Top Tips for Photographing your Baby in NICU

For many the NICU is a completely surreal world.  You feel overwhelmed by all of the machines, wires, probes, noise and how big it is with SO many babies.  This however is YOUR baby's story and for many it will be important to try and capture all that is going on so that you can share it with others who are unable to visit and also so that you have a record to share with your child when they grow up.

The NICU is a tough environment to take nice pictures.  Hopefully we can share a few tips with you to make those memories a little more polished.

Know Your Camera

It doesn’t matter if it’s a point and shoot, your iPhone or a professional DSLR.  Know how to:

• Turn it on and off
• Focus it properly, for most cameras that is pushing the shutter button halfway, for your iPhone holding it still until the yellow square appears and locks
• Turn the flash off.  Keep your flash turned off whilst photographing in the NICU regardless of the type of camera you have.

If your not an experienced photographer keep your camera on automatic settings for both exposure and focusing.  If you have more experience you should know to set your white balance, turn your ISO up and how to meter and choose the right depth of field for the shot you are taking.

Remember to hold your camera still whilst focusing, as the image is taken and for a moment after.  Consider bracing yourself against a chair, wall or table if you are a bit shaky.

*Note - some NICU's will not allow mobile phone use, other's require airplane mode.

Video

Almost all cameras and phones now have video capabilities.  Along with still images you may like to capture short clips of your baby moving and the sounds of the NICU.  Similar principles apply to taking video, know how your device works, keep as still as possible, move slowly, zoom slowly.

Keep It Simple

When looking to take your photo consider if there are things in the image that could be removed to keep the image simple, or consider if you are able to move yourself to change the angle of the image to remove some of those things.  Sometimes getting up high, down low or simply moving left of right will dramatically change the outcome of your photo.  The plastic from the isolettes will create some glare, again moving and shifting your angle can help to minimise or eliminate that.

As baby gets bigger and you are able to freely pick them up and move about within the nursery consider some images by a nearby window which will create some beautiful soft light and provide a change of background scenery.

Capture the Environment

Your baby may be spending days, weeks or months in the NICU.  Make sure you step back and take an image of their bay from a couple of different angles which includes all of their machines and monitors.  If they move bays or nurseries be sure to do the same again.  One day your child might like to know which machine was which and what they all did.  Even if you don’t know the answers a photo can help them understand.

Milestones & Details

As your baby moves through the NICU and reaches milestones like 1kg, 2kg, moving from an isolette to an open cot, first cuddle, first breastfeed etc make sure you are taking photographs to mark the occasion, these moments will never be firsts again.  Treatments and monitors change all the time in the NICU, take images that capture the details eg : blood pressure being taken, sunglasses for phototherapy lights, when they are finally IV free, tiny fingers and toes etc, remember this is your baby's story.

A sense of scale

Babies in the NICU are all different shapes and sizes, many are very, very small  Use your partners hand, a wedding band, a coin or a toy as a size comparison for your baby.  As they get bigger take further images so you can see just how far they have come.  As your baby will no doubt have restricted visitation no one will truly understand just how small your baby is unless you can provide that sense of scale.

Routine

Participating in baby's cares is one of the few things that parents can do for their baby whilst in NICU.  Changing that first nappy, massaging their head when their CPAP hat is off, giving them a bath when they are bigger.  These things are generally part of baby's overall daily routine.  Time your visits with your partner so that you can take turns in the cares whilst the other one captures the moment.  Don’t forget the quiet moments too.  Sometimes you will just sit with your hand on bub, sit quietly and read to them, or might hold them skin to skin (kangaroo care) these moments are just as important to immortalise and can create really powerful images for you to look back on.  If your partner isn’t available to take an image for you don’t be shy about asking the nurses, they will be delighted.  It’s important for you to be in the photos too.

Home Time

Finally going home is almost an equally overwhelming feeling as finding yourself in the NICU in the beginning.  Don’t get caught up and forget to document this momentous occasion!  Collect up all of baby's NICU mementos, show them in their car seat, at the doors to the NICU, at the doors to the hospital, in the car, at home in their bed and being welcomed properly into your family.

