Wednesday, October 24, 2007

Parenting Magazine-Bonding With Your Preemie

In the current issue of Parenting Magazine you will find an article "Bonding With Your Preemie". I wasn't sure about copyright laws so I am only going to paste a link to the story.

http://www.parenting.com/parenting/article/0,19840,1666646,00.html

Personally, I wonder if the author has even ever stepped one foot into a NICU. If she has, and her suggestions worked for her, clearly she must have had a late term preemie. Not one of those suggestions would have been even remotely possible until Paige was almost ready to go home.

One of the suggestions by the author is to stroke your baby for 15 minutes, 3 x per day. She states that this suggestion is based on a recent study. I have just spent quite a bit of time looking for any study citing this suggestion, but have not been successful. If anyone has found it, please post it. Touching Paige for 15 minutes, while she was still in the NICU, was clearly painful for her. Actually we were told NOT to touch her with stroke like movements. I quickly learned why this was a good suggestion when I forgot the rule and decided to pet her head. I felt horrible and never did it again until she was much older.

Since November is National Prematurity Month, I would have expected much better reporting from a magazine geared towards parents of children!

20 comments:

23wktwins'mommy said...

What kind of information are they trying to give to parents? You're right, it must be the 34 weeker they are referring to.
This is always a "problem"...bonding with your preemie. The NICU talked a lot about that. Not in terms of telling us what to do, but in our candid conversations about just how strange the situation was...to not be able to hold, feed, interact with your 1 pound, struggling for his/her life baby.
Every parent is going to react to the experience differently. And that's OK. There is nothing normal about having a critically ill newborn. Some will withdraw because they are afraid of getting too close when the reality of possible death is too real. Some may need to be at the hospital 24/7 and become as involved in their child's care as possible. Some may take pictures, others may not want to remember their child in that way.
There is no right way to bond with your extremely premature baby. This process doesn't truly take full effect until the baby is home. I loved my children and felt a very strong bond throughout our NICU "ride", (I was the very involved NICU parent), but it was nothing like getting them home to cuddle and coo at in the privacy of our home without the glitz and glam of the NICU.
And a year later, in spite of all the nurses who cared for them in their first 4 months of life, and in spite of the private duty nurses who come to our home to help care for them, they still know who Mommy and Daddy are, and still prefer us over anyone. The bonding and attachment does take place even when the baby has been taken from your womb at only 23 weeks into your pregnancy.
And even stroking your 34 weeker 15 times 3x a day, or whatever? What ever happened to the natural way parents bond with their child? That's going to different between people and across cultures. There is something robotic about reading an article about bonding and counting how many times you touch your baby. I didn't go to the link and read the article so forgive me if I sound harsh. It just sounds strange to me for a closer-to-term preemie, and impossible for extremely premature babies like ours.

Jennifer said...

http://www.jmoninger.com/Jeannette%20Moninger%20bio.htm

We could use this as an opportunity for education - the above link is her bio/contact information.

Jennifer said...

http://www.jmoninger.com/
Jeannette%20Moninger%20bio.htm

Oops - cut off. You can copy/paste the two lines above.

Anonymous said...

I've just read the article - it's totally ridiculous - even for a later gestation baby!!!

William was 33 weeks (okay 9 years ago but still...). We couldn't hold him for 3 days - and he wasn't so fragile really, just feeder and grower.

During tube feeds we got to hold the TUBE not the baby!

Even then, when we could hold him it was only for an hour and then the nurses pushed to get him back into the cot.

Nicholas was a 36 weeker, 6.5 years ago. I got to hold him briefly, while he was on CPAP, at a day old.

Stroking AND talking was too much for William for several months.

Even if bonding works 'naturally' parenting a preemie is sooo much more!
Thomas never went to the NICU so my experience is 6.5 years old. I got to snuggle with Thomas skin to skin for 30 mins after he was born and while that was an amazing experience, parenting him with his various issues has also been a battle. Contact isn't an all healing magic!

Eleanor, mummy to -
William, 33 weeker now 9 years,
Nicholas, 36 weeker now 6.5 years,
Thomas, 36 weeker, nearly 2.5!

Sarah said...

It's articles like these that are so misleading. I think there should be a definite distinction between 'preemie' and 'micropreemie,' so the public has an idea of what NICU moms go through. It ain't a bed of roses. In all fairness, no NICU stay is a happy stay (unless you've had a micropreemie as your first baby and your second one was in the NICU as a precaution for a day), but it was extremely difficult to bond with our son without being able to touch him, kiss him, or hold him.

We (hubby and I) bonded with our son by making CDs with us singing and telling stories, reading out of the Bible.. things of that nature. The nurses played it for him every day. I just played it for our son the other night and he actually recognized it. It has a calming effect on him. That was the best we could do. We couldn't hold him for 8 weeks, or 56 days and 22 hours to be exact. And stroking?! Forget it. Touching him and talking around him was painful in the first few weeks.

He's been home 3 months, he was hospitalized for 8.. and we still bonding. I have to work at it daily.

