Baby
When we’re pregnant, we often don’t think about neonatal care being a possibility for our babies when they arrive. We don’t think about it, because it isn’t really spoken about. Yet it’s more common than many realise, with 1 in 7 babies needing an admission to a neonatal intensive care unit (NICU).
I’m Dr Frankie Harrison, a Clinical Psychologist and a parent who has been through neonatal care. My first baby was born at 31 weeks due to preeclampsia, and it was through my experience with NICU that I realised that the things I was feeling were not being spoken about. So many people needed validation and understanding of their emotions and thought processes after NICU, which led me to co-founding Miracle Moon – an online community offering support for parents in such circumstances.
One of the biggest questions we get asked in our community is about bonding. When you’re in neonatal care you are often underprepared, lacking in knowledge and it can feel incredibly overwhelming. It can feel difficult to connect with your baby for many reasons (which we will dive into in this blog post), and there can also be a huge amount of shame attached to that. Which is why we need to be talking about it more.
My bonding experience
When my baby was born, it was a shock. I don’t feel like I was given the information I needed to know what to expect, in any way. I was physically very out of it due to the medication I was on for pre-eclampsia and the process of an emergency section felt incredibly surreal. It took a long time for me to say “I gave birth” because, honestly, it just didn’t feel like that. It felt like my baby was just taken from my body. One moment I was pregnant and the next I wasn’t. I remember lying in recovery after my section and feeling like I was in this bubble. I now can reflect on that time and realise, I was numb, dissociated and this was my brain trying to protect me from the trauma I was experiencing.
I was lying there, with my baby in another place in the hospital and I didn’t know how to feel or what to think. When I first got taken to see my baby over 12 hours later, my initial thought was “which one is my baby”. I saw him and it took days to really connect with what he looked like and what had happened. His face was covered in tubes, his body was covered in wires, he was tiny and I found it hard to connect to the fact that I was his mum. I was encouraged after some time to hold him and care for him, feeding him through his nasal gastric tube and changing his nappy. At first, I felt utterly terrified that I was going to do it wrong and hurt him. My partner is a Radiographer and he went into a caring role with ease, as he had experience being in neonatal units and handling small and poorly babies. At the beginning, I leant on him and I took the back seat. It took a while for me to feel connected, to feel like I had this intense love that people talk about.
Reasons it may be difficult to bond in NICU
It helps to know what you can be up against when it comes to bonding and connecting with your NICU baby.
Hormones and Trauma
The NICU experience can trigger a rush of stress hormones due to the high level of threat we feel under. This can reduce our production of our happy, love hormone oxytocin, that we need to build to be able to help us feel connected with our baby. We are often going through something very stressful and can be sent into survival mode – fight, flight, freeze or fawn, which is unconscious and out of our control. This survival mode is there to protect us, but can leave us feeling disconnected.
Physical distance
When we are in the unit, we have very physical barriers between us and our child. Most NICUs encourage parents to visit their baby as often as possible after they are born, but there may be a period of time before you or the baby are stable.
When we meet our baby, we may be unable to physically touch them, they may be in an incubator or cot. They may be covered in wires and tubes, making it hard to see them. We may be told that we are not able to hold them for some time. We have a physical distance that can make it difficult for us to be able to connect.
Uncertainty and Confidence
It can feel incredibly uncertain, knowing how to care for your baby and how they are going to be one day to the next. When we are able to see our baby, we can often feel like we don’t know what to do… Can I hold them? Touch them? Feed them? It is important to talk to the nurses on your ward about what is happening and whether you can do these things. They will tell you about ways you can touch, hold, feed and care for your baby and as you do more, your confidence and bond will grow.
The benefits of bonding
If you have missed out on moments like “the golden hour”, it does not mean that you cannot bond or that your bond has been impacted in the long term. Bonding is a two way process and it is not something that just happens once.
Feeling bonded with your child and them feeling securely connected with you is an important part of being a parent. A strong and positive bond can have an impact on your mental health and wellbeing as well as your child’s. It helps your child to lay healthy relationships with others. It can even have an impact on your child’s physical health, development and overall life outcomes. A strong attachment doesn’t fully predict these outcomes for a NICU baby who may have other difficulties, but there are absolutely a lot of benefits for the child in having a secure attachment with their caregivers. As I have mentioned before, bonding is an ongoing process that happens over years, so if your NICU stay was difficult, there are always ways to repair that bond.
How can I bond with my baby?
The use of physical touch
If you are able to hold your baby, you can do so through a practice called “Kangaroo care”, which is where you hold your baby, chest-to-chest, skin-to-skin. It not only helps with bonding but also has numerous health benefits for the baby, such as stabilising their heart rate, improving their breathing, and promoting weight gain. Some babies are too sick to be held straight away, there is a method called “containment holding”, where you put your hands gently on your child’s head and feet, to help them feel contained and held.
