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Dr. Elana interviews Dr. Erin Psota, Canadian naturopathic doctor and mother who had to navigate life for 2 months in the NICU with her first born child. This episode may be a tear jerker for some of you mamas, but it sure is a great resource to support you parents who have or are currently navigating life in the NICU. Dr. Psota’s story may be unique in that she had some time before she delivered to plan for her NICU experience. If your story is similar, or you have mama friends with a similar story, you will want to hear how she gracefully navigated the NICU.
Dr. Erin Psota 0:03
Even if you have a baby who can’t come out of their incubator, you can still take their temperature, you can still hold their hand, you can still rub their little feet. There’s always ways where you can connect with your baby.
Elana Roumell 0:15
Welcome back to Whole Mamas Podcast. We’re here to give you tools, resources and evidence-based information so you can make the best decisions for yourself and your family. Whether you’re trying to conceive, or navigating life with a toddler or a teenager, we got you covered. I’m Dr. Elana Roumell, pediatric naturopathic doctor and creator of Med School for Moms – an online resource where I teach moms how to safely be a doctor mom. My co-host is Stephanie Greunke, registered dietitian and program director for Whole30’s Whole Mamas Club and co-creator of the Whole30 pregnancy program, Healthy Mama, Happy Baby.
I’m so happy to start off this month series on navigating the NICU. Steph and I, we love supporting moms through all different experiences. And we really haven’t yet touched on moms who’ve either had personal experie`nce with the NICU, or have friends who they want to support who have gone through time in the NICU. So this month we have various interviews lined up with moms who share their personal experience. They are courageously sharing their stories to help us moms guide us through their personal experience. Now on today’s show, I invited a colleague of mine Dr. Erin Psota. Dr. Erin is not only a naturopathic doctor and colleague of mine, she’s also a dear friend and one of my instructors that helped me teach my new online program at school for moms. She specializes in pediatrics and practices in Toronto, Canada. On this episode, we’re going to get personal with Dr. Erin. She’s going to share with us what it was like for her on the side of being the patient, finding out the news that her baby will be born early and will inevitably need a NICU stay. Dr. Erin’s story is so moving, when I first heard it, I knew her experience would be a gift to others to inspire hope and optimism through scary times. So I’m excited to bring Erin on to the show today. So let’s go ahead and welcome her and hear her story.
Hi, Dr. Erin Psota, I’m truly so happy to have you on today not only for our listeners, but also selfishly I find this topic to be something that I’m personally not very up to date with. I haven’t had a personal experience with the child and the NICU. And I think it is just such an important topic that we’re navigating this for our mom listeners and, and also for so many of us moms who have friends that have children in the NICU. We want to know how to support them. And so I know as a colleague of mine, you’re also a naturopathic doctor, hearing your story and hearing how you navigated this, both with the medical background and as a mom was really inspiring to me, and I knew we needed to have you on today’s show. So thank you so much for the time away from your busy practice and coming on today’s show to help teach some of the moms what you’ve learned through your experience and shining some wisdom that you’ve gained from your experience. So thank you again today to being here.
Dr. Erin Psota 2:58
Thank you so much for having me, I’m really happy to be able to share our story and talk to your listeners on the podcast.
Elana Roumell 3:05
Great. Well, thank you. So as you know, we start all of our episodes with our nourish yourself segment. So my first question to you as a mom, what did you do today or what will you be doing today to nourish yourself?
Dr. Erin Psota 3:18
So today is a bit of a delayed gratification answer. But I booked myself a massage for tomorrow at a spa where you get to sit in the steam room before and after your massage and really maximize the benefits of the massage and relaxing alone time.
Elana Roumell 3:33
Awesome. I love that, oh, you’re gonna enjoy. That’s so wonderful. And I always find it so interesting to hear what people are up to. Because, you know, I think a nourishing practice could be as simple as making a warm cup of tea. And it can also be as luxurious as this type of massage. So I’m so proud of you and impressed for you to just get that on your schedule and make that happen, because I know how busy you are. So you enjoy that.
Dr. Erin Psota 3:56
I absolutely will, thank you.
Elana Roumell 3:58
And so, something that I’m doing today, to nourish myself, it’s also coming later in the day. I actually have yet another meeting with an assembly member of here in San Diego. And I’m meeting with another group of doctors to really help fight this sad bill that we have going on about vaccine rights. I’ve been incredibly involved. I know Dr. Erin Psota, you’re in Canada, so you’re probably not very familiar. But hear in California, unfortunately, we’re having a lot of proposed bills trying to exclude medical exemptions from medically fragile individuals so that they’re no longer able to be protected against some of these vaccines. And so I’ve just been incredibly passionate about this, since I do work with a lot of Pediatrics, you know, kids just similar to you do in your practice. And my job is to really protect these kids. So I’ve never been such a litigious person, but I’ve been going to meeting to meeting, making so many calls, getting a lot of people together to really take action. And the reason why I bring this up is that as much energy and time this is taking me, it is incredibly nourishing to me. And the reason is, is that it feels really good to take action, when you feel like something may interfere with your life or your patients life or people in your community’s life that truly is wrong. It doesn’t feel fair to me, it’s not giving these medically fragile individuals a fair chance to really have a say in what their doctor feel like it’s important for them to do or not. So anyway, it really does fill my tanks, and it’s a nourishing practice to me. And although I’m pretty exhausted from doing all this advocacy work, the upside of it is that it really does fulfill me and nourishes me. And so if anything can, by me sharing that, inspire some of the listeners to really take action, if you are a California resident, I do a lot of promotion on my Instagram page just to share and educate. And so it really does feel good when you’re in action. And so that was just something I wanted to share, since I am gonna be doing that later today, yet again, in another meeting. So I’m looking forward to that and it really does make me feel good.
