How to get outside with your NICU baby

Editor’s note: This article discusses Post Partum and Post Traumatic Stress Disorder (PTSD) and some readers may find it triggering. My first daughter, Miranda, was born at 26 weeks and 4 days' gestation in January 2013. She was born nearly a trimester premature because of Preeclampsia and HELLP syndrome, and weighed only 1 lb., 2 ozs. at birth due to Intrauterine Growth Restriction (IUGR). As a Micropreemie, there were many concerns for her health, including respiratory development, neurological damage in the form of brain hemorrhaging, pulmonary issues, retinal damage and possibly, above all, germs and infectious conditions. After a mostly uneventful 80 days in the Neonatal Intensive Care Unit (NICU) at 4 lbs., 4 ozs. and in stable condition, we were cleared to take Miranda home.

First days hiking with a NICU baby

For a long time after she was born, it felt hazardous to take Miranda places. Her small size and diminutive features often drew kind but imposing inquiries from strangers, and even the best-intentioned of people had a hard time being told to keep their hands away from a baby. The common cold can pose serious risks to babies born prematurely, and many have immature or compromised immune systems for as long as a year or more after birth. As NICU parents we were trained by staff to wash our hands often and thoroughly, and after discharge germs were priority number one. Miranda also needed a vaccine to protect her against Respiratory Syncytial Virus (RSV), which can quickly debilitate former preemies if not treated properly and promptly. It was suggested we protect our daughter from risk of illness by drastically limiting our time outdoors and in busy public places during the first month of her being home, and then again in the following winter. Having spent the first three months of her life in the hospital, my husband and I were eager to share Miranda with the world. We wanted to share our world with Miranda and achieve some normalcy after the chaos of her birth. Feeling trapped at home inside the lush green paradise of Oregon was unsustainable.

Gaining freedom through hiking

Hike it Baby appealed to me as a NICU mom because it created opportunities to get my child and me outdoors for some fresh air, exercise and social interaction without the nose-wiping, toy-sharing and germ-swapping typical of many playdates, indoor play centers and kids' venues. It also allowed me to introduce my daughter to the wonderland of the Pacific Northwest and begin to develop her appreciation for nature. It rained our entire first hike, and while Miranda had passed out in her carseat from the fall chill, dampness and activity, I congratulated myself on braving the elements and exposing my daughter to the sights, sounds and smells of our home state. Hiking with Miranda would require focus for safety, and lots of good breathing, so it was entirely acceptable for talking to take a backseat, and if I became upset it was unlikely the other hikers would take note.

Struggling between joy and sadness

I struggled with untreated Postpartum Depression as well as PTSD from my NICU experience, and it was difficult to manifest a lot of emotions that were visible on the surface, especially happiness. If I allowed myself to get too happy, it would easily cross over into a great and deep sadness that was hard to control. I felt like my emotional wires were crossed for a long time after the NICU and I knew social interaction with other moms would be a double-edged sword. On one hand it would allow me to celebrate and commiserate around the motherhood experience, while on the other hand it could potentially trigger a lot of the grief, resentment and sadness I sometimes felt in the company of term babies and their families. Parents of NICU babies and preemie parents are everywhere, and I've met more than a few through Hike it Baby. I've also been able to encourage other NICU parents to get outdoors through partnering my peer-to-peer support organization, NICU Families Northwest with Hike it Baby. Fresh air, physical activity, sunshine and even rain can be healing for people coping with trauma. Socially connecting with peers normalizes our experiences, and witnessing the natural world around us encourages a meditative sort of reflection that can help relieve stress and anxiety.

Six Tips for Getting Outside with your NICU baby

It's been over four and half years but I continue to be inspired by our NICU experience and the way Miranda overcame her challenges. The strength and determination that our children are born with, and the courage and love their parents give them from day one, motivates me to do all I can to help NICU families heal and thrive. Here are some tips to help your family get outside and thrive in the outdoors with your NICU baby.

1. Plan ahead and prep your outdoor kit in advance. Everything you can do to remove your mental obstacles to getting out the door gets you and your baby that much closer to the trail. It's easy to make excuses the day of, and no one will blame you if you don't show, but you and your baby will reap the benefits if you are mentally and physically prepared.
2. Pack light but right. Hiking doesn't require all the toys and tools a home playdate would so leave the excess at home. You'll want to layer yourself and your baby for the weather, plan for any small snacks you might want, bottle, comfort item for baby (blankie, pacifier, special toy- tethered to your carrier if possible), hydration, and a conservative spit-up/diaper kit.
3. Find the right carrier. Having a smaller than typical baby or one with gross motor challenges can create additional challenges for babywearing. Talk to other NICU parents, ask the Hike it Baby community, stop into a local baby shop to troubleshoot, or consult someone from a local babywearing group to overcome these issues.
4. Find a hike that works with your nursing/feeding/pumping schedule. N/F/P-ing on the trail are all acceptable, welcome, and encouraged, but life is easier with a well-fed infant. Don't be shy if you need to use a nipple shield to nurse on the trail, mix formula to feed or supplement, or push some food to your baby's stomach through a g-tube. Hike it Baby is a come-as-you-are community and parents are incredibly respectful of individual comfort.
5. Start small with walks around your neighborhood, and take advantage of the opportunity to talk to your baby about the natural world. Let him/her touch leaves, smell flowers, and feel rain. Carry a small tube of hand sanitizer with you and some wipes, but enjoy the fresh air and local landscape knowing you're acclimating your child to your regional flora and fauna, and encouraging an active, outdoor lifestyle.
6. Don't panic if your baby doesn't seem to love hiking. Tears and fussy behavior are expected in babies and kids, and it's important to remember that you benefit from time outside as much or more than your baby. Connecting with peers is vital to parent health especially in the early months, and healthy parents raise healthy babies. Ask for suggestions to adjust your baby for comfort and take them with a grain of NICU salt, knowing their solutions are well-meaning and it's okay if they don't suit your particular situation or baby's needs.

Read More:

• One Mother’s Journey to Overcome Postpartum Anxiety and PTSD
• The Less You Carry: Dealing with Postpartum Anxiety

For more insight into the NICU family experience:

• NICU Families Northwest

Photos courtesy of Anna David.