The use of smell
Most units will promote the use of smell swatches, these will be two pieces of fabric, one that you can put on your skin and one that you can place next to your baby. You will be encouraged to swap these regularly so that you get the scent of your baby and they get the scent of you.
The use of sound
Talking, singing and communicating with your baby is incredibly important and powerful, but may be something that you build your confidence up in doing. One way of doing this is by reading to your baby. Your baby will know your voice from when you carried them, therefore we find that babies respond really positively to this sound.
The use of sight
Take pictures and videos of your baby, document your experience in some way (writing, drawing, logging). It may not feel like you want to do this at the time, but the majority of parents I talk to wish they had done this more. You can also spend time looking at your baby, at their face and their movements. It’s harder to do through a perspex incubator, but spending time sitting next to the incubator and looking through the holes helps you to get to know them, watch how they move and learn how they are communicating.
Caring for your baby
The nurses and health care workers talk about “cares”, where you look after your baby on the unit, including things such as oral care, feeding, changing nappies, cleaning and monitoring your baby. You may be encouraged to express next to your baby, if you decide it is right for you and you are able to do so. Feeding may look different to how you imagined, but this is all part of the process of looking after your NICU baby. Participating in cares can feel scary to start with, especially if you feel your baby is very vulnerable, but it can help you to develop that connection and to feel more like a parent.
Give gifts
Quite often, if we are underprepared for a premature birth, we may not have all the things that we need – whether that’s our hospital bag, or everything we need for our baby either at hospital or home. When you’re able to, spending some time buying things online may help you feel more connected to your baby.
Looking after yourself
For a parent in NICU, our own basic needs are often unmet. Are you able to get some rest? Have you had access to food, water, and outside air today? It’s important we prioritise our own needs when we can in whatever way we can, to be able to build our strength for our child.
It may be that you do not want to leave the cot, so think about how you can look after yourself in this space; whether that’s bringing in healthy food and home comforts, writing, talking, creating, or just resting. If you are able and willing to have some space from your child, taking a walk, going out for lunch or coffee can be helpful in creating a bit of space and restoration.
There may be some help available in your unit, such as peer support groups or psychology support. If you feel you need more help, please access it. Miracle Moon’s online community has lots of resources to help you in this time.
Separation at home
There may come a time when you need to leave your baby in the hospital. This is painful and difficult for parents. Something that helped me was developing a “goodbye for now” routine. By providing a feed, cares, reading a story or singing a song, having a cuddle and saying goodbye for now, this felt like I was tucking my baby in for the night until I saw him in the morning. It also helped me to feel more like a Mum.
It is OK to call the unit as much as you like when you are home. Some units even use technology so you can see your baby when you’re not with them. The nurses may keep a diary or notes, or you can ask them to do this when you are away from them.
Ask the nurses to involve you in as many firsts as possible, for example, ask if they can wait for your return to move them to different rooms, dress them, bathe them or feed them. It is important for you to be involved in as many of those activities as possible.
Imagining coming home
We still get that urge to nest, even if our baby has been born prematurely. Therefore, spending some time at home, preparing the baby’s space, or getting the things you need can help you to develop some hope and connection with the idea of your child coming home. This may feel too overwhelming for people, so it is important to do what feels right for you.
I expected to feel a sudden rush of love and connection with my children when they were born, because that is what I was told I would feel. That there was nothing else like it. But what I felt was mostly fear and then numbness. I didn’t feel instantly connected. I didn’t really feel a lot, for quite some time. And I know that that was my nervous system giving me a “freeze” response to protect myself, to help me survive.
I didn’t feel that sudden rush, but what I felt was a trickle of love that built over time. There were certain things that helped me to get to that point where I felt more connected to my baby when they were in hospital and when we got home.
It can feel incredibly overwhelming having a stay in neonatal care, no matter how long you’re there for, no matter what gestation your baby is born at and I want you to know that whatever you feel is valid and real and OK. It is normal to feel a whole host of emotions and you are not alone in them. So many of us have felt everything you have felt too.
You can listen to Dr Frankie Harrison’s episode of Parenting SOS on Happy Mum Happy Baby here.
Biography
I am Dr Frankie Harrison, a Clinical Psychologist and a parent who has been there too. Alongside my co-founder Georgie (also a NICU parent and graphic designer) we have developed an online community where you can meet other people who get it and have lived it. We have a podcast, online resources, webinars, workshops, guides and accessible content. We are in the process of developing a membership to build our community and support available. I also provide group therapy and individual therapy, including EMDR which can help in processing your NICU experience.
You can find more out about us on our website www.miraclemoon.co.uk or on Instagram @miraclemoonuk
