NICU and Divorce

Parents of small, sick  preemies  can, for many reasons, lose each other.

Parents in NICU have a scenario that the normal newborn family, home in 3 days, never has.  Because of the construct of the small space for isolette and chair etc., parents come into the unit and the mom absolutely zeros in on the isolette,  (Reptilian brain again.). Her body completely fills the space at the isolette and there is almost no way around that.  The father sees her back and little else, and again and again, he eventually sits in a chair and reads a book, appearing as uncaring and callous.  Sometimes the mother will hand the wrapped baby to dad but it’s still an offering from her, not ownership by him which is a must in a happy partnership.

I would tell this to all the parents of long term little ones and now, fifteen to twenty years later, I’m learning that the majority of our families are still intact so this may be the core problem.

Now for the bad news.  The divorce rate in families with long term NICU babies is believed to be 97%.  Tulane calls it 100%.

I believe the father as ‘left out’ is the major cause.

There is an easy way around this for fathers and I have seen many do it.  They come in alone, often before work for the 6AM bath and feeding.  It seems that this experience creates a sustained bonding.

We are enculturated to focus on ourselves with such intensity that everyone else is left out.  Intimacy is frightening and humans no longer look each other in the eye.  They don’t even look their pets in the eye.  It’s too much giving up control and allowing vulnerability.  Force yourself to do it.  Begin with a child or maybe the cat.  Talk to this spirit as independent from yourself.  When brave enough, look an adult you love (and trust) in the eyes… it’s a soul to soul experience.

Only the last years in NICU did I begin looking newborns in the eye and talking to them as an adult (and what was looking back at me was very adult… try it.)  I’d say to the boys:  “You are born onto earth and have parents who are going to give you a great childhood.  And you are quite handsome, like your father.”  And they smiled!

The notion that newborns smile is gas is complete nonsense, driven by those who have no experience.  We in NICU see it all the time and a classic example is the photo called  Laughing Premie from Loma Linda.

So, how can parents avoid divorce after NICU:

  • Choose a baby sitter.  Have the person take a CPR class for infants.
  • Include Dad in the daily care of the baby.
  • Do not focus completely on the baby.  It’s hard on the marriage and hard on the baby.
  • Make some feedings by bottle so Dad can see the curve of his baby’s cheek, that beautiful corner of the baby’s mouth where tongue, bottle and cheek meet.  So he can feel how strong the baby’s pull on the bottle is.
  • Don’t always hand the baby to Dad, he must be a full partner, not a participant.  There’s a difference.
  • Do not criticize parenting of the other.  It turns the critic into everyone’s parent, not a nice place to find yourself.
  • Once a month, go to a restaurant with booths (so no one can shout and no one can cry) for a family meeting. Bring notes if you want to.  The agenda is to be objective and to answer the question:  “How’re we doing?”.  This way, gripes don’t ooze out and ruin the time at home.  Just put it into the notes and save it for the family meeting.  Home must be safe for everyone, always.
  • Plan a date.  Once a month, every other week, you each plan something very special that will please the other and make good memories.  Not a dinner and movie date.  Something like sitting on a dock in morning mists, with a thermos of coffee and breakfast treats.  Feeding ducks in a rose garden pond. Visit art galleries on a First Thursday.  Sit on a bench and guess what passerby’s do for a living.  Visit a toy train store. Go to garage sales or a flea market.  It need not cost money.  The upshot of this is that you know your mate is thinking of how to please you and you are thinking of your mate in positive, loving terms.
  • Learn Partner Yoga.  Do it with your mate.  Do it with your children.
  • Become romantic.  Set up candlelight dinners.
  • Look into your partner’s eyes.

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Children’s Ear Infections, the Cause and Cure

Don’t let young children blow their noses!

Sinus means cavity and our faces have 4 of them.  Two in the forehead and two large ones in the cheekbones close to the nose.  When born, these sinus spaces are closed and as the child grows to adulthood, the sinus’ elongate filling with air and the face lengthens.

The Eustachian tube  goes from the area behind the nose to the middle ear.  In children under 7, the Eustachian tube is short and more horizontal due to the compressed sinus.

Therefore, if the child has stuff running from his nose and he blows, the stuff (schmutz)  will be forced into the short Eustachian tube and into the ear where it multiplies, causing pain and bulging the eardrum, often with enough pressure to burst the eardrum.  Then the mucosa swells, closing the little hole that drains the ear.  (Bacteria need a perfect culture medium to multiply and this dark, moist, warm, sweet apace provides that.)

You can fix it.  A marvelous Pediatrician, Dr. Robert Day,  taught me this long ago, using nose drops designed to reduce swelling…

Privine is an over the counter nose drop that’s been around for a long time and it instantly reduces swelling..  They’re the only drops that work and hard to find.  Amazon has them also.  (Nose sprays don’t work for this trick.)