Once you have all of your images you may consider putting together an album or scrapbook which tells baby's story.  There are many ‘drag and drop’ sties which make this very easy to do.  For our readers we have managed to secure a discount from Blurb valid until 23 June.  When checking out enter 15%OFF (save 15% off on orders $50+*), 25%OFF (save 25% off on orders $100+**) or 35%OFF (save 35% off on orders $250+***).  Please see conditions at the end of this post.

A couple of things to note.  Many hospitals don’t like for their staff to be photographed so always check with baby's nurse that they are ok with being in your image.  Also always check with the nursing staff before moving baby or anything in or around baby.

All images appearing in this article were taken with a consumer point and shoot camera on automatic.

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**Offer valid through June 23, 2014 (11:59 p.m. local time). Valid for printed books only. A 25% discount is applied to your product total with a minimum purchase of USD $100, CAD $100, AUD $100, EUR €75 or GBP £55. Maximum discount is USD $150, CAD $150, AUD $150, EUR €120 or GBP £100 off product total. This offer is good for one-time use, and cannot be combined with volume discounts, other promotional codes, gift cards, or used for adjustments on previous orders.

***Offer valid through June 23, 2014 (11:59 p.m. local time). Valid for printed books only. A 35% discount is applied to your product total with a minimum purchase of USD $250, CAD $250, AUD $250, EUR €200 or GBP £150. Maximum discount is USD $150, CAD $150, AUD $150, EUR €120 or GBP £100 off product total. This offer is good for one-time use, and cannot be combined with volume discounts, other promotional codes, gift cards, or used for adjustments on previous orders.

The Challenges Continue for Adison

This is part 3 of a 4 part series.  You can read part 1 here and part 2 here.

Bringing Adison home to our family was amazing.  His entire NICU stay he was unable to meet his siblings as the NICU has a strict parents only visitation policy.  The children were overjoyed at meeting their new brother but also cautious knowing just how fragile he was and how close he'd come to never coming home at all.

Around 6 weeks after coming home i became concerned for Adison's health.  He was lethargic, not nursing well, irritable and having grey spells when travelling in the car.  Both the local ER and his followup NICU paediatrician brushed off my concerns but i knew something wasn't right.  At our routine cardiology appointment it was revealed that Adison was in the preliminary stages of heart failure.  He had left the NICU with a patent ductus arteriosis (PDA) which had now caused pulmonary hypertension, meaning that the blood rushing to his lungs was at too high pressures thus putting his heart under extra pressure.

The cardiologist was confident that the pressures could be controlled with medication so that was organised and we were sent on our way.  The plan was for a catheter procedure to plug the PDA when Adison was around 1 year old or 10kg whichever came first.  Just 3 days later, after 5 doses of medication we landed ourselves in the local hospital ER.  Adison had rapidly deteriorated and had had an unprecedented reaction to the medication where the pressures drop too low, it was a scary time.  We were immediately transferred to PMH and the Doctors kept us waiting a couple more days whilst they worked out a plan of attack and made sure PICU beds were available.

Post op in PICU.  I had a mild irrational panic when i saw him, my baby, on a big bed, with no side rails.  He was heavily sedated and not going anywhere!

Yet again we were at life and death cross roads.  I was taken to the surgeons office to consent to a thoracotomy and PDA ligation.  They would make an incision on Adison's back under his shoulder blade, enter between the ribs and manually tie off the offending artery which runs between the heart and lungs.  The surgeon made it clear that without the surgery Adison's heart would ultimately fail and he would pass away.  With the surgery there was a very real risk that the main artery to the heart may tear as they went to tie off the PDA which would cause him to bleed out on the table.  I had to trust in the steady hands of the surgeon and the strength of my son and sign the consent.  There was no other real option.  Russell and our other children were home in Australind and again I was faced with this confronting situation alone.

Whilst 6 months had passed since Adison's birth he was still a tiny 4.5kg.  Hours past and finally I was told that everything was successful and Adison would be spending quite some time in PICU ventilated and sedated until they were sure that everything would be ok.  10 days later we were discharged.  Adison was doing much better but this had been a significant setback that would take him many months to overcome.  Adison came home on a hospital apnoea monitor and nocturnal oxygen.  Damage had been caused to his lungs and he required additional support whilst sleeping.  He was also having regular apnoeas and no one was quite sure why.  Sleep studies later revealed the apnoeas were caused by his premature central nervous system.

Home oxygen.

I can sit!  1 year old and still tiny in size 000 clothes.

