Pregnancy complications - possible preemie to prepare for!
November 17, 2015 11:10 AM   Subscribe

I am 25 weeks pregnant, and was just admitted to the hospital with an incompetent cervix (IC). My condition is stable, but this is a stressful time for us and I'm looking for some help on how to prepare for what could be my new, preemie, very tiny, baby son. Thank you!

We're attempting to keep Little Everyday inside for as long as 34 weeks. The doctors are optimistic as everything seems stable and I've been put on complete bed rest until he arrives - in the hospital for at least until 28 weeks.

I had just managed to get a (somewhat tenuous!) grasp on the basic baby checklist/ registry items I'd be needing for a newborn, but now with a possible preemie on the way I'm a lot more stressed out. Google is failing me for comprehensive preemie prep lists, so I thought the best way to get a handle on things would be to perhaps solicit first-hand information.

1. I had picked out the Britax B-Safe Travel system for a newborn, and am relieved to see that it (usually) fits preemies. Has anyone had experience with it for preemies? I haven't ordered the newborn insert yet, but it looks like I'd need it.

2. Are there cannot-do-without items that preemies might need? I'm assuming a preemie with no complications (fingers crossed) but any anecdotal cautionary measures are absolutely appreciated.

3. I've used Lucie's List as the basis for building my registry, are there any other recommendations? I've signed up for Amazon Mom, and am also registered at Babies R Us and Amazon.

4. My biggest source of uncertainty is quantities of what to get. Let's say I need preemie diapers for a 34 weeks old, 4+ baby. Is a box of preemie diapers enough? How many newborn and size 1 diapers should I stock up on? Amazon Prime will be useful in those situations where I need things ASAP, but somehow there seems to be a lot of comfort in being prepared.

5. I realize babies have very basic needs and do not plan on going overboard. If there's anything I've overlooked that would give my baby a safe, comfortable, loving start... please let me know. It's hard being in here and feeling like I might be failing this little life but I'm going to do my best to ensure he has the best chance at surviving.

6. Has anyone had experience with an incompetent cervix? Mine is a terrifying 6 mm (should be >25 mm). I'm on progesterone shots and bed rest, and have had no contractions or pains. I was admitted on a routine ultrasound that caught the issue, and have no other complications. I'm expected to stay in here for another month or so, and if I go home I'll be on complete bed rest until he gets here. My scientist brain wouldn't stop me from reading available literature so I realize IC management is a crapshoot and unique to each mom... but personal experiences are always so helpful.

I'm sorry if this post seems scatterbrained and devoid of emotion. Focusing on how to get ready for the baby helps keep me from losing my marbles and thinking of the absolute horrors of this situation - I'm just so glad it was caught in time.

Thank you as always, Mefites, for your help!
posted by Everydayville to Health & Fitness (34 answers total) 1 user marked this as a favorite
First, overall, don't worry too much about preparing material goods. I totally understand your desire to, but really, with Amazon Prime especially, pretty much everything is obtainable within a day. Really. Really. And I know you're bored on bed rest too. But really, don't buy stuff.

1. Your carseat sounds fine. If he is a preemie, you'll be instructed to either use yours or perhaps you have to get a different one. You can order it 1 day on Amazon. Don't buy it now. Actually, with regard to car seats, don't buy too early. I bought a bigger car seat early because I thought that it was a good deal. By the time my kid was old enough to use it, it was nearly expired. D'oh!
2. Don't worry about this until you actually (maybe) have a preemie and then do exactly what the NICU nurses tell you to do. Buying stuff now won't matter, especially if it isn't certain that he will be a preemie.
3. Honestly, and I know this is hard to hear, you don't need much and most of the stuff you can get used VERY easily. Babies use stuff for like a month, maybe 2 or 3. So there are dozens of like-new swings and bouncers and jumperoos on your local Craigslist RIGHT NOW. So start scrolling through Craigslist to get a good idea of what the prices are. For clothing, find a friend or 3 with a slightly older child and be on their hand-me-down train. I look back at the amount of money I spent on new clothes and toys and books and I am so mad at myself because I could really use that money NOW to pay for childcare (my kid is 7). So many toys and clothes went unused.
4. This is especially true for diapers. You can get diapers that day - you can also buy them at a regular store. And you don't know if Baby Everydayville might be a heavy pee-er or prefer Hugs to Pampers or something. So have 1 pack of newborn diapers, 1 pack of size 1 and order as you go along. Don't stock up.
5. Swaddle blankets are good. The SwaddleMe brand is good. They're like $9-12 on Amazon. I liked the Gerber brand onesies and Carters brand pants. Old Navy has lots of cool not-cutesie stuff. A bouncy seat is a good idea. There is a Fisher Price one that I see recommended on AskMe often that wasn't around when my son was a baby.

But again, really, I know that shopping fills the time and makes you feel prepared, but I promise you that stocking up isn't that helpful when you don't know exactly what sizes your baby will be at particular seasons, when there is so much high quality used stuff out there, and your baby may be particular about what he wants.

I'd focus on doing things that you'd like to get done and can do in bed - like organizing old digital photos, digitizing photos or videos, purging old books or CDs that you don't need. Read books that you won't have time for later. Maybe do some projects FOR the baby like knitting a hat, making an iron-on transfer on a onesie.
posted by k8t at 11:30 AM on November 17, 2015 [23 favorites]

First, you have all my best wishes.

Regarding necessities once you get your baby home, my personal experience was that things just needed to be smaller. Continue planning as you have been. Don't stock up on diapers to heavily. Buy diapers as you need them and wait to open them so they can be returned for the next size after a seemingly overnight growth spurt. The items I needed the most of were cloth diapers for spit-rags and flannel/receiving blankets for swaddling, propping, and all the other helpful uses they have.

My 32-week preemie son came home at 4 lbs, 2 oz, nearly a month before his official due date. We were lucky to be unencumbered by oxygen or monitoring machines. He was in all respects a perfectly normal baby, just very small.

