Navigating the NICU, from NICU nurse, Zach Drolette
00:00:00 Alyssa
You're listening to Voices of Your Village. This is episode 230. I got to hang out with NICU nurse Zach Drolette and dive into what it can look like to experience a NICU stay and ways to advocate for yourself, for your family, for your tiny human or tiny humans and how to also practice self care in this often exhausting roller coaster of a season. We have a special little intro here for you as well where you get to hear from NICU parents who have walked that journey and can share their words of wisdom. I'm so excited to be able to share this episode with y'all, especially with these special guests. Before we dive in. I wanted to let you know that my first book, Tiny Humans, Big Emotions is available for preorder right now. And if you head over to www.seedandsew.org/book and preorder, it then come right back to that website www.seedandsew.org/book, pop in your name and email and preorder number and we will send you some bonus goodies. I'm so excited to get this book out into the world. It is your comprehensive guide to raising emotionally intelligent humans. And y'all just imagine this world with me for a second. A world filled with emotional intelligence all around us. Where we get to live it and breathe it. Our tiny humans get to live and breathe it. It's pretty dreamy right? The future is emotionally intelligent because you are doing this work. Head over to www.seedandsew.org/book to snag Tiny Humans, Big Emotions. All right, let's dive in.
00:01:54 Alyssa
Hey there. I'm Alyssa Blask Campbell. I'm a mom with a Master's degree in Early Childhood Education and co-creator of the Collaborative Emotion Processing method. I'm here to walk alongside you through the messy, vulnerable parts of being humans, raising other humans with deep thoughts and actionable tips. Let's dive in together.
00:02:24 Alyssa
Hello, everyone. Welcome back to Voices of your village. Today I get to hang out with a friend of mine. I get to hang out with Zach Drolette. He is a Boston based NICU nurse who grew up alongside his mother's in home childcare, which fostered his love of children and propelled him into a career caring for our tiniest humans. He's looking forward to sharing his experiences working with these infants and their families. And I'm looking forward to getting to hang out with you today. Zach, how are you?
00:02:47 Zach
Good. How are you? Thanks for having me.
00:02:49 Alyssa
Yeah, I am jazzed. I'm doing pretty well. This is something that we've had so many requests for. I think it is often filled with so many unknowns, and sometimes when you're going into delivery, you know that there's a NICU stay that's on the horizon or a potential NICU stay on the horizon. And sometimes when you're going into delivery, it catches you off guard and you didn't see it coming. And I want to be able to dive into what it looks like or what it can look like and how people can move through it with as much support and love, kind of as possible. So thanks for diving into this with me today.
00:03:34 Alyssa
As we're getting started. Before we started recording, I was chatting with you a little bit, and one of the things we're talking about is how it is so overwhelming, right? Like, you go from maybe you're in labor and delivery, and you as a labor and delivery nurse as well, have, I'm sure, experienced this, where this baby comes out and they're not going to the NICU, and there's still so much that happens and unfolds that's, like, unexpected. Didn't see this coming. Holy shit. Having a baby's hard and my body hurts and all that jazz. And then this added layer of, oh, and now this expectation I had of being with this baby and going home, and all that I envisioned in going home with this baby is pushed to the wayside because we're going into the NICU. And just that emotional component, I think, of, like, what does this mean? So if somebody finds themselves in those shoes of, like, they are in an unexpected NICU stay? What can a typical NICU stay look like?
00:04:51 Zach
Yeah, a child being born is just a joyful and incredible moment. And it's been like that since the beginning of time. So it can be such an exciting time, and that's why I love the job that I do. But sometimes those complications can happen, and they do end up in the NICU with us. And it's not lost on any of us staff that work in the NICU that's supposed to be a happy time. And then it can end up being a really scary and vulnerable time for parents. So you can see a wide range of NICU admissions. It can be something that is super complicated. You can see a very critical, ill infant that's in the hospital for months or maybe even years. Up to, you could even be there for a couple of hours or just a day or two, a full term infant that does okay, so you can see a wide range of different complications.
00:05:55 Alyssa
When a baby is in the NICU. What can we do? I feel like I know a lot of the like, what can't we do? What can we do? Like, if you're a birthing parent, we can talk about a non birthing parent as well, but what can you do?
