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12 Tips to Avoid the NICU

As much as I love working with my preemie babies, I think it is more important for YOU to learn how to help avoid us NICU providers.


Yes, premature births are on the rise. Working as a bedside Neonatal Nurse (and having worked in many hospitals across the Southern CA region) I can say first hand how prevalent this is becoming.


But this is not a time to fret! In fact, I think this is a time to EMPOWER you! More knowledge and education the better! I have a few things I can confidently say I have learned over the past 8 years in NICU Nurse practice that may help you along your way. I hope to give you some insight into how to help prevent a premature birth (or NICU admission) & provide some useful Tips in your own pregnancy!


Let's start from the beginning

A pregnancy normally lasts about 40 weeks. Important growth and development happen throughout pregnancy, especially in the final months and weeks.


Premature Birth

Preterm birth occurs for a variety of reasons. Most preterm births happen spontaneously, but some are due to early induction of labour or caesarean birth, whether for medical or non-medical reasons. (World Health Organization).


A premature birth is a birth that takes place more than three weeks before the baby's estimated due date. In other words, a premature birth is one that occurs before the start of the 37th week of pregnancy. Premature babies, especially those born very early, often have complicated medical problems.


Here are sub-categories of preterm birth, based on gestational age:


Problems that a baby born too early may have include:

Feeding difficulties


Preventing Premature Birth

Preventing preterm birth remains a challenge because there are many causes of preterm birth, and because causes may be complex and not always well understood. We don't know why this happens. However, there are some predetermining factors and important steps every pregnant women can take to help reduce their risk of preterm birth and improve their general health.


THEREFORE, I DO HAVE SOME TIPS THAT MIGHT HELP YOU BEFORE OR DURING YOUR PREGNANCY!


1. Get Healthy BEFORE your pregnancy

Although this may seem obvious many factors such as excess weight, blood pressure, diabetes, and overall physical well being are HUGE factors in a pregnancy and women's well being. Getting a handle on all of this prior to pregnancy is key!!


2. Prenatal Care Prior to trying to conceive, check in with your Doctor! A Pre Pregnancy Doctor Visit can help shed some light on changes you may need to do prior to pregnancy. Example: change in medication regimen, adding a vital supplement, decreasing your weight, managing blood pressure, controlling sugars (Diabetic Type I or II and then Gestational Diabetes).


3. Take a Prenatal Multivitamin.

One of the most essential ingredients being Folic Acid. Recommended dosage being 400 micrograms (mcg) of Folic Acid. Why is this so important? Folic Acid is an essential helps a developing the fetus brain and spinal cord. These develop within the first 10 weeks of conception, and often the time when you don't even realize you are pregnant! Taking a multivitamin prior to pregnancy can help prevent neural tube defects such as spina bifida, anencephaly, encephalocele, and other various issues.


4. Lifestyle Considerations

We are in a busy working population. Many women are focusing on their career where stress, lack of sleep, and long work days are priority. Our general population is waiting longer to have children. My suggestion, if you are planning on having children attempt to limit stress, plan ahead, and try to start your family with a healthy mind & within a good age range. Advanced maternal age (AMA) is now considered 35+. While women can have healthy pregnancies later in life, statistics start changing after 35 years of age.


5. Blood Pressure Management

High blood pressure is one of the greatest risk factors for a Premature birth. The increased pressure affects blood flow to the placenta and can limit blood supply to the growing fetus. (AKA essential nutrients, oxygen, eliminate waste etc). Women with gestational hypertension have high blood pressure that develops after 20 weeks of pregnancy. Many babies are delivered early due to Pre-Eclampsia. Preeclampsia is a serious condition of pregnancy, and can be particularly dangerous because many of the signs are silent while some symptoms resemble “normal” effects of pregnancy on your body. It characterized by high blood pressure and usually the presence of protein in the urine. Swelling, sudden weight gain, headaches and changes in vision are important symptoms; however, some women with rapidly advancing disease report few symptoms. My point, go into your pregnancy with knowledge and good management of your blood pressure.