I have no experience with incompetent cervix, I had to deal with pre-eclampsia. However, it was detected early, similar to your experience, and the steroid shots to mature little lungs are what I am most grateful for.

Good luck.
posted by Talia Devane at 11:36 AM on November 17, 2015 [2 favorites]

Regarding preemie prep, some things to think about that are not material goods:
- Is your local hospital with a NICU close to your home? If it is not, do you have a plan for temporarily residing near the NICU hospital? When my son was in the NICU, it was a ~12 minute drive to the hospital, which made things very easy.
- What is your plan for taking time off work while baby is in NICU? What's your employer's policy regarding this sort of thing?
- What was your original plan for going back to work and how can you possibly adjust it?
- What was your original plan for childcare and might it need to be adjusted if the preemie needs special care?
- What is your health insurance coverage for a preemie like?
posted by k8t at 11:40 AM on November 17, 2015 [3 favorites]

Do you have meals, helpers, cleaners, etc. for after baby?
Do you have company for in the hospital now?
Do you have a craft itch that needs to be scratched? (I'd be all about crocheting a baby blanket right now, infused with good thoughts and wishes for baby everyday.)

I realize none of those are specific to your situation (and I wish you nothing but the best!), but those are concrete things you can focus on without spending oodles of money.
posted by Ms Vegetable at 11:41 AM on November 17, 2015

I'd get some really top of the line swaddling blankets. I've heard that premies can benefit from swaddling even more than full-term newborns. The blankets with velcro are really great but if your baby is extra small the velcro might not be in the right place. Something like the miracle blanket would make swaddling easier but be more flexible for smaller babies.
posted by bq at 11:46 AM on November 17, 2015 [1 favorite]

Deep breath! That your IC has been identified and you are getting the needed care is a huge plus...I know it doesn't feel like it, but many women don't know until the baby is already coming RIGHT NOW, and that means less opportunity to optimise things for you wee one. But to your questions...

Based on my experience with a Britax infant seat that was rated down to 4lb, I'd say its a good choice (my DD was a tiny term baby, and it fit her well. Britax seats are generally regarded as good for wee ones). Your hospital or the NICU you might deal with may very well have loaner 'car beds' (Angel ride is one brand which can be used for smaller babies who are safe to go home but who don't do well in a regular baby seat quite yet. Folks don't typically 'buy these' as they are used for such a short time, so loaners are the way to go. They will very likely do a 'car seat challenge' to make sure any preemies tolerate the car seat/reclined position well before they are cleared to go home. So, don't panic the car seat question :-)

As for preemie diapers, seriously, don't sweat them...Don't buy ridiculous quantities as your needs/preferences may change. Some babies outgrow newborn ones quickly, and some babies are in N size for months (ask me how I know this...). You may also find one brand doesn't agree with you babies tush. If you do need preemie diapers, I recommend the Pampers Swaddler P size. (they also make an XS (teeny preemie) size, but its hard to find for sale outside of hospitals because they are typically still in the NICU at that size).

If you can order from the UK, Mothercare has preemie 'starter' these sets in sizes down to 'teeny'. Carters and Babies R Us typically have some preemie clothes if you need them. Online is sometimes your best friend, but be assured if you peanut comes early, the NICU will have things for them to wear once they are at the 'wearing stuff' stage, which isn't right away. If nesting makes you happy, maybe pick out a 'coming home' outfit in 'preemie' (5lb) or small term (7lb ish) size, so you will have this on hand. Many babies don't come home till close to a small newborn weight, so its a safe choice.

Do ask for a tour of the NICU/facilities if you know where you are likely to deliver, if its possible in a wheelchair. Usually they have someone who can help arrange this and explain the NICU to you when you are not just post delivery. If you are planning on nursing, see what your insurance will cover for a pump, but don't run out an buy one....the hospital can usually help you get set up with loaners and pumping for preemies can require more 'clean' practice than for term babies.

Good luck and enjoy your (hopefully not born quite yet) peanut.
posted by Northbysomewhatcrazy at 11:51 AM on November 17, 2015 [3 favorites]

I'm seeing a consensus on not buying diapers too early.

A couple more things...

Velcro swaddle blankets were not really a thing I remember being a thing that was even available for either of my babies. I love origami, I fold tons of boxes and ornaments for Christmas. I had this book, Babygami. It looks like it may be out of print now but you may still be able to find it. I can do that super-tight nurse's swaddle like a, well, like a nurse. And 10 flannel blankets won't cost half of one of those specialty things.

For equipment, all I really needed (beyond feeding and cleaning) was a pack'n'play with the bassinette insert and a vibrating/bouncing chair. My Maya Wrap (another product that may no longer exist, it was three yards of knit material that could be tied multiple ways for carrying baby) got used so much more than any of the strollers I ever tried. They were nearly universally horrible.
posted by Talia Devane at 12:03 PM on November 17, 2015 [1 favorite]

A person very dear to me just celebrated his 11th birthday... which I mention because his mom has IC. She spent most of the pregnancy on bed rest. He's a healthy, awesome kid.

During her bed rest, I think she found some online forums with other women on bed rest, and they were helpful.

I also suspect the most helpful thing for you to do right now, if you can, is to take a step back and think about what you can do with your time that isn't baby-related.

Some ideas: an online class or MOOC on a topic of long interest; learn a new craft; write that novel; write letters to older family members; binge watch Netflix.

Best of luck to you and your child!
posted by bluedaisy at 12:20 PM on November 17, 2015 [1 favorite]

I just recently had a surprise 36 week baby who weighed 4-13 at birth and about 4-7 when we took her home 4 days later. (so, late pre term, no problems luckily, and no time in NICU, but small even for gestational age).

