Vulnerability and Preemie Parenthood

by Deborah L. Davis, Ph.D. and Mara Tesler Stein, Psy.D.

For most parents of preemies, some sense of vulnerability lingers after homecoming. Many parents find themselves vigilantly watching for any signs of trouble, ever ready to intervene and fearing that the saga of prematurity will never end.

Hypervigilance -- I'm not sure it ever completely goes away. I think I have developed an awe for my children, that they can overcome anything, but a fear that they may have a lot to overcome. As soon as one of them wheezes, I am taken right back to the panic of the ICU. I think I will always be afraid that I might lose them still. Every parent must feel that to some degree, but I know I probably check occasionally [to see] if they are still breathing. ~~Stephanie

Feeling vulnerable is a natural reaction to what you've been through. The more fragile your baby was at birth and the more precarious the hospital course, the more likely you will be to continue to see your child as vulnerable -- regardless of the current outcome. You may pay close attention to your baby's breathing, sleeping, and eating. You may watch anxiously for developmental milestones and work overtime to shield your little one from infection.

Like most preemie parents, we were quite obsessed with her "numbers" -- how much she ate and how much she weighed! I kept charts of everything! It was also weeks before I was comfortable while she slept. I had to check on her constantly, to be sure she was breathing. She visited the doctor weekly for a while, to be certain she was gaining sufficient weight. We also took her to a developmental clinic on a regular basis. ~~Renee

I will admit that I tend to be on the neurotic side of things ... but this whole experience with Nicholas has just about pushed me over the edge. I am constantly jumpy with him. If he doesn't eat well one day, I watch him like a hawk and have everyone up in arms in case there's something wrong with him. Whenever we go to the store, I clutch him to me as if I'm afraid someone might breathe on him, which in all truthfulness is exactly what I'm afraid of. ~~Sterling

I do remember being very paranoid about her health. A small child once tried to touch her fingers, and I almost screamed at him. I was always thinking, "Get away from my baby!" This was tough because we had our own toddler at home. But we always had her wash her hands before "playing" with her sister. It really bothered me when visitors would not understand. I guess you have to have been there yourself. One friend came over with her two-year-old daugher, who wanted to "touch" the baby. I asked her please not to. My friend's response was, "Oh she is very good with babies." I wanted to scream at her, "This is not the issue, you idiot!" Garms are very scary to preemie moms. ~~Linda

Acknowledge the risks

When you express concern about the risks of infection for your baby, others may suggest that you are being "overprotective." However, your vigilance is justified: parents of preemies have some very serious issues to worry about. When some of your friends and family tell you to relax and treat your baby "normally," they are really just expressing their wish that your baby were a regular, hardy kid. But wishing does not make it so. It is your job to be mindful of the real risks and to take precautions that will make a difference for your baby. It is also your job to be mindful of your baby's growing resilience and strengths, and to avoid impeding your child with your needless or unfounded worry.

Separating real from imagined threats
Distinguishing between reasonable fear and unreasonable worry can sometimes be difficult. You may sense that you overreact sometimes. You may know that your sense of vulnerability has een heightened by trauma. But your baby did spend time in intensive care and does need special handling. How special is something you must determine with input from trusted advisors (pediatrician, friend, family). It is perfectly appropriate to protect your infant from real risk. Doing so is not being "over-protective" -- it is being careful.

No matter what you do, though, your control over your baby's health is limited. This can make you intensely vulnerable.