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Old 05-03-2011, 04:03 PM   #1
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Moms of micro preemies, help me!

I don't even know what with yet, but it sounds like I will be picking up a baby born at 25 weeks either tomorrow or at least sometime within the week. I'm a foster parent and this would be my first placement. Baby is about 5lbs now and almost 3 1/2 months (not adjusted) now. What should I expect? One of my sons was a preemie, but he was born at almost 35 weeks and spent just 10 days in the NICU without any significant problems. This baby is still on oxygen (is this pretty easy to deal with?) but not tube fed. They will train me on the oxygen. Guess there are shunts in the brain? Anyone can tell me about that?

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Old 05-03-2011, 04:22 PM   #2
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Re: Moms of micro preemies, help me!

I have no advice, but I want to wish you luck and say it's a brave and wonderful thing you're diving head fist into
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Old 05-03-2011, 08:22 PM   #3
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Re: Moms of micro preemies, help me!

wow, likely you have a lot of work on your hands. it depends how dependent the baby is on the oxygen. it depends how fast the flow rate is that will depend on how much you need to worry about it whether it's constant or it's just a nighttime and nap thing. Carrying around oxygen AND a baby is a PITA. I used to have to carry a baby and an apnea monitor and that thing weighed more than my baby. Keep in mind you have to REALLY be careful with germs and visitors. Lots of handwashing and hand sanitizer. Thankfully RSV season is over though. The baby might be nippling all feeds but might not be really doing it quickly or without a lot of work. Preemies are notorious for taking forever with feeds and needing to be woken up multiple times during a feed to finish it. You'll likely be using special formula with extra calories. You probably will have to deal with reflux issues, most preemies have it. A wrap or some sort of carrier in which you can put the baby upright on your chest is GREAT for decreasing the projectile vomit. Also, the baby is right around his due date probably so be expecting a newborn, NOT a 3 1/2 month old. Always use his adjusted age for milestones, NOT his chronological age. He's probably going to have some developmental issues in the future due to his extreme prematurity.

Preemies are a labor of love, no matter what their gestation. They aren't tiny little cute newborns, they are babies who were deprived of vital weeks and months of growing and developing and their health suffers because of it. Expect to spend lots of time on this baby because he's still got a long hard road ahead of him.

Best of luck to you mama. Being a foster parent is a beautiful gift to the children you care for.
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Old 05-03-2011, 08:43 PM   #4
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Re: Moms of micro preemies, help me!



Oxygen is a pain and once they are home with it, it is an act of Congress to get them off of it (usually involves a sleep study among other things). Feeds are defiantly going to be a challenge if you have never dealt with what we NICU folks call 'chronics'. They take FOREVER to eat and can not be fed like a regular baby. Instead of holding them in the crook of your arm, they need to sit up right in your lap to aid in breathing, keep them awake, and allow you to assist them with their latch and pacing. Make sure you have the RNs go over the baby's likes and dislikes before you go home! Unfortunately, they are also extremely poor sleepers and fussy (usually related to neurodevelopement and an inability to regulate their state of awakeness and sleep). My boys are 7 months actual, 4 adjusted and still wake at least 4 times a night. I send some prayers up for you and your lil' blessing. Such a wonderful thing you are doing!
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Old 05-03-2011, 10:13 PM   #5
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Re: Moms of micro preemies, help me!

Well this is helpful. Thanks. Didn't realize the oxygen was a huge deal. I guess I should have since I've seen older people on it. I don't know if it's full time or not though. They said she's doing well otherwise so we shall see. Luckily my dh is a RN (although not with babies, but should be helpful) and I have someone I'm friendly with who's dh is a Neonatologist so hopefully those two factors help a bit. I'm nervous though!
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Old 05-04-2011, 05:02 AM   #6
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Re: Moms of micro preemies, help me!

but remember, it will depend on how dependent he is on the oxygen. is he on a constant high flow? does he still desat from time to time? is he just on it for naps and nighttime? those things will really depend on your amt of time spent with this little dude and how much of you he needs.

newtwinmom, how could I forget the feeding positon? actually I feed all babies like that. I did that just the other day at work with a 9 week old term baby and the mom looked at me like I was on drugs. you mean all babies don't need to sit straight up in my lap with my finger under their chin to manage their latch and stimulate their suck??????? guess it's just my babies.
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Old 05-04-2011, 07:20 AM   #7
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Re: Moms of micro preemies, help me!

I have no idea how much oxygen she's still on. They just mentioned it to me on the phone and that I'll need to be trained on it. Hoping it's not all the time. Anyone have any idea about the shunts in the brain?
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Old 05-04-2011, 08:38 AM   #8
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Re: Moms of micro preemies, help me!

Quote:
Originally Posted by newtwinmom View Post


Oxygen is a pain and once they are home with it, it is an act of Congress to get them off of it (usually involves a sleep study among other things). Feeds are defiantly going to be a challenge if you have never dealt with what we NICU folks call 'chronics'. They take FOREVER to eat and can not be fed like a regular baby. Instead of holding them in the crook of your arm, they need to sit up right in your lap to aid in breathing, keep them awake, and allow you to assist them with their latch and pacing. Make sure you have the RNs go over the baby's likes and dislikes before you go home! Unfortunately, they are also extremely poor sleepers and fussy (usually related to neurodevelopement and an inability to regulate their state of awakeness and sleep). My boys are 7 months actual, 4 adjusted and still wake at least 4 times a night. I send some prayers up for you and your lil' blessing. Such a wonderful thing you are doing!
Also, after she's finished feeding she will need to sleep sitting up for at least half an hour to prevent projectile spit ups and any reflux issues. A sturdy bouncy chair should be ok (like a fisher price infant to toddler one) or a carseat.
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Old 05-04-2011, 01:04 PM   #9
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Re: Moms of micro preemies, help me!

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Originally Posted by WynneBabies View Post
I have no idea how much oxygen she's still on. They just mentioned it to me on the phone and that I'll need to be trained on it. Hoping it's not all the time. Anyone have any idea about the shunts in the brain?
This could be a not good thing. Shunts are used to treat hydrocephalus. Many times (but not all) hydrocephalus is a result of or causes neurologic issues/delays/deficits. The baby may have cerebral palsy, may need periodic revisions of the shunt, may have issues that you have no idea about.

What is the expectation about you having this baby? Is this a long term thing, or just a short term thing? Do the parents still have rights?

I don't need to know the answers to these questions, but consider the answers before you take this child for sure. It sounds like you are going to have a huge commitment on your hands and you'll want to make sure your family is up for the challenge. She'll probably need pt/ot/st and early intervention, and still may never be a developmentally normal child.

I wish you all the best.
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Old 05-04-2011, 07:08 PM   #10
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Originally Posted by WynneBabies
I have no idea how much oxygen she's still on. They just mentioned it to me on the phone and that I'll need to be trained on it. Hoping it's not all the time. Anyone have any idea about the shunts in the brain?
In preemies, shunts are typically required in babies with a history of intraventricular hemorrhage ( IVH). After the bleeding stops and the clots shrink, the child develops dilated ventricles ( spinal fluid spaces) in the brain. The shunt is required to drain the extra fluid. The shunt alone doesn't tell you much about the child's neurological prognosis and outside of malfunction, wont require any care or concern on your part. If you learn more about the baby's history, the things you want to listen for that are associated with poor outcome are 'grade 3' or 'grade 4 IVH' or PVL. As the PP said, if you will be caring for this LO for more than a few months, expect lots of interventional and specialist appointments.

I forgot to mention earlier that with oxygen comes an apnea monitor so make sure they go over that with you as well.
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