Transition home – the first week

Many parents talk about the roller coaster of emotions they experience when they go home from hospital. Feelings of joy and relief at getting to this stage are mixed with anxiety and nervousness at being away from the routine and monitoring of the hospital. It’s not unusual to feel overwhelmed and alone when you go home. In fact some parents have said this time is ‘down right terrifying’. So it is important to be aware of the whole range of emotions you may experience. We are all different and it is important that you can share your feelings with those around you and try to find ways that help you cope with the transition. It is not unusual for it to take a few months to relax into your home routine.

Parents often say that they find it hard to find time to look after themselves when they get home with their baby but keeping an eye on you and your partner’s health and wellbeing will help you and your baby (Taking care of our family).

Here are some thoughts from other parents about their experience of coming home with their premature baby:

• Take time to celebrate progress. There’ll be lots of reasons to feel positive.
• Deal with things one step at a time.
• Take time out for yourself everyday even if it’s just a five minute walk around the block or to the shop, do relaxation exercises or listen to music and rest as much as possible.
• Go with your instincts in establishing your own routines.
• Watch out for burnout – you may be coping with your routine but if you are constantly on the go you could be exhausting yourself – it is important to share your activities with others around you even if you don’t think they can do things for your baby as well as you can.

As there are so many changes and new experiences during these first weeks at home it is important to let others help you. Family and friends can be a great source of support at this time and there are many health professionals and support organisations you can contact to ask for advice and support.

Challenges to coping

The trauma of premature birth

Premature birth is a traumatic experience. After giving birth you may have experienced shock, confusion, anger, or a sense of loss. Some parents feel okay at first and the trauma hits them weeks or months later. Be aware that the experience of trauma can stay with you for months or even years. If you are finding it hard to move on, talk to your GP or health visitor about getting support to work through your experience.

Expressing how you feel

Each member of your family may cope with stress differently so talking with your partner, family, or friends about how you feel and what you are thinking is important. It may not be easy to express how you feel and what you are thinking so discussing simple everyday things is important. Talk about what you’re doing, what they’re doing, how you feel, and how they feel. At other times you may want to talk and share experiences with people outside of your family, for example, other parents, volunteers, and health and social care professionals. There are also people who will help support you through TinyLife and other organisations. Support & Advice

Competing demands

The competing demands of bringing your baby into your home routine, whether this is your first baby or your fifth, are many, and your home life will change. The demand of this can feel even more challenging if you have a premature baby who needs additional support or medication. Competing demands can make you feel out of control and may be difficult to cope with so it is very important to recognise how this makes you feel. It is important to ask for help to do things that are important to you but you are struggling to find time for.

Tiredness

Parents can neglect themselves when they are caught up in the ongoing care of their premature baby and this can lead to feeling very tired and physically exhausted. Not all parents like asking for help because they feel they must always be there for their baby themselves. To look after your baby you need to be well and that means taking time to rest and relax. Ask for support. Remember that being in good mental and physical health yourself is part of taking good care of your baby (Looking after yourself). Family and friends may help if they are around but they may not live near by or be available. Look for organisations that can offer support such as Tiny Life.

Going back to work

While it is good to get back into your work routine, it can also be a very stressful time for mums and dads as it is another change that can add to tiredness, frustration, isolation, or feelings of resentment. If your baby is sick you may want to spend more time on leave so it is important to get advice. If you need advice there are a number of local organisations who might be able to help. Get advice.

• Keep connected: talking with people you are close to.
• Follow our tips on looking after yourself.
• Don’t be afraid to ask for practical support.
• Find out the leave and benefits you and your partner are entitled to.

