To the Extended Families of Preemie Babies

Preemie parents struggle to find balance. When our baby comes home from the NICU, we want to celebrate. We want to have everyone over to ooh and ahh over the tiny being. We want so badly to have a “normal” experience with our baby. But we are also painfully aware of the risks involved.

When doctors began talking about our son, Jax, coming home, they simultaneously talked about the importance of isolation. One of our doctors told us “the most effective way to prevent sickness and re-hospitalization is to limit exposure.” No contact, no germs. Maybe it’s not time to celebrate after all.

Thankfully, our family has been very understanding about our decision to keep Jax in isolation during cold and flu season. I think they “get it” because we started an open dialogue with them before Jax was even out of the hospital. We shared all of the information from our doctors. We shared our concerns. We asked for their help keeping Jax safe when he came home.

Unfortunately, some preemie parents get resistance from family about their decision to keep their preemie in isolation. So here’s what I have to say to those people.

Dear Extended Family,

Isolation isn’t about you. Let me explain…

Babies who are born prematurely are different than full-term babies. First, premature babies have under-developed lungs and often require life-support and breathing tubes for days, weeks and even months. An important goal for every premature baby is to breathe on their own. Unfortunately for some preemies, this doesn’t happen. Some preemies come home on oxygen support or on a ventilator. Their tiny lungs are not capable of keeping them alive without the help of a machine.

Even if there are no outward signs of breathing trouble, a baby born before 37 weeks might have immature lungs. (You can read about how babies grow in the womb here.)

Second, “during the last three months of pregnancy, antibodies from the mother are passed to her unborn baby through the placenta.” A baby is born prematurely misses out on these antibodies. “Premature babies are at higher risk of developing an illness because their immune systems are not as strong and they have not had as many antibodies passed to them.”

When you put these two things together — immature lungs and a weak immune system — you have the perfect storm. A simple cold can cause respiratory distress and re-hospitalization.

We are in isolation to keep our baby out of the hospital and living. It’s not about you. So, please don’t be offended when we:

• Decline your invitation to the party. 
• Ask you to wash your hands! (A lot!)
• Ask you to get a flu shot and a Pertussis vaccine. If you choose not to do this, please don’t be offended if we choose not to allow you to come in contact with our baby.
• Don’t allow you to visit when you are sick, even if it’s “just the sniffles.”
• Ask you to remove your shoes when you visit.
• Remind you not to smoke before visiting, or ask you to shower and change your clothes prior to visiting. Third-hand smoke is real and babies with immature lungs are extremely sensitive to smoke.

We know these things can be a drag. We know hand-washing can dry out your skin. (We will still ask you to wash and give you lotion.) We know you think your new boots are really cute with your outfit. (We think so, too, but we will still ask you to take them off.) We know you believe in alternative medicine. (We do, too, but we will still ask you to get a flu shot.) We know you have always heard that “babies need to be exposed to build immunity.” We know this isn’t true for preemies.

We know this is different for you. It’s different for us, too.

We know you want to see us! We want to see you, too. We miss you! But for now, we need to do what’s best for our baby. Isolation is a way to keep our baby healthy and out of the hospital. I know how much you love our child. So we know you’ll do everything you can to keep her safe, even if some of the things we ask you to do are out of your comfort zone.

Thank you for your understanding,

A Preemie Family

A version of this post originally appeared on An Early Start.

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