Helen Harrison said...

One important reason why it is difficult to "bond" with a preemie (the way parents are said to "bond" with a full term child) is that preemies don't *behave* like term babies as newborns or after they leave the NICU, or, for many, ever.

They are more fussy, harder to feed, harder to get to sleep or keep asleep, and generally more hyper and distractable (or more lethargic -- a big danger sign!)

They just don't interact with caregivers the same way fullterm babies/children do. And it is the *interaction* of baby and parent that characterizes the "bonding" process as it is (somewhat idealistically, IMO)described in the "bonding" literature.

I think it is cruel to put the burden of "bonding" on the parents(read "the mom"). And parents (read " the mom") should not feel guilty about not being "properly" "bonded."

That being said, I think anything parents can do to feel more connected with their child -- preemie or term -- is good, but it is unrealistic to think that timed stroking sessions(even if medically possible, and if your preemie tolerates it) is going to cement the kind of "bond" described in "bonding" literature under the circumstances of extremely preterm birth.

I have put the word "bond" in quotes because there has been a great deal of controversy among professionals about the entire concept.

medrecgal said...

They make it sound so cliched. "Bonding" isn't something that is so time-sensitive and absolutely crucial that it has an expiration date after which it will do a baby no good... it's an inaccurate descriptor for a long term process that goes on long after a baby has left the NICU. Actually, in some situations it's better for a baby to have LESS stimulation, rather than more. Of course it is perfectly natural for a parent to want the more physical interaction that would occur with a term baby, but there are still many other ways to connect even when constrained by the technology of the NICU (as others have suggested). To me this just shows the narrowness of the article's perspective.

What's really important is giving the parents of a preemie the right tools and information to their particular situation, as well as opportunity to respond as each individual sees fit. There should be no "prescription" for how to get to know a baby, just far more support and compassion than I'm seeing from the comments here and on previous posts. Perhaps taking cues from the baby is the most sensible path.

Laura said...

aaacccckkk!!!!
i did hold my 24 weeker daily while he was on the vent but he was 32 weeks adjusted age. the only thing i would concur on is the suggestion of reading or singing softly. one thing that always amazes me in my 18 years of nicu practice is how even the tiniest of preemies seem to respond positively to their parents' voices plus it seems to help (at least for me it did) while sitting helplessly at our baby's bedside.
i like what 23wktwins'mommy said how we all bond differently and that is okay. i really try to incorporate that in my practice when guiding and supporting parents in the nicu.
thanks for the heads up on this article.

Laura said...

oops i forgot....
my biggest pet peeve is the sweet little grandmas who want to et the tiniest and sickest of babies. i know they mean well but he/she is not a puppy or a kitten and all the alarms blaring and the baby turning gray doesn't mean that they like it.
sorry, had to get that off my chest.

Anonymous said...

Thanks for the link to the author. I emailed her with my concerns about the article.

Paula

Cath Young said...

First of all, I want to let you know, Stacey, that I think your blog is so insightful right to its name. I did not "get" it at first but now that I've worked my way through so many of your posts, I think the name and purpose are downright ingenius and unique.

As to the Parenting magazine article, well, I find most such articles in any given mainstream magazine or publication are so general that they are not helpful for anyone who is undergoing a hardcore experience of sorts. Yes, it is a good thing to bond with ones newborn, preemie or otherwise. But pat formulas and advice are not going to cut it for any infant or child who is under special circumstances.

There are, however, micro preemies who can be touched and handled early. Some very tiny, early ones, barely 2 lbs, multiple birth babies on some blogs are being touched and held, and they have a ways to go before release. Our neighbor who had a set of micro preemie twins were holding, patting, and bonding in that way (though not scheduling 3 visits a day) while the babies were very tiny, long before coming home.

I think some of these mags are intended for doctors/clinic offices. Though your readership seems to be comprised of educated, informed, involved parents in the preemie cause, when I have been in the level 3 PICU/NIcu units in several major cities, many of the tiny babies there have parents that can barely take care of themselves. Reading Neonatal Doc's site, among other NICU doctors' experiences, that seems to make up a bulk of parents who are preemie moms, and some simplistic advice in a colorful magazine that basically says "bond, show interest, be there" may be useful. Too many of those babies do not have parents even visiting often, much less touching and bonding with these babies that these parents/caregiver are going to be taking home and are going to be in their care.

I think the article is typical of general magazine fare.

twinsx2 said...

Several Items:

Eleanor-good to see you! I’ll email you later with my ID.

Cath:

Don’t be quick to judge who is there and who is not there. We went twice a day for over 100 days. I went in the morning and stayed until the early afternoon. Then Dh and I went at night between 10-12 pm. We saw a lot of parents then. Parents who went back to work to save their maternity leave, parents who had to wait until the other came home from 2nd shift to watch other kids at home. And, don’t forget the parents who have no one to help them and can’t come as much as they want. Plus there are some cultural differences that some times cause the parents to stay home. I saw that on several occasions. They parents are raised in a culture that doesn’t value parental input into medical decisions so they don’t come unless requested. Very few babies have no one.