Dr. Erin Psota 6:07
That’s great. I actually do have sort of my ear to the ground on on what’s going on in California, mostly because sometimes Canada follows suit when us laws come into play. And you know, I would say even my own little kiddo, maybe she’s not considered medically fragile at this point, she definitely sort of orbits that sphere. So I’m pretty conscious of, of vaccine exemptions, and what’s happening both in the US and Canada right now. So I’m glad to hear that you’re doing that.
Elana Roumell 6:35
And I’m really glad you are aware of that. And that’s what I tried to educate even non California residents is you still need to be up to date with this. Because if we do have this bill pass, you’re going to be next. And so we all have to be fighting. So thank you for the support there. And it’s actually a very pertinent topic, I think to this episode. But you know, we’re going to be talking a lot about these NICU babeies who had a start in their life that makes them just more susceptible to having a more watchful eye on them. Right. So they are either premature babies, but not all, NICU babies are premature, right? They can range from pre premature babies or not even pets do babies, you know, it all just depends. There could be so many different conditions that warrant a NICU visit and, and these babies start out with needing some extra attention and extra care and, and that’s really my philosophy, and I know yours too Dr. Erin Psota, is that we really treat our kids as individuals, we take into account their their history, their family history, and we want what’s best for these children. And so I think it’s so important that we’re here as parents to support these little guys, and protect them from whatever harm that may come up and with vaccines is just it’s such a controversial topic and so complex because there’s really no right way or wrong way. It’s very, it’s very challenging. It’s it’s risky to not give vaccines, it’s risky to give vaccines, there’s just so many different topics.
But that’s not the topic of today’s episode. I think we can easily talk for hours about that. But I just wanted to bring that up since it is kind of on my mind and so pressing, but I am glad that you’re you’re on top of it. But let’s jump into the NICU and how, as a mom, and as a doctor, you’ve been navigating life in the NICU for a number of months. So if you don’t mind, maybe as a start, let’s share your story. Let’s share how old your little girl is and what your process was with navigating life in the nick you and what and then we can go into some of the great questions we got from some of our moms.
Dr. Erin Psota 8:40
Sure. So Edie is two and a half now, she’ll be three at the end of at the end of August. And for us things actually got really complicated at our 20-week ultrasound. And the story really, from that ultrasound to Edie’s actual birthday could probably we’d be the subject of a whole other podcast. But that actually meant that we were prepared for a hospital delivery in an operating room. We knew that she’d need medical interventions, regardless of when she was born. And they really tried to prepare us for any possible outcomes from possibly not even making it to a live birth, to needing life support, and, you know, anything sort of in between. And I don’t mean to start out all doom and gloom because we were always really optimistic. But I do think it’s important to hear that we were expecting a scary beginning, which I think is different in terms of mindset, then a surprise, early delivery, or complications with delivery or a surprise diagnosis and and otherwise normal pregnancy. So I’d even been admitted to the hospital for 10 days before I actually went into labor. So there is time for the information to sink in. And I’d gone for a tour of the NICU the day before Edie was born, which was actually just the floor above me. So there’s a lot of sort of prep work that had already gone into what I knew about the NICU and what we were sort of steeling ourselves for before she even arrived.
What I actually found really helpful, as soon as we got launched into the high risk/special pregnancy category, was joining some Facebook groups that were really specific to Edie’s diagnosis. So I wanted to mention that that also sort of helped me sort of prep for potential treatments or outcomes around what might happen before she was born and after she was born too. Edie e was actually born at 32 weeks and four days. We got to see her really quickly before she was whisked away to be stabilized. And it was maybe eight or 10 hours before we were finally allowed to go up to the NICU to see her, and even though that felt like and still seems like eons when I say it out loud, we were just so relieved that she had made it and she was okay. And she was okay for us to actually go up and see that, you know, we didn’t care how long it took.