Couple things I would say:

1) At her size, I didn't really need preemie clothes and only used preemie diapers from the hospital. But she's still in newborn diapers at 6 weeks and probably above 6.5 lbs. (so we have used hundreds of NB diapers).

2) I had no newborn clothes and needed warmer ones than what we found right away. I liked the sleepers (up to 7lbs) from Old Navy - the cotton is softer than much of the Gerber/Carter's stuff and it's nice that they snap all the way up because you don't have to put anything over the head which can be stressful. Though, yes, blankets are perfectly good and she was mostly in those for the first couple weeks.

3) no hats fit her at first. We used the hospital beanie forever; you might ask for an extra one and or order one that style. And you will want your baby in a hat.

4) breast feeding with pre-term is even more challenging than normal. we rented a hospital grade breast pump, the Medela symphony, although I have a different one through insurance. They were short of the rentals at my hospital, so you might look into that right away after you deliver to reserve one. Also, I found and still find that the "My Brest Friend" nursing pillow is WAY better than the Boppy or bed pillows. If I did it again I would bring it to the hospital with me.

5) If I knew I might have preterm, I would look into if it's possible to get donated breastmilk. We supplemented with formula for the first 5 days or so but the disadvantage is they sleep more with formula and you have to wake them up to feed (which may happen anyways). I'm not sure what policies or possibilities there are, but you may want to know ahead of time.

6) Our Ergo carrier was too big even with the infant insert. You might look into a sling of some kind. Kangaroo care is really good for all babies, especially preemies.

7) Also, my mother is a L&D nurse and she says her hospital doesn't send home babies below 5lbs. my hospital was more concerned about % birth weight lost and other markers, but the car seat thing may be moot if they won't send home a really tiny one. Our Graco 35 was rated down to 4lbs, so we were ok.

8) you might want to establish your boundaries around visitors quickly. Ours was that we generally didn't want visitors to hold her while she was still tiny, and for visitors with kids, we met them at a nearby playground, which was nice to get out of the house but not have kids touching everything at home!

Good luck! It's amazing how much they can help you with now, so I hope you have a smooth journey.
posted by vunder at 12:26 PM on November 17, 2015 [2 favorites]

Don't worry about much. You'd have time to get everything. We had the same thing happen at 23 weeks 6 days and managed to keep the baby in until 38 weeks. Bed rest until week 36. So all is not lost!
posted by flink at 12:27 PM on November 17, 2015 [1 favorite]

Thinking good thoughts for you, your partner and your Little Everyday! This sounds stressful but it also sounds like you're dealing with it really well.

Regarding quantities of stuff to get, I would hang on to receipts just in case and if you end up with more preemie diapers than you need, you can donate them somewhere. Diapers in particular are a thing poor women frequently struggle to pay for so know that if your Little Everyday doesn't use them, you can pay it forward by donating them eventually.

If you find yourself with offers from friends and family who want to be helpful, you can ask them to help you collect odds and ends from Craigslist.

As far as things to do while on bed rest, if you don't know how to knit, this is a great time to learn. Best wishes!
posted by kat518 at 12:31 PM on November 17, 2015

My son was born at 5lbs, 2oz (not a preemie, just small and early). He didn't fit in newborn clothes so someone ran out for preemie stuff. We had him in newborn diapers from the start. He was born in super hot summer so he rarely wore clothes, period. For the most part, he was in diapers and Aden + Anais swaddles. Our favorite clothes, though, were the magnetic onesies by Magnificent Baby. I'd imagine if your kiddo does have any issues, it'd be nice to have easy open/easy close clothing. My kid grew out of the preemie stuff quickly. I say wait on most clothes and diapers until you have a good idea of little one's size. And even then, you can get away with very little. Re: car seat, mine was almost too small for his even with the newborn insert.. the nurses directed me to sit in the back with him to make sure he didn't slump/block his own airway.
posted by adorap0621 at 12:34 PM on November 17, 2015

I'll write tomorrow with more advice but to clarify I meant you shouldn't worry about "stuff" yet! And yeah- shopping on bedrest can be a bad thing. I have a 1991 Nintendo now I never used.

I was in the hospital for a month- my iPad was essential, lots of comfy underwear and lounge clothes and temperpedic pillows were worth buying, I had 3.... They are supportive in anyway you need to use them and they don't fall off the bed.
posted by flink at 12:37 PM on November 17, 2015

My SIL had IC with both of her kids. She spent both pregnancies on bed rest after a cerclage. First child was born at 27 weeks. He's now in the honors program in college. :)

It'll be okay. Your kiddo is lucky to have you.
posted by heathrowga at 12:37 PM on November 17, 2015

Oh! And your last question, I had 5 mm of cervix left and no pain, I just noticed a small bit of pink mucus in my underwear and my instincts told me to go to the hospital, they did an ultra sound and told me to lay right back down and admitted me,
The neonatal intensive care team came to speak with me about what would happen if he were born... I got through the night and a few days later they thought my waters had broken but they hadn't. My husband was on a business trip and I live in a non English speaking country where I don't speak the language yet. But I felt a calm reserve that kept me feeling safe and it lasted the whole time.
posted by flink at 12:42 PM on November 17, 2015 [1 favorite]

I did two weeks of hospital bedrest for ruptured membranes; my son was born at 34w5d, 4.5 pounds but otherwise completely healthy and is doing fantastic to this day.

Hospital bedrest can be very challenging as it's difficult to "rest" per se - there are always shift changes and activity almost around the clock. Don't hesitate to ask for "do not disturb" signs on your door during rest hours. I also tried hard to structure my day, such as I could, with times to read, write email, watch Netflix, etc. Broken up with meals and medical stuff that helps you get through to the end of the day and a proper "sleep" time. I really liked any kind of small toiletries I could use in bed - lotion, wipes, chapstick, hairbrush/mirror.