Open and drain the ear canal:

  • Lay on the the child on the bed with head slightly tilted back over the edge and put one drop into each nostril.  Wait a few minutes.
  • Now, still tipped back,  turn the head slightly to one side and put another drop into the nostril on that side.  Wait again.  He can feel a tiny pop as the sinus tract opens.
  • Repeat this with the other side.
  • Sitting up, he will feel the secretions running down the back of the throat.
You can get rid of the schmutz by just wiping the nose but that will make the skin sore.  Kid’s instinct is to eat it and this causes no harm (other than being disgusting).  Stomach acids will kill the bacteria.  Mucous in the stomach is not digested so if there is enough of it, the child may throw it up and that’s fine.

End Winter Colds

To prevent winter colds put water pans in bedrooms, under the beds is fine.  In one day, adults loose 200cc of water from breathing (one large glass full) and this must be replaced by moisture in the air we breathe back in.  If the air is dry, and it becomes dry with the heat on, the nasal and bronchial mucosa thickens to protect itself.  This thickness is the perfect culture media for the first bacteria that flies by!  It’s warm, sweet, dark and moist.  This is how colds begin.  Echinacea increases t-cells to fight the bacteria and Vit. C  kills it.  At one time in evolution these things were in our diets but difficult these days so they should be added.  The water pans should have a large surface exposed to air.  In Wisconsin, they were in everyone’s home.

I have had many beginnings of colds in the last 40 years but only one severe one.  (A co-worker came to work sick and spread it everywhere… in an NICU!  Employees who go to work sick ought to be punished as should parents who send sick children to school.)  At the first tiny glimmer of a cold, I fluff up the pillows, dress warmly, get a good book, some tea, take Echinacea (the root, not flowers, roots are concentrated) and drink Odwalla C-Monster.  The cold lasts 1 day, no green stuff, no coughing, no fever, just the tiny scratch to the throat that’s the first clue.

To fix chest congestion use Vicks Vapor Rub on the skin.  It contains Camphorated Oil, Eucalyptus and Menthol.  Camphorated Oil, rubbed on the chest and covered with a little piece of cloth, wool is best.  It acts as a counter-irritant, bringing greater blood supply to the outside of the chest (the skin gets pink) but it  also brings increased blood supply to the inside of the chest cavity.  This loosens the thicken mucosa and it’s coughed up.  Never take Vicks Vapor Rub internally!

Kids should be calm and quiet when they are sick.  Make them go to bed. The time when a cold is risky business is if the cause is a Strep bacteria and not a virus.  Strep creates debris and if the patient is active, that debris can get pumped everywhere in the body.  Streptococcus A causes Strep throat, an extremely sore throat with white things spotted on the back of the throat.  That’s  bacterial debris and can migrate throughout the body causing kidney damage, Rheumatic Fever or Sub-acute Bacterial Endocarditis, an infection inside the heart.  SBE produces bacterial debris plaques which stick to the underside of heart valves and can, with exertion, break loose into the blood stream and plug the first small size blood vessel which is often in the brain, causing a stroke.  Use the handle of a spoon and with a flashlight, check the back your child’s sore throat, maybe morning and night for white spots. This is the ‘cold’ that needs antibiotics.  Antibiotics do nothing for virus infections and simply sensitize the body to the medication, meaning that it loses the ability to kill bacteria. Strep is mostly seen in school age children.

A Very Bad Pacifier

Very good in NICU, but using this pacifier with older infants and children creates problems with feeding, tongue and teeth.

About 20 years ago, a new pacifier came into production designed for babies in NICU.  It was completely latex free which was it’s feature.

It is OK for very small NICU babies… definitely not OK for bigger babies.  This is why.

Teaches bad sucking:  There are 2 ways a baby gets milk out of the bottle or breast; by sucking, an event that uses tongue, palate and cheeks to pull a stream of milk out and by chewing the end of the nipple which only empties milk at the end of the nipple into the baby’s mouth.  A full term baby is born knowing how to suck, he has probably been sucking a thumb for months, but not so the preemie.  Sucking occurs at the back of the tongue and he must be taught.

Keeps the tongue in the front of the mouth or sticking out of the mouth: There is not enough of a hub on this nipple to capture for sucking or to keep the pacifier from falling out of  the mouth when at rest. Therefore the baby must press it against the top of his mouth with his tongue, and this is a mistake.  You can understand the problem if you put this pacifier in your mouth and attempt to hold it in place without using bottom teeth.  Then try sucking on it, there is no bulb to keep the back of the tongue down and curled… no way to engage it to suck and therefore it essentially blocks the throat.

