Need help/advice about getting a NICU graduate to sleep at home

Gompers, BSN, RN · Apr 13, 2005

It might be that your house is too quiet compared to the NICU. Many NICU babies have trouble sleeping at home, and we always tell parents to make sure a radio or TV is on at all times for the first few days. Doesn't have to be loud, just something in the background. Lullaby tapes don't work as well, it usually works best if it's the varied noises you get from TV/radio. They're used to hearing alarms, voices, and general commotion, so just go about your business after you put her down. No "be quiet the baby is sleeping" or tiptoeing around her. Seriously, it just might work.

Congrats on bringing your baby home!

luvbug · Apr 13, 2005

I have also heard the one about the noise, and another suggestion would be to have a fan on or something to make "white noise." That seemed to help with my daughter. Also, I had to have her sleep in her infant seat ( the one that goes in the car) for a few nights, then I put her in it and put IT in the crib for a few nights, then transitioned her to just the crib. Hang in there :)

Gompers, BSN, RN · Apr 14, 2005

Also, I had to have her sleep in her infant seat ( the one that goes in the car) for a few nights, then I put her in it and put IT in the crib for a few nights, then transitioned her to just the crib. Hang in there :)

That's a good point...many NICUs keep the babies' beds up on an angle all the way to discharge. So laying on a flat bed at home is going to be different for them, maybe a little harder to digest or might make reflux worse. I wouldn't recommend trying to tilt the baby's bed at home though. Just tough it out and within a week it should be fine.

Another thing I thought of has to do with feedings. When we nurses feed the babies, we tend to feed them more than parents feed them. We'll have parents say the baby isn't hungry anymore, and the baby is wide awake but just isn't opening her mouth for the bottle. Then yeah, the baby usually doesn't fall asleep if we put her down in that state. We nurses tend to really feed those kids, until they're basically falling asleep during burping and stuff. Then they're OUT when we put them down. Maybe that's part of it?

GOOD LUCK with your new baby!!!!!!!!!

Ami_J · Apr 14, 2005

I was a NICU baby, and my parents often tell me stories of when they had to take me home, I wouldn't sleep if it was quiet. What they did is played the radio and left the lights on at night. Because a NICU is anything but dark and quiet, tey would gradually turn down the radio each night and also had a dimmer on the light

LilPeanut, MSN, RN, NP · Apr 14, 2005

Me being the crunchy, attachment type, it's not abnormal for your child to want to be near you while they're sleeping. Have you considered cosleeping at all?

Even with cosleeping, I found my son did better with a low playing radio when he first got home, instead of the silence of our house.

prmenrs, RN · Apr 14, 2005

Try these CD's:

http://www.amazon.com/exec/obidos/tg/detail/-/B000981AU2/qid=1113438835/sr=1-2/ref=sr_1_2/102-2435050-2125740?v=glance&s=baby

There were only 2 used ones on Amazon, but try searching on Google. I always had good luck getting our 'crabbier' babies to sleep w/these. (Don't take that description wrong, they're babies who have been much sicker, and stayed in the NICU much longer than the average premie, so they have pretty good reasons to be unhappy.)

webblarsk · Apr 14, 2005

Me being the crunchy, attachment type, it's not abnormal for your child to want to be near you while they're sleeping. Have you considered cosleeping at all?
Even with cosleeping, I found my son did better with a low playing radio when he first got home, instead of the silence of our house.

Cosleeping? As in the same bed with the infant? Isn't that dangerous? Especially for a premie? Maybe its just me..........................Or maybe that isn't what cosleeping is....................:uhoh21:

LilPeanut, MSN, RN, NP · Apr 14, 2005

Yes, and it is not as dangerous as you think. If you are a non-smoker, not on any sedating drugs or alcohol, are not grossly obese and take proper precautions, there are studies to suggest that it can be safer than putting a child in a crib.

Precautions are basically to make your bed much like a crib, firm mattress, no pillows, only a light blanket. If you do not roll out of bed on a regular basis, then you are extremely unlikely to ever roll over on your child.

The developmental team that followed my son was very impressed on his head shape and chalked that largely to the fact that we coslept and nursed, so at each feeding, we'd roll over together. It kept him sleeping on his side, rotating and even better, when we slept, it would be face to face, and much like kangaroo care, my breathing helped to regulate his breathing, etc. I was able to pick up on hunger cues faster, and yet still get more sleep.

Another thing they've found is that cosleeping babies tend to wake up just slightly, then go back to sleep more than babies in cribs and one of the theories wrt to SIDS is that a child goes into too deep of a sleep state and then cannot rouse themselves out of it.

Keep in mind that many of the pushes to keep children in cribs come from crib manufacturers, who obviously have a vested interest in keeping children in cribs. In many countries, co-sleeping is the norm and they do not have higher rates of SIDS than the US.

Various reports over the last decade about cosleeping families have spiked research into the consequences of this worldwide behavior. While the actual research findings are not sensational enough to gain media publicity, the truth is now documented that room-sharing and cosleeping (with non-smoking parents) drastically reduce the incidence of SIDS [check-out Mothering's Sept/Oct. 2002 issue]. Beyond increasing infant survival, many believe that the gained physical cues and emotional security provide lasting mental and physical benefits.

http://www.icpa4kids.org/research/children/bonding.htm

http://www.lalecheleague.org/FAQ/cosleep.html

http://www.askdrsears.com/html/7/t071000.asp (this one has some good references to studies)

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12003443&dopt=Abstract This study specifically deals with establishing circadian rhythms in pre-term infants with cosleeping.

Burnt Out, ASN, RN · Apr 14, 2005

Thank you all for your suggestions!

We have been keeping the TV on in the living room and bedroom for the noise-her NICU nurses did tell us that she might not sleep without some noise like that. I also try to go about regular household things too-wash dishes, run dishwasher, do laundry-if we can.

I do encourage her to eat as much as she can stand-her daddy does too. After we burp her, we try to get her to take a little more. She takes anywhere from 1 oz-2 1/2 oz at each feeding (her ped told us that this is normal for a baby her size)-she usually is asleep when we burp her.

I have put her in the bed with us several times, but I am a heavy sleeper but I usually don't sleep as deep when she is there with us. I have been wondering if co-sleeping is safe with a preemie: we don't smoke but I am overweight and I am currently on antidepressants for post-partum depression so I have gone back and forth about co-sleeping. I have seen the sleepers you use with co-sleeping and have thought about ordering one to try and to help increase her safety while sleeping with us.

Any other words of wisdom?

BittyBabyGrower, MSN, RN · Apr 14, 2005

We do not advocate co-sleeping with preemies...a full termer usually has a bit more neck and head control and can move if their nose gets squoosed. Is your baby on a monitor? I might feel a bit better if they are on a monitor.

LilPeanut, MSN, RN, NP · Apr 14, 2005

It depends on whether your medication has a sedating effect. You should never cosleep with a baby if you are taking a medication that affects your alertness. Being slightly overweight isn't as much a risk, it's when you start getting lots of body with not as much awareness of what's going on around you. A cosleeper is a good idea if you are nervous, there are types that either work as sort of an "island" in the bed, or the sidecar arrangement. In the nearly 5 years I've coslept between 2 kids, I have never had a hand or arm or any other part of my body need to be moved off of any part of my child's face, by them or myself.