00:06:16 Zach
Yeah, again, definitely it really depends on what's going on with the infant. But the parents are really important in the infant's care, especially as the birthing parent. Providing breast milk for the baby, especially premature infants that's treated as like a medicine for those kids. Pumping and providing milk is really important too, if you can do that. And then another thing, too, is just both the parents being a part of the infant's care, understanding what the plan of care is, advocating for your baby and making sure that you're on board with the plan. I do a lot of educating with the parents and really making sure they understand all the monitors, all the different equipment we're using, explaining all the changes that are happening and where the infants at developmentally so they can kind of understand what they need to do, where the infant's going. Just really have them be a part of that healthcare team.
00:07:22 Alyssa
Yeah, that's so helpful. I'm, like, forever the kid with my hand in my air being like, tell me about this. What does this thing do? What are you doing now? What's that? To the point where I'm probably often very annoying in those situations, but I like to have that information and also, when it's in, like, a medical scenario, find myself sometimes afraid to advocate or to ask questions or I guess even thinking in parenthood, even outside of the NICU you say, the times that I feel like I haven't been Sage's best advocate is when it's a medical scenario. And there's this part of me that's, like, I grew up in a culture where doctors are always right, and that's what I was told, and you're supposed to defer to them. So I love that you bring parents into this and help them understand what is that machine doing? What's our goal here? And we talk a lot at Seed about mini stones to milestones. There's a whole part in my book about this. If we're looking at milestones of, like, this baby goes home or this baby eats on their own or whatever, what are those mini stones that lead up to that? I would love to highlight a scenario to be able to look at what are some mini stones you might be looking at that in the moment, I think can feel so small. And I've heard from so many NICU parents celebrating those small wins so huge to then getting to that milestone to celebrate. So let's look at feeding, for example. I feel like feeding is a big one that I feel like I hear about a lot. I don't know. Is this legit? Is that common? Did I make that up?
00:09:08 Zach
Yeah, no, I think that is one of the big milestones, for sure. I think that's a big one for parents, too, because that just parental instinct. Like, you just want to feed your baby, you want to hold your baby. When babies are able to do that, it's a big moment. So that is a big one. I mean, first, lung development kind of happens. Lungs are fully developed for an infant around, like, 36 weeks, and sometimes they're still not fully developed after that, or they can have complications coming out after. One of the bigger things we really work a lot with infants is breathing issues. And they can't eat a bottle or breastfeed or anything like that until they can breathe appropriately. So that's one of the first things we really make sure that the infants can breathe okay. So milestones there. If they're intubating, we're able to pull out the breathing tube. If they're on sort of any sort of respiratory support, we can take that away and they can breathe on their own. Those are all big milestones that we see a lot of the time. If they're on oxygen, then we can take that off. And then from there, we start kind of working on feeding. So taking their first bottle is always a big moment. Usually, I like to have the parents around for that, to kind of see that when we can pull their, we have a tube that goes into their belly that we can feed them through and when they can take enough by their bottle that we can pull that tube out, that's always a big milestone, too. So those are some of the bigger milestones that a lot of our kids see.
00:10:49 Alyssa
That's sweet. So when we're looking at breathing, is it something that you would say, would you go into it being like, okay, that breathing tube, I guess, or like the mask or whatever, is just going to come off and be off? Or is it like that's going to come off for a certain amount of time and then go back on? What would that trajectory potentially look like?
00:11:10 Zach
So in a NICU stay, in general, especially if it's a longer term, it can be a roller coaster ride. It's never a straight trajectory. It's never the baby's going to get better and better and better. It's very up and down. Some days you'll have good days, then you take two step forward, one step back.
00:11:31 Alyssa
Like parenting in general, so not linear.
00:11:34 Zach
Exactly. Right. Yeah. So sometimes you can take that breathing tube out, and then they do good for a couple of days or even a couple of weeks, and then something happens. They get sick and they need it again. Or the mask that helps with their breathing. Sometimes that can go on, and then they need it back on because they just tire out. Sometimes you can have backtracks, and that's part of it. And we do talk a lot about that, that it's not this straight trajectory, because I think parents hope that once these things kind of go away, they're never going to come back. And sometimes they do. So we do talk about that a lot, but we just kind of keep trying to chip away at some of those things and keep moving them in the right direction.