Risking ‘buck teeth’:  The basic physical things a baby learns remain his preference for a lifetime.  Learning to apply pressure with the tongue against the upper ridge of teeth will possibly cause him to tongue-thrust during deep sleep.  This applies heavy pressure against the back of his upper teeth, pushing them outward.  Braces will change it but his tongue thrusting will continue recreating the problem.  The tip of the tongue has a normal position, gently resting against the upper palate.

For more pacifier tips and tricks see PACIFIER posts on sidebar.

Teaching a Preemie to Suck

There is only one pacifier shape that teaches good sucking.  All others, except the Nuk, work against it.

Because of prematurity the baby is born before the full, strong sucking reflex was established.  He must be taught to suck,  to gain cheek muscles,  to learn the correct combination of sucking and pulling without air leaks and to transfer these skills from the bottle to the breast. Working in NICU for 20 years, I’ve used this system of teaching sucking efficiency with hundreds of babies and it works every time.

  • Hold the bottle near the neck with the thumb and middle finger and using your last 2 fingers, support him under the chin, then when he starts sucking, put traction on the bottle. The chin support  brings the jaw forward and the tongue forward and his response to the traction is to curl his tongue around the nipple. This with the ring of the nipple against his mouth gives a firm, efficient package and he will begin to build up strength, cheek muscles and stamina.  He will take a few sucks and then stop to rest.  This is hard work for him in the beginning.  Some nurses twist the nipple repeatedly in the baby’s mouth, others pump up and down or back and forth. The baby will not learn to suck if that’s the case. They are simply expressing milk into it’s mouth. (and it makes me crazy)
  • The Pacifier. There is only one pacifier that teaches them to suck correctly. It’s the original Binky (pink image below), a rather large, rounded bulb with a stem fitting into a curved mouthpiece. This thing is magic.  It will teach him to suck at breast like a normal newborn. Email Binky (Playtex) and ask where to buy them near you.  The NUK pacifier was designed by a German orthodontist to bring a receding chin out and it does not strengthen the tongue.  Other pacifiers are either too short, too straight or too flat, preventing the infant’s learning a good tongue curl and grip.

 

 

 

 

Gerber is again marketing the original Binky for which every parent should grateful.  It’s called First Essentials and if not in your grocery stores, it’s available on Amazon.

Start a Baby Sitting Co-op

The Capitol Hill Babysitting Co-op has been working for 50 years.  

During the Kennedy years, we lived in Washington, D.C., just behind the capitol dome, an area of old row houses, some restored and known as Capitol Hill.  Scattered about were  young eager professionals in the new Administration, and someone began a baby sitting co-op which is now famous.

Capitol Hill Babysitting Co-op – Wikipedia, the free encyclopedia

This is how it worked:

People joining the co-op were friends of those already in it.  No money was exchanged.  Instead we used theater thickets (script), each one representing 15 minutes.  So for a six hour evening, you left with 24 tickets, giving you 6 hours worth of sitting from someone else in the co-op.  There was a phone list and when you wanted a sitter, you began calling.  Within months the group of parents grew into two groups, four by the end of the year.

Returning to Portland and living near our beloved Reed College, I began the co-op.  Sometimes the dad would be the sitter, sometimes the mom.  I remember every one of the houses.  How lovely to sit in a different house, listening to their music, quiet hours of reading.  occasionally new friendships were made but most often the social exchange was business-like and polite.

Would you worry about becoming stuck with children who won’t go to bed?  Take your copy of the PACIFE Music to Calm CD.  They will fall asleep.  Quickly.

Rules of the co-op can be expanded to taking your children to someone elses house during the day. This probably needs a bonus such as double or triple scripts depending on the number of children.

Add another twist.  Include grandmotherly types who can exchange their script for some garden help for example.  Or for cat sitting.

Co-ops need a set of rules, a board and one person for oversight. All paid by script.

Shaken Baby Syndrome

Shaking a baby that won’t stop crying may be an instinct of frustration. Even the saints among us have been to that point and somehow stopped themselves.

PACIFE Music to Calm stops the crying minutes after the screamer takes a breath and is quiet enough to hear it.  The mathematical character of this music along with the primal tunes Bernstein talks about quickly engage them.

Newborn drug babies, after the third day, begin a terrible and violent drug withdrawal.  The muscles in their legs undulate and cramp (we can see it and feel it), they purple cry nonstop, they shake, they have explosive diarrhea that eats their bottoms raw and they are beyond comfort.  This is the comment of one NICU nurse about a baby in drug withdrawal…

“I found a tape player and began to play the PACIFE music for him… I’d no sooner put it into the tape player than he stopped crying. It’s instantaneous. He’s looking around with a relaxed, peaceful face.”

– S. S., NICU Registered Nurse