you get to know your baby and help you feel connected during periods of separation. Your smell will also bring great comfort to your baby. It's a good idea to get two small pieces of soft material; leave one in the cot next to your baby and tuck the other down your top next to your skin. Then each time you see your baby, swap the pieces over. Looking at photographs and smelling your baby will also help you express your breastmilk in times of separation. Once you feel well enough, ask the team caring for your baby how you can help. They will show you how to care for your baby whilst in an incubator. Additionally, regularly check in with them to see if there is anything your baby needs. Sometimes, a little trip to the shop to buy a book to read to them or a cute hat can be the refreshing slice of normality you need as a new parent.
How can I soothe them if I am unable to pick them up?
No parent wants to see their baby distressed, especially if they cannot pick them up for a cuddle. However, it is good to know there is a particular way to hold a baby in the incubator without picking them up; this is called comfort holding. Comfort holding is a calming form of touch where you keep your hands steady against their body; the reason for keeping your hands still is because premature babies often find steady hands more calming than stroking. Ask the nurse caring for your baby to show you how to do this. Something else that can calm an unsettled baby is non-nutritive sucking; this is when a baby sucks on a soother or their hand. Non-nutritive sucking is known to decrease the stress response during an unpleasant procedure. It also helps them calm themselves, which preserves energy, and it speeds up the development of their sucking reflex, which will support them to move on to oral feeds quicker.
How can my partner & I support each other?
Welcoming a new baby to the family requires a team approach, especially when faced with unexpected circumstances. Open communication is vital; even though you are walking this path together, you may be going at different paces or facing emotional challenges separately. Self-care is also of utmost importance; when all your focus is on your baby, you must also check in with your own needs; caring for you is caring for your baby! Finally, in a place where it may feel like your world is upside down, don't forget the joy that familiarity can bring. Your favourite home-cooked meal or a phone call with a friend to hear about their new job may be just what you need for a bit of headspace.
We're going home! Any advice?
The big day has arrived! Your beautiful baby has been here for what may seem like a long time now; however, remember to take it steady and continue reaching out for support from those around you, as caring for your baby at home may feel very different. It is common for parents to experience various emotions, from feeling very excited to wholly daunted by the challenge ahead. However, remember that even though you are now at home, there is still a network of healthcare professionals here to support you all, both individually and as a family. As tiny as they are, your little one may notice this change too. They have been used to an environment that is perhaps noisier and brighter than your home. If they are struggling to settle, try playing some white noise and experimenting with calming mood lights. Finally, savour these precious moments. It's time to soak up those newborn cuddles, embrace the slow mornings where you do nothing but gaze at your little one's facial expressions and enjoy showing them around their new home and introducing them to the broader family. You've certainly earnt this!
