It’s Q&A Friday! 

Before we start, I want to flag two things that flooded my inbox and DMs this week: UV nail dryers and period underwear. I wrote about nail dryers below and I think that Dr. Jen Gunter does a really nice job covering the Thinx issue. I also wrote a post about PFAS in 2021 related to chemicals in breastmilk. Hopefully, these together will give you a clearer picture.

As always, the first question today is available to all subscribers (spending time in the NICU), and there are a few bonus ones behind the paywall (about separation during military deployment, the safety of UV nail dryers, and