When I think about those first few hours and meeting her for the first few minutes, and in the beginning, at first everything really seemed overwhelming – from how many tubes and wires she was connected to, to all the machines that were around and what was beeping and the alarms going off in her room or in other rooms, and even things like the nurses schedules and the schedules that they have the babies on. But everything actually really runs smoothly. And you get used to things really quickly. Again, I’m going to sort of sound a bit doom and gloom here. But in the interest of of being really honest about what my mindset was like, for the first few days, I was really secretly terrified that Edie was going to die while I wasn’t there. And I would wake up at home and have this increasing sense of panic that I have to get to the hospital urgently. And once I directly voiced this concern to one of our primary nurses, she assured me that they do everything humanly possible to contact the parents immediately, if things were to take a turn. So before things, whenever they can, before things get to really serious, they would call me. And knowing this and actually saying that out loud to somebody, really helped to alleviate my sense of panic. And it let me sort of relax when I was at home and let me relax in the mornings before I got to the NICU. It let us get into like a good routine of getting myself up and showered, and to and from the hospital every day. And since Edie ended up being in the NICU for two months, that routine was actually really important. So I’m glad that in hindsight, I didn’t panic every day about like, ‘Oh my god, am I going to make it in time? Is something going to happen? Did I miss anything overnight, and they didn’t get in touch with me?’ I felt really good knowing that, of course, they would contact me right away.
Elana Roumell 13:18
Now I’m going to interrupt because there’s so many different points that you mentioned that I think are so important, but this is I mean, I’m so engaged right now, I’m sure the listeners are too. Your story is really fascinating. The first part is you acknowledge it’s not that common for moms to be so prepared ahead of time prior to a child having to go the NICU – oftentimes it’s either an emergency transfer, or the diagnosis comes up post labor, even though right there was no complications during pregnancy. So in your case, I could see how that was a definite benefit for you. You had time almost to process it, you had time to join those Facebook groups, you had time for you and your husband just to sit say, ‘Oh my goodness, what’s the best case scenario? What’s the worst case scenario? Where’s our support system?’ So I think that’s really a wonderful gift I would say that you guys got. And I appreciate you just acknowledging that that’s not how all parents have it. But I like that there are ways to still go about getting that support even after the fact. So thanks for sharing that.
The other part that you brought up, and I’m mostly just curious about, is what your day to day schedule was because you said you would go home. Even the eight to 10 hours without her there, to me that feels like aeons, right? You mentioned that. But for you guys, you knew that’s where she was going to go. You knew that’s where she was getting the best care. So you were you were prepared for it. What was it like, though? And what was your day to day where you weren’t with her even in between those evenings? Could you stay overnight? Did you have to go home? But what was it like for you? And of course we’re talking about now Canadian hospitals, which could very well differ from us, but we surely have some Canadian listeners. So, you know, not knowing if this is the same policy at all hospitals.
Dr. Erin Psota 15:07
Sure. And I will also say that we live in Toronto, so we’re in a big city. And I would say that we have we were lucky to be at one of the best NICUs probably in in the country. So I I can only speak to that really lucky and wonderful experience I have. No I don’t have a good frame of reference for what other NICUs are like, so we count our blessings for that for sure. And, you know, in terms of our day to day in, in hindsight, I often tell people that we actually got more asleep with her in the NICU then parents who have a have a newborn at home. We knew that every night when we left her, she was in the care of highly skilled nurse who was only in charge of her and one other person, baby, and she was fed every three hours and monitored constantly. And even though I was at home waking up to pump every three to four hours, that was probably more difficult emotionally, but pumping was quicker and more efficient and more predictable than a newborn. And so that actually helped us get a bit of peace of mind, and some rest at home.
But in terms of the the actual day to day, I would get up and pump. because that’s what life was like, and by the time I was done pumping and cleaning pump equipment, I would set out to the NICU and just spend the day with her there. I got used to her routines and did all of the things that I could do to take care of her there. After the first two weeks of parental leave that my husband could take off of work, he went back to work, and so every day he come right from work to the NICU and that would be his time to get to hold her and and probably sneak in a feed when she was when she was on bottle feeds with breast milk, he would get to feed her. Then sometimes I would go home first and sometimes I would wait for him and and we would go home at the end of the day together and grab a bite to eat sleep and get up and do it all over again. And with respect to your question about staying over for us, it depended on what kind of room we had. There are some rooms in in the NICU that we were equipped with sort of a bench that would have been probably okay to sleep on. Our room was little smaller. And we just had sort of this reclining chair that was most definitely not okay to sleep on. But once I once I started to transition to breastfeeding and she was stronger and able to breastfeed more, then they put me in a breastfeeding mama room down the hall. And so I started staying over at the hospital more more often once that transition was happening. Then, before we actually took her home and this was really helpful, their transition process is to get the whole family to stay at the hospital in in a room that isn’t a NIC room with your infant baby before you take them home so that there’s a bit of space between being constantly monitored with nurses to ask questions to, to all of a sudden I’m home and there’s no more wires and nothing and what if I’m panicked about that. So was sort of this mid range where we were all together as a family, but with no wires and no monitoring and no beeping.
Elana Roumell 18:51
I love that it kind of eased the transition for you. That’s fantastic. And how long was your total stay? Did you say two months?
Dr. Erin Psota 19:00
Yeah, we were there for two months. She was born in August the 26. When we took her home on October the 26.
