Introduction
For our 52nd podcast episode, I was joined by Dr. Jess Daigle. She is a board-certified pediatrician and neonatal/pediatric hospitalist. Additionally, she is the proud mother of two premature infants, Liam and Avery. Her son Liam was born at 31 weeks’ gestation and spent 5 weeks in the NICU. After her family’s personal NICU experience, she founded and is the CEO of Mom & Me, LLC which focuses on helping both mothers and infants thrive during the postpartum journey and beyond. Dr. Jess carries out her mission by offering local, in-home/virtual care services to newborns, with a particular focus on NICU babies. With the goal to support new mothers and ease their transition home, she also offers life coaching for NICU moms. Dr. Jess helps them navigate through their NICU journey so they can become the empowered, confident mom they deserve to be.
Jess and I are both very passionate about empowering NICU parents to be present and engaged while their baby is in the NICU. She speaks about how her personal NICU experience changed her professionally and addresses why it is so beneficial for parents to advocate for their infants. We also discussed the many layers of NICU trauma and why it is so important to support families during the NICU journey and beyond. We share the importance of healthcare members being present, open, and intentional during their patient interactions and how going the extra mile will leave a lasting impression. Lastly, we close out the episode by speaking about how parental empowerment can not only positively shape a parent’s NICU experience, but also provide better outcomes for the infant and entire family unit!
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Episode 52
Our Guest
Jess Daigle M.D. FAAP
Dr. Jessica Daigle, “Dr. Jess,” is a board-certified pediatrician, neonatal/pediatric hospitalist, and Founder/CEO of Mom & Me LLC. She is the proud mother of 2 kids both born prematurely, with 1 staying in the NICU for 5 weeks. She has a concierge medical practice in Atlanta, GA that provides local in-home/virtual care services to newborns with a particular focus on NICU infants. She supports mothers to make the transition home easier and less overwhelming. Additionally, she offers life coaching for NICU moms to help them navigate their NICU journey and be the empowered, confident mom they deserve to be.
Dr. Daigle received her Doctor of Medicine at Louisiana State University New Orleans. She completed her pediatrics residency at Morehouse School of Medicine and received extra training in neonatal-perinatal medicine at the University of Maryland Medical Center. She is a former Medical Director for the Level 2 NICU at Wellstar Spalding Regional Hospital in Griffin, Georgia, and currently works part-time as a hospitalist.
Dr. Daigle is passionate about NICU and Postpartum care. She believes moms and their babies should thrive not only survive on their postpartum journey and onward. She lives outside of Atlanta, GA with her husband and 2 kids and can be found on IG @momandme_md.
Jess’s personal NICU experience
Jess, her husband, and two children live in Atlanta. Liam was born at 31 weeks’ gestation and is now 10 and Avery was born at 36 weeks’ gestation and is now 4.
Jess had a miscarriage prior to her pregnancy with Liam. So with Liam’s pregnancy, she was placed on bedrest in the hospital for 63 days from 22 weeks until she had him at 31 weeks’ gestation. She received 2 rounds of steroids, one course at 24 weeks and an additional course at 28 weeks’ gestation.
She went into labor and Liam was born that day. He did require surfactant after his delivery and was intubated for a day then extubated to room air. From that point, Jess said he was essentially a “feeder, grower.”
Jess said the experience was interesting for her because at that point she was already a physician and knew the medical pieces of the NICU. But, since her husband did not have a medical background, she asked the NICU team to speak to them in layman’s terms. In doing so, it made her realize how important it is that the care team speak in simple terms to families. With her medical background, she was thankful that she knew what could happen, but found it to be a double-edged sword. She recalled it being more “nerve-wracking” to know what could lie ahead. Jess said Liam struggled with elevated jaundice levels that required treatment with phototherapy repeatedly.
After 5 weeks, Liam was was discharged home from the NICU. Unfortunately, a week later, she noticed that he developed congestion after his feedings. After a swallow study showed silent aspiration, he had to have a ng tube replaced and she felt like it was such a setback. She had to learn how to place his ng tube and it made her really think about families who have to take on the healthcare role at home once their babies were discharged from NICU. It was a different perspective for her. Although she was worried, her husband encouraged her to have faith that Liam would improve.
What is normal really?
She remembers asking herself, “will my son be normal?” But now she realizes that there is such a range for premature infants and what really is “normal?” She began to truly understand the fears that families have while their infant is in the NICU and in the years that follow after her own NICU experience.
