Questions Re: Preemie and Adoption

congrat on your new baby. My thought at this point is to have faith that things will happen the way you need them to. I know right now that seems lame, but in a few months when all this is behind you , you will look back and say "everything came together for this to happen" You just may have a long road ahead of you. Any chance you and daddy can swap up long weekends? Maybe your employee will work with you on this. keep us posted.

Is the baby stable? If you arrive and relinquishment occurs, I would think the baby could be flown to your local NICU. It would be short trip if they are only 8 hrs away by car. Of course, baby would need to be out of danger for the trip. Both my babies came at 33 weeks and had no health problems. I know that is 4 weeks later than this baby and those 4 weeks can make a BIG difference, but perhaps baby is stable to move? Then you would not be out of state and could be there as much as possible. Also, your family and friends could pitch in where they can't long distance. Good luck and I hope this match is perfect! Kim

From what I heard... I wouldn't take a baby from the NICA at that age, so yes you would probably have to stay there for a long time.

As a nurse I would never suggest moving a premie until they are very stable or close enough to discharge. Also most of yje time even though breast milk is best, premies are not able to latch an actually breast feed so more than likely it will be expressed milk(pumped) for quite some time. An ideal situation would be if the aparents could be there and have access to the NICU so they can do kangaroo care, skin to skin and feed and bond with the baby.. The mother will be discharged from the hospital long before the baby. From what I understand the mother can relinqush while baby is still in NICU, it may be different state to state, but where I live it can bve done. I do know of a case where the amom stood at a Ronald McDonald House while the baby was in the NICU for about 7 weeks and then flew the baby home to her state for the remaining 2 two weeks. The baby was fed expressed milk and donor breast milk from a milk bank. Whatever you decide, good luck . Life in the NICU is a whole different world I can assure of that. EZ

I had my son at 28 weeks. He spent 2 months and 2 days in the NICU. I was going to comment on the bf'ing but EZ said what I was going to say. I tried to bf my ds maybe 3 times, but it just took too much energy for him to latch on and get a full feeding. I pumped for 5 months! So, yes, breast milk would be very beneficial for him, but she will probably have to pump vs. actually bf'ing!!! My dd was born at 33 weeks and I didn't have the gumption in me to pump again so I went straight to formula and she turned out just fine. Also, I highly recommend kangaroo care if at all possible! My heart goes out to you, the baby, and the pbm. What a stressful situation and then adding the fact that the baby is early makes it even more stressful. Hang in there!

My daughters were born at 31 weeks and stayed in the NICU for 29 days. I stayed at the nearby Ronald McDonald House the entire time. My husband was there for the first week, then returned home to go back to work. Relinquishment was done four days after they were born and we asked for them to be transferred to a hospital closer to home. Simply put, our insurance wouldn't pick up the lifeflight expense unless they needed to be moved to another hospital for medical reasons. Since they were in an excellent hospital with a top-notch NICU, insurance would not cover the expense of transporting them. So I stayed. ICPC was processed during the time we were there and when the girls were discharged, we were able to just head straight home. Good luck to you!

kimanne-- Wow, what a whirlwind for you! My oldest ds was a 28 weeker (71 days in the NICU) and I am a doc in the NICU. Given your situation currently and that reliquishment hasn't happened yet, who are you getting the medical information from? If pbmom will allow you to be in on updates from the medical team at this point, that is what I would recommend doing. Even though a baby born at 29 weeks is very likely to survive in this day and age, there are still a long list of complications that can happen- and every baby is different. And while the baby may check out medically fine now, a complication may occur that would change that. Discharge date will depend on how the baby is doing. Most babies do go home before the due date, but there are some that don't- again all depends on if there are any complications. This is potentially such a hard decision to make and, I assume, that you don't have first hand access to the information. Also, if possible, connecting with the social worker in the NICU may be of benefit to you and pbmom as well. My advice is to get as much information as you can while still respecting pbmom's limits, both about this baby and about babies born at 29 weeks, in general. There are so many potential issues, that I don't want to alarm you unnecessarily by listing them, but do find out what you can. If you want more specifics, please feel free to pm me. As far as breastfeeding goes, babies born at this age can't orally feed yet and pbmom would be supplying valuable nutrients, antibodies to the baby, especially with the first milk. Babies aren't able to suck-swallow-and breathe consistently all at the same time until about 34-35 weeks gestation (with a due date being at 40 weeks gestation). I know this is long, but I really feel you need to know what you are potentially agreeing to and if you've already decided to match, then you need to know what is going on witht he baby and what to watch for in the future. Being the mom of a premature infant can be exceedingly stressful- it's a long journey full of ups and downs that will continue even after you go take your baby home from the NICU. I brought my baby home 8.5 years ago and even though it was the most stressful thing I have ever been through (keep in mind that I am a NICU doc!), I would do it again in a heartbeat! Best of luck to you and feel free to pm me with questions! Congrats!

We adopted Owen last year and he was a preemie born at 26 weeks, we didnt find out about him (agency was still searching for aparents w bmom) until the day he was discharged which was 8 weeks later - so a nicu stay of 8 weeks. No health issues then or now luckily ! One thing I wanted to say on the breastfeeding is that for our son the bmom didnt want to bf or pump so they used a breastmilk bank - a place where others moms have donated breast milk. That way he got the benefit of the breast milk. So if your birthmom isnt interested in bf that's always an option. With our son he was assigned a foster mom, she stopped by the nicu every few days because she wasnt allowed to hold him in the beginning and she couldnt stay very long so before you take any time off I would also find out the NICU policies. good luck and if you have any more questions feel free to PM me ! oh also TPR can happen the same way regardless of the nicu stay (meaning if its after 10 days or 3 days whatever the baby being in the nicu doesnt matter from a legal standpoint). g.

