I am super excited to introduce you to, two amazing child life specialists and fellow bloggers, Caroline and Sydney at Connecting With Compassion. They wanted to share their tips and experience in working with families and preemies in the NICU.
We are Connecting with Compassion! My name is Sydney, and I am currently learning the ropes as a first year child life specialist at a hospital in Idaho, And I’m Caroline! I am currently working towards my master of public and healthcare administration as well as teaching preschool part time. We are both Certified Child Life Specialists, graduates from Georgia Southern University with degrees in child and family development and emphasis in child life. Our passion, as well as our blog, is all about child life (and much more!)!
One of the newest areas that Child Life Specialists are appearing is the Neonatal Intensive Care Unit better known as the NICU for our littlest patients. We get questions all the time about what Child Life services can be offered in the NICU. We were both lucky in our internships to have a rotation in the NICU and learned a lot!
Here are just SOME of the Child Life interventions a CLS can provide in the NICU:
Positive touch: Negative touch is anything painful, uncomfortable or invasive. CLS can use positive touch, but also encourage bonding by teaching and modeling to parents how to perform positive touch. Newborns in the NICU need constant and firm, yet gentle touch. Stroking, patting or rubbing can be overstimulating to preemies. Some more examples of positive touch are: containment with the tucking of an infant’s feet to promote a womb like atmosphere, letting a baby grasp your finger in their hand, and motionless touch.
Eye exams: An eye exam is one of the most invasive tests a premature baby endures during their NICU stay. Research by NIDCAP says that support during a NICU eye exam can cause lower stress responses. There are a few different holding positions that promote positive coping for these infants.
Procedural support: CLSs can provide procedural support during IV starts, heel-sticks, circumcisions, PICC lines, umbilical lines, lumbar punctures, eye exams, etc. CLSs can utilize a sucrose solution (brand name: TootSweet, or SweetEase) to promote non nutritive sucking with a pacifier, finger or just drops of the solution. Positive touch also can act as procedural support. It’s important to remember that for infants events such as diaper changing can be just as stressful and considered a procedure needing support. Teach and model for your nurses so you know they are supporting the infants! Some other tips are: using swaddling to promote containment of the infant and in bright rooms shielding the infants eyes.
Developmental play: CLSs can offer developmental play sessions focusing on tummy time, trunk support, reading to baby, grasping a rattle or toy, introducing a mobile when appropriate, tracking with eyes, mirror exploration, etc.
Sibling support: CLSs can offer one-on-one sessions, medical play, preparation to see NICU sibling, sibling support groups, book, and Skype/Facetime sessions during restricted visiting seasons.
Sydney recently started a NICU sibling support group at her hospital called “What about Me.” She starts each session with reading “No Bigger than my Teddy Bear.” Then each child draws a picture of their family (some children do not draw their new baby because they have not made the connection that the baby is a part of the family, and this also helps discover each child’s family structure). Then she utilizes a baby doll and real medical equipment to promote mastery of the NICU experience, answer any questions that the children may have, correct any misconceptions, and then facilitates a therapeutic art project such as big brother/sister shirts, decorating picture frames so their baby can see a picture of their sibling(s), and many more.
One additional intervention is more in depth sibling teaching. Often times we have siblings of long-term stay babies come in for multiple teaching sessions as their baby sibling’s treatment plans changed, new surgeries, or change in prognosis. These sessions include hands-on developmentally appropriate activities and materials, medical play, and games such as Therapeutic Uno to evaluate siblings’ understanding.
Family support: Having a child in the NICU can be very taxing on the parents or guardians. No new parent expected a child to be born early, or sick; they often expected a perfectly healthy baby. They have to adjust to a new normal. Be care of your personal judgements when parents seem absent. Some families live several hours from the hospital, some have other children at home, and some can’t extend their maternity leave to stay in the NICU. And honestly, there are some parents who are even afraid and intimidated by the hospital environment. CLSs can encourage self-care techniques, making sure they take breaks from the NICU world and they know it is okay for them to take these breaks. Prove to be a safe and supportive person in the hospital for them to vent to or just have a nice chat.
CLSs can also facilitate a parental support group for these parents.
Sydney once noticed that a NICU mom seemed bored, Sydney offered some arts and crafts to her, the mom had a blast painting a keepsake box and a canvas that afternoon, she mentioned it to everyone she saw and was so grateful that someone was thinking about her and not just the baby.
Child Development Knowledge: CLSs are experts in child development. Using developmental theorists like Erikson and Piaget, they are able to identify behavioral cues, modifications needed in the environment (sound, lights, etc.), and developmentally appropriate care for each infant based on gestational age. (Did you know that a hiccup or a sneeze can mean that these infants are stressed out?)
Working with other Therapies: Working with Occupational therapists, physical therapists, speech therapists and social workers to create a comprehensive patient care plan.
Bereavement: Unfortunately some of this population is born too early or too sick and dies. Utilizing books such as “We Were Gonna Have a Baby, but We Had an Angel Instead” as well as therapeutic activities for siblings, can help to create memories for the family during their small amount of time with their baby. Creating molds and footprints to promote legacy building, and utilizing companies such as Now I Lay Me Down to Sleep to take pictures of these tiny friends are great memory making tools for these families. Some parents will prefer to leave the siblings out of the situation thinking that it may be too hard for them to cope. This is when your child development expertise comes into play. You must advocate for the siblings! You know it can benefit their coping if they are involved and given a “job” during and the days following the death.
Other: Car Seat Education (requires a certification), Infant Massage Instructor (requires a certification), Community outreach, Scrapbooking clubs, etc.
Do you work in the NICU? What are some of your day to day responsibilities? What would you like to see Child Life Doing?
To Learn more about Caroline and Sydney follow their blog at ConnectWithChildLife.BlogSpot.com
Don’t forget to check out Shani’s post on our blog too! It’s all about the importance of volunteering.