NICU essentials

Having a baby in the NICU was something we were not at all prepared for. I’ve been approached by friends with loved ones in similar situations and asked if there were any items I found useful while Harper was in the hospital. I rounded up the things I thought were helpful to serve as a reference. Having a baby in the NICU is tough, but having these things can at least make you feel a bit more comfortable during this time.

NICU top ten essentials must haves

1. It was several weeks before Harper was able to start breastfeeding, and even then she didn’t take much milk. The first thing I did after being discharged from the hospital (besides going to see my baby girl) was rent a hospital grade pump. It was recommended by my lactation consultant to establish and keep up my supply while exclusively pumping. I used a Medela Symphony. They had some available for use at the hospital, but I needed one to keep at home as well. I already owned a Medela Pump in Style, which I kept in Harper’s cubicle at the hospital to make pumping a little more convenient (that way I didn’t need to worry if all the hospital pumps were in use). The hospital where I delivered and the NICU both supplied me with extra pump accessories. This is so important because it cuts back on how many times you have to wash and sterilize the pump parts.

2. Since I was hooking myself up to my pump every few hours, making it as easy as possible was imperative (for my sanity). By using this Easy Expressions bustier, I was able to use my hands to surf the web, check my social media, read, write thank yous, etc. Being able to do something to pass the time made pumping *slightly* more palatable. By the way, I got mine in white so I could bleach the milk stains out of it.

3. Harper didn’t start bottle feeding until about the last week she was there, and the NICU provided her first bottle. However, they recommended Dr. Brown’s bottles with a preemie flow nipple. Preemies are more prone to reflux, and Dr. Brown’s bottles are good for reducing that as much as possible. We had used Avent bottles with Noah (and use them now with Harper), but in the beginning, the Dr. Browns bottle were great. Even if you plan on exclusively feeding your baby breastmilk, you will still need to fortify some of the breastmilk with formula and give it by bottle.

4. A cooler bag with an ice pack is a must-have for transporting breastmilk from home to the hospital. The NICU provided a decent-sized Medela one, but having a cute one makes it a little more enjoyable, plus it can double as a lunchbag or daycare bottle bag later. As far as milk storage goes, the NICU provided me with small plastic bottles called snappies to store my milk in, along with labels to record the date and time. Preemies don’t need much milk compared to what you are pumping, so make use of the NICU’s freezer to store it. I ended up donating quite a bit of mine to Mother’s Milk Bank since there was no way Harper could use it all before it expired.

5. Sterilizing pump parts is a must. I quickly learned how important being sanitary was to protect a vulnerable preemie from germs and sickness. I washed and sterilized my pump parts after every use. At home I used my Avent microwave steam sterilizer (super easy to use), but when on the go I used a Medela microwave steam bag. The NICU provided a couple of the Medela bags, and they are reusable up to 20 times.

6. I checked out several books about preemies from my local library, and found The Preemie Primer to be the most helpful one. The author, Jennifer Gunter, is an OB-GYN who delivered her triplets at 22 and 26 weeks, and gives a lot of insight to the healthcare system and explains a lot about the health and development of a preemie.

7. Between the frequent pumping, practicing nursing, and the kangaroo care, being comfortable is a must. These Basic Stella nursing bras are so comfy, and easy to slip on and off for pumping. These Be Maternity camisoles from Target were awesome for kangaroo care. I would actually lay Harper on my chest and then pull the camisole over her to keep her warm and snug. As an added bonus, they are really smooth to the touch, which made infant massage a lot easier during her developmental therapy sessions.. I had three from my maternity wardrobe, and always kept one at the hospital.

8. A journal or notebook was handy to have. I kept a daily log of Harper’s progress, including weight gain and other milestones. I also used it to jot down other thoughts and record her birth story while it was still fresh in my memory.

9. It was awhile before Harper could wear preemie clothing. They had little kimono style jackets they would put on her. This was due in part to her small size and also because she had to have a stable temperature before she could wear clothes. The NICU had a lot of preemie outfits, but I also brought a few from home because I was excited to dress my little girl. Ideally the clothing should have snaps and open feet to accommodate all the leads and the pulse-ox on baby’s foot. I also didn’t like slipping anything over her head because we had to remove her oxygen cannula each time. Hats help keep baby warm (plus they’re super cute). Toward the end of Harper’s stay they started using sleep sacks instead of all the NICU bedding. I got Harper a preemie sized Halo swaddle sleep sack to use at home. Swaddling helps give preemies containment that makes them feel safe, and keeps their limbs in a more flexed position at midline, like they would have been in utero.

10. Staying hydrated is a must when nursing, and the NICU only allowed closed/covered drink containers. They also had an ice and water machine, which I made good use of, but I would take my favorite cocktail of ginger ale and cranberry juice in an insulated tumbler.

I’ll discuss some other points worth considering as well. Before you can bring baby home, you will need to have an appropriate car seat. If your baby is very small, you may need to buy one with a very small weight limit. We already had a Graco Snugride 35 car seat that we used for Noah (accommodating 5-35lbs). Fortunately Harper fit in it just fine and passed her car seat challenge (90 minutes in the car seat with stable oxygen and heart rate)  – she was about 6.5 lbs when she came home, but they send babies home much smaller than that. For extremely little babies you may need to get a special car bed.

If your baby is born during flu season, be sure to inquire about Synagis shots to protect against RSV. They may be covered by insurance depending on birthweight and other risk factors. Also ask your hospital social worker about Supplemental Security Income (SSI). This is a government program that provides assistance to some at risk babies. They will send you a monthly check while your baby is in the hospital, but the biggest benefit is that if your baby qualifies for SSI, then he/she may also get Medicaid benefits, depending on what state you’re in (which can help reduce costs tremendously even if you have private insurance). Also ask your social worker if your baby qualifies for the Early Intervention program. This is a free program for at risk babies through age three which will provide access to occupational therapists, physical/developmental therapists, and other professionals.

Other practical points to consider: having meals prepared for you, childcare (if there are older siblings) while you are at the hospital, professional house cleaning service, car detailing service, are all extremely helpful. Gift cards to restaurants nearby the hospital also came in handy. Don’t be afraid to accept help when people offer, as difficult as it may be to swallow your pride.

If you are going to have a lengthy stay, some pictures or simple decorations around the baby’s cubicle can add a personal touch and make it feel less sterile. Our nurses did a great job of making cute little signs with Harper’s handprints and footprints. I also kept a few granola bars in my bag along with my wallet, because you never know when you will become ravenously hungry or if you may need to stay at the hospital longer than anticipated. Usually a snack would get me by, but I ate my fair share of meals in the cafeteria there as well.

I hope this is useful advice for anyone going through a NICU experience or who has a loved one in that situation. Please don’t hesitate to comment or contact me if you have any other questions! I’m working on another post to share the most helpful items we had in the early days at home with Harper.

* Update: You can find my Preemie essentials post here.

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