When the unexpected happens

All parents want a healthy baby. But sometimes the happy event doesn’t unfold as expected.

Even under the best conditions, things may not go as planned. Deciding to have a family brings great happiness and also some degree of uncertainty.

If your baby suffers from an infection, birth defect, or other health problem she may require hospitalization after birth or in the days following. This comes as a shock to parents who must learn to live with this new reality and adjust to a role different from the one they envisaged.

The birth may also occur before the date scheduled. The baby is considered to be premature when birth takes place before 37 weeks of pregnancy. A premature baby may require some of the special care presented in the table on the following page.

Care of premature babies

Birth before 34 weeks

Transfer to a neonatal intensive care ward in a hospital that has one.

Your baby may

  • Receive phototherapy (exposure to light in an incubator) if she has jaundice
  • Be placed in an incubator to keep her warm
  • Receive intravenous solutions
  • Receive help breathing
  • Receive help feeding

Birth from 34 to 37 weeks

Extra care, but less of it.

Your baby may

  • Receive help feeding
  • Receive phototherapy (exposure to light in an incubator) if she has jaundice
  • Receive help breathing (only in rare cases)

A few suggestions for difficult moments

You may feel guilty and helpless if your baby is hospitalized for a complication such as premature birth, infection, birth defect (whether discovered before or after birth) or another health problem. Whatever the situation, here are a few suggestions to help you through these difficult times.

You don’t know what’s happening

Don’t be afraid to ask questions about your baby’s health and the treatment she’s receiving. If you have worries about the care and treatment, ask if an alternative is available. She’s your baby and you have the right to be involved in decisions affecting her.

It is the responsibility of members of the care team to keep you informed. However, time constraints sometimes make having these conversations difficult. Ask them when the best time to talk is. If you never get to see the doctor, find out when he or she usually visits.

You need support

If possible, ask your family and loved ones to help you by taking care of the house, minding your other children, or taking turns being with your baby. It’s possible you may not always be able to be at the hospital, especially if you have other children.

In the case of a prolonged hospital stay, it’s essential you rest yourself so you can stay healthy and be able to care for your baby when she first arrives or returns home. Remember that your child will need you not only during the hospitalization but afterwards as well.

Feel free to ask for psychological help if you feel you need it. Specialized hospital teams include social workers and psychologists.

Your hospital’s specialized team can advise about help you can receive at home. You can also request a follow-up with your CLSC when your child is discharged from the hospital. It’s important not to neglect post-hospitalization care, which may also be difficult for some parents.

If your baby is suffering from a chronic illness or has a particular health problem, check if there are resources for parents of children with the same problem. The help of other parents who face the same challenges can be useful.

The following website lists many resources available across Québec:

laccompagnateur.org
www.laccompagnateur.org

There is also an association to support parents of premature infants:

Préma-Québec
1-888-651-4909 / 450-651-4909
www.premaquebec.ca/en

Suggestions for making a hospital stay easier

Many parents want to stay by their hospitalized baby’s side. Sometimes when they are able, the father and mother can take turns beside the crib during the day, or may want to spend the night. Check with your hospital to see what options are available. For example, see if they can offer a room where you can stay with your baby if you want to. Some hospitals may however have space constraints that make staying with your baby difficult.

Your baby is in an incubator

Don’t hesitate to ask for help touching your baby in the incubator or holding her in your arms or kangaroo style, i.e., skin to skin under a blanket. Feeling your presence will help your baby. If you’re unable to take her out of the incubator, ask if you can put a scarf or piece of clothing that smells of you beside her.

Breast-feeding when your baby is in the hospital

Your baby may be able to nurse and take in part or all of the milk she needs. Even if your baby is not yet able to suck, it is important to stimulate your breasts in the hours after birth to get your milk production going. Express your milk until your baby can breast-feed on her own. Your milk can be refrigerated or frozen until she is ready. At that time supplements can be added to your milk if necessary.

Ask for help expressing your milk. Breast pumps are often available in intensive care wards. Don’t be discouraged if you get only a few drops the first few times. Your breasts need regular stimulation to produce what your baby needs.

Don’t forget that your baby has a tiny stomach and only needs a few drops of milk when first starting to breast-feed. Having a photo of your baby, being close to her, or making skin-to-skin contact for a few minutes beforehand can help you express more milk.

If you weren’t expecting to breast-feed, it’s not too late to think about it. Premature babies and hospitalized newborns have special needs, including the antibodies only your milk can provide.

Who is allowed to visit?

Some hospitals may allow visits by your other children and members of the immediate family. Be sure your visitors are not sick when they come to see your baby. Even an ordinary cold can be serious for a newborn.

It can be a good idea to talk with your other children about what’s going on. The baby’s siblings also have concerns about the baby’s health. Reassure them that what’s happening to your baby is not their fault. Slightly older siblings may believe their jealousy of the new baby has caused the complication. You can also get them involved in caring for the newborn whenever possible.

Death of a newborn child

While not uncommon years ago, today it is fortunately rare for a child to die before birth or in the first few days of life. The cause is usually extreme premature birth or birth defects. Whether it can be explained or not, losing a baby is always traumatic for the parents and family.

When a baby dies during pregnancy, the mother is often requested to deliver it naturally or through induction. After delivery it can be particularly trying for her to go through the physiological postpartum response, such as lactation and bloody discharge.

At the hospital some parents may ask to hold their stillborn baby in their arms, to dress her, or take photos. Subsequently an autopsy may be performed to determine the cause of death. Various funeral options (e.g., cremation, burial) may be proposed.

Back home it’s normal to go through periods of shock, outrage, disorientation, and sadness. The intensity of the emotions experienced and the time needed to recover will vary from person to person. The two parents often do not mourn in the same way or at the same pace.

Parents who have experienced the death of a newborn say that the presence and support of their loved ones helped them through the ordeal.

There are also support groups for parents who have lost a child. These groups can provide valuable assistance to parents as they go through the mourning period, and they can share their experience with other bereaved parents. You can also see a health professional (e.g., psychologist, social worker) for counselling individually or as a couple.

Consult your CLSC to find out about services offered there or other services in your area. You can also seek help from these organizations:

Centre d’études et de recherche en intervention familiale (CERIF-deuil)
This centre provides telephone and email support.
1-800-567-1283, ext. 2387
deuil@uqo.ca

Parents Orphelins
www.parentsorphelins.org/en

You can check with Commission des normes, de l’équité, de la santé et de la sécurité du travail for details about absences and leave you may be entitled to (see Parental leave and preventive withdrawal).

If your baby died after 19 weeks of pregnancy or after her birth, you may also be entitled to receive maternity benefits under the Québec Parental Insurance Plan.

Commission des normes, de l'équité, de la santé et de la sécurité du travail
1-844-838-0808
www.cnt.gouv.qc.ca/en/leaves-and-absences/family-events/maternity-leave/index.html

Québec Parental Insurance Plan
1-888-610-7727
www.rqap.gouv.qc.ca/travailleur_salarie_autonome/evenement-particulier/index_en.asp