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Preemie NICU Clothing Information
copyright Maureen, NJ 2007 - All Rights Reserved

In loving memory of Marissa

I can tell you from  20 + years  of personal experience as a NICU nurse , the preemie items ARE CERTAINLY USED by the NICU nurses in any hospital.This is especially true of inner city hospitals that serve a low income population and therefore the parents may not have the means to purchase  even little personal items for their baby. And they are used in vast quantities. 

Preemie HATS
A preemie has a large head for it's body size, and experiences tremendous heat loss from its head. Consequently, the nurses try to keep their heads covered all the time. If a preemie has to "waste" calories by trying to maintain its temperature( or struggling to breathe independently) , then there are no calories left for weight gain or lung development.

Each and every time a baby is taken out of its isolette and handed to a parent to be snuggled, there is a good chance that the little knitted/ crocheted hat will be knocked off its head ( because most are too big for the smallest). Once on the floor, the parents can take it home and wash it, keep it,or do whatever, but it cannot be given back to the baby to wear  due to the risk of pathogens and  bacteria that are on the floor, on everyone's shoes, no matter how clean the NICU is.  And so the same baby may use several hats in any given day  ( Our floors were washed a minimum of  3 times a day, and STILL weekly cultures taken of the floors were scary. Infection control is an ongoing battle in any NICU..)

(Note from BEVQ - Yellows are not a good color for preemies as most preemies are jaundiced and since their skin color is already yellowish, wearing a yellow hat makes the baby look worse to the parents and nicu nurses.  You can use a bit of yellow in combination with other colors and that's fine.)
 
YARNS
I can also say that the  best yarn for these little hats is that  baby yarn that everyone hates with the little silver thread going through it... It does not release fiber/fuzzies very readily, and therefore is permitted for use on a baby with a trach, or on a vent with CPAP. No wool yarn is permitted to be used (even a wool blend) in the presence of oxygen since there is a potential for static, and even a small "shock" can be dangerous in the presence of increased ambient oxygen. Plus, the younger the gestational age of the baby, the more likely skin reactions are to "foreign" materials... some babies look like  a rash head to toe just from contact with the " used a thousand times and really soft" receiving blankets that we used instead of sheets. Soft really is important to them.

(Bev Qualheim who had 3 premature babies ~ soft baby or soft sport weight yarn is good.  Make sure the items you make have a lot of stretch to them as preemies have really delicate skin.)
 
HEAD SIZE
If I may suggest, that we make some hats and blankets really, really small.  The lower level of viability is a head circumference of 20.5 cm. That is roughly the size of a large egg at the widest part. Smaller than this, there is little likelihood that a child will survive, no matter how much effort is expended on its behalf.

Because some of these teenies are not the first but maybe the 4th or 5th pregnancy ( and this is as far as they have been able to get), and even if the staff knows in the delivery room that this child probably won't survive the night, we do everything possible to show these special parents that this child is every bit as much a person deserving of love and care as the 10 pounder in the next isolette... the parents  will have noticed the birth weight of that 10 pounder may have been just a pound, but that was 6 months ago. And that gives them hope, even for the moment.

The less likely it looks that a child will survive the night, the more important it is for the nurses to have TEENY hats (egg sized and very stretchy.. as you would see using a 2 x 2 rib), booties no bigger than a 1-1/4" sole, and blankets no bigger than about 10 x 12. As these babies are laying out on the warmers, the very fact that the clothes provided are NOT too big for their baby is comforting ...  they have all walked past the warmers where there is baby using a 1/2 cotton ball and saran wrap for a diaper, or a blanket made of a sheet of saran wrap to trap the baby's body heat.... the parents just don't realize that these babies are the same size as theirs, who happened to survive that first night....
 
BLANKETS and COLORS!
Finally, may I suggest that we steer clear of the traditional pink, blue, lavender, mint  and yellow for these  extremely teeny blankets and hats.  A dying baby has AWFUL color, and the blue and lavender especially make the baby look  even worse. Usually,the parents want to take pictures of their newborn, even if it is no longer alive, and the best made blanket in a traditional baby color blue makes those pictures ghastly. That is all they will have to show family and friends.  

Blankets and hats that are made white, with a small trim of color that will indicate whether the child is a boy or a girl, truly enhance the baby's appearance, and make the pictures easier for the parents in the weeks to come. (blankets and burial layettes that are used once the child has passed are lovely in the traditional baby colors...It is only for the blankets used while the child is still alive that white is the preferred color)
 
I know our hospital had the loving attention of women all over who made plenty of hats and blankets suitable for  babies about 3 lbs and larger, but it was the nurses who made the smaller hats, because the volunteer knitters did not know that we needed some to be even smaller, and even if we asked for some smaller, I think they did not believe we could possibly use them.... It would be a tremendous blessing to NICUs everywhere to include some sets for the smallest of the small....

*** Added Jan 2008:  Any fabric that has the potential to fray needs to have the raw edges bound in the most secure manner available. Whether this is  a crocheted edge over a (single) turned down edge, or turning the hem over twice does not matter. I have seen tiny fingers and toes turn black from having the blood supply cut off after getting them tangled in fringe, button holes, open stitching in a beautifully crocheted blanket, etc. The nurses cannot be at every baby's cribside at every minute, and it does not take long for a squirmy baby to get tangled up in thread of any kind. The finer the thread, the more present the danger.... worsted weight yarn ( while not terribly appropriate for preemies), will usually only cause some swelling below the site of the entanglement. Sewing thread, unravelling fabric edges,and fine fringe, can actually cut through a baby's delicate skin... the younger the gestational age of the baby, the more likely this is to happen as well.
 
Not to mention that even preemies will put anything in their mouths....if a baby is on a ventilator, there is no danger of them choking on a shread of thread. It is the babies that are not on ventilators who can experience a small shred getting stuck in their throats....



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