27Feb

10 Life Lessons from the NICU

By Sue Ludwig

If you’ve never stepped foot in a neonatal intensive care unit (NICU), you might be tempted to think it’s a bustling place filled with baby noises like fussing, crying, and cooing.

You’d be wrong.

Mostly the babies are quiet. There are monitors, pagers, and ventilators beeping. Phones ringing. Staff and parents talking. But a noticeable lack of fussing coming from the babies. It’s hard to cry loud with small lungs.

So how is it that these fragile, nonverbal, babies have so much to teach me?

Well, like any of us, I learn in direct proportion to how much I pay attention. And by how much I intentionally engage in my work versus just going through the motions.

When you pay attention, these babies speak volumes.

Here are 10 lessons I’ve learned from the babies in the NICU:

1. Being born early does not mean less human, less valuable, less worthy – ONLY less prepared.

Pregnancies are full term by 37 – 40 weeks. So when a mother has her baby at 25 weeks gestation, no matter what I tell her, she often feels shame that her baby is still “in the process” of developing.

Well, who isn’t?

A few years ago I was writing up research for publication. I thought I was a decent writer. After spending countless hours writing this paper, my mentor came back and basically told me to start over.

I sobbed on the spot from exhaustion and the shame of feeling inadequate for this work. I was ashamed to still be developing as a writer.

Here’s the thing. We’re always in process! We are each starting over and over again in an endless cycle of learning and development.  No guilt, no blame, no shame. (Especially when you’ve done all you can to bring your baby safely into the world!)

2. We each communicate differently.

It’s easy to judge another person when she communicates differently, slower, or in a different dialect than you.

The babies have taught me to listen first, assume nothing, and leave judging for the Olympics. And more importantly – that I am responsible for half of every interaction with someone. So if I am busy thinking about what the other person should be doing or saying, I am likely not present for my end of the communication.

3. Small and feisty goes a long way!

If you’v ever been to an NICU you’ve seen this one in action!

4. Environment Matters.

Loud noises are stressful. The babies respond to this stress by being startled frequently, spending less time in a deep sleep, and having changes in their heart rate and other vital signs.

What about your environment?

When you walk into the door to your home, do your surroundings add to your stress or decrease it? Is it cluttered, do you have space, do you have freedom to move? Are the sounds pleasant, or are they just noise?

The environments we create for ourselves directly affect our mood, our productivity, and our well-being. The babies have taught me that we thrive in an environment that serves us.

5. Connection heals.

There’s nothing better for a baby than loving connection with her mother and family.

Recently a mother in our NICU held her tiny baby on her chest. The baby was still on a ventilator. This is known as “Kangaroo Care” or “skin to skin” holding.  This mother, like so many before her, said that this was the only activity that truly allowed her to feel like a mother since her baby was usually in an incubator. Babies breathe and sleep on their mothers amazingly well even in this fragile state.

We are meant to be in connection with others.

Separation from that connection leaves us more vulnerable and less likely to maintain health. When our connections are loving and consistent, we thrive. Often when we feel vulnerable, angry or sick it’s because we’ve stepped away from the connections that heal us.

6. Eating Should Be Enjoyable!

In the NICU we’re obviously concerned with how much weight babies are gaining. In our quest for improving weight gain, we often overlook the significance of the actual experience the baby has while eating.

We pay too little attention to the fact that feeding is a bonding experience – social and nurturing. But we know that many premature babies nationwide have issues with feeding long after they’ve left the NICU. I believe that part of the problem is that hospitals often view feeding more like a medical intervention than a nurturing experience.

We should enjoy eating! But we often forget it’s a nurturing experience for our bodies and feed only our emotions or are completely distracted while we eat, giving no attention to the experience or the food.

Babies have taught me that eating should not be automatic. It should be intentional and engaging.

7. Tenacity is an inside job.

About a decade ago a boy in our unit was born weighing just about a pound. He had significant lung disease months later when he was discharged home. Now, at age 9 he is the fastest boy on his soccer team.

Who’d have thunk?

He taught me that tenacity isn’t definable at the surface. It’s something deeper, more elusive than brawn and background. It comes from inside. You know you are stronger than anyone would guess. Even when you weigh just a single pound!

When I reflect on that boy’s strength I think, “Who am I to think I can’t achieve something?”

8. Comfort and sleep are crucial to healing.

This is true for both mothers and babies. Mothers of babies in the NICU are often torn between taking care of themselves and being in the NICU with their baby. Moms need to sleep, rest, and take some breaks from being in the NICU in order to recover and take care of their babies.

Babies in the NICU are doing very important work when asleep. Factors influencing growth and crucial brain development happen when they are sleeping. Protecting sleep is imperative (for all of us!).

9. There are times for fighting and times for letting go.

For a premature or sick baby, most days are about fighting and growing.  They are about one more hurdle, one less tube, one more step toward home. And most babies win that fight.

At other times, when all that medicine and love have to offer is not changing the tide, the nurses and doctors do the impossible job of helping a family lovingly let go.

On the letting go days, I know only to go home and hug my own children in humble gratitude. Loss is a powerful instructor. Life is precious, yes.  And the babies teach me that it is hard to comprehend the gravity of that truth until we are asked to let it slip away.

10. Fragility and strength are not necessarily opposites.

If you look around the NICU and witness these tiny babies defying what seems reasonable for such a small person, you observe that fragility is often just strength’s first teacher.

I have rarely witnessed a population of patients that inspire such loyalty in their caregivers. Across the country I’ve noted that the NICU team appears, in my experience, to love this work.

Maybe because we have the best teachers.

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