Way too many people make judgments on the parents. Unless you have lived it, no one has any right to make any judgments. I do judge my friends harshly. They went to Florida to Disney World when their three triplets were in the NNICU. Other than that, I reserve judgment. And I was there a loooong time. I have the right.

The Preemie Experiment said...

I think the biggest problem that I am having with the article is that it is fueling the severe misconceptions about prematurity.

I am still unable to locate any research that shows it is beneficial to stroke your baby for 15 minutes, 3 x per day. Anyone find it yet? I have written to the author asking for her source but have not heard back from her.

Helen Harrison said...

Stacy,

I have seen research about massage for preemies, though I'm not sure I'm familiar with the precise one you are looking for. But, I wouldn't be surprised if it is one of the studies by psychologist Tiffany Field.

However, whatever benefit may come from massage in some cases has to be balanced by the harm that touch can unfortunately cause for many other preemies at various stages of their early care.

It is a question of intervening very carefully and individually with fragile babies. I don't think a recipe recommendation is a good idea given the many challenges these babies (and parents!) face.

I still haven't read the Parenting article. Since I got home from the latest trip East, I've been preoccupied with Ed's newest problem -- possible impetigo -- his second outbreak of skin infection since his surgery in June. I suspect it is all related to his infected surgical scar and the long course of antibiotic treatment that followed.

We're just back from seeing the MD, and are all hoping we're not dealing with a "superbug." Meanwhile, we're not doing a lot of "therapeutic touching" around here -- except for applications of mupirocin ointment and Purell.

Anonymous said...

I found problems with this artical as well and Lexie was a 34 weeker only in the nicu for 27 days. I could hold her and talk to her and touch her but not in the ways described in the artical and it did not feel like bonding. Lexie did not "like" being stroked as the artical described.
I think the artical would have been a lot better if the auther had put in that when the preemie is able to tolerate these things or after you and your preemie are home these are some suggestions that may haelp you bond with you baby. Or something along these lines
JoDee

Astrid said...

Thank you all for commenting. I'm learning from this blog everyday. As an adult preemie (born at 25-26 weeks in 1986), I don't know a lot about my own NICU experience. I guess I wasn't being touched much, because there are no pictures of anyone holding me. before I was nearly ready to come home. My parents were able to come to the NICU often.

As for bonding, I guess it'snot a one-sided issue, ie. the parent who is supposed to "bond with the child". Bonding is reciprocical, even if of course a baby doesn't know they're doing it. If for one reason or another a baby has a different response to stimuli (and preemies almost invariably have this), bonding is more difficult.

Cath Young said...

No judgements, twinsx2, not even in reserve. Any parents with children in the hospital for ANY reason are under tremendous stress. Believe me, having spent 2 years in a hospital with my middle one, I know. My husband who would have loved to have been with our son, could not. Like you, I have 5 kids, and we did not want to lose the house, insurance, etc.

Just saying that magazine pieces tend to be aimed to a very vague, general audience, not for specific cases. Why 3 times a day instead of 2 or 5 or 10? Who knows? Saw an article in same mag advising parents to read 3 books a day to toddlers, with no reason.

Hopefully, the mag which is widely distributed and read lets parents know that bonding by touch is being done in some cases with even preemies. There was a time when nearly ALL babies in NICU were hands off to parents. Heck, parents did not stay in the hospital with sick kids those days, and little was made of those policies. Now the pressure is the other way. Gotta be there, gotta be hands on, literally it seems.

Yes, there are preemies, even micropreemies that can be touched, massaged, held, but not all of them. That is the problem with this generalized mag articles. Just as they too often reassure that all preemies will "catch up", they give a lot of too general advice but this is not a problem isolated to preemies or Parenting Magazine. Magazines, in general, tend to do this. There should have been something in the article advising parents to discuss with their NICU whether their preemies can be touched, and if it would be beneficial to them; not blanket advice to "touch 3 times a day".

terri w/2 said...

'Just now read the article. It appears to be a last-minute kind of fluff piece. .like someone said - hey we haven't done anything regarding preemies in awhile, anyone got any ideas? And this little filler got written.

Agreed, it is very superficial and somewhat misleading.

Kathy said...

To be fair to the author, it's possible that she wrote 10,000 words that we would have appreciated, but an editor who had 4 column inches to fill asked an intern to hack it down to fit the slot. On the other hand, it's also possible that she's never met a preemie, but got an idea or an assignment and spent less than an hour doing research for this piece.

Since she's a professional writer on many topics, I really doubt that she's a mother of a preemie. It's possible that she's not a mother at all, just someone who gets some freelance writing work from parenting magazines.

Bec said...

I don't have a lot of time to comment tonight, but I wanted to say on the stroking thing, my daughter was born at 26w3d we were told NOT to stroke, not only because in her first few weeks her skin was so fragile it tore just doing the things that had to be done, but also because stroking causes over-stimulation, desating and bradys where on earth did this woman pull her suggestion to stroke a premmie 3 times a day?!?