I can only reiterate so much of what is said above...if it helps you feel prepared, buy a case of size 1 diapers as you will use them eventually. Extra small size swaddles and hats were also critical for me, and try to find a preemie size coat or outer layer. It does help to have clothes that fit, and will make you feel better as well to be able to dress your baby properly (this is part of the whole newborn experience that you should get to enjoy and not have it be oh crap nothing fits right). I also found it much nicer to have a proper baby bath with a sling and not be trying to do a sink bath with a tiny floppy newborn preemie.

You will get through this. It is so hard, but you are doing the right thing. Be positive and take it a day at a time, hour by hour. That experience for me was terrifying and all consuming; it is now a six-second phrase that is just the precursor for all the rest of the story, all the joy and adventure that has come to follow in the five years since my son was born.
posted by handful of rain at 12:52 PM on November 17, 2015

I had preemie twins at 31 weeks - one was 2lbs 4 oz and the other 3lbs 11oz. They are 9 now and absolutely perfect, but I well remember how incredibly scary that time was.

Everyone has already covered the 'don't stress about getting too much stuff in advance, particularly diapers' angle, so the main thing I want to tell you is to find out what your hospital's release policy is. Our hospital's policy was that babies could not go home until they would have been at least 35 weeks gestational age, so they spent 4 weeks in the NICU. If your hospital has a similar policy, you may well not need to get much, if any, of the special preemie gear.

It sounds like you are doing a great job taking care of and preparing for your baby, so just remember it is equally important to take care of YOU. Best of luck!
posted by widdershins at 12:52 PM on November 17, 2015 [1 favorite]

The Graham's Foundation is an organization that you'll want to know about.
posted by zizzle at 12:52 PM on November 17, 2015

A few thoughts:
- He is likely to be in the hospital for a while, so you can always order things then (Amazon Prime) when you know more.
- Worry now about donated milk/getting ready to pump. Preemies particularly benefit from human milk, so start looking into options. If you want to pump, you will likely need a hospital grade pump and need to learn now about how to be on a good pumping schedule. If not, look into local donated milk banks.
- As K8t said, focus on your logistics. Where are you going to sleep/live while he's in the NICU? What about your partner? Can you have friends/family start figuring out a schedule now to bring you meals?

Good luck! Babies survive born at 25 weeks...
posted by papergirl at 1:05 PM on November 17, 2015

Personal experience here, had bleeding at 24 weeks by placental abruption, delivered at 33 weeks, baby stayed in NICU for 7 weeks. I was put on pelvic rest to try and keep baby in there until 34. Didn't make it. Little one is now 3, happy, and healthy.

That being said, everyone's experience is so different - please take this one thing at a time and you and your family will be in good hands. Our doctors and nurses collectively helped us with so much while little one was in the hospital. We learned to change, feed, and bathe her. It was so hard but we were and are grateful for that experience. If you decide to nurse, notes are inline below.

1. I didn't get the Britax System but we had a Chicco Keyfit 30, daughter passed car seat test with the infant insert just fine (though she was over 4lb by the time we could take her home and fit just fine.)

2. Backseat mirror, this book: Preemies helped put so much of my brain at ease. Grocery delivery/house cleaning (because you'll need time to recover and pump milk for baby if in NICU). Sleeping bras, Netflix to watch while pumping. Carseat bunting if you live in a cold climate. A co-sleeper if you are interested in the co-sleeping thing. We had an in-bed Secure Sleeper that worked out great.

3. This registry helped immensely: Alphamom's registry I love that it has buy NOW and buy LATER items. Every baby is different. I would suggest getting baby swings, etc. from a consignment shop or for cheap - every kid is different and keeping things simple is best. The tough thing about baby stuff is that you don't need it for very long, but you use the shit out of it for the time you do, so go used (most of the stuff will barely be used.) The other thing is that if you are in a small house/apt, no point in buying a lot of baby apparati if your kid ends up hating it (ours liked the swing for a week at most.) In lieu of a changing table, we got a Pack N' Play with a Newborn Napper/Changer for up to 15 lb and used the shit out of it until she grew out of it.

4. Amazon Prime will get stuff to your door faster than you think. In all seriousness, the little one grew out of her NB diapers before she left the NICU - my word of advice is to take what ever is not pinned down from the hospital. Diapers, wipes, plastic tubs, you name it. During baby's NICU stay, circles of crafters gifted her amazing hats, blankets, and clothing - but once baby gets home, the supply of gerber 5-packs of onesies and socks (cheap!) helped us wrangle newborn blowouts well.

5. By asking this question first and foremost, you are already such a giving mother that wants to do right by her little one. My heart goes out to you for experiencing this. From one mother to another, seriously, build some networks of other parents so you have someone, anyone to reach out and freak out, whatever. It is enormously tough to parent alone, and if possible, talk to someone about the potential for the birth to not go as planned. People want to talk about the experience of childbirth as if it's all about the baby - but you grew this baby and the baby needs a healthy mom - you are just as important. Take the steps for self care where you can.

6. I didn't have an incompetent cervix but had a placental abruption which resulted in bleeding. Scary as hell but we made it through. If you're anything like me, you probably have researched the shit out of what is happening. However, take this time to enjoy pregnancy as you are able - get pictures done, have fun setting up the baby space in your dwelling, rest and eat well.

As hard as it is/was to believe, people have had and do have children with a lot less stuff! We realized soon enough that babies need diapers, food, a place to sleep, and you. As long as all those bases are covered, you'll be alright.
posted by thirteenthletter at 1:14 PM on November 17, 2015 [2 favorites]

Nthing the recommendation to use a hospital-grade breast pump.

Also, make sure the NICU nurses are feeding your baby the milk you are pumping! I know that sounds weird, but when my daughter was born, I was pumping milk and bringing it to the NICU, where the nurses told me to put it in a refrigerator, properly labeled. I can't remember now what led me to ask, but at some point I was told that they weren't actually giving my daughter the milk I had pumped, because there was no doctor's order in the baby's chart for that! I was flabbergasted, and to this day can't imagine why someone did not tell me sooner. (I think it was a week or even two before I learned my daughter was not getting my milk.) This was 23 years ago, but having also worked in a hospital, I can imagine that kind of ridiculous miscommunication happening today.