00:12:20 Alyssa
Sure. Yeah. I think that's a really good metaphor for parenting across the board. And this thing of just like, sleep and how it's like we'll have people who are like, okay, they're sleeping through the night. And I'm like, great, and I'm not going to let you know in this moment. They probably won't be forever right now. Right. That's going to change again, and they're going to go through a developmental leap or there's going to be a sickness or whatever, and you're going to be back to wake ups and support and whatever. Parenting isn't linear. Being human isn't right. There's so many ebbs and flows. That's so helpful to go in with. I'm such a goal, give me a goal and I'm on it. Love to go after goals. And so I think that would be something for me personally that I would have to really go in with that mindset of, like, we might reach a goal and then take a couple of steps back. And it doesn't mean that was all for nothing or that we're not going to get there. We're just on the road there, and it's not linear. We don't reach a destination and check a box. Yeah, that's tough. When it comes to, I'm such, I love a good baby snuggle. Like, my neighbor actually right now is pregnant and due in a couple of months, and I was like, oh, yes, thank you. You just pass that baby over any time. They can lay on me at any point. We'll take them at any hour of the day. Give me all those snuggles. And I think that for me, would be so challenging in the NICU of like, can I touch them? How much can I touch them? Are things going to come out? Also, we know the benefits of touch in health and wellness across the board. Emotional health, physical health. What does that look like? What is possible? Can we touch them?
00:14:08 Zach
Yeah, I mean, even our sickest, smallest preemies, we encourage the parents to come in and put their hands on the babies, hold their hands. Sometimes, if they're still very unstable, we can't take them out to do skin to skin where they can hold them right on their chest. But as soon as they're stable enough to be able to do that, we encourage the parents to do it. And then as they become kind of more stable, we encourage that every day. If the baby can tolerate it, it's all about the baby, right? So wherever the baby's at that day. So if they're having a tough day and it's not the day to hold, sometimes it can be a little overstimulated to take them out and do all that or a lot of procedures or anything, but any days we can have them out and do skin to skin. It's so beneficial to these babies.
00:15:01 Alyssa
Yeah, so beneficial. Okay. The burnout is so real. And the burnout is real if this is a first child or an only child, and then if you add on, like, I have a friend recently who has had a baby in the NICU for a couple of months and has a toddler at home and is going back and forth and parenting a toddler and going back to the NICU and feeling forever like she's not able to be in any one space enough. And that burnout is so real. What can we do about that as parents, as caregivers?
00:15:49 Zach
Yeah, I mean, definitely. Right after you have that baby, I always tell parents, you have to make sure you rest and recover and take care of yourself. Especially even a vaginal delivery C section is major abdominal surgery. You need to make sure you're taking care of yourself and you get yourself well to take care of this baby, because if you're not well, you're not going to be able to take care of this baby. That's like, number one. And it's hard when the birthing partner gets discharged from the hospital. That's always a very hard day. Parents going home without their baby is really difficult. So, yeah, definitely. Don't feel guilty, especially if you have another child at home. You have other things going on. Don't feel guilty if you can't come in for a couple of days or you can only be there for a very short amount of time. We understand at the hospital that there's other things and your baby is well taken care of by us at the hospital. And you have to make sure you're taking care of your things at home, too, and just getting ready for when the baby does come home, because it's a lot when the baby does come home, because you have to adjust to that. You start to get adjusted to what it's like to kind of commute back and forth in the hospital and deal with that, and then you have to adjust that. So we always say we don't put any like, don't feel guilty at all for taking the time you need outside the hospital and also being in an ICU. It's a very overstimulating environment. There's a lot of lights, there's a lot of noises, and it's constant. So it's not even very realistic to stay there for long periods of time or for days on end. It can be just overstimulating. So we don't encourage that anyways for parents to be there for all that time. So we encourage them to come in for whatever time they can come in and participate in the cares however they're comfortable with, whether that's just being there for rounds or being called rounds are when we all kind of discuss the plan of care for baby every day, whether they want to be there for that and listen to that, or they just want to come in and do one feed or one hold and then go home. However, they can kind of come in and be a part of that care and incorporate that into their life outside the hospital, too.