We discussed how the idea of “normal” is so arbitrary, so it is crucial for families to know that progress with their infant is all relative. As long as their infant is progressing in the right direction then that is what should be their guiding compass. Comparison is not necessary, especially with NICU infants.
How has the NICU experience impacted your profession?
How Jess’s personal NICU experience impacted her profession
Jess acknowledged that she has always been an empathetic person, but the experience made her more aware. She admits that in healthcare, there is a large barrier between the education you received and your own experiences. But, when the two meet, it is so much better. Now when she sees a family after their infant has been in the NICU, she sees the parents in a much different way. Now, she has a much better understanding of the psychological and emotional aspects of their experience. Jess’s personal NICU experience provides her with more clarity on what she may need to address with families. With each patient encounter, Jess is now even more empathetic and intentional. If she is genuinely worried, she will let the parents know.
The NICU experience highlighted that this her work is humanism and life, and we need to embrace that more. With her perspective, she is not afraid to cry in front of her patients and feels that it enhances the work she does. Families want to know that you’re in it with them. Even though their experience was difficult, Jess is grateful that she is on this side of it and able to help other families through the experience. Although she is not able to change the fact that their baby has required admission to the NICU, she can have a positive impact on their journey.
What are some common issues or concerns of NICU families?
Jess said that the main three topics she helps families with are feedings, sleeping, and the ability to feel confident in caring for their baby. Parents feel that their baby, for the most part, has been taken care of by the staff at the hospital and they often feel lost. She encourages parents and reminds them that although they may not feel as though they were not caring for their baby in the hospital, that they have always been their mother/father. She encourages parents to change their perspective around that because there are different phases to parenting.
Dr. Jess is passionate about empowering parents to be the advocate for their baby. For families with children that have complex medical needs, she encourages them to have an organized system at home and take it step-by-step. With a change in focus on what you can do versus what you cannot control promotes ownership and empowerment. She also encourages families to try and coordinate the care between providers as much as possible.
Jess is also passionate about breastfeeding and encourages it in the NICU as well. In training, she admits that learned the basics regarding the benefits of breastfeeding, but they were not educated on some of the common barriers for NICU families. She has personally educated herself on the Academy of Breastfeeding Medicine’s recommendations and believes in getting the baby to the breast for breastfeeding as soon as they are ready and to follow the protocols for supplementation.
The layers of NICU trauma
There are many layers for NICU families when they have a baby admitted for intensive care. It is important for pediatricians, obstetric providers, and everyone who works in the field need to be aware of the complexity and understand that it is not just a moment in time, but moments that keep adding up.
Sadly, there is a community assumption that once a baby is home from the NICU and is doing well, that the previously experienced trauma will no longer exist. Unfortunately, a healthy NICU baby does not negate or take away from the trauma that was endured during the NICU journey. Many mothers also had traumatic deliveries or spent time on bedrest with or without a NICU admission and that experience does not just dissipate if they have a healthy baby. We as healthcare providers need to acknowledge their experience and support them better.
Providers need to empower and educate mothers and put them in contact with educational and supportive resources. Mothers need to know that it will also be a journey of healing and they will need to go through a grieving process. Their family members and friends also need to support them through the process. If we do not support people through their difficult times, it can make them feel like something is wrong prolonging the negative cycle. If their feelings are not validated, they never see the way out. It is important for family members and friends to acknowledge that the parent’s time in the NICU was difficult. Additionally, many couples do not openly share their feelings or concerns with one another because they either do not feel the same or may be concerned with judgment from one other.
Being intentional and going the extra mile
Jess shared more about her miscarriage and has learned that as she speaks more openly about it, her husband has also started to open up more. She vividly remembers the nurse who reprinted her polaroid pictures of their baby after she had smudged them with her tears. Taking a moment to go the extra mile for a patient does not have to take a large amount of time, but it’s more about the intention. The fact that you were willing to help the family is what they will remember. Small, simple, empathetic gestures mean so much to families whether they are enduring a loss, during their labor process or in the NICU. Never underestimate the power of doing the little things, because families will remember it and you.
Dr. Jess said that when she goes into work, she has an acute awareness that the families are going through something difficult and she makes it her intention to recognize it. Over time and with consistent practice, it becomes a natural part of you. She has learned that families also appreciate honesty. Jess likes to acknowledge the experience that families have and isn’t afraid to admit if she doesn’t know the answer. Jess knows that some providers become uncomfortable in front of patients if they do not have all of the answers and are often too egotistical to admit it. She said she likes to be real and honest with her families.