3 years on and we have had numerous admissions to hospital for pneumonia requiring oxygen for many days, sleep studies, MRI, 2 sets of grommets and his adenoids removed.

Adison's gross motor skills were very delayed, he rolled at 9m, sat at 13m, and didn't walk until 22m.  He was on home oxygen until he was 18m at which time he could finally maintain stable levels of oxygen whilst sleeping.  Adison continues to suffer from chronic lung disease and is very susceptible to cold and flu bugs.  The challenges don't stop there, we attend speech, occupational therapy, physiotherapy and numerous specialist follow up appointments to help Adison become the best person that he can be.

In spite of the labels that follow Adison around the medical world, chronic lung disease, cerebral palsy, hypotonia, verbal & oral dyspraxia, dysarthria, sensory processing disorder, he is an amazing, bright, confident little boy who's catching up, every moment of every day.

Look at me now!  Just one of the gang.

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Adison's NICU Journey - Up Close and Personal

This is part 2 of a 3 part series.  Part 1 can be found here.

After the whirlwind that was my classical section birth at 4am, finally at 8pm that evening I was functioning enough to be wheeled into NICU to properly meet my new son for the first time.  Wow!  That was confronting on so many levels.  The heat from the NICU made me feel physically sick but I was determined to stay as long as possible and see my boy.  To find out what I could about all these tubes wires and machines keeping him alive.  It was noisy, bright and there were SO MANY BABIES!  I think the thing that shocked me most about NICU was the sheer number of tiny babies being supported and kept alive by the amazing staff and technology in the NICU.  After a very short period I couldn't physically stay there any longer, it was time to return to my room.  Adison was ventilated but stable.  They were treating him with prophylactic antibiotics as they felt he may have an infection and he was moving about, flapping his little arms and legs in his incubator.  In spite of all this Doctors had ordered feeds of 1ml of breastmilk per hour as tolerated in a bid to prime his gut.  We had also been approached to participate in two research studies which we consented to.  One was on genetic prediction of preterm birth, the other was on the type of lipids given in the NICU.

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Meeting Adison 865g.

The next couple of days were about recovery for me and progress for Adison.  On day 3 the Doctors decided that Adison was breathing well enough to be taken off the ventilator and put on CPAP.  My milk had come in, I was in pain and was an emotional wreck.  My husband and children were staying with my parents.  2 of my kids were sick.  As I shuffled past the nurses station, holding the wall to help me balance and hunched over because the pain was too great, but struggling on because there was no one to wheel me to NICU a nurse popped her head out the window and said, "I think we'll send you home this afternoon."  I burst into tears and continued to walk to the NICU.  I could not contain myself, my thoughts.  How could they possibly discharge me when I can't even walk properly and my baby is in the NICU?  Where will I go?  Home is 2 hours away.  How will I possibly look after my other children when I can't even look after myself?  It was all too much.  When I got to the NICU I couldn't say a word.  I sat quietly and watched my baby and cried.  I returned to my room and was visited by an admin staff member and we had an argument about me staying 1 more night.  In the end I won.  I stayed 1 further night and was discharged the following morning.

As a rural mother I was offered accommodation at Agnes Walsh House.  I had never heard of the facility before, in fact I had never set foot on the hospital grounds until wheeled in by the ambos just days before.  I wasn't sure what the accommodation was like, what it cost, where it even was.  I asked for information, a hand out, anything, nothing came.  All I could find out was that it was for mothers only.

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Very sick.

On day 4 I had my stitches removed and was discharged from hospital.  I went home to my parents house in the northern suburbs of Perth.  Adison was initially doing well on CPAP but as the days went on he moved less and less, he was struggling more and more.  On the evening of Day 6 I called the night staff before going to bed to check how he was doing.  This had become part of my routine.  The nurse looking after him said, "I'd be lying if i said he was doing well."

No words can describe the terror you feel when you hear words like that.  Overnight Adison became worse, at that point they didn't know what was wrong but suspected some kind of infection.  He was ventilated again and blood tests and a lumbar puncture revealed he had contracted a very nasty infection, heamophilous influenza which was now ravaging his body.  So we waited, watched and hoped.  Adison was pumped full of antibiotics, received the first of three blood transfusions and was on minimal handling to give his body every chance of recovery.

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First cuddle.

