Abigail delivered her triplets at 24 weeks after initially going into labor at 22 weeks and 3 days.

An early first trimester ultrasound with triplets.

Being pregnant with triplets is by definition a high-risk pregnancy from the onset. There is no blissful enjoyment of finding out you are pregnant. You immediately get referred to a high-risk perinatologist, have weekly ultrasounds and numerous appointments, and immediately start having conversations with your doctors that you never want to have. Parents navigating the decisions that come with higher-order multiple pregnancies (anything more than twins) are faced with impossible decisions from the moment they find out they are pregnant. Impossible decisions. Decisions with no right or wrong answers and every decision simply brings on another question.

Here are the themes we talk about in this episode.

1. There are no right answers, only answers that feel best for your family.

2. During your NICU stay, you can and will do hard things. You may not love it or like it, but you CAN and you WILL do the hard thing that is required of you.

3. While navigating the NICU, there is practically no time to process what is happening. Everything comes so fast, and you are simply focused on the next milestone. And then, finally, there it is — the magical milestone where you get to take your baby(ies) home — NICU Discharge. There is a common belief that if you just can get your baby home, the NICU will be behind you. But in reality, the processing happens after your NICU stay is complete. There is still work to be done so you can process your NICU journey. Additionally, for many babies, medical issues don’t just stay in the NICU. They follow you home.

4. The gift of therapy.

5. Do not be afraid to ask for help. And take the help.

6. Bridging the gap between NICU discharge and initiating intensive therapies.

This is the last episode for 2020. I hope you will join us for more family stories, medical storytelling, NICU education, practical parenting and a host of new collaborations coming to the Mighty Littles Community in 2021.

www.tinabryson.com

www.thecenterforconnection.org

Kangaroo time in the NICU!

I am excited to welcome Kim Walls back to the podcast this week for part 2 of our Focus on Touch in the NICU series. Kim is the founder of BEB Organic and an advocate for the importance of touch in our lives. In our first Practical Parenting Focus on Touch Episode (link here), we discussed why touch is important and laid out the practical tips for parent’s first touches in the NICU. In this episode, we are going to focus on Kangaroo Care, also known as skin-to-skin care, in the NICU.

1. Improved temperature stability (keep babies warm)

2. More stability in heart rate and breathing = less apnea and heart rate drops (bradycardia)

3. Improved weight gain for baby

4. Babies spend more time in a deep sleep

5. Improves chances of successful breastfeeding

1. Improves milk supply

2. Excellent bonding time

3. Reduces maternal/paternal stress and improves parent’s confidence in their ability to care for their infant

1. Discuss skin-to-skin (Kangaroo) care on rounds. This helps ensure the whole team (MD, nurse, parents) are on the same page. There is nothing worse than mixed messages around holding when you are prepared to be able to hold your baby, and then someone says no.

2. Plan it with your baby’s nurse. Let them know when you will be at the unit.

3. Avoid strong artificial scents, like perfume and body wash.

4. Dads - don’t shave

5. For moms, Kangaroo care can help increase your supply, so make sure you pump before you do your skin to skin time, or have a supportive bra with nursing pads in place.

6. You do not need any special clothing to be able to do Kangaroo Care. Having a stretchy shirt or a button-up shirt. You can also wear a hospital gown and put a blanket over the top of you and your baby.

Hello bright eyes!

At the end of the episode, I ask for some book recommendations; books that were particularly helpful to Kim either in her parenting or in her life. These were her recommendations:

• The Power of Onlyness: Make Your Wild Ideas Mighty Enough to Dent the World by Nilofer Merchant

• A series from the Gesell Institute, authored by Louise Ames and Carol Chase Haber, which starts with “Your One-Year-Old: The Fun-Loving, Fussy 12 to 24-month old” and continues through “Your Ten- to Fourteen-Year-Old”. These books help parents recognize what is developmentally appropriate at each and every year.

Hello everyone!

Thank you!

Thank you for following Mighty Littles.

Thank you for following the podcast.

Thank you to the parents who have trusted me to share their stories.

Can you believe it? We are here for Episode 25 of the Mighty Littles Podcast. For me, this is a huge milestone. When I started this new adventure into podcasting and blogging and writing a book back in March of 2020, I had no idea how it would go. I was filled with fear and anxiety. Nearly paralyzed by self-doubt and fear of failure. What if I fail? What if no one listens? What if I offend someone? What if I say the wrong thing? What if I don’t have enough to say? (ha — this is just not an issue, really). What if I suck?

I remember just thinking about all the reasons I shouldn’t do it. So I took a deep breath and started laying down the hoops. Just jump through one at a time, and eventually, you find yourself at episode 25! One interview leads to the next, and one podcast leads to the next. I am so proud of what this podcast is doing and I am incredibly grateful for everyone who was there cheering me on in the beginning and those of you who jumped on along the way. Thank you. Thank you. Thank you.

