Crying babies

[HyperSaurus, RN, BSN]

I've been trolling through a lot of the older threads here lately, just trying to soak up anything I can--Merenstein and Gardner is my friend.

Last night was my first night on my own (just doing feeder/growers right now). I have one infant who is a bit of an oddball--a bit 'neuro-y' as some other nurses have described her. When she's mad (and it's not hard to get her mad), she arches like crazy, some cortical thumbing has been noted, and she's really hard to console. She gets so frantic that she won't suck on her pacifier, instead she just continually roots. She doesn't nipple particularly well. She scooches herself out of her swaddle.

She sometimes calms with cuddles, tight swaddling, or being held in a 'centered' position (arms in, legs bunched up, upright against the chest), but not always.

It's hard not to get flustered with her (esp since I'm new and not particularly adept at methods of consoling or cuddling or even keeping that stream of soothing talk that other nurses do)

I'm not sure if I'm asking anything particular right now--is it normal to get flustered with a kid like that (I've seen references here to dreams of jumping out a window to escape screaming babies), or are there any good ideas to calm a baby?

[Bortaz, MSN, RN]

I've been known to ask for an assignment change after 3 or 4 days of a baby like yours. I don't think it's odd at all to be frustrated. A lot of times I just put them in the crib, swaddled tightly, and walk away to do something else. Just let her cry. Sometimes that's all you CAN do.

[zeus&lincoln]

The description you provided of that baby sounds like a lot of our NAS (drug w/d) babies on the unit. They do tend to be "extremely fussy." It sounds like you are doing all the "right" things. It is totally ok to be frustrated and I think the fact that you recognize it is awesome! I have no particular suggestions, I just wanted to see what other, way more experienced nurses had to say about this-- great post! :)

[NicuGal, MSN, RN]

Totally...sometimes you have to walk away...or pass screamin demon off to someone else!

[Bortaz, MSN, RN]

If all else fails, pinch them. :)

[PurpleLover]

If all else fails, pinch them. :)

Lmfaoooo

[NicuGal, MSN, RN]

And then pass them to the co-worker who has been sitting doing nothing all day lol. Poor babies...they do try your patience...

[HyperSaurus, RN, BSN]

I've had several ask me if she was a NAS baby. Nope, just an odd, crabby, duck.

[milkglass]

Withdrawal and neuro babies are tough no matter how long you've been there. I agree with the walking away and letting her cry at some points, and I agree with trading assignments (sometimes we do even after one shift). Otherwise it sounds like you're doing everything right!

Sometimes we use vibrating chairs, swings, and a fancy "swing" chair brand called a Mamaroo which as been a complete sanity saver for the withdrawal kids! Not sure if a neuro kid will like that stimulation, we haven't had any in a long while.

[Bortaz, MSN, RN]

I also have been successful using my iPod on my phone to play them some soothing music. Can't do that much now, because there's one particular heifer on my unit that will write you up for doing it, because she's convinced it's "the wrong kind of music" and non-therapeutic.

I hate my job sometimes.

[prmenrs, RN]

Even tho she's not supposed to be a NAS baby, she may be having pain somewhere. She may benefit from a physical exam, looking @ her ears, teething, gas pains; she doesn't like to eat. Does she have thrush?UTI? Would an empiric trial of a dose of Tylenol calm her down? Gas pains? How abt some Mylicon? Some docs hate Mylicon, but if you're desparate enough, you'll try anything.

Does the baby have a primary? Does he/she have tricks that help? Write them down. If your unit has cuddlers, use 'em. Sometimes, if they have digestive issues, a glove filled w/warm water, or a K-pad, wrap the glove in a diaper completely so if it leaks... Try to swaddle that against her tummy.

After a while, these babies become a puzzle you really want to solve. And when you do, it is sooo satisfying, even if it's only for a little while.

Staffing: a baby that requires more consoling, like this one, should be staffed accordingly. Her nurse should not be juggling 3 other kids, plus admits and discharge teaching and God knows what all if this child needs you to hold her 24/7. When Mom is there (I'm assuming she is) she needs support, too.

Best wishes!

[TiffyRN, BSN, PhD]

I was at my end with an NAS kid one night, a coworker rescued me by taking him from me swaddled, laid him against her chest with his ear up against her iPhone playing extremely softly playing lullabies, she had tucked her phone just under her scrub top to keep it in place & not touch the baby. She did this until the kid's breakthrough dose kicked in & I had gotten caught up. . . and was able to be therapeutic for him again.