Anyway, I have no experience with IC -- my daughter was born prematurely because I had difficult-to-diagnose appendicitis (they thought it was food poisoning), and my appendix actually ruptured, which sent me into premature labor. The baby was delivered and my appendix removed in the same surgery session. I was 30 months pregnant when this happened. My daughter was 3 lbs. 7 oz. at birth and spent four weeks and a day in the NICU. She is now a beautiful, intelligent, creative, and wonderful young woman -- if I do say so myself! So although it is nerve-wracking at the time, it certainly can all work out in the end.
posted by merejane at 1:25 PM on November 17, 2015

A few other things that came to mind:

If you haven't already switched to a gentle laundry cleanser, do so now and start washing you and your partners clothes with that, plus everything of your baby's.

We filmed some of the stuff the nurses showed us how to do: swaddle and sink bath. This was helpful for later reference. The problem with the tub bath with sling is that the baby can get cold really fast, and preemies can be bad at regulating their temperature as it is. Maybe there's a strategy I don't know about but we were shown to wash and somewhat dry the head/hair first, with the baby swaddled, then do the body. I assume you can do this with the tub with the sling too.

I assumed we wouldn't use a changing table really because most people seem to say that and I remember with my little brothers we never used one, but we put a changing pad on a lowboy dresser that we already had and it's actually been excellent and all changes are there so far.

Another clothing thing - I really like the little cardigans as a layer. They work even when slightly too big.
posted by vunder at 1:58 PM on November 17, 2015

No experience with the IC, but I did just have a 37-weeker in September, so maybe some of my experiences will be helpful. Our little one was born at 5 pounds, 15 ounces and left the hospital at 5 pounds, 9 ounces. He spent a couple of days in the NICU, but we were discharged from the hospital on time.

I'd suggest you get more information about the NICU where you plan to deliver, including what level of care they provide and if there are complications that would require him to be moved to a higher level NICU. I delivered in a facility with the highest level of care, but I would have wanted to know in advance if there was a possibility of him being moved. I'd recommend you get information about visiting hours, rules for visitors, policies for personal items in the NICU, and just get a general idea of what to expect. I wish I'd had more information, though it all turned out to be fine. (For example, visitors were limited, but grandparents didn't count against the limit, as long as they were accompanied by my husband or I. Another example, there was a locker room near the NICU for family members to shower and dress, but we didn't know about it. My husband went home to shower. Maybe he wouldn't have used it anyway, but it would've been nice to know).

Comfy clothes to wear while I was still in the hospital and going back and forth from my room to the NICU was a must for me. I had a cotton robe from Jockey that was perfect. Not too hot or cold, not bulky at all, but made it so it didn't really matter what I wore underneath.

Once the baby went to the NICU, my life revolved around pumping breast milk more than I might have expected. This was a miserable, awkward experience. Not sure what would have made it better--maybe a hands free pumping bra? I could pump in my room or in the NICU pod, but it was always weird and awkward. And it was pretty much impossible to do anything else but sit there and be milked. Once I got home to the hands free pump that I got from my insurance company, pumping was much less of a chore. I could at least read, or browse the internet, or snack, or hold the baby.

I also used a large purse to lug stuff back and forth from the NICU. I had happened to pack some snacks for my husband in the bag, not knowing how useful it would be to have the bag itself. It was nice to toss a bottle of water, my pumping supplies, my phone/tablet, charger, etc. in a bag to take down to the NICU with me. Also hand cream, to counteract the drying effect of the millions of times you will have to use hand sanitizer to go in and out of your room, the NICU, your baby's space in the NICU, etc. My skin got painfully dry.

If you don't plan to breastfeed, or it doesn't work out, learn about proper formula prep. Most education programs are so focused on BREAST IS BEST that it can be hard to find good information about bottle sterilization, proper preparation of formula, etc. We learned that ready to feed formula is best up to 8 weeks old, especially for Preemies, because powdered formula is not sterile. But even if you can't afford ready to feed, there are ways to mitigate the risks (boiled water, sterilized bottles and bottle pieces, good handwashing, etc.). Some of it seems obvious, but we had to go looking for the information, because nobody wants to talk about it. In our case, the baby got formula in the NICU because of blood sugar issues, and after that, he never really cared to work at breast feeding. I pumped for while, but that didn't work out as well as I would have liked either (supply is rough when you're exclusively pumping). Anyway--we were prepared for formula feeding, and got the same formula the hospital was feeding via Amazon to ease the transition to home.

In terms of STUFF:

Car Seat: As I said, our little one went home at 5 pounds, 9 ounces. We'd picked the Peg Perego Primo Viaggio 4-35, rated safe down to 4 pounds. It has two different inserts to position tiny babies. At 11 weeks, we're still using the stage 2. We're happy with our choice, but I've heard good things about the Britax one you've chosen also. Our baby was big enough we didn't have to do a car seat test in the NICU, but we witnessed them going on, and the other posters are correct. The NICU will help you make sure your seat works.

Diapers: We used a 30-pack of preemie diapers, then a box of 128 newborn Pampers Swaddlers, plus another 60 newborn diapers (one pack of Huggies, one pack of the Target brand). We could have used two large boxes of the newborn Pampers, but everyone said not to stock up, so we just kept buying small packs. Now we're in Size 1's of the Kirkland brand from Costco. So far so good. He's about 12 pounds (I'll weigh him tomorrow). Every baby is different, though.