DH and I were with our son as he spent 19 days in the PICU, 9 days in the NICU, and 5 days on med-surge. This wasn't due to him being a preemie, but to him being born with a very severe, rare heart defect. His birth mom terminated her rights in front of a judge when he was 11 days old, and on day 40 (yes, day 40!) the judge terminated all birth parent rights, and tribal rights. Rights could have been terminated whether he was in the hospital or out. He was flown from his birth state (very emergently) to our home state's children's hospital. My personal opinion after dealing with a medically fragile baby is to not have them flown just to be closer to you. It just isn't worth the risk.We were with him every single day while he was in the hospital, even the days where he was paralyzed and completely sedated. On the days where we didn't feel very well, we put on gowns, gloves and masks to be able to see him. It was hot, but I couldn't bear to be away for very long. I would have such a difficult time not being there, so I really can't give you any good advice. I know a lot of the preemie parents weren't able to be there due to work, but really, the babies do so much better with someone there. I'd recommend that you do whatever you can do to be with that baby as much as possible.I find it really odd that a parents time would be limited in the NICU due to hospital policy. At our children's hospital, a parent can be with the child 24 hours a day, as can a grand parent.Our hospital had their own version of a Ronald McDonald house where a lot of parents stayed for free. Really check into that. We could have stayed there, but chose to stay with family instead. That should be available to you most likely.It's very important for the babies (birth or pbirth) mom to sign the release allowing the docs to give you the info on the baby, if she feels comfortable doing that. Our son's birth mom did that and I am SO glad she did.Life in a hospital for days on end is hard, but so worth it when you get to bring that baby home! :) Our stay was long, and we'll have more (more open heart surgeries), but that's just what we have to do. HTH. If you have any specific questions, let me know.

Our son was also a preemie (born at 31-32 weeks). We did not get the call until he was 3 weeks old, so we only spent 1 week in the NICU with him. I second the others who have supported pbmom providing breastmilk if she is willing. I was donating to a milk bank prior to adopting our son and they started feeding him breastmilk within a couple days of us arriving. Between the breastmilk and the extra attention he really thrived once we got there. There are a couple of other things I would suggest you consider. #1 If baby is covered under state medical insurance will that change if TPR is signed (it didn't for us)? Even if you have good private insurance NICU bills will be expensive. #2 Our ped was very insistant that visitors be limited and our son NOT go to a daycare/be around other kids for a quite a while, due to his suseptibility to illness from being a preemie(even though he was healthy at the time). So, you will not only have to consider the time you will spend with him in the hospital, but also the time someone will have to with him at home. We ended up finding a babysitter that watched only one other child and he was able to go there after a month. Good luck! We now have a happy healthy two year old that is perfect in every way! He is my healthiest kid :)

Our DS was born 15 months ago in CA. He had an infection and spent 8 days in the NICU. Bmom could not sign TRP until after he was discharged. I believe it was the agency that handled the TRP and ICPC's rule. (They had a baby where bparents signed TPR's, then medical issues arose while baby was still in the hospital and the aparents backed out. The agency was then the legal guardian of the baby and won't do TPR now until the baby is released.) Once TPR was filed with the State of CA for us, the ICPC process started. (My dh had to fly back home and our sons sweet bmom bunked with me at the hotel for that week. It was an emotional rollercoaster, but I never doubted for a moment her commitment to the adoption. It was hard on her too, as she could feel herself bonding with him more and more each day. We also were not allowed there from 6-7 am and 6-7 pm while they did shift changes.) So, ask your agency their rules and the state's rules about TPR. And like previous posts stated, check insurance rules, medical info, local housing, etc. Best of luck!!!!

I just wanted to add something that may be of help to you. If a baby is born 2.9lbs or less, he/she is eligible for SSI benrfits and medicaid for up until a year or more. SO you might want to look into that if you are really worried about insurance and hospital bills. I know a mom of triplets(her own through IVF) that recieves these benefits and get about $2500 a month in cash benefits along with medicaid. This does not go by income prior to having the babies and not at all like welfare. A hospital social worker would be able to guide you about this. Hopefully baby will be born at a healthy weight and not require to be in the NICU , but if by chance he/she does it is best to know all your options. As others have said, NICU ife is a whole different world and preemies are prone to so many more problems, but so many do so well it is amazing. My best advice is to know what you are going to be getting into because life with a preemie can be really challenging even after discharge from the NICU. Sleep apnea monitors and other devices are not uncommon after discharge. Research research and research some more. EZ

Thank you everyone for your responses. PBM is supplying breastmilk and I do not have an issue with that. Baby girl is doing very well at this point and I can only hope it continues. She is evidently very active, brain u/s was clear, she is feeding as well as iv fluids. Relinquishment has not occurred as of yet. We had the first call with the primary birthparents today and are going for a visit this weekend. We will proceed from there. I'm not sure how it's all going to work out but we are attempting one step at a time. Thanks again. Kim

Oh I had forgotten that the baby was was born already when I last posted. Good luck and enjoy your visit. EZ