Hand to Hold's Official Blog: Written by Parents for Parents

NICU Rhythms

NICU baby NICU schedules

via freeimages.net/Benjamin Earwicker

In 2009 I led our family through a 56-day NICU stay with our son Giovanni, who was born 2 ½ months premature at 2 ½ pounds. Reflecting on our NICU journey, I shared the same rhythms familiar to most NICU families. I participated in feeding, diapering and taking my son’s temperature every three hours. I kept this rhythm by pumping every three hours 24 hours per day. I found comfort in the consistent rhythms, rituals, cycles, structures and practices outlined by our NICU staff. It’s been six years since our NICU stay and my family still compliments my strength, in awe of my ability to maintain the schedule by waking every three hours. Giovanni is now six years old and a healthy elementary school boy in the 76th percentile.

Through our experience in the NICU, I discovered a talent for creating structure for people and organizations. This led me to pursue my Master of Arts in Organizational Leadership with a Concentration in Servant-Leadership from Gonzaga University. My graduate studies allowed me to be a stay-at-home mom, while retraining for a career once my son started kindergarten. In 2015 my graduate studies led me to participate in a five-day retreat at St. Andrews Abbey, a Benedictine Monastery east of Los Angeles. We studied a 1500-year-old text called “the Rule of St. Benedict” and building community that Monks still practice today. As I studied building community and observed the Monks’ practice, I began to see similarities to my own life as a NICU parent. What appeared as strength and courage to overcome our NICU journey is nothing more than committing to routines that are outlined by NICU staff. All religions commit in some way to this practice.

Rituals play a big role in how Monks design their day. Ritual wakes us up inside and helps us live life more completely. When called to meet as a community, Benedictine bells ring, calling all Monks to meet together.

The NICU has rituals that staff and families with a preemie recognize. When NICU alarms go off, NICU staff stop what they are doing and attend to the preemie. Kangaroo care is something familiar to many NICU parents as a way to bond with one’s preemie baby. Are there other rituals in the NICU that are shared by preemie parents?

Monks use cycles as a part of personal health and community life. Monks meet at specific times each day, every day, to build community. Just as a Monastery Bell call Monks to meet together, every three hours most preemie parents will rush for an opportunity to care for their baby. When I was not in the NICU with my son, I pumped every 3-hours. After our NICU graduation I continued the three-hour cycle for the first six-months of my son’s life every 24-hours which included feeding, diapering, temperature and then pumping. My 3-hour cycle became so routine and natural that even when I forgot to set my alarm I would naturally wake up every 3-hours. I slept around the clock between the 3-hour cycle mirroring my son’s 3-hour cycle. I made a commitment not to skip this routine more than one 3-hour cycle per day where I did chores or did errands so I could be as rested (as much as can be expected) to care for my son. If you have a child at home and a preemie in the NICU, asking for support from family and friends may help keep the cycle.

Once Giovanni turned 6 months old and started gaining weight and health, he began sleeping through the night. Our 3-hour-cycles were kept during the daytime until he was 2 years old, when he had the ability to make decisions for himself. This consistency provided space for us to bond consistently. Giovanni learned the cycles just as much as I did and looked forward to them.

Structure plays a significant role in Benedictine life. There is something healing about order and structure. Community is built on order and structure. Quiet hours (silence, no speaking) are from 9pm to 9am daily in a Monastery. More than just silence to heal and grow, it’s respecting the other Monks’ need for quiet thought and contemplation, and the structure helps us think of others first. The way Benedictine bedrooms, refectory (cafeteria) and community center are designed is modeled after the chapel where they meet at scheduled times every day.

NICU structure and order is designed to meet the needs of a preemie baby. Every NICU space is intentionally designed to help preemie’s grow healthy and learn to suck-swallow-breathe. In the NICU, excessive noise increases a preemie’s blood pressure, heart rate, respiration, and oxygen saturation. Do you think excessive noise in our adult lives increases our blood pressure, heart rate, respiration and oxygen saturation?

Humans naturally seek relationships within a community. Support groups allow parents to share stories and build relationships with others experiencing a NICU stay. At Hand to Hold we offer Helping Hand mentors to support parents navigating a NICU stay, a form of community.

My son Giovanni is now 6 years old and in kindergarten. He still loves to Kangaroo Care and “snuggle” every night before bed. At 47 pounds, kangaroo care is getting a little heavy but for now it’s bearable and he loves it. Giovanni doesn’t remember the NICU but he does recognize the rituals, cycles and structure that I have developed from our NICU stay.

My experience in the NICU followed by the Benedictine Monastery led me to begin studying at my local Monastery where I am studying to be an Oblate, a lay contemplative. If this study interests you please reach out by e-mail to Katie@courageoussteps.org.

Katie Reginato Cascamo About Katie Reginato Cascamo

Katie Reginato Cascamo, M.A. is the Founder & Principal Consultant for Courageous Steps, that offers management and leadership consulting to organizations that care for preemies and special needs by providing tools for meaningful organizational health and employee engagement. Katie also leads a workforce development program for families benefiting from Temporary Assistance for Needy Families (TANF) through Goodwill Industries. Her son, Giovanni, was born 2 ½ months premature at 2 ½ pounds in 2009 is now a healthy and strong second grader who wins 5Ks in his age group, is a gymnast, loves YMCA and excels in school. 

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