00:18:08 Alyssa
Sure. Yeah. That guilt. I think it's just so real. We're so ingrained, I feel like, at this point, to not lean on our village right, that so many of us have. We're living in households where it's single family households. We don't have extended family in the house most of the time in a lot of cultures, especially here in the States or even nearby for a lot of families. And we really come away from that village mindset in so many ways that I think leaning into that is tough to say. Like, yeah, I don't have to be the only one to care for this child. And I have these other humans that are a part of my village right now to lean on and to support them, to support me. We know that self care is so crucial. And listen, I couldn't even sit for a while after giving birth, right? Self care is real. Everything hurts. There's fluid from every hole in your body. And like, you also need to be nurtured and taken care of alongside taking care of this tiny human. And I think really allowing that and letting yourself because I think that guilt is going to come up and being able to recognize it and acknowledge like, all right, I have this narrative that I'm supposed to do it all and it's okay for me not to. And part of being healthy right now means not, part of me showing up as the parent I want to be right now means leaning on my village, means asking for help. It means accepting help. All that jazz that I think is honestly practiced for the rest of parenthood. It's hard. And we're not meant to do this alone. And so many of us are.
21:40 Alyssa
Have you been scrolling the Internet? And there's all these tools for calming your child and how to regulate and whatever, and you try them and your child just gets amped up or that doesn't work. Or you find yourself in these cycles where it's like epic meltdown. Try to come back from it and you just feel like you're putting out fires all day long. If this is you, you aren't alone. And we collaborated with an Occupational Therapist to create our Sensory Profile quiz. This is going to help you learn about what helps your child regulate what's happening in their unique nervous system. We are all different and figuring out what you're sensitive to or what helps you regulate is the key for actually doing this work, for getting to a regulated state, for having tools, for calming down, for having tools for regulation. Head on over to www.seedquiz.com to take the quiz for free. You can take it as many times as you like for as many humans as you'd like, and we will deliver results right to your inbox to get you kick started on this journey. Seedquiz.com.
00:20:11 Alyssa
One hot take that someone had sent over that I was like, oh, I love that was about writing everything down. And I even like, even outside of the NICU, like, gosh, I look back and I'm like, I wish I would have done that at the beginning. I keep a journal for Sage that I started when he was like five months old, that I wish I started from the beginning, where every night I write one sentence of just like a takeaway from that day. And then every year I get to see, like now I'm looking at ones I wrote last year. I'm like, oh, my gosh, last year he was just like he just went up the stairs for the first time. And now he's saying things like, I'm going to run upstairs and get something, come back down. It's cool to be able to compare those, but we forget it. We forget all the things. Our survival brain is so good at not remembering all the things because you are leaking from every hole and everything is hard in so many ways, but I think this is how we keep having kids is that we forget everything. But I love that idea of bringing a notebook and writing everything down. Is there anything else that you've seen parents do in terms of hot tips in those early NICU days? Like bringing a notebook that could be helpful for the short term or for the long term?
00:21:28 Zach
Yeah, I mean, it's so funny. You see all the different personality types and whatever. So some people love just they want all the details they want to know. Oh, you made this change on the vent. You did this. Yeah, exactly right, all that, that's me.
00:21:45 Zach
Just write every detail down and do that. There's some parents that really they just want to come in. They just want to know the bigger picture. They're just there one thing I do, and we kind of talk about this with parents. Whatever is going to work for them, whatever's going to bring them the most peace in this anxiety driven time. Because there's some parents I really just want to come in. I just want to know what the bigger picture plan is. Are we close to getting home? Are we not? And I'm just going to come in, I'm going to take care of the baby, and I'm going to go. And you just let me know if there's something I need to know. Where there's some parents that want to come in and just want to know all the details. They want to be a part of every little thing, and we see the whole spectrum in between. One thing I encourage all the parents to do, though, is just take lots of pictures. I always am, like, any pictures of skin to skin, especially the first time, bath time, diaper changes, any of the big milestones, just lots and lots of pictures. So you can look back on those and see even the micro premiums when they've been there for four, five, six months, and you just kind of, like, are caught up in the day to day, and you're just trying to survive and get through. And you can look back at those pictures, look at how far we've come. We've come a long way. So that's always, like, sometimes parents look back at and be like, oh, yeah, I remember when three months ago, it was, like, a lot. So that's like, one thing I always do is take lots of pictures.