Elana Roumell 19:05
My goodness! May I ask, just from an emotional standpoint, how it felt for you to have to leave the hospital to go home and go to sleep? I mean, I hear what you’re saying is you’re panicked in case you got that call or you missed something. What was it just to even leave her, just that emotional attachment to her,ow did that feel for you?
Dr. Erin Psota 19:26
You know, once I got over the panic, I’m sure other moms will have a bit of a different answer on this one. I think that knowing how important that it was for me to not feel super exhausted, and knowing that getting home was the only way that I would get any rest, and knowing that being at home was when my husband and I could actually talk and connect about our days and her day. I mean, we never really wanted to leave her. But it wasn’t as sort of heart wrenching as you would think it would be. You know, it wasn’t likeh , ‘Oh my god, I can’t believe I have to leave her at the end of the day today.’ We always felt like, ‘Okay, she’s asleep. Now she’s fed, we cuddled with her as much as we could all day today. I know she’s in really good hands with the nurses. Now it’s time to go home.’ And it was a doctor or a nurse who said to us early on, ‘You can only take care of her as well as you take care of yourselves.’ And I think we both really took that to heart. And so it was like, ‘We’re leaving now we know, you know that we’re going to be back in the morning, and you know that you’re safe here and the nurses love you, and we’re going to be back. So it’s okay.’
Elana Roumell 20:43
I find this to be incredibly inspiring. I’m not sure how I would do it, if I was in your position. Of course, all of us wouldn’t know until we’re actually there. I think your story is incredibly inspiring. So moms understand and truly believe how important it is for us to not neglect our needs and to put our needs first so we can show up as the best version of ourselves. It’s not a selfish act, it’s actually something that’s a necessary act, which is, again, why we always start our episodes with the nourish yourself segment. It’s something that we want to continuously remind moms that it’s not only okay to do, it’s essential that you do and so thank you for sharing that. So honestly, because, you know, we may have a mom thinking, gosh, how could you do that? That must be so wrong or so hard. But you know, at the end of the day, that really was what was best for Edie. And now that I know her as like this great toddler, she’s thriving and just doing so well. And I mean, that’s a whole nother story we can go into is where she is now. But going back into the past, you really did what you needed to and I really commend you for that, because it’s not easy to make those choices.
Dr. Erin Psota 21:55
No, certainly, it wasn’t easy. But there got to be a point of, ‘Well, you know, even if we sat here all night, it’s not like we could do anything.’ Right?
Elana Roumell 22:05
Right, what would you do? Exactly. I appreciate that. Now, let’s talk about the day bonding. So if you were there all day long, you got to snuggle as much as possible. One great question just asked a lot about how do we bond with the wires and the cords and all the IVF? They really want to feel like the primary caretaker. And yet they’re still dealing with all the doctors and the NICU nurses and kind of navigating what are they allowed to do in terms of caring for the baby versus what they need to get permission to do? Can you speak a little bit about your experience, and maybe help some of the moms who are currently navigating this and give them some tips, what they can do?
Dr. Erin Psota 22:47
Sure, and this might also depend on the NICU that you’re in, as well. For us, I know that we are at a really forward-thinking NICU – they were really concerned about what they call family-centered care. And so they really made sure that we did everything that we possibly could do. And so at first, we really didn’t have to think very much, we just kind of were like zombies, who did what we were told by the nurses and the doctors, and we went to the meetings and the support groups, and we took the CPR class, but they also were really keen to get us invested and bonding with with Edie. And so that means that the nurses really showed us how to get our hands into the little incubator, and talked to us about handwashing procedures, and helped us to figure out how to change diapers within her little box, figure out which wires like would pull, which wires were actually IVs and going into her skin, vs which were just sticky things,that that kind of thing and navigating those little, little pieces. They really were keen on getting us holding her as much as possible, as soon as she was okay to come out of her little incubator. So as soon as she was extubated, and as soon as she didn’t have to be under the UV lights constantly, they got us holding her right away. So lots of skin to skin time and they have the babies on a three hour schedule. So we really knew what times she would eat, and what times they would want her sort of in our arms so that they would be able to do her feeding to with her in our arms or when they would not want to put her in our arms after feed. There wasn’t sort of too much jostling around after feed. So we got good at figuring out the schedule. And they were really great at helping us navigate what baths were like, and getting the wires off of her for a bath and teaching us how to how to hold her, because they’re really, really little before they’re full-term babies. And it’s really easy, more so than your average first time newborn mom, to feel like, ‘Oh my god, I’m really going to break this little person.’ And with every day that went by, we got used to either what she was already attached to, or she would get stronger and need one less machine or one less wire. We would get more comfortable and taking out of the incubator, putting her in and out of her crib when she got to that point on our own. So I really credit the nurses to to helping us bond with Edie and the policies of the hospital. But they really reinforced for me that you could pretty much do anything and everything. And if you ask, they are really great about even if you have a baby who can’t come out of their incubator, you can still take their temperature, you can still hold their hand, you can still you know rub their little feet, there’s there’s always ways where you can connect with your baby.