Swaddling: We used the Aden and Anais muslin swaddles the most. They're pricey, but I loved them. We still use them all the time for blankets or burp cloths or car seat drapes or cover-my-clothes-while-I-take-him-downstairs-because-I'm-already-dressed-for-work-cloths. Tried the Summer Infant SwaddleMe's a couple weeks in there, but his tolerance for those was short-lived. And he just kind of rolled around in a Woombie. The muslin swaddles were the best. When our room was cold from A/C, I'd just use two of them.

Clothes: Our kiddo was in Preemie clothes for the first 3-4 weeks. We had 3-4 sleepers, 2 "outfits," a 3 or 4 pack of plain onesies, and 2 random pairs of soft pants. We still did laundry every other day or so, but our baby spits up a lot. By week 3, he was too long for some of the things, by week 4, I'd packed up just about all of the preemie sizes. Now, they look incomprehensibly small! At 11 weeks, he's in 0-3 sizes, but most 3 month things (especially pants) are too big in the waist. Length-wise, 3 months is just about right.

Bed: I splurged on a Halo Bassinest, and I loved it (still do, though I'm just about to transition him to the crib). It seemed like an expensive item for something you only use for a while, but it gave me peace of mind to know that we were sleeping safely and he was right by me. We also have dogs, and this one seemed more sturdy than other co-sleepers or bassinets I looked at. We could have gotten along without this, but I don't regret the purchase either.
posted by terilou at 2:08 PM on November 17, 2015

Oh man, that sounds tough and scary, hugs! Our preemie came as a surprise, 6 weeks early, but was generally healthy other than some necessary lung development and growth. He spent 10 days in the NICU and was what I think they sometimes call a "feeder and grower".

Seconding widdershins "find out what your hospital's release policy is" and more generally get to know how your NICU works if possible. If you're able to be in a wheelchair, ask for a tour of the NICU and an overview of how things work. Some things that I wish I had understood better are: how rounds with the doctors are structured, how nurses are assigned to specific babies, is the charge nurse open to requests for specific nurses, visitation rules, policies on kangaroo care, how progress is measured/ what are the milestones they look at, breast feeding/pumping support and accommodations, release procedures for your child.

To this last item specifically. With our son, despite being in the NICU around the clock for ~10 days we weren't told until literally the very last minute (before discharge) that we had to watch some informational videos before our son could be released. And so he had to stay another day. That sucked. As for the car seat, we had a Graco snugride 35 which is rated down to 4lbs, our baby was 5lbs (and plenty long) and the nurse said that it would not work and they would not perform the car seat test (another requirement) with that car seat (but they did have a list of carseat models that they would accept). So that was also unnecessarily (IMO) stressful.

SOOOO, my point is that there's a lot of information about how NICUs in general and specific work, they are complex places that most of us don't have any experience with. And our experience was that most of this information wasn't on their website or in the handouts they give you, but stuff we had to find out by asking (or realizing that we should have asked) very specific, pointed questions. General questions got very general and only minimally informative answers. Information wasn't volunteered. We were too dazed and confused to do a very good job of this, but you have lots of time (sorry about that! bedrest sounds tough!) to learn about your particular environment. Hopefully your sweetiepie will stay put long enough that ya'll can skip that whole part of the process, but if he does need to spend some time there, I think any knowledge you gain will help you navigate the experience better.

In addition to a tour, I think a great way of gathering some of this information would be to ask some of your (I.e. your personal maternity) nurses. You're going to be there long enough to get to know a lot of them, so pick a few who you trust and like, and ask them for their help in understanding what would happen if your son needs to spend some time in the NICU. Or if you have specific questions, ask if they know. They may or may not, but they might find out for you.

As for stuff we relied heavily on the first couple of weeks home for baby: baby hats, muslin swaddling blankets, lots of baby washcloths for soaking up dribbled milk when he was still learning to suck, kimono style onesies so you don't have to go over the head (I think gerber has some plain ones pretty cheap), the vibrating bouncy seat, netflix (well, okay, that one was for us).

We had no luck breastfeeding til he reached term so I was exclusively pumping for 6 weeks, so some things related to that: if I had forwarning, I would have brought a supply of fenugreek and lactation cookies (the Belvita breakfast cookies worked pretty well for me) to the hospital and I'd load up as soon as the baby is born - I don't know but they might help jumpstart your milk which can be a little more delayed if the baby is early. I'd also see if you can get a doctor or nurse to order you some All Purpose Nipple Ointment. My doc actually refused but gave me a script for an antifungal and told me to mix it with OTC hydrocortisone and antibiotic ointment. Pumping in this situation is real rough, so I would use this mix occasionally (1-2x a day maybe) to try and PREVENT infection, yeast infection, whatever. Also lots of extra pump parts so you're only having to wash them once or maybe twice a day, and a big bowl or small tub (we used one of the hospital tubs) to wash the parts in.

I bet you guys will do great, you're being monitored and will have immediate access to trained professionals who know how to take care of you guys!
posted by pennypiper at 2:45 PM on November 17, 2015 [1 favorite]

I have a 25 weeker, now three years old. It has been (and continues to be) a bumpy road, but longterm we have an excellent prognosis. My answers assume that your child will be born very soon, which I hope not! Have you had steroid shots for his lungs?

I second the recommendation to tour the NICU if you are able to, and if not to at least meet one (or more) of the neonatologists on staff. This will do wonders in helping you know where your baby is if you are unable to go with your son after the birth.

1. Car seats - your car seat will probably be fine (is it rated starting at 5 pounds?) even without the newborn insert. The staff there will do a car seat check for safety before he is discharged, and will help you roll towels and blankets around him to keep him safer than the newborn insert will.

2. Look for pajamas with snaps instead of zippers so that cords can be fed through, and onesies that snap across the front instead of needing to go over the head.

3. Standard registry items will still be useful. Most of the preemie-specific stuff you'll get from the hospital.

4. Do not stock up on diapers. You won't know sizes or sensitivities or preferences until after your son gets here, and Amazon Prime can deliver anything to you so fast that you will hardly have time to run out. Stock up on wipes if you need to (but for a reality check, I have used only two Costco-sized boxes of wipes in the 11 months that my son has been in diapers, and my daughter was in diapers for about six of those months, too. So, stock up, but don't go overboard!).