00:23:13 Alyssa
I love that. Yeah, I love that because it's the longest, shortest time, and every day feels like so many days when you're in it, and all of a sudden you're like, oh, yeah, we're a week in and look at how far we've come. Or we're two months in and look at how far we've come, and look what they were doing two months ago or what they looked like two months ago. And it changes so much. I love the taking of the pictures. I also had someone who said, oh, creating a schedule for visits so that if you need that break and you also are like, but I don't want the baby to be alone or without family. The baby's never alone, but without family, then create a schedule. Who else can come? Do you have family friends that are family? Do you have a co partner in this who can come also be there so that you can step out? I think is huge. Yeah. And just from the emotional side, like, grieving, right? Like, allowing yourself the time to grieve what you envisioned so that you can be present to what is. As you were describing, that spectrum of, my response to anxiety is like, give me all the information I want every detail that helps me feel in control. It helps me feel like I can be a part of this system. And then the other anxiety response of dissociation, I will come and I will show up as much as I can. And that one isn't better than the other. They're just two different responses to a really overwhelmed nervous system. And it's okay to be in an overwhelmed state. Like, you're going to be in a dysregulated state right now, and that's okay. And just allowing that to be true.
00:25:06 Zach
I'm lucky enough to work at a hospital, too, that we have a lot of supportive staff. We have social workers, we have psychiatrists, we have chaplains, so we have family support people. We have a lot of places for parents to go to get support or just to talk or anything like that, just to kind of help with that. So I always encourage parents if they're having a hard time. And those staff are so good about just constantly checking on parents because, again, we just know how much of a vulnerable and scary time this is for parents.
00:25:39 Alyssa
100%. I continued therapy. I would love to be in it for life. I love my therapist, but I remember my first postpartum session and I was like, oh, I didn't realize how much I need this until I was in it. That's awesome. I love that suggestion that's available for you at the NICU. I know in most states, I think this is true, that if you've been in the NICU for over a week or over ten days or the child has that they automatically qualify for early intervention services. I think that's the case in Massachusetts. Are there resources like that available at the NICU of, like, okay, when it is time to be discharged, you're going home with this babe. What do you have for resources to turn to for support? Is there a person they can just ask?
00:26:35 Zach
Yeah, so definitely earlier intervention is a big one. A lot of the time, our kids, we have a lot of follow up appointments with different specialties in follow up clinics, in physical therapy. So, yeah, I mean, that, that's...
00:27:01 Alyssa
Is it something you connect them with as the nurse, or is it something that they will just, like, be connected to? So say you're like, maybe you're not receiving additional therapies when you leave the NICU. My niece, for instance, was in the NICU, left, went home, didn't need additional therapies, but could have qualified for early intervention just from the amount of time that they're in the NICU. Right? Like, is that something that the hospital connects you with, or is it just something that kind of we expect parents to know and if it is A, we expect parents to know. I just want to do a PSA of like reach out to early intervention, even just to see I'm a huge fan. We know that 80% of that brain is developing by the time they're three. Earlier intervention is the bump. I had early intervention for Sage. His crawl just, it wasn't a typical crawl. And I was like, there's no harm in an assessment. He had an evaluation, was assessed, qualified for PT. We did it. He's thriving and doesn't need ongoing PT because we got in as an infant and helped tweak some of those things. But I guess, like a little PSA for parents, early intervention is the bomb. And I think that in most states, if you've been in the NICU for an extended stay of over a week, that you might automatically qualify for services.
00:28:24 Zach
Yeah, I know in Massachusetts, most of our kids do qualify for EI. We have a care coordination team. That's amazing.
00:28:34 Alyssa
Cool!
00:28:35 Zach
They are usually totally on top of that a lot of the time. If they've been in the NICU at all too, they qualify for visiting nurses coming a couple of days after discharge, too. So they set that up a lot of the time. I would just say if you are worried about anything, any delays or you do just want an assessment or something, reach out to programs like that and see what's available to you, because all this development in those first three years is so important. Yeah, if you're questioning any of that, especially too, like going to your pediatrician, they have a lot of information about where you can get services and stuff, too. So that would be another place that you could ask those questions.
00:29:18 Alyssa
Sure. And you don't need a doctor referral to have an assessment for early intervention. So if you are questioning it and your Ped isn't, as was the case in my household, go ahead. Go ahead and reach out. Rad, you were mentioning the stimulation of a NICU, I mean, the stimulation of a hospital in general for me is a lot. The lights, the sounds, the constant beeping in these spaces. And I can only imagine how heightened that is. The beeping. The beeping. I think as a sound sensitive human, I married a drummer, and he is like constantly tapping on things, and I am constantly asking him to stop. The noise, I think would be so much for my nervous system. And I am wondering, A, how do you do it? Zach, do you have any hot tips for just other nurses out there or humans who are spending time in a NICU? And what might that look like? I was picturing, like I would need air pods. I would need to listen to something else outside of beeping.