Elana Roumell 26:06
I love it, you know, as challenging of a situation a this is, sounds like this hospital was a really wonderful supportive place for you guys. It doesn’t sound like you had to fight for your rights or really feel like you had to advocate for Edie. You really felt like she was under great care and what great peace of mind you had. I’m so happy to hear that. And sure, I wish that for all Moms. I’m not sure what their experiences are. I know, my co-host Stephanie Greunke’s also going to be interviewing some other moms. So for the listeners, I do recommend you listen to those others because everyone’s experiences different. We all have our own unique experience. But this hospital just sounds wonderful! Amidst the situation, I feel like it couldn’t get much better than this. Would you agree?
Dr. Erin Psota 26:17
Oh, it really couldn’t. And I like what you said about advocating because they were really clear with us from the beginning that we were the constants in her life. Doctors and nurses get to go home and sleep and get to take time off. But we would be the ones who were there every day. And so they would take it seriously, if we said, ‘You know, I think she’s working harder to breathe today than she was yesterday.’ And they knew that there’s no caregiver who’s spending the day in the NICU who isn’t paying attention, who isn’t going to be able to say I think her colors off, or I think she looks a bit swollen here, or I think that IV is really giving her trouble. And when we said things like that, they would take it seriously and they would look into it or you know, they would make a note of it and and follow up and measure or increase or oxygen or do whatever it took to sort of make us feel like we were making sure that she was getting the care that she needed. So they were really clear about that.
Elana Roumell 28:12
Excellent. And I would say maybe for the mom listeners out there is encouraging them to speak up because perhaps they don’t feel like they may be taken seriously. And they want to put all of those decisions into the nurses or doctors hands. But even if they don’t have such a receptive staff, it’s still so important to be your child’s number one advocate because at the end of the day, the parents are more bonded to that child than anybody else. And so they can pick up on some of these signs and ques much sooner than even some of the machines or the nurses or stuff. So I think that is really a brilliant tip. So thank you. And again, I’m just so glad you had such a great experience there.
I have a personal question, because I’m sure other listeners may benefit from this, just how you navigated life I’m just sitting here imagining myself in your position. And I think to myself, my goodness, how am I blocking off all my patients? Or how am I just stopping cooking at home? Or how am I going to figure out how to take time off all these other commitments that I have in my life. And of course, you had to also come up with those choices and make those really challenging decisions. Now again, in Canada, you have a better maternity leave than we do, although you’re self-employed. So you have some obstacles there. But what was it like just navigating, figuring out how to even be available two months straight to be at the NICU, that was your full time job! Can you speak a little bit on that? I hope that’s not too vague of a question.
Dr. Erin Psota 29:44
No, no, it’s not. It’s not vague, though that will definitely be one of the differences in terms of I think Canadian maternity leave questions. Like you said, even though I am self employed, she was due in October, and I plan to be off from October until February for sure. And and then in February I would sort of decide how I was going to go back to work, whether it would be you know, one day or more, what have you, and then my husband was going to take parental leave because he got a year.
Elana Roumell 30:21
Dr. Erin Psota 30:22
Yes, it really was. Now what the challenge was for us initially was that I didn’t plan to take August to October off, I planned to still be pregnant at that point. And so I spent the 10 days in the hospital on bed rest before she came, sort of tying up loose ends of my practice making sure that I found people to cover my practice from August until February instead of October until February. Once I knew that that piece was taken care of, I really was able to commit my time to just taking care of her. And by sort of fluke, my dad was in town to do some kitchen renovations for us. My dad happened to be in town when I went into the hospital. And then so my mom came to town to join them. And so they were here for for probably about six weeks of of that two month, maybe not quite six weeks of that two months day. And and so they did a lot, there was a lot of cooking that happened home so we could just sort of go home and eat. And certainly I know this sounds really not naturopathic at all, but there are definitely days where I’m certain that my breast milk was made of moccachino and Krispy Kreme.