5. Your baby needs your love and that's about it. The medical staff will provide the medical care (to you and to him) that is needed, but no one can replace mother's voice, touch, and love. Talk to your child a lot, sing to him, and try to be as good as host as your body will allow for as long as it will allow - but don't consider yourself a failure. (I know, it's hard.) When I was on bedrest, listening to my daughter's heartbeat was a wonderful comfort - she was listening to mine, I was listening to hers, it was like this wonderful circle of life.

6. I did not have IC, but I'm glad you know that each situation is unique. Check out to see if they can match you up with a mom whose situation is similar to yours. Ask your nurses for all the services that your hospital might offer bedridden moms-to-be: aromatherapy, massage, nail/hair treatments, physical therapy and especially mental health support. Being on bedrest is really, really hard on you, physically and mentally.

If you would like to know more about our NICU stay and subsequent preemie issues, feel free to memail me. It was very definitely a roller coaster, but we have been lucky to have a good outcome. I volunteer with our NICU now, talking to parents shortly after they are admitted and giving them an idea of what to expect. Every preemie's story is different, but having a sense of what's possible was helpful for me to know.

Also, today is World Prematurity Day, so you if you search that hashtag on social media, you will see a lot of success stories right now, in case that would be helpful.
posted by peanut_mcgillicuty at 3:05 PM on November 17, 2015

Response by poster: Thank you all, so much, for these responses. Besides the actual answers to the practical questions I had, the kind words of support mean so much as I sit here trying to figure how to best emotionally and practically prepare for the baby. Anecdotes on your own preemies and how they turned out perfectly are also so great to hear - congrats and thank you.

It looks like holding off on most things and looking to the NICU for guidance on feeding, bathing, and other techniques is what I will do in addition to getting basic things like pumps, a few diapers, and a handful of easy-to-wear suits. The NICU being such a great resource is not something I had thought of, so I will definitely take advantage of the time I'm in here to do that, starting with a tour. They've had some NICU folks talk to me already, but the past couple days have been such a haze nothing has really occurred to me to ask. I was moved to this hospital from another one when I was admitted because the NICU facility here is the highest in San Diego. If I go home, this facility is a ten minute drive.

With re: sleeping, I had already picked out a cosleeper, and I think I will still stick to that plan. Does anyone have a specific cosleeper to recommend?
posted by Everydayville at 3:28 PM on November 17, 2015

Oh another thing: consider babylist for your registry. It allows people to buy from different places but keeps everything together.

Also, I wish I'd gotten the Halo swivel bassinet mentioned above.

And also, I was completely unprepared with nursing clothes. I am large chested under the best of circumstances, so proper fitting nursing bras were difficult to find and I needed nursing tanks in large sizes.
posted by vunder at 3:37 PM on November 17, 2015

Nthing not doing the baby items shopping till baby arrives because what you'll need will depend so much on the specifics with a preemie. The breast pump is great if you know you are delivering early, especially if you have an option to rent. Early delivery often means difficulty with milk at the start because your hormones haven't quite caught up yet either, and a great hospital grade breast pump can make it much easier. If you have to buy, they often have decent resale value, if you're don't plan to pump long-term either.

The most useful things for bedrest are getting a comfy body pillow (two is even better!) if you can, and a handsfree type desk thing so you don't go nuts lying down unable to do anything. Set it up like you're an astronaut on a mission. And really do what bed exercises you're allowed to do, the leg flexing and what not because it helps later with recovery when you are suddenly expected to be back on your feet and chasing around a screaming newborn after weeks of lying very still.

Oh swaddles - preemies love swaddles. The Woombie was a miracle because it was so easy and we just used our two to shreds.

The other thing is if you have the time now, set up your NICU and early days with the baby to be as stress free as possible. Automate the hell out of everything. Prepare and stock up on the adult side for all that stuff. Prepay bills, arrange for things to be done, answer and sort overdue tasks - clear your slate and set up help for the next couple of months. Then when hurricane baby hits, you won't have Regular Life plus Baby, and you can thank bedrest you when you shuffle into the kitchen at 3am covered in baby vomit, starving, and realise that yes, there is frozen lasagna ordered five months ago and labelled in portion sizes, and all you have to do is reheat it, and you weep in gratitude. Which you totally would do.

BTW, I also took notes, read the Cochrane handbooks and textbooks and found that very soothing because more information made the doctors and the hospitals make sense, not less terrifying, so if that works for you, go ahead. I was lucky to have a sympathetic obgyn who answered my questions and explained things briefly and well.

Get an app for your phone for recording baby info (there are lots - I used TotalBaby, but I'm sure there are better ones now) or just a pencil and notebook. There's a lot of info flying about and you'll be too overwhelmed to remember it. Get used to just entering the data first and making sense of it later.
posted by dorothyisunderwood at 4:57 PM on November 17, 2015

I didn't read everyone else's answers but I wanted to chime in here and say hello, fellow IC mom here! I currently have a healthy 5.5 month old that my OB told me would never come to term who fooled everyone by staying put until being evicted at 42 weeks via csection. I was on progesterone from 6 weeks until 34 weeks and was told to expect to go into labor within days of going off of it since I was at less than 2 mm but alas, cervix decided to do nothing, it was ridiculous.

All babies really need are clothes, diapers, a place to sleep and a car seat. We did white onesies for the newborn stage, pampers swaddlers for baby 1 and huggies for baby 2, an arms reach cosleeper for both and you've picked a great car seat, so you're good!

I loved using muslin swaddling blankets with my summer babies and two layered flannel blankets with winter babies. When they're out of the swaddling stage wearable blankets are wonderful, ikea actually makes my favorite.