6. Diabetes Management.

Type I, Type II, and Gestational diabetes. Diabetes is Diabetes! Sugar is Sugar. It's all about the sugars! Sugars affect a growing fetus in many ways. Babies exposed to high sugar levels can experience breathing difficulty due to less mature lungs, high red blood cell count (polycythemia), high bilirubin level (newborn jaundice) increased risk for birth defects and even stillbirth. It also increases the risk for birth defects, including problems with the formation of the heart, brain, spinal cord, urinary tract, and gastrointestinal system. (Stanford Children's Hospital) In addition, they may grow excessively (Macrosomia) causing a birth injury or "traumatic birth" and then develop dangerously low sugar levels after birth (hypoglycemia). How does this happen? After delivery they are no longer supplied with the sugars provided by the mother, therefore the baby continues to have a high insulin level, but it no longer has the high level of glucose from its mother, resulting in the newborn's blood glucose level becoming very low. Sugar (Glucose) is one of the essential parts of a rapidly growing brain, if the levels drop too low after birth it may cause brain damage. (Hence NICU care and management). VISIT THE PRENATAL NUTRITIONIST FOR SOME GREAT TIPS!

7. Quit Smoking & Bad Habits

For help quitting, see  How to Quit Smoking & Avoid alcohol and drugs. Most likely if you are reading this, it wouldn't be an issue, but in case it is please seek medical advice to help.

8. Healthy Mindset!!!!

I can not begin to express this one enough. One of the best things you can do for your baby is develop a healthy mindset. What do I mean? Limit stress as much as possible. If you struggle with anxiety or depression seek attention prior to pregnancy and make sure you have a good support system after delivery as well. A healthy mind set will truly help your baby in every way. From hormones & chemical imbalances to a healthy lifestyle this can truly help you and your baby. If you are a mother with a "High Risk Delivery" head over to check out this awesome book!! Pregnancy Brain: A Mind-Body Approach to Stress Management During a High-Risk Pregnancy. By: Parijat Deshpande (Author)


8. Educate Yourself. Warning Signs of Preterm Labor

Any woman can have Preterm labor. Preterm labor is labor that occurs before 37 completed weeks of pregnancy. Seek medical attention for ANY warning signs or symptoms of preterm labor. Contractions that made your belly tighten every 10 minutes or more often, change in color of your vaginal discharge or bleeding, fluid leak, low dull back ache, cramps that feel like your period, belly cramps with or without diarrhea. (See video below)



9. Communicate with Your Healthcare Provider.

Regular check ups and checking in with your provider is key to a successful, happy, healthy pregnancy. Communicate openly about your current health status, family history (any history of preterm births in your family), and develop a rapport with your provider. Tip: When you think of a question, make a note of it in your phone to ask your provider at your visit.


10. Relax & Enjoy your Pregnancy

As stated earlier, we live in a fast paced, high stress world. Stress can put a negative affect on you and your baby. Listen to your body! Get to know your body. Getting off your feet may be necessary during this time. If you need to put your feet up and take a load off be mindful of that.


11. MOST IMPORTANTLY! Do Your Research.

No one plans to have a Premature baby. But it does happen! And in my opinion, knowledge is power. Speak to your healthcare professional about your hospitals facilities and make a general plan IF you were to deliver early.


WHAT WOULD HAPPEN IF...SOMETHING WERE TO HAPPEN?

So many Moms & Dads admit to our NICU with NO knowledge of what to expect or what resources are available to them. If you are planning to travel while pregnant, do a little research about the hospitals near your destination. What would happen if you did go into preterm labor, what hospital would you go to, how far along are you, what would you expect for your baby at that gestation? I have personally cared for many babies whose parents were traveling out of state (and out of the country for that matter). And life plans changed when baby decided to come early! All I am saying, plan ahead. Educate yourself/s. If you are seeking some NICU insight check out my blog on all things NICU!.

11. Ethnic & Race Consideration

We are not clear the reasons for premature births but some races, ethnicities, & various populations / regions are at higher risk for a Premature Birth. In general Black & Hispanic races are more prone to premature birth. Whether it is accessibility to healthcare, lifestyle, genetic components, or mistrust in the healthcare system, these populations are higher risk and statistically have a higher rate in premature birth. However, preterm birth is truly a global problem. In the lower-income countries, on average, 12% of babies are born too early compared with 9% in higher-income countries. Within countries, poorer families are at higher risk. The United States is one of the Top 10 Counties for Premature


I truly hope you found this information helpful! I am in hopes that this brought you helpful tips and useful information about Preterm Birth. I understand this topic can be "Taboo" and "Off-Putting" however, after my years of experience at the bedside and working with families with premature babies, I felt this post needed to happen! Knowledge is power! My hope is to bring awareness and while I love caring for my NICU babies, hopefully see a few less premature babies along the way!



Rescources & Sited information for Preterm Birth Information



Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, Sponsored Capella University MSN student, a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

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