Slowly he started to regain some of his strength and his CRP levels came down.  The treatment was working and he was getting better.  Finally on day 18 I had my very first cuddle with my baby boy.  Words can't describe how I felt.  At one point I thought that moment would never come.  I had sat by his bed and quietly whispered to him that it was ok, that if the fight was too great, it was ok for him to go, I would not make him suffer.

After three false starts over the coming week and 2 further lumbar punctures Adison finally made it off the vent and back onto CPAP.  Things were looking up.  He was tolerating his feeds and most importantly he was putting on weight and growing.

On the morning of day 28 I walked into the nursery and was surprised to see a big open cot in Adison's bay.  I immediately assumed Adison must have been moved overnight but thought I would just walk down to his bay to check.  

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Adison and his favourite friend 'Blue Dog'.

To my surprise Adison had been taken out of his incubator overnight has he had progressively got hotter over the previous 24 hours and there was nothing to indicate that he had an infection.  They had turned his incubator off and opened all of the portholes and he was still hot.  They were left with no other options than to take him out of the incubator and into an open cot.  He had only just hit 1kg and I was told normally they waited a bit longer than that but Adison wanted out.  He had just moved onto full feeds which he was tolerating well and his TPN had finally been removed.  My baby was IV free for the first time in his short little life.

After 7 weeks of visiting the NICU daily it had become so routine that I had to remind myself that it was an intensive care unit.  My baby was growing but he was still requiring a lot of breathing support to keep him alive.  Without CPAP he was not maintaining his oxygen saturations.  Adison had become the healthiest baby in the NICU and there was rumour that he would be moved out to HDU (High Dependency Unit) that rumour was right and later that week he was moved.  I was so anxious about the unknown, but my fears were allayed, HDU was lovely and the staff just as friendly as the NICU.  Some of them the same faces.

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First try on PBF oxygen.

Many more weeks went past and the biggest hurdle we faced was breathing.  Adison really wasn't ready to move off CPAP.  His head was suffering terribly from being squashed by his CPAP hat and it was decided that his head needed a break and he would be tried on PBF oxygen to give his head a rest.  It was decided they would try for 1 hour every other day to begin with and add foam inserts into his hat to protect his head more from the CPAP.  It was at this time that Adison began non-nutritive sucking where I would express off my milk and offer an empty breast for him to nuzzle.  He was so keen but could only manage 3 or 4 sucks before wearing himself out.

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First cuddle with Dad.

My husband was yet to cuddle Adison.  He had returned to work in Bunbury so was only visiting on weekends.  Between juggling our 3 other children at the weekend and visiting Adison we'd not been to visit him together at all.  We finally made arrangements and Russell had his first cuddle.  Wow, what a way to get the emotions flowing that was!

Christmas was rapidly approaching and poor Adison seemed stuck.  He was still cycling off CPAP and onto PBF, he'd had a few set backs going back to full-time CPAP.  He'd needed another blood transfusion and was having a few breastfeeds here and there but was wearing himself out too quickly.  It was a waiting game yet again, and then quite quickly he decided to get a wriggle on!

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First bath.

He managed to move off CPAP onto PBF and get a proper bath for the first time!  We was sucking more feeds and the door was looking closer and closer.  He moved from his big white cot into a smaller wire basket, passed his newborn hearing screen and continued sucking more feeds.

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Heading home, 2.7kg.

But of course there is always a hitch with getting these little ones home.  Adison had an ingroinal hernia and as it was Christmas break there were no surgeons at PMH who could operate and he was not to be discharged without the repair.  So we waited, and waited.  Then he needed an extra eye exam, so we waited for that too.  In the end the Drs made arrangements for 3 babies to have surgery at PMH as they were all ready to go home and just waiting on hernia repairs to get out the door.  A lovely Dr returned from Christmas break early and conducted all of their surgeries.

Finally on January 8, 2 days before his due date and 100 days after he was born we left KEMH NICU in Perth and headed for home back to Australind.  We thought the worst was over, that now we would watch our baby flourish, but things change fast!

Part 3 of Adison's story can be found here

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If you would like to share your NICU story with our community please get in touch via our personal experiences page.  Your stories help people through their own journey to know that they are not alone and that in spite of all of the obstacles facing their baby these little ones are true warriors.

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Adison's Birth Story

This is part 1 of a 3 part series.

