Feeding the baby before and after neonatal surgery
Babies who need neonatal surgery often have complex feeding needs, both before and after surgery. Although some may be able to breastfeed or take a...
Parents whose baby needs surgery face a long and emotional journey, from the initial shock of diagnosis, to worrying about their baby’s health after birth, the surgery itself and recovery from their operation. The outcomes were often very unpredictable and uncertain. Parents we talked to described their often very different ways of coping (and sometimes not coping) during this emotional marathon.
Zoe and Barbara both had positive messages for other parents. Zoe’s daughter had gastroschisis*. She said the first few days were the hardest but there were some positive experiences along the way.
Parents’ journeys were all different, but many described how hard it was to keep going when they didn’t know where the end was. Being in hospital, often in neonatal intensive care (NICU)*, for weeks and months on end, was stressful and a real strain. Fiona and Mike described how hard it was to witness some of the sad outcomes for the babies around them, as well as their intense worry for their daughter. Although for the most part people felt they had no choice but to keep going, day by day, it was common to experience moments when they just broke down. Emma remembered, ‘That was my breaking point day. Embarrassing looking back now, but I think everyone has one.’ Amy said she wasn’t prepared for the strength of her emotions, she was so scared for her daughter.
The twists and turns along the way were hard for parents to cope with, and at times they found they couldn’t cope. Nicky’s son was born prematurely. She had been strong through the early weeks but when he had another set back she found it was the point when she fell apart (see ‘Emotions, support and counselling when a baby has neonatal surgery‘). Victoria developed post-traumatic stress and was having therapy to help her emotionally once her son was home.
Parents had different ways of coping with their worries and the uncertainties surrounding their baby’s health. Many described the adrenalin kicking in, just getting their heads down and getting through it.
Louise’s twin son had congenital diagphragmatic hernia (CDH)* and she was surprised at how strong she was. ‘My sisters commented that they were surprised because I’m a worrier as well, like my mother, but they were surprised how strong I was, but I think I was, no this is, he’s going to be fine and I’m on a mission to get through this.’
Many felt that they needed as much, almost forensic, detail as possible about everything that was going on with their baby to help them feel in control. Amy said she stayed by her daughter’s cot as much as she could, and chatted constantly to the nurses, learning and gathering information; ‘it was about that control and it was the little control I did have and finding control when you don’t have any. Or finding a way to be helpful when you’re helpless.’
Some found that being positive and staying hopeful was the best way for them to cope. Jane said, ‘I still do tend to cope with things by just making a joke out of them, I think that’s just the kind of person I am.’
Pamela said that when her son was born prematurely she and her husband made a decision that the only way they were going to get through was to be ‘relentlessly positive’.
Others felt that pessimism, exploring and facing up to the worst-case scenario, was their way of coping. While Amy E said her husband blocked out what was happening, for her facing up to the worst was her way of coping. ‘Even if it was horrendous I wanted to be there so I knew, cos I had in my head what I imagined would be worse than it was gonna be.’
At one point one of the nurses turned to Emma and said, ‘You are planning your son’s funeral, and you [her husband] are thinking of him being 18’. She felt that this was the only way she could cope.
There were also points when the worry got too much. Emma said her husband just had to leave the hospital for the whole of their son’s surgery, the situation was so intense.
“He disappeared from about 11 ‘o’ clock in the morning didn’t come back until 6 ‘o’ clock at night, the whole surgery, just went. He said, ‘I couldn’t cope I was gonna thump someone for holding him down and just making him scream’ he was that upset and that fed up having people hold him down, even though it’s for [son]’s good, as a dad he was like ‘I wanted to thump one of them so it was better for me to walk away.’ And it wasn’t that he was bad against the doctors it was just it was an intense situation.’ Emma
Some parents felt they needed to shut down or bottle up their emotions. Shanise said, ‘I think my emotions and my feelings were the last things to think about.’ Pamela said her husband was a ‘bottler-upper’ and ‘better at shutting stuff out.’ Mike said he ‘tried to keep it all inside’ and there were parts of the experience, ‘just don’t think about it’.
Parents often found that they coped differently with the stress and worry, which could be a way of helping each other get through. Some talked about how they would have opposite approaches; one positive and one negative, or one emotional, and the other practical. Rebekah said she herself wasn’t really ‘an emotional support person’ but her husband was more emotional and more of a worrier. Adam felt he had to prise his wife away from her daughter’s bed during the surgery. She wanted to sit by her cot and wait, but he forced her to eat some lunch and walk around the hospital grounds.
Looking back, parents could draw strength from the fact that they did cope and had come through the long ordeal. Michelle and Harry said they wouldn’t have chosen the experience but feel well equipped to face anything now. ‘You get through it, don’t you?’
*Footnote definitions:
Gastroschisis
An abdominal wall defect, that occurs when the baby’s tummy wall does not develop fully in the womb. A hole is present next to the umbilical cord through which the baby’s intestines protrude into fluid around the baby while in the womb, and outside the baby’s tummy after birth.
Neonatal Intensive Care (NICU)
A unit for critically ill newborn babies and infants who need the highest level of nursing and medical care. Babies in NICU often require support for their breathing. Those undergoing major surgery will often be looked after in a NICU.
Exomphalos
An abdominal wall defect, that occurs when the baby’s tummy wall does not develop fully in the womb. Some of the baby’s intestines and sometimes other organs such as the liver, develop outside the tummy and are covered by the umbilical cord.
Congenital Diaphragmatic Hernia (CDH)
A hole in the diaphragm, the sheet of muscle that separates the chest and abdomen.
Hirschsprung’s disease
A rare disorder of the bowel, where the nerve cells do not develop all of the way to the end of the bowel. The section of bowel with no nerve cells cannot relax and it can lead to a blockage. Babies all need surgery and may have ongoing problems with stooling (pooing) normally.
Babies who need neonatal surgery often have complex feeding needs, both before and after surgery. Although some may be able to breastfeed or take a...
Babies with surgical needs are often cared for by multi-disciplinary teams while in hospital. There was often a complex group of paediatricians, surgeons, neonatal nurses,...