Bed rest gets pretty boring, one fun thing you can do is hire a hairdresser to come wash, cut and style your hair at the hospital, it's a nice to be able to do normal things. If you have questions or want to chat me mail me, best of luck!
posted by julie_of_the_jungle at 5:30 PM on November 17, 2015

Small suggestion: consider using lanolin on your nipples now, to soften them up for nursing. I had a very difficult time with extremely sore nipples when nursing my firstborn. Later, I read somewhere that using lanolin while pregnant can prevent sore cracked nipples later.

So I planned to do that during my second pregnancy, but was waiting to start until closer to my due date. Then my baby was unexpectedly born 10 weeks premature, before I had had a chance to try the lanolin, and -- well, too late to try out that tip! If I'd known she would be born early, I would have started with the lanolin earlier.
posted by merejane at 6:41 PM on November 17, 2015

When our baby (34w6d, 4lb12oz) came home, she really liked sleeping in the aptly-named By Your Side cosleeper on our bed. We have a queen, so it was pretty tight quarters and we migrated it to a sidecar crib after a few weeks, but I think she preferred the cozier environment it offered, compared to the wide open expanse of crib.

The NICU nurses really are a fantastic resource I think everyone should have. Which is not to say that everything out of their mouths is a pearl of wisdom; unless it's something like "here's how the feeding tube works", take what they offer as advice, rather than medical advice. (Specifically, if anyone gives you a nipple shield, make sure you check in about that with a lactation consultant sooner rather than later.) But still, it is particularly well-informed advice, so definitely consider what they have to say.

A major thing this thread is bringing home to me is how different preemies are. We didn't need special hats, but definitely had to make a run for preemie sizes to cover the first two weeks home, and even some of those were too big at first. She wore preemie diapers for a month or so, at which point cloth could finally fit between her thighs; we had some that said they went down to four pounds but that was clearly a lie. By two months she was in size one disposables, not sure what we're on now. Halo sleep sacks worked awesome for us (they come in preemie), but if you don't want to spend the money, you can also swaddle normally and then put the next size up onesie on over top, crotch snaps undone, and it's basically the same thing. However, if you can swing it, I'd say the Nesting Days carrier is absolutely worth getting. It goes down to five pounds and our neonatologist approved it before then, and it's just lovely for snuggling close skin-to-skin when they're teeny.

Just in case it's not on your radar, look into delayed cord clamping. I had planned to ask for it even with a full-term baby, and am glad that we got to take as much advantage of it as we did.
posted by teremala at 9:20 PM on November 17, 2015

Hello! Just wanted to come back on this morning and share any more advice I can give.

Incompetent Cervix is very scary. Its by the grace of God that little baby flink is here with us now because usually people have multiple losses before they end up with a prophylactic cerclage. And cerclage is not for every type of IC, as you know. When it happens to you suddenly everyone comes out of the woodwork and you realize its actually much more common than you thought before. My husband has more friends whose partners had IC than didn't. I am not kidding you, I know 3 other women in our circle (in our TOWN! even) who had experiences just like yours but who went on to carry their babies to term. One had 2mm of cervix left and didn't have a cerclage and the situation was stable on bed rest and when she came off bedrest she still went to term. I had my cerclage out at 36 weeks and still went 2 more weeks! So you have a lot of reason to hope this baby will stay put.

If you are looking for positives in this, I know that the day those NICU doctors sat down and told me to prepare myself- and my husband flew home- that is the day we became parents, and its given us a really sweet bond with our baby... my other friends who had babies at the same time said they felt that they didn't have that same feeling- I feel ours came from feeling like: this is team flink and we are going to get through this as a family and baby flink just felt very present and real. Its hard to explain.

As for the tempur pillows I recommended- I had a medium sized one for the head and a body pillow. The body pillow was great, during the day it rested next to me and when I had the IV in my hand it really hurt but I could just rest it on the pillow.... We used the pillows again when we spend another week in the hospital sometime later.

But about time in the NICU- while baby flink came at a healthy 38 weeks... when he was a month old he got bitten by a mosquito and had a very bad systemic infection. We spent a week in the intensive care unit with him then... one highlight of the experience was that we learned a lot from the nurses and it made us more confident parents... we learned how to resettle him, how to soothe him... what kind of crib he liked etc. And you would be surprised how tough these little babies are!

And you know, it must not have been THAT bad, because now we are expecting another baby! I will have a prophylactic cerclage this time, and it all seems very simple wheras the last time it was complete panic mode!

But I will tell you what- this time I had my hospital bag packed the second I found out I was pregnant, there was nothing more annoying than needing a TON of different little things, like chapstick, fingernail file, hair clip, hairband, shampoo, nail polish, a pen and notebook, little biscuits, my favorite pjs.... I am serious, like 50 small "things"...

I send you big hugs! I think that there is a good chance that 6 months from now you'll be living a completely normal life again, well as normal as life can be with a new baby!
posted by flink at 12:48 AM on November 18, 2015

I just remembered, gas drops were great for our baby. Preemies don't have the muscle development to comfortably push out gas, so staying on top of the issue really helped. We were initially doing a combination of nursing and formula-fortified EBM bottle feeding (which my research indicated was worthwhile prior to term) and when we gave a dose with each bottle-feeding (straight milk didn't seem to cause as many issues down the line), she was a lot more comfortable. Check with the doctors of course though!

If I didn't mention before, our little one is now 4.5 months and doing fantastic. Our time in the NICU turned out to be merely an observational stay (no issues with breathing, eating, or staying warm meant we were released within hours of one another) and now she's solidly within the standard unadjusted growth curves and walloping milestones.
posted by teremala at 7:27 AM on November 18, 2015

I don't know anything but just stopped in to say I'm thinking about ya! And also I think it's really mean to label someone else's cervix incompetent. You can do it!
posted by SassHat at 2:32 PM on November 24, 2015

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