00:30:29 Zach
Yeah, no, I mean, we do have some parents that are there for longer periods that will bring their headphones and kind of like tune out with that. Yeah. No, I mean, definitely. When I first started, probably the first six months to a year, I would come home and still hear the beeping as I'm trying to go to bed and the lights and stuff. You do get used to it over time. But one thing I think that's also great about my job is that I go there for those 12 hours, and I'm fully invested there for 12 hours. And then when I leave and I give report and I give the nurse that baby to take care of, I separate myself from there. So it does help, kind of. And then I don't have to respond to anything at work. And then I come back in, I take care of my baby. So having that kind of clean break from work does help, kind of. When you go back in there, you can kind of come in and handle that stimulation overload. So you do get used to it.
00:31:25 Alyssa
That sounds healthy. A clean break from work. I wonder what that's like. Sounds so lovely. Rad. Okay, cool. Yeah. I think I would need headphones. I think I would also need to just, like, say I wanted to stay and be there for extended periods of time. I would have to take a walk, like leave the beeping, leave the space, walk away, come back proactively, pour into that nervous system.
00:31:58 Zach
We have separate areas for parents to go eat and drink and just take a break from that environment. A lot of times, if they're there, we'll encourage them to go out and go out to eat, go to a dinner, just you guys. Especially if there's another kid at home, somebody's watching them, hold the baby for a little bit, do these scans, and then go do something for yourselves away from this. We do encourage that, for sure, because it's a tough environment to be in for just long periods.
00:32:27 Alyssa
Totally. And hard to, I bet, give yourself permission to do that, to walk away.
00:32:33 Zach
So I try to always remind parents that it's okay to do that. It's okay that you miss a day or you need to take a break from this. Always reminding them exactly.
00:32:46 Alyssa
The idea of taking a shower was hard for me at the beginning. Separating was something that was really hard for me in the newborn phase. And I could see two of my dear friends have had NICU babes, and they shared that same thing. Just like, the permission to walk away and say, like, I have a vulnerable newborn and I am going to walk away just inside feels like there was a primal pull to be like, I can't do that. And building that awareness and overriding that system is hard. We even talk about it with when we educate on shaken baby syndrome. Even just like full term infants going home that aren't in the NICU, we really talk about recognizing when you're hitting your kind of breaking point. And if a baby's crying and you've tried everything you can, and you're getting frustrated, and that's different for everybody, right? Like, some people have more patience than others, and that's okay. It's just recognizing when you've hit that point. And it's okay to put your baby down and walk away as long as they're in a safe place. Walk away and take a break until you've calmed down, because it just takes one moment of frustration that something can happen. And nobody wants to hurt their baby when that happens. But when you're sleep deprived and the hormones are all changing from postpartum and you haven't slept and the baby's crying and you've tried everything possible, it's very difficult. So just recognizing when you get into that point, it's okay to put your baby down, walk away and take a break, whether that's meditation, listening to music, yoga, whatever it is that's going to be able to calm you down so you can go back and respond your baby. And it's okay if your baby's crying. Your baby can cry there, and they will be okay. So, yeah, we always talk about that, too, that even when you go home, not even just in the NICU setting, that it's okay to give yourself that break.
00:34:50 Alyssa
Yeah, for the rest of time. Eventually, they'll be a toddler, and they'll be following you as you go to the bathroom to take a break, and you're shutting the door, and you're taking that space because you're going to lose it in their face. And taking that space and having them follow you and cry is more beneficial to them than you staying and losing it. And it's not like a trip to the spa, because then like, oh, I feel super calm and relaxed when I come back. But no, I'm in a more regulated state, whether it's the toddler or the baby crying or whatever, like, okay, I can do this a little bit longer. What is the expectation? What does discharge day look like? What milestones might you have to hit in order to navigate discharge?
00:35:59 Zach
For the baby?
00:35:59 Alyssa
Yes.
