Hello Ellen,

I agree with Mary's post on the importance of preventing unnecessary interventions and recognizing that some dyad are better off with some kind of intervention.
Nevertheless...
You wrote: "There was nothing I could have done that I didn't do to prevent his early birth.  I do not believe he was ever cold, and I doubt that he was lonely.  He was touched regularly with kindness, both by his parents and NICU staff."

I suppose it is also important to make a difference between optimal care at a NICU and optimal care in a term, healthy situation.
I chose to have unmedicated home deliveries four times and was blessed enough to get one with each daughter.
While they were either in my arms or at the breast or with my husband most of the time during the first days and weeks, I often tried to imagine what it would be like to 'visit' your baby when s/he's in an incubator. I don't pretend to be able to that; I think there is no way that you can know how that feels, all the worries added, until you experience it yourself (like with many other life events).
I don't think it is very hard to see, though, that a baby in an incubator does not get as much closeness as a healthy term one, either before or soon after birth. It's obvious: when a baby is born premature, it will never be able to be as constantly close to mom's body as when it would still be in the womb. As hard as it may be to realize it... I think we could reasonably argue that preterm babies *are* lonely at times. Even if we would sit next to them all of the time, 24/7, then that tiny little baby would still miss out on the safety of his mother's womb, where it would be tightly surrounded by the fairly cramped space and all the body sounds his mama has to offer him, all her movements, her voice and all the vibrations that come with it.
Isn't that why KMC is so valuable...? Isn't that why we don't (shouldn't...?!) try to make babies come earlier, because the right habitat for a fetus is the womb, until it has reached the age of about 38 weeks...?
I think that part of the grieving parents do when caring for a preterm baby is the fact that they are well aware that that dearly beloved little one should not have been there yet. I think that baby *is* lonely at times, because there are biological expectations that are not met: being in the womb. That is why bottle babies miss out: the biological expectation of being at breast is not met. As well as we try to make up for what they miss out on, I think we should keep realizing that babies are lonely when they are not in the womb when they are so small, or not at breast when just born. Keeping that in mind keeps us alert in trying to improve baby care and letting Mother Nature go her best biological way whenever possible.

All of this is *not* to say that parents of NICU-children are not rendering enough care. It is only to say that the functioning of the womb and the breast deserve deep respect because they can never be fully replaced, no matter how hard we try. Like 'Breastfeeding Made Simple' says: babies are hardwired for certain things and we do them a favour by trying to meet their expectations.
I'm glad your baby made it through all the diffulties, Ellen, and that you were able to give him the best you possibly could.
By the way... hard wired... how does that get translated into Dutch...? ;o)

Warmly,

Marianne Vanderveen, Netherlands

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