Protection versus overprotection?

All children are precious, but when they arrive early and give you a real scare, I think you cling to them even more tightly. Sometimes your need to protect them is very real - if, for example, they are prone to lung infections following chronic lung disease, or have other medical issues which require them to avoid anyone likely to be infectious. KEMH recommended that I avoid taking Talia into shopping centres and other crowed places for the first few months, and that she not attend childcare for her first two years, as she had struggled to breath for so long and came home after 11 weeks of CPAP with O2 and another week just with oxygen via PBF. Fortunately for us, she has had no lung or chest problems since discharge, but I know other prems who are in and out of hospital every winter and come down with bronchiolitis as easily as some kids come down with a cold. So precautions are important, and despite what your family has to say on the subject, if you want your child kept away from Granny because she has a cold then your decision should be respected!

However, as the years pass and our little ones grow and amaze us that anyone so tiny could come so far, sometimes I wonder if we maintain that sense of vigilence for longer than we need to. A while ago, a friend told me of a colleague, a psychologist, who had done some research involving premature children. Her unofficial summary of his findings was “The kids were normal but the parents were not.” From what I remember her saying, he had not found evidence that premature birth lead to increased psychological problems - but he did feel that the parents of those ex-prems were much more anxious than parents of full term kids, and worried about their kids much more than parents of other kids he had studied. When I mentioned it to some other prem mums, they admitted they had noticed it themselves - for example, if their child had flu-like symptoms they would tend to panic and go directly to A&E rather than waiting to see a GP.

After that conversation, I decided I really needed to consciously try not to overprotect my prem. I am relaxed about the common cold and “normal” germs - and thankful for a child with a great immune system despite her unpromising start. After a year and a half, I started using childcare. But some things are harder. I read an article in a parenting magazine last year entitled “cottonwool kidlets”.

The level of protection your child needs will change as they grow older. Obviously very young children have no ability to determine danger so they rely on their parents to keep them safe, however the problem emerges when parents are unable to let go of their growing child and allow them to explore their own independence. Parents have to be careful about over-protecion because a child can pick up on separation anxiety and can also become anxious. And we know anxiety in early life can lead to anxiety and even depression in adulthood. Anxious children can become timid, shy and develop social phobias like a fear of meeting new people. This can be tough on them when they start school. Parents need to give children safe but effective opportunities to play and explore, and to learn to cope and self-soothe.

It all makes sense… but it’s not always easy from a parent’s perspective. My child is already much more timid than her peers and takes a long time to adjust to situations where there are crowds or she is separated from me. It might be just her personality and nothing to do with her prematurity, but either way I hope I can help her to grow more resilient, and to keep myself from becoming an over-anxious parent.

A new year’s resolution

2009 has been a very busy year for our family, and as a result I have not managed to keep up with everything that I planned to do… including updating this website. However, I’d like to keep it going, as I can clearly remember many lonely late night pumping sessions when I would sit at home, separated from my daughter, searching the internet for information about premature babies, and I would have loved to find something like this - a local site which would (hopefully!!) point me in the right direction to get the support and information I so desperately wanted.

So for 2010 I resolve to check all the links and add new information as I find it, and I hope it will help new parents as they take their first uncertain steps down the prem path.

Fun in the backyard sun

I found these suggestions in a magazine and they are too good not to share, because it’s a list of ideas about having fun in your own back yard - perfect for a germaphobe premmie parent trying to avoid crowds! Especially good if you still need to entertain a toddler at the same time.

Hanging around
Tie a balloon by a string from the washing line and hit it with the tube from a cling wrap box.  No toddler?  Babies will still love watching colourful washing or ribbons blowing in the breeze or listening to wind chimes.

Messy but delicious
Melt some chocolate and take turns dipping pieces of fruit.  If it’s just you and the baby, looks like you get to eat all of it.

Nature lovers
Make a list of things to see or collect - a leaf, a flower, a feather, a spiderweb - then go for a walk to find it all.  If you don’t have a budding collector, put your prem in a baby carrier or cover the pram and go for a walk around the block to admire your neighbours’ gardens.

Bubbles
Toddlers will love to chase and pop bubbles (or catch them on another bubble wand); babies will just love to watch them drifting around.

BYO Teddy Bear
Spread a blanket, take out something nice to eat and drink, and enjoy a mini-picnic at home or in a nearby park.  Breastfeed or have some tummy time in the shade, if your baby is happy to do so.

Wet wet wet
Have fun with spray bottles of water (spray feet rather than faces), or put some bath toys in a water table or bucket of water (and supervise very closely).