Part of being intentional is also allowing yourself to be present, to feel your emotions, and to openly express them which is part of trauma-informed care. The concept of trauma-informed care is rediscovering our own story so you can connect authentically and compassionately with the stories of others. Mary Coughlin, the founder of Caring Essentials and pioneer of trauma-informed care in the NICU believes that stories matter and by embracing our collective stories each of us can and does make a difference in the lives of others and ourselves everyday!
I spoke with Mary Coughlin on our 31st podcast episode about the importance of trauma-informed care in the NICU which correlated nicley with my conversation with Dr. Jess. Click the link to listen!
Dr. Jess’s advice for former and current NICU families
Dr. Jess wants families to know that you have a right to advocate for yourself and your baby. The healthcare space is always moving rapidly, which is not an excuse, but it’s the reality. Although many units are working towards a more family-centered care approach, we are not 100% there. So one of her key messages to any family with a child whether they are in the NICU or not, is that you have a right to advocate and understand everything going on with your child.
She encourages parents to speak up and ask questions regarding their child’s care because she feels that it sets the tone for how you will be as a mother or father moving forward. As parents, you have the right to ask questions and be fully informed. Although some providers may be more forthcoming with their updates and education, if you feel as though you are not receiving enough information, start asking questions.
Dr. Jess encourages families to recognize that this is a journey. Just like a road trip, there will likely be detours along the way. If there are days that you need to rest more, then rest. Whatever the case may be, acknowledge how you feel and do not judge yourself if you are unable to make it to the NICU one day due to work, your other children at home, or other responsibilities. Motherhood is difficult, so show yourself some grace.
As parents, it is likely that you did not anticipate your baby being admitted to the NICU, but if this is where you are, try to find ways to empower yourself during the journey. How can you empower yourself to do your best on this journey? Once you shift the focus to what you can do, you will feel more empowered. Be in charge of letting the NICU care team know when you’ll be visiting and how you would like to be contacted. By taking the lead, it will give you the best possible experience. No one can say exactly what your journey will look like, but we have more power than we often recognize and Dr. Jess encourages families to tap into it. She often hears from families that they regret that they did not ask more questions. Take charge of the situation and show yourself that despite what is going on, you are showing up for yourself and your baby. In doing so, it mentally increases your positive endorphins.
Research has shown that empowered NICU parents are key to the infant and family unit’s success. I strongly encourage parents to be in the NICU with their baby as much as possible and to be engaged. It’s important to try and be present during rounds and ask questions. If you are uncomfortable asking questions in front of the big group, either speak with your baby’s nurse beforehand and they can advocate for you and your baby or ask the provider to come back around when they are done rounding to answer your questions. Do not allow your intimidation to prevent you from asking questions. The more questions you ask, the more you will begin to understand your baby’s plan of care. In doing so, it will prepare you to learn how to care for them while they are in the NICU and therefore, ease your transition to caring for them at home post-discharge.
Dr. Jess said if we can empower people to be authentic where they are, then that’s when you can get to the place you want to be. Once you are being authentic and realize that you are not where you want to be, that is when you’ll ask yourself how can I get to where I want to be or how can I help my baby? Lastly, she wants to remind NICU families that although the NICU is a big experience, that it does not have to define the rest of your life. Or if you are going to let it define you, push it in the most positive way. That way, you will find purpose in your pain.
Dr. Jess said that if through her work, she is able to make one family feel less alone, then she is doing what she is meant to do!
To get in touch with Dr. Jess, you can find her on instagram @momandme_md
Closing
Thank you so much to Dr. Jess Daigle for joining me on our 52nd podcast episode. Jess and I had so much to chat about and our passion for parental engagement and empowerment in the NICU are completely aligned. I appreciate Jess offering concrete ideas on how parents can advocate for their baby while they are in the NICU and once they are home. Empowerment and advocacy will look different for each family, but just know that you, as the parent, are an integral member of your baby’s care team! Although you may feel as though the NICU staff is caring for your baby, you are still very much needed. You are the therapy for your baby! So do not let this time go by and regret that you did not ask enough questions or bring up your concerns. By taking the lead as Dr. Jess said, you will feel more empowered which will also improve your mental and emotional state during a very difficult time.
For our healthcare members who are listening, please do not underestimate the small, empathetic gestures you can offer your patients. As you heard from Jess, and I can tell you from personal experience that they do make a remarkable and unforgettable difference! Additionally, try to take a moment each day you go into work and reflect on your purpose and intention. Lead with love, be authentic, openly connect, and show your families that you care. I promise you, by doing so, you will help them feel at ease and they will not forget you and how you made them feel!
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