Elana Roumell 31:53
You were kind of in a survival mode. And that’s okay, because I know you personally, you’re a very healthy eater. So I can see that there are times of this just vulnerability and sheer panic of what may happen. And so we may act in ways and do things that may be a little bit different than our norm. I think overall, you truly navigated this with such grace. I have to say that I think what you had in your benefit was the time to prepare that a lot of moms don’t. And so if they just delivered let’s say full term and without any knowing that something may be a problem, all of a sudden, their next two months are going to be in the NICU, this is a very different type of situation than yours. Yet, it’s still great to see your perspective because everyone has their own unique experience and it’s just how we all navigate it. That really takes a lot of partnership from our, our spouses, our family members, our community and this is where reaching out for help is just it’s a non-negotiable, it’s so very important. And I’m so glad you were able to do that and I do I recommend this to all the moms listening. If you’re listening just as a friend of someone who is navigating the NICU, it’s, I think, approaching them not only just saying, ‘What can I do for you?’ it’s just being more direct and saying, ‘I want to cook for you. So you know, on Thursday night, I’m going to come and bring over dinner, is that going to be okay with you?’ You know, be direct with them about it. Or, ‘Oh, you have another child I’m going to pick up your child’s from school I’m going to take him home and I’m going to play with him until you’re home from the NICU. How does that sound?’ You know to just try to support your friends as much as you can by being as direct because they simply do need to help
Dr. Erin Psota 33:42
All of that sounds like amazing, amazing advice and I want to speak about preparedness on the other side of things. Even though we were prepared for the possibility of the NICU, things were scary. During pregnancy and leading up to the NICU, we actually were not prepared at home and I want to tell other moms that that was totally okay, so we did not change anything about our house other than our kitchen reno’s, but that was beside the point. We didn’t have a nursery, we didn’t have a crib, we didn’t have a stroller, we had no baby clothes, we really had nothing, because our pregnancy was scary. And we didn’t need any of that initially. And all of that fell into place. And the two months that that she was in the NICU, we didn’t need to be super prepared.
Elana Roumell 34:36
I appreciate you sharing that. I think that’s actually great. I think some moms may have wanted to, some moms may not, but I find sometimes we’ll make ourselves “wrong” for not being so prepared, because you don’t really you didn’t really know if Edie was going to make it or not. So then having all of this nursery stuff and strollers could actually have made the grieving process even more challenging. Yeah, so I think that was a pesonal choice that you made, and I fully support that. I think there’s just no way to do it wrong and I appreciate you sharing, that’s great.
Dr. Erin Psota 35:08
Mostly I just wanted people not to panic about not having enough stuff.
Elana Roumell 35:12
Right. Yeah, there is always time for that. I think that is a great point. Let’s go back to some of the other moms questions, because I think they’re just so brilliant. And they talk a lot about how at times if your child is a premature baby in the NICU, again, not all children in the NICU are preemies. But in this case, that they can sometimes have feeding struggles. And this is not uncommon, as you were mentioning, at first, she wasn’t even strong enough to take to the breast. So she was bottle fed or I’m sure tube fed. Can you give some moms some insights into what to expect? Because many, many of our moms here are really pro breastfeeding. You know, they they want to be able to supply breast milk to their child, they’re sometimes curious if they’re going to have to push that in the hospitals or if the hospitals are just automatically going to feed them for me like of course, again, every hospital policy may be different Can you share what your experience was and what moms can do to try to be as proactive so that they can help assist during these feeding struggles?
Dr. Erin Psota 36:10
Sure. So because of these complications during the pregnancy, she was actually started on a specialized low fat formula. She wasn’t allowed breast milk because of the high fat content until they could see how she was doing. They were actually concerned with fluid building up around her lungs, so she was monitored really frequently with chest x rays. Their goal, and again, this a testament to our hospital and the lactation consultants there, their goal was eventually to get her to transition to breast milk and eventually learned to breastfeed. And so I pumped and I built up a milk supply in the first few weeks. And then we slowly introduced breast milk as they x rayed and we watched what they call “work of breathing” to see if she was having trouble. Until eventually she was on 100% breast milk and no more of that low fat formula. Now at that point, she was fed entirely by an oral gastric tube. And then once she got to about 34 weeks or or 35 weeks, they changed it to a nasal gastric tubes so that she could start to learn how to breastfeed and and this I had no idea with before. But I learned that any earlier than about 34 weeks that babies don’t actually have the neurological capacity to coordinate breastfeeding, which is actually a really complex neurological process. And I also learned that breastfeeding is very tiring for little babies who are already working hard to breathe. So it’s a little bit like exercise, and you don’t just sort of run a marathon one day, you have to train. So we started with daytime feeds when she was awake to start to learn how to breastfeed. And then once she got tired, she would go back into her little crib or her little incubator, and then they would finish the feed with breast milk but via the NG tube. And there’s a dietician who checked in regularly and computes weight gain or loss and calculates the amount of milk or formula for each feed and then determines whether you need to top up with breast milk or a more calorie dense formula.
There is a point where they were concerned that she wasn’t gaining enough weight. And so there was a few days where we actually did top up with some formula just so they could make sure that she was getting a more calorically dense milk. And they determine if you need to stick in feeds or things like that. And again, once we started to more complete feeds, I started staying overnight, so we could transition to more on-demand feeding. But as far as the actual breastfeeding and building up supply goes, our hospital had a great team of lactation consultants, and they were really supportive and they did everything that they could to get breast milk into babies. The only milk bank that in I think in Canada, there might be one in Vancouver, I’m not positive, but the only one in Ontario, for sure was at this hospital. And so you can donate breast milk to the milk bank there. And any hospital in Ontario can ask the milk bank for for donated milk for premature and medically fragile babies in the NICU. So even though that’s not what we needed for Edie, it was really nice to know that some of the other babies around us were getting donated breast milk because of how supportive the hospital was about getting breast milk into into these little preterm kiddos. It’s wonderful.