00:36:01 Zach
So there's two big things that babies need to be able to do. They need to be able to maintain their vital signs, so they need to be able to make sure their heart rate doesn't drop at all and that they breathe and they don't have any dips in their oxygen. The second thing is making sure they're eating enough. They can eat, gain weight. So those are the two kind of big things that babies need to do. We kind of get to that point. And it's hard, right? Because babies kind of do their own thing. Like, they're kind of on their own schedule. So sometimes it can come quicker than we anticipate. Sometimes it can be longer than we anticipate. So it can be kind of a shock where it's like, all of a sudden, it's like, no, they figured it out. They started eating. They're doing great. They're going home tomorrow. So those are kind of the big things they need to do before they go home. And then usually discharge day is an exciting day. It's a terrifying day for parents.
00:37:07 Alyssa
They're like, oh shit, now I have this kid to take care of without this staff to lean on.
00:37:11 Zach
Right, and you're so used to them being on the monitors, and then they're off the monitors. So it's exciting because parents are, like, wanted this, but now it's, like, terrifying. Like, oh, now I'm bringing home. So we do a lot of education leading up to this too. So it's not just kind of like a dump all on that day, but it's still kind of is. There's just a lot of things that get done on the day or two leading up to discharge, so we try to kind of do as much as we can leading up to that. So it's not as kind of a crazy day for the parents, but it always is just kind of like making sure all the appointments are set. You're bringing in your car seat and everything. You're probably getting everything ready at home. So it is kind of just a crazy day. But those are kind of the two big things that babies need to do to be able to go home. And it's so variable. You can never really give, like, a specific date because babies just...
00:38:08 Alyssa
They're humans.
00:38:09 Zach
They're always surprising.
00:38:10 Alyssa
Yeah, totally. You brought up a really good point there that I just want to highlight that they went from being on all these monitors where maybe all you wanted was to take them home, and then now you're taking them home and you feel that anxiety start to set in of like, is there oxygen dropping? How will I know if it does? I had a lactation consultant come to my house, and we didn't have a NICU stay. And I still was just like, can you just and I had been told, like, his latch is good. He's nursing well. And I was like, I just need another set of eyes on this boob right now. Is this, how are we doing? She was like, this is great. Cool. But you are all of a sudden going to have all those thoughts probably pop up of like, Are they okay? And I hope that we could get all parents, but especially NICU parents, access to social workers, to therapists, to a space, to a support group, to a space to be able to lean on and say, like, oh, I'm noticing these thoughts. I'm feeling that anxiety start to come in. And maybe now your postpartum anxiety spikes or depression or any number of things coming up and to hopefully have a team to lean on, even if it's your doctor you reach out to or a partner that can say, hey, these are things I'm noticing. Let's get you some help. Yeah, I think that that's huge to acknowledge and it's a wild ride. I encapsulated my placenta and consumed it, which for a lot of people listening right now, are probably throwing up in their mouth. I'm not like a make my own soap kind of person. And for me it was hormone related, where I was like, I'm going to have this huge drop in hormones if this placenta leaves my body and all those hormones are gone at once. And so I wanted to be able to wean off of them. And at my six week checkup, my midwives were like, yeah, if you're still taking the placenta, you can stop, whatever. So I just stopped and nothing had changed in my life. And all of a sudden I was sobbing. Everything felt harder, my world got really dark and my husband was just like, hey, did you stop taking the placenta pills? And I was like, all right. And it was just that. It was a shift in hormones. All of a sudden, the thing I was trying to avoid. And so I went back on them and then weaned off them and didn't experience that again. But it was this glimpse for me into like, hormones are bonkers and depression is so real and anxiety is so real and you don't have to do it alone and there's support and help in navigating that.
00:41:00 Zach
Absolutely. Yeah.
00:41:02 Alyssa
Zach, thank you so much for your time. Is there anything that you would like to leave NICU parents with today?
00:41:11 Zach
I don't think so. I mean, just do the best you can. Just be there for your baby. That's the most important thing. You're their advocate, you're there. So just be there for them, love them, and the rest will fall into place.
00:41:28 Alyssa
Yeah. You didn't do anything wrong. You're doing enough.
00:41:31 Zach
Exactly. Don't blame yourself.
00:41:35 Alyssa
No. And lean on those nurses. They're pretty rad. Thank you, Zach.
00:41:42 Zach
Yeah, thank you.
00:41:44 Alyssa
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