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By Jamie Burt, RN BSN

NANN Footprints: Stories from the NICU October 2019

Noah. Noah. We are not new to “his kind.” This baby boy that has found his way to our NICU. But we are new to being a NICU with the medications and  tools that allow us to adequately care for him through his complete hospital journey.

Noah. What will his foster mom call him? Will he be adopted? Does he have relatives that will ultimately connect with him, will he ever know his  birth mom? His family of origin?

The debate is heated! Some blame her. They are willing to give her a harsh sentence! She should be punished, maybe even go to jail. How could a mother knowingly do this to her child? She knew that he would have to suffer through withdrawal. They are sure she will not have to suffer the same fate.

Some are much more pragmatic. They say this is just a part of obstetrics with which we will continue to deal. What’s the difference in this and other substance abuse such as alcohol? Perhaps nothing except the withdrawal is more acute. Who’s to say which has potential for more enduring, lifelong effects?

Some want to help this mom. She presented so quickly, they feel bad for her and her baby. Could this have been avoided? If she had sought prenatal assistance, could we have reached her early and possibly steered her towards a road of support and recovery? It’s not ours to judge. Who knows her path and what circumstances led her here? For now, our efforts must concentrate on him, for she is gone.

Eat, sleep, console. We are so far from that conceptual goal. Feed, hold, cry, wake, stomach pain, diarrhea, diaper rash, sweaty, sneezy withdrawal! What did he do to deserve this?

How can we best ease his pain? The sweet girls of occupational and physical therapy spend extra time with him, gently moving and slowly positioning for comfort. Soft words are spoken by the nurse as she draws him close, tummy to tummy, and tucks his legs up tight. A darkened room and a swing on low settings soothe for a short duration. A volunteer with ready hands and generous heart is turned away because, alas, he is asleep, and he hasn’t slept well for days! Bless the NNP that says she will check him when he is awake!

Another week passes. Slowly we titrate his medicine down. He doesn’t tolerate it well. It feels like we are starting all over again. Time marches on, soon he will no longer be considered a neonate. Three weeks and counting. The cries of pain, the sleeplessness, the fussiness. This process is painstakingly slow. Pain. What will he remember? Will he remember the quiet songs we sing to him? The moments he feels good and we engage him in deep conversations as we gaze into his eyes. How could we not fall in love?

This journey we call life, his was a rough start. But with baby steps, the next part of his journey finally comes. We say goodbye and fill his bag with clothes, items we have purchased just for him. We wish him well, we pray over him, we bless him. Our hearts overflow. We send him with notes that he may never see but his foster parents will. We include them to remind those that carry the love for Noah from here.

He was never alone. He was never forgotten. He was never abandoned, uncared for, or unloved. We have been here from the very beginning. It was our beautiful, challenging, rewarding opportunity to care for this wonderful child. A harsh beginning, yet we welcomed him into this world and the safety of the open arms, and hearts of his NICU nurses.

*Noah is an alias for several babies to whom we have been honored to provide NICU care, as well as part of our hearts.