Grieving and coping after the premature birth of your baby

I just found an excellent article online here: http://www.preemie-l.org/ALEXIs21.html

This article really mirrors my own experience of worrying about my emotional responses to having a premature baby.  It has taken me a long time to figure out what was going on, and to move forward and feel that I was healing.   I wish I’d found this a long time ago!

Breastmilk, formula and mother guilt

I keep seeing this issue come up for premmie mums. You’ve expressed for your baby while they are in the NICU (and often longer) as much as you could, you’ve given breastfeeding your best shot, but at some point despite all your best efforts it just doesn’t work out, you can’t keep your milk flowing and it feels like the end of the world.

You are not alone in feeling this way.

First, if you’ve expressed milk for your child while they were in hospital, woken up in the middle of the night at home to attach yourself to a breastpump far away from the child you want to be holding, and endured all the dairy cow comparisons, you are a legend. You have given your child the most amazing gift, one which has made the awful hospital journey that much easier for them to negotiate. You’ve dealt with stress, grief, fear and everything else on the emotional roller coaster and still delivered the elixir of life. As time passes, I hope you will look back on this achievement, as I do, with considerable pride.

If you’ve managed to establish breastfeeding, you are a champion - and so is your prem! It’s not easy trying to suck when you’re on CPAP or have an NG tube in the way. You might have had a prem with a weak suck, or who needed the help of a nipple shield, or other assistance. It may have been a battle getting nurses to stop tube feeding or topping up while you’re trying to move to all suck feeds. It’s nothing like the pictures in the hospital of chubby full term babies instinctively suckling within hours of their birth. Yet your persistence has been rewarded by the amazing feeling of your child connecting with you in one of the most powerful maternal bonding experiences around. This moment may be fleeting but it is definitely one to treasure.

Then things go pear-shaped. Your baby isn’t gaining weight, the stresses and strains of the whole prem experience lead to supply issues, you just can’t bear to keep expressing after everything you’ve been through. Or maybe you expressed or breastfed for months and months after coming home - but you wanted to keep going for longer, and it just isn’t working out. You’ve searched the internet for every possible means to increase your milk supply, you’ve been on prescription drugs but even they don’t help, and despite everything the pro breastfeeding lobby says (and you consider yourself a pro breastfeeding mother) sometimes mothers don’t produce enough milk to keep both baby AND mother healthy. Because ultimately your mental health is just as important as your baby’s physical health - and sometimes this gets overlooked. I was on the verge of serious postnatal depression because I was so worried about Talia’s lack of growth and my inability to produce more milk for her, when I desperately wanted to keep breastfeeding.

Then comes the awful moment, the time you had always thought you could avoid - when you have to go and buy a tin of formula. For me this came when Talia was about 6 months old, 3 months corrected. Personally I found this step so horrible that I looked at tins many times, picked them up and read them but couldn’t put them in my trolley. My mother (who was hugely supportive of my breastfeeding goals, and very impressed with the resources available to help me, such as the Breastfeeding Centre etc) reminded me gently that I had gone onto formula at 6 weeks of age during the 1970s when breastfeeding levels were at an all time low and support for mothers to breastfeed was minimal - and I’d turned out OK, and no-one could tell whether I’d been breastfed or not.

Eventually it was my sensible GP (who is a mother herself and had done all she could to help me by giving me a 6 month prescription of motilium) who asked me to consider making the move, because she could see I was digging a big hole for myself psychologically, and didn’t think depression would benefit either Talia or me. She also reassured me that I had done an amazing job to breastfeed under the circumstances - and eventually I believed her. Still, the first day I offered formula I was still a mess of tears and disappointment. I hadn’t cared about getting a big pregnant belly, I didn’t feel guilt about her early arrival, but not being able to continue breastfeeding felt so much like failure.

I continued to breastfeed as well as formula feed for several months, but Talia found the bottle so much easier and eventually my supply which had never been plentiful dwindled beyond redemption. However, I gradually relaxed and was able to enjoy it without worrying so much about her weight gain.

Now I look back and things are much more in perspective - the joy of 20:20 hindsight. It’s true that no-one can tell which babies were breast fed and which were formula fed. It’s true that giving my daughter breastmilk while she was in hospital was the most critical thing, and that anything beyond that was a bonus. It’s true that I fed for longer than some mothers did, and for a shorter time than others, that I produced more milk than some but less than others - but it’s not about comparing yourself to other mothers. I know I did my best under the circumstances I faced, which is as much I could realistically ask of myself, and that’s all that matters now. The guilt has gone the way of my breastfeeding cleavage, and it is not missed at all - unlike the cleavage.