Early in 2010 my husband Russell, our 3 children and I moved to Australind.  Not long after our move we found out were were expecting baby number 4.  The next few months were smooth sailing pregnancy wise until...

On the morning of September 27 2010 I was lying in bed, awake, feeling baby kicking.  I commented to Russell that baby was kicking a lot and took his hand to feel my tummy.  Right at that moment I felt a warm trickle and jumped out of bed for the toilet.  By the time I sat down my pyjama bottoms were soaked and I said to Russell that I thought my waters had broken.  We were both in disbelief.  I was only 24 weeks pregnant!

I called the hospital and threw a few things in a bag whilst Russell got the kids some breakfast, then I drove myself to hospital.  I'd actually never been to the hospital before and needed a couple of goes to find it.  When I finally arrived I got out of the car and there was a big gush, and at that moment I knew for sure that my waters had really broken.  I think I had been in denial up until that point!  I made my way into the hospital and found the maternity ward.  I spoke with a lovely midwife who was most helpful and got me settled before the Dr arrived.  They both made it clear that I had to be transported to Perth, to King Edward ASAP and they had already put in a call to the Royal Flying Doctor Service to airlift me.  They did not have adequate facilities for a 25 week baby at St John of God Bunbury or Bunbury Regional Hospital and given my 1 hour 15 min labour with my third baby there was some panic that things might progress rapidly.

I managed to phone Russell and through the tears let him know the situation and asked him to call my Mum in the city and make arrangements to head to Perth with the children.  Meanwhile I swallowed meds to stop contractions, was swabbed for Strep B which I had with 2 previous pregnancies, had blood taken and had an injection of steroids to help babies lungs produce surfactant.

A few hours later I was transported via ambulance from the hospital to the airstrip, then flown to Perth and again transported by ambulance from Jandakot airstrip to King Edward.  I was assessed and admitted on arrival, more blood was taken along with another swab and I was advised I was now on strict bedrest.  That night I hardly slept a wink.

The next morning I was taken off for an ultrasound to check on baby and make sure he was OK.  Thankfully he was OK, but the scan showed there was no amniotic fluid left and that baby was a footling breech.  Later than morning the team of Dr's assigned to me attended and advised that as baby was a footling breech I would need to have a cesarean when the time came if he remained in that position.  Further they advised as baby was only 25 weeks it would need to be a classical cesarean as there wouldn't be enough room otherwise.  I signed the consent required and asked what the averages were like for women in my position.  How long did they normally last before the baby was born?  I was told the reality is generally they last not longer than 1 week.  I received another injection of steroids to help babies lungs.

The following day, we are now at Wednesday 29 September Russell and I decided that if we made it to the following Tuesday for another wellness scan on baby we would find out if we were having a boy or a girl.  We also decided that if baby arrived in the meantime we selected the unisex name Adison.  Just as well we had that discussion!!  At 3.45am the following morning I got up to go to the bathroom.  When I got back into bed I felt a very strange sensation, like there was something there that shouldn't be, then it started flapping about!  I pressed the call bell as I was concerned and waited for a midwife.  While I was waiting the flapping got worse and I grew more concerned.  I hit the emergency bell and immediately half a dozen midwives flew into the room.  I explained that I could feel what I thought by this time must be a foot flapping about where it shouldn't be.  They called a 'Code Blue' and whisked me out of my room and down to theatre in the blink of an eye.  When we got to theatre they checked and sure enough there was a little foot prolapsed.

They had just enough time to give me a spinal block which meant I was awake for the operation and Adison was born via classical c-section at 4.04am.  He weighed 865g was 34cm long and a head circumference of 23cm.  I was able to give him a quick kiss on the forehead as he was taken to the NICU for attention.  His Apgar scores were 6 and 8 so he was going ok, but going to need lots of help.  Unfortunately Russell missed his birth and arrived at the hospital as the nurse handed me the phone to tell him our baby was a boy.

Meeting Adison for the very first time.

The balance of the day was a complete blur.  When they removed the spinal block I received a loading dose of morphine which had me fuzzy and asleep until 4pm.  At that time I started expressing for my little man and when Russell came back to the hospital that evening I visited the NICU and was able to see him properly for the very first time.

This is only the beginning of our story.

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If you would like to share your story with our community please visit our personal experiences page, complete the form and we will be in touch.

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