Looking after yourself

Many of the things that help your physical wellbeing also help your emotional wellbeing. These are some basic things that can help you look after yourself:

Getting sleep

This is easier said than done! Tiredness after giving birth is to be expected, (After birth) as is a broken night’s sleep with your baby waking up. It’s important to identify ways of maximising your sleep and finding times to rest during the day. (Taking care of our family)

Eating well

Eating well is important for keeping your energy up, particularly if you are breastfeeding. (Physical wellbeing after the birth)

Exercise

Exercise can help you de-stress; whether it is going for a walk, doing some exercises at home, or taking part in your favourite sport, it is important for your well-being. The National Institute for Health and Care Excellence (NICE) also recommends exercise for reducing mild and moderate depression. However, it can take a bit of planning and being creative about identifying opportunities. (Physical wellbeing after the birth)

Skin to skin contact with your baby

You may have practiced kangaroo care in the neonatal unit. If so, you know how good skin to skin contact with mum and dad is for both you and your baby. You can hold your baby on your chest, skin to skin, at home. It is a great way to relax with your baby and it will help you and your baby feel close and bond through touch and smell. Make sure the temperature of the room is comfortable for you and your baby. (Taking care of baby)

Looking Ahead- challenges first year

Realistically, for all parents, there are going to be highs and lows throughout your baby’s first year. Looking after your well-being is very important for your baby as well as you! Don’t be hard on yourself, and remember it is okay to ask for support. Sometimes the whole family is stressed and you may need to look for support outside of your family and friends. Your GP and health visitor are important sources of support. However, sometimes you may just want to talk with other parents. You can find out more information on sources of help and support here.

Looking after yourself: what other parents say

There are many things around new parenthood that are common, no matter what experiences you have in the early days with your baby. You may find it helpful to be part of parent networks and groups. Many parents find it useful to keep in contact with other parents whose babies have been in NICU, or meet others through parent support groups who understand your journey and worries.

Here are some suggestions from parents who have experienced bringing their premature baby home:

• Take time to celebrate progress. There’ll be lots of reasons to feel positive.
• Deal with things one step at a time.
• Take time out for yourself every day, even if it’s just a five minute walk around the block or to the shop, do relaxation exercises, or listen to music. And rest as much as possible.
• Go with your instincts in establishing your own routines.
• Watch out for burnout – you may be coping with your routine but if you are constantly on the go you could be exhausting yourself. It is important to share duties with others around you even if you don’t think they can do things as well as you can.

Low Mood & Anxiety

What to look out for

It is not unusual for parents to experience low mood and significant anxiety in the year after giving birth. You may feel sad, anxious, worried, tired, frustrated and/or angry when you get home. However, these emotions tend to lift after a few days or week. You may be worried about any number of things; for example, your baby’s health and wellbeing, your health and wellbeing, your relationships, money, and the future. Mums and dads can experience anxiety and depression after premature birth and sometimes there may be a delay in recognising the symptoms because you have felt the need to hold things together for your family.

If those feelings are particularly overwhelming or don’t go away you may need more help. If you feel you are not bonding well with your baby you may want to talk to someone about how you feel. NHS Choices provides helpful information on physical and psychological symptoms of depression and anxiety. nhs.uk

Getting more support

Usually health care professionals will ask you about your mood and anxiety after giving birth at your regular follow ups (6-8 week check-up). If for some reason you have not had the opportunity to discuss how you feel with your GP or health visitor and you are feeling stressed or low, it is important to contact them to discuss how you are feeling.

If you start to feel life isn’t worth living or that you want to harm yourself or your baby, get help straight away. See your GP, call NHS 111, or Samaritans on 116123 for 24 hour confidential support. People living in Northern Ireland can call Lifeline on 0808 808 8000. Deaf and hard of hearing Textphone users can call Lifeline on 18001 0808 808 8000. Calls to Lifeline are free to people living in Northern Ireland who are calling from UK landlines and mobiles.

Other resources for parents

Am I depressed? – Tommy’s website

Looking after yourself – Tommy’s website

Mental health in pregnancy – Out of the blue website

Boots Family Trust Alliance –   Boots Family Trust