Now that I’ve said thanks, let’s dive into today’s awesome episode. Sara England joins me for a conversation about her son Sam. He was born at 25 weeks with Trisomy 21 (Down Syndrome). We touch on so many themes that there are too many to really count, but here are a couple of highlights.

• Talking about miscarriage is becoming more normal, and is hugely important in the healing process. As moms, we fall in love with that baby the minute the pregnancy test is positive. And because we don’t talk about it, miscarriage can feel completely isolating.

• Postpartum Depression and Anxiety can cause us to lose who we are as a person.

• It is ok to feel two things at once. You can be grateful and angry at the same time, or joyful and overwhelmed at the same time. It is ok. Motherhood is hard sometimes. And we need to make it ok to talk about it. “I wanted this so much, and I need help” - this is a phrase that should be normal in every new mom’s conversations.

• Discharge home from the NICU is not the end of your NICU Parenting journey. It is simply the first step in your journey as a parent of a NICU baby.

• Never underestimate the importance of Mamas holding their baby in the delivery room - 25 weeks and intubated and all.

• Grief is not linear. It is ok to choose the speed at which you dive into resources available to you.

• It is ok to change providers or therapists if someone’s personality and biases don’t match up with your child’s needs.

A candid conversation between Brittany Bergman, author of Expecting Wonder: The Transformative Experience of Becoming a Mother, and Dr. Anna Zimmermann about pregnancy and motherhood.

Dr. Joanna Parga-Belinkie, a neonatologist at Children’s Hospital of Philadelphia and Co-host of the Pediatrics On Call Podcast from the American Academy of Pediatrics, joins the Mighty Littles podcast for the first of (hopefully) many podcasts focused on NICU Education. I received feedback from listeners (families, nurses, and NNPs) that they would appreciate more podcasts focused on NICU education. So I am bringing more education to the podcast, starting this week talking about Respiratory Distress Syndrome.

Information on RDS.

Respiratory distress is a common reason infants are admitted to the NICU. But there is a distinction to be made. Respiratory distress is not the same thing as Respiratory Distress Syndrome (RDS). Respiratory distress is a descriptor - the baby is working hard to breathe and has respiratory distress. RDS is a diagnosis, defined by surfactant deficiency.

In this episode, Dr. Joanna Parga-Belinkie and I have a discussion about everything RDS - why babies have RDS, how we diagnose RDS, what our treatment options are, and surfactant!

In part one of our series on touch, you will meet Kim and find out a little bit about her background and passions. We talk about how Rose Oil can decrease water loss from the skin as well as why it is important to avoid hormonal disruptors in your products.

We move on to talk about practical tips for how parents can interact with their infants in the NICU. What type of touch do preemies need? How can you best interact with your baby? When can you touch and interact with your baby? And how to give hand hugs to your baby. I have included a couple of videos here to show some initial touches in the NICU.

Faith was born at 22-23 weeks gestational age and spent 140 days in the Neonatal Intensive Care Unit (NICU). Overcoming severe respiratory illness and vision issues, she is now six years old and recently graduated from Kindergarten.

During our conversation, Lizzie and I talk about:

• How difficult making decisions at 22-23 weeks gestation can be. Somewhere between 22-23 weeks is currently thought of as the edge of viability, and many providers have strong opinions about what parents should be doing.

• The benefit of primary nursing for micro-preemies.

• The benefit of journaling and documenting your NICU journey.

• Communication between parents and neonatologists must occur for everyone to feel like they are part of the team.

• The NICU is the start of the journey, but going home from the NICU is where the real work of parenting a preemie begins.

• Beads of Courage. Learn more about Beads of Courage here.

The Messy Mama Podcast and Mighty Littles join forces to bring your our Top 10 NICU Survival list. A unique discussion between a NICU Mama x 2 and a Neonatologist giving you insights into the world of the Newborn Intensive Care Unit.

1. Know the players

2. Learn the routine

3. Establish boundaries and a communication plan

4. Getting updates on baby.

5. Ask questions!

6. Kangaroo Care

7. When can baby go home?

8. Journal

9. Grattitude

10. Accept help

Listen to the podcast for all the details! There are some great tips in this podcast!

Dr. Zimmermann in the NICU.

Taryn with one of her Ex-NICU Babies!

Marquita had an uncomplicated pregnancy up until she went into preterm labor at 22-weeks. Kas was born weighing 440g. Being born at the edge of viability, she was given the option to “go with it or not” - you don't have time to think about it - you just have to make a decision. Marquita and her family decided to see what Kas would do. He had his misbehaving moments, but it was clear to the family that he was fighting, so they kept fighting for him.

How do you survive an 8 month NICU stay with your baby:

Nurses - they are a combination of your best friend, your favorite teacher, and your therapist.

Reading - Read, read read.

Connecting with your baby when you visit can keep you going and fighting for another day.

Find them on Instagram @Kas_Kares17