Elana Roumell 39:37
It’s excellent. And again, just as breaking it down into your day to day, what would it look like for you to be at home wake up and pump? Would you bring your milk to the hospital? And that goes straight to Edie? Or what was the process, just so people have an awareness? And again, of course, every hospital may be different, but let’s share your story.
Dr. Erin Psota 39:58
Yeah, absolutely. So basically, this, I’m a rule follower. And so when the lactation consultant said pump every three hours, that’s pretty much what I did. And so I had a hospital grade pump rented for home. And then the hospital itself had a pump in the room. And then they also had a dedicated pump room with other pumps in it. And so you there was lots of opportunities to pump whenever and wherever you needed to. And so every three hours, wherever I was, I would pump and then if I was at the hospital, all I had to do was put the milk into the fridge and somebody would come by and collect it to freeze it. And if I was at home, I would label it and freeze it and then just bring it to the hospital The next day, and then they would put it with my ever growing stash of milk. And then the nurses would take care of estimating how much milk they would need for the next day to come from my my supply. So they would say okay, ‘Well, if you’re going to be here for for the day, then maybe we’ll just take out this many ounces. But if you’re going to miss a feed and maybe you know go out somewhere, then we’ll take out more or if that we would always make sure that we had enough for a bottle so that my husband could give her a bottle when he can just hear from work.’ So we sort of got good at guestimating how much needed to be sort of unfrozen for the for the next day,
Elana Roumell 41:28
I have to say how nice as a new mom, you know, not experienced and at the NICU, you just kind of going home and figuring all this out. I can see what you’re saying is, ‘Well, I did end up getting more sleep, or I did have a lot more help navigating how much milk or even how to change diapers’ you know, you really were very supported. I’m not saying that your situation is better than others. But I’m just trying to look for any shining lights in these stories is where you could benefit and I think that helped you become more confident as a mom when you were able to bring her home to know how to navigate these things. So I think that was really great experience for you.
Dr. Erin Psota 42:11
Absolutely. I don’t wish people to go into the NICU. But I also know that it is not necessarily such a terrible experience to be in, in the NICU even things like they had a dishwasher set up in the pump room so that you could just throw all of your parts in and disinfect your parts. And you know, if I’m really honest, that was probably the most annoying thing to have to do that eight times a day.
Elana Roumell 42:39
Yeah, yeah, we’ve all been there. So again, I want to reiterate, yes, we wouldn’t wish this on anyone. But I think especially for us as both naturopathic doctors, we both value integrative medicine, meaning that yes, we have a love and a passion for natural therapies. But we also have a great appreciation and knowledge for conventional medicine, there’s a time and a place and there’s no other place in the world, I would want my child if medically necessary. There’s a means for a NICU stay, it’s probably by far the safest place for her to be with the best type of care, who knows exactly how to specifically help this child and I think it’s truly a gift and something that we can all applaud all the nurses and the doctors and all of the advancements in medicine to truly keep these kids who could have died even decades prior. I think it’s something really special and amazing. And if your doctor were to recommend a NICU stay, I’m certain no parent would argue with that. But knowing that there could be good experience coming from that I think is just settling and hopeful for some of these moms may be listening or about to potentially be going into the Nicki. So I appreciate all of this.
Another question that I thought was interesting, and then we’re going to wrap up in a little bit, but just trying to look because they were such great questions, I think this is probably a good one is one of the questions was how do you heal from the trauma of a NICU experience? Did you find that even after bringing Edie home, there was still some work that needed to be done on an emotional level for both you and or your husband, or even together that really had to be completed in order for you guys just to kind of get back into what a normal routine of life would be with a child? What was your experience even after the NICU?
Dr. Erin Psota 44:34
It’s interesting. Even though I think that being in the NICU in some ways can be a traumatic experience, I wouldn’t say that I I consider us traumatized from it. And you know, that’s not to say that I don’t have sort of moments. The first time that we had a follow up visit in the in the weeks after taking her home, we actually ended up having to follow up at the hospital that across the street from where she was at the NICU and really being able to look up and see the room that she had been in for those two months, like all of a sudden was so emotional for me as I was standing on the street corner. You know, with this, like new baby out of the NICU going, ‘Oh my god, that’s where you live for your first two months. And that’s where they saved your life and got you to us.’ And I’m sure I looked like a bit of a basket case having a having a mini breakdown on the street. But there’s certainly those moments with like anniversaries of this is when we brought you home, or this was the last time you were in the hospital, or this is about the time that this happened, those I still find are challenging moments for I think both my husband and I but we mostly just acknowledge them. We talk about how lucky we we think we are now. I don’t feel traumatized, and that might be because I do have a medical background. And I asked all my questions, and I feel like I advocated for her when I needed to advocate, and we did feel like we had a lot of support. Ultimately, we’re just so glad to have her home with us. But I don’t certainly take away from the moms who do feel like it was a really traumatic experience. Because, I did see Edie have IV lines poked into her. And you know, she did have lumbar punctures, which I think that no parent wants to see. But coming at things from a medical perspective, on my end, I think that I was able to say like, ‘Oh my God, this lumbar puncture seems terrible. But I also don’t want her to have meningitis. So we got to find that out and we have to, we have to move on.’ So I feel like I probably buffered a lot of the traumatic things for my husband who is a lot more sensitive and emotional than I am. But I feel like we talk about the NICU even still, but not in a not in a like ‘God, I can’t believe how awful it was!’ kind of way.
Elana Roumell 47:09
I’m glad you mentioned some may feel more of that trauma, while others may not. And I think it’s important to honor wherever you’re at. One of the things that I think you had in your favor that was truly a gift, was that you do have a medical background. You really did know the questions to ask, you knew where to go to research, you knew what type of conversations you could have with the doctors to make the next medical decision, you were truly proactive. And I find that to be such a gift to the family, of course, and to Edie. What I wanted just to leave the guests by saying is that I actually find your personal experience to now really be a gift for your patients who may be experiencing this. I think as doctors, one of the best things we could do is empathize with our patients. And I think now, when you do have patients who also have NICU experiences, you can really help hold their hand through this. And I think that’s a real gift, something that I don’t personally have with my patients. I know, I love referring patients to you who may be in that situation. If you’re a listener in the Toronto area, and you want some more guidance in this, I think Dr. Psota is my number one go-to contact for that. And I do find that, again, a lot of these challenging times, do bring us some gifts. And I think that Edie is truly a miracle and a little baby that we’re all just we’re so lucky to have in our lives. And not that we don’t look at all of our kids with such love. But I don’t know, there’s just always something about these miracle children, either the children who were took years and years to conceive, or those who really fought for their lives to then be here with us, I find those kids to just be really magical little kids and the strength that it brings to the parents I think is extraordinary. So I thank you so much again for taking the time to share your story with our listeners. Like I said, Stephanie Greunke, my co-host is going to be also doing a couple other interviews. So for moms who really want more and want to learn from other parents, everyone has their own unique experience and everyone has their own unique tips and advice. I thank you again today Dr. Psota for coming and sharing so eloquently and really with such grace and it’s admirable. So thank you for that. And I surely hope that doesn’t happen to your next child, I hope that there may be one coming up again, we never know. But you know, if that is the case, I know that you’re also going to be able to get through it with so much courage. So I wish you the best with all that. So you have to keep us posted.
Dr. Erin Psota 49:52
Thanks. I’m really delighted to be able to talk about our experience with Edie and I’m a pretty firm believer that you the the babies that you have pick you for a reason and I’m really happy that Edie picked us to be her advocates and I’m really happy that she picked me to learn so much about maternal fetal medicine because I am really surprised at how often it comes into play and my practice. You know, it’s like until you really see it from from that perspective, you don’t know how many people ended up with complicated pregnancies, complicated births, even a few days in the NICU and it’s nice to be able to say to people, ‘Yep, we we were there too.’ So I’m, I’m really happy to have that experience in the long run. And I’m happy to have been a podcast guest for you today.
Elana Roumell 50:45
Great. Well, thank you so much. I hope you enjoy that massage. You absolutely deserve it. Enjoy the rest of the day. And again, thank you so much. I look forward to hearing this episode and sharing it with all of our guests.
Well, I hope you enjoyed this episode and look forward to listening to more stories coming up on navigating the NICU throughout this month. If you’ve enjoyed this episode, please help us out by sharing our podcast with your mama friends, and writing a review on iTunes. Let us know what you enjoyed about this episode and help us grow our village. You can also visit our website at wholemamasclub.com/podcasts to review show notes, find past episodes and leave comments and questions for future shows. Please remember that the views and ideas presented on this podcast are for informational purposes only. All information content and material present on this podcast is for informational purposes only and not intended to serve as a substitute for consultation diagnosis and or medical treatment of a qualified physician or health provider. Consult with your qualified physician or health care provider before starting any diet supplement regimen or determine the appropriateness of the information shared on this podcast or you have any questions regarding pregnancy or your prenatal treatment plan. Now go on, have a good day and nourish and nurture yourself and your family.
- A heartfelt story about navigating life for 2 months in the NICU
- What a day to day mom’s schedule looks like
- Ways to best support your child in the NICU
- What you can expect with feeding your NICU baby
- How to be your child’s best advocate while in the NICU
- How to support a mama friend who may be navigating the NICU
- What a Canadian hospital NICU experience was like
- Resources for mamas and more
This episode's guest
Dr. Erin Psota ND is a Toronto-based Naturopathic Doctor with a focus on children’s health, ADHD and autism spectrum disorders. She is committed to guiding parents through the maze of health care decisions so they can rest easy knowing they’re doing the best they can for their children. After obtaining her Bachelor of Science Degree at the University of Waterloo, she completed her medical studies at the Canadian College of Naturopathic Medicine in 2005. Following three years of private practice she completed a selective Pediatric Residency in 2010 at the Southwest College of Naturopathic Medicine.