To the mom next to her child’s hospital bed, here are five strategies to soothe yourself so you can soothe your little one

To the mom next to her child’s hospital bed, 

I see you sitting there, your eyes fixed on the tracing lines, your back aching from leaning over the cot,  your ears buzzing with the incessant beeps of the monitors. I know what its like to be unable to pick up your child because there are tubes and needles everywhere you look. I know what its like to be transfixed by oxygen saturation levels and heart rates and the tempo of his breathing. 

Maybe this is your first time in hospital. Maybe you have a newborn baby and nothing went to plan and you find yourself in the NICU; or maybe you are a veteran, a mom who has done this many times before. Maybe this will be a brief stay, or maybe you will be here for a long time. 

I have spent more days than I care to remember in hospital with my little boy. My first two Mother’s days and my first two Easters as a mom were spent beside his ICU bed. In fact, as I write this I’m sitting next to yet another hospital cot. After a wearying day he has finally succumbed to sleep. As I sat here, I started to think of all of you, who, just like me are trying to navigate this tough season. I wanted to share some of my thoughts and experiences,  both as a NICU mom and an occupational therapist with an interest in how we can harness the power of our sensory systems to self-regulate even in the midst of such a challenging environment.

Right now I know all you can think about is your little one. But I also know that to be there to give them the best love and support that you can, you need to look after yourself. In order to do that, it helps to understand a little about how our sensory systems work, and how we can take advantage of this to optimise our functioning.

Our sensory systems are responsible for collecting, calibrating and collating all the information that comes to us through our seven senses: sight, hearing, touch, taste, smell, proprioception and vestibular. The last two, if you haven’t heard of them , are to do with knowing where our bodies are in space and perceiving movement. Our sensory system then puts together the information it has collected to action a response. If we are under stimulated we will feel sluggish, tired, unmotivated. If we are over stimulated we will feel overwhelmed, stressed and hyper alert. The optimal state is normal arousal, or calm alertness, neither over or under stimulated.

It is in this state that you will be able to meet the constant demands placed on you: to take in all the new information about a change in condition, to understand the strategy for managing the next stage of treatment; but most importantly to sustain yourself through what might be a marathon of emotional upheaval. We can get into this state through self-regulation.

 Self-regulation is simply changing "our levels of arousal and alertness be appropriate for the task at hand." (1) This is so important, not only for you but also for your little one. You see, by regulating yourself, you will help to soothe your child (no matter what age they are) by a process called co-regulation. This concept is defined as   “the interactive process of regulatory support that can occur within the context of caring relationships” (2) In other words to calm a child, you need first to calm yourself.  

The hospital environment can be a strange mix of both over and under stimulation : the onslaught of sensory information is relentless, and most of it signals danger and triggers an automatic stress response. But in between the moments of crisis, there are just the same four walls and the little circle of space circumscribed by how far the wires reach. 

I am certainly not suggesting that you will be able to avoid those spikes in adrenaline when the alarms sound, but by curating what you can of your sensory input, you will be able to bring yourself back to that calm alert state a lot quicker than if you had no strategy at all. Most of these suggestions also incorporate an occupational therapy staple: activity. OTs believe that through engaging in our occupations (the things we need and want to do) (3) we can influence our physical, mental and spiritual health. (4) In a hospital environment, our occupations become limited, but they don’t have to be. There will be many hours when you are sitting next to a sleeping child. If you have the inclination, distract yourself with a happy task. The idea here is not to overwhelm yourself with something that feels stressful, or feeling guilty if all you feel like doing is sitting still. Its about something that allows a little chink of creative light in amongst the darkness. Maybe for you its journalling, or doodling or knitting  

 Obviously hospitals  have strict rules in place for infection control reasons so always ask first but here are some practical suggestions you can put in place:  

If you want a cheat sheet to keep on your phone to remind you of these strategies, click here to download it!

Sight

• Carry photos of happy memories with you, or scroll through your favourites on your phone. It will remind you of how that is life outside these four walls. During one particularly long admission I created a 100 page photobook. It reminded me of all the happy times we had had and would have again! 
• Perhaps you have a favourite bible verse or quote, which you can doodle into a work of art 
• Use your journal to sort through what you are feeling and experiencing 

Sound

• Sing to your little one, or play a favourite song on your phone and sing along if that feels easier.
• I have noticed that when my son’s heart is racing in pain or distress, playing him something familiar will slow its galloping beat. The hard evidence is there in front of me as the numbers on the monitor begin to dip. If it has that effect on him, why not on me? 
• Play some sounds of nature through headphones to counteract the beeping 
• Read to your little one, even if they are tiny, the sound of your voice will soothe them and you! And it helps that feeling of helplessness when so much of the rest of their care is in someone else hands
• Listen to a podcast that uplifts or encourages you
• Listen to voice notes from friends and family cheering you on
• Have silence breaks, go outside the ward, perhaps outside, sit somewhere and close your eyes and enjoy the break from all in incoming input!

 Touch

• Bring a favourite blanket (for you and your little one!), something soft and strokeable 
• Knit or crochet an article of clothing 
• Rub hand cream into your hands (you are definitely going to need it after all that hand-washing!) 
• Pat and gently stroke your little one. Just like you can soothe them, they can soothe you. If they are a bit bigger, you can massage them 

Smell 

If you have a tiny newborn, the most important smell  is you, so try not to mask that. However, if your child is older, choose scents that soothe you.

• Spray your favourite perfume on a scarf you are wearing so you can smell it when feeling overwhelmed.
• Keep a hankie sprayed with lavender or chamomile in your bag
• If you have brought your own pillow to sleep on, spray it with your favourite room spray

 Taste

Chewing has a regulatory effect on your central nervous system so keep something you can gnaw on. The greater the resistance, the better. I suggest biltong (Like beef jerky for those of you reading this who are not South African), dried fruit, especially something tough like mango, chewing gum, apples, chewy sweets (though don’t overdo it on the sugar) Tastes like peppermint and citrus and anything  spicy will  pick you up, as will anything cold and bubbly (like a cold bottle of sparkling water) or crunchy ( a sour green apple always works well). Munch on these things  during that exhausting late afternoon slump! Things that are smooth, sweet and warm are calming so grab a cup of rooibos tea with honey before you settle in for the night. 

Proprioception and vestibular 

Proprioception is known as “the universal regulator,” (4) meaning it calms you down or picks you up depending on what your system needs. Deep pressure can be very soothing so something like a weighted lap mat or blanket (especially if you are sleeping in the hospital) can slow your heart rate, and breathing and reduce anxiety. (NB these are graded by weight so are not necessarily safe to use with your child!) When you feel confined in the ward, movement might feel restricted, but try and shift your position regularly and have “movement breaks.” You can stand and stretch, march on the spot or do calf raises. Its also really important to take regular breaks from the bedside. Movement, particularly if it is outdoors, is very helpful so when you do get a break take your coffee outside and walk! When your child is ready for a stint outside the ward pushing them in their pram or wheelchair will give you helpful proprioceptive feedback too!  

I hope these ideas are helpful! 

If you want a cheat sheet to keep on your phone to remind you of these strategies, click here to download it!

If you'd like to read more, follow me on my Facebook page at Mental Wealth

(1) Lombard, A. 2015. Sensory Intelligence. Wrgemoed. Metz Press

(2) Rosanbalm, K.D., & Murray, D.W. 2017. Caregiver Co-regualtion across development: a practice brief. OPRE Brief #2017-80. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, US. Department of Health and Human Services.

(3) WFOT 2012 http://www.wfot.org/FAQs/AboutOccupationalTherapy.aspx

(4) Du Toit V. 2004. Patient Volition and Action in Occupational Therapy 3^rd ed. Pretoria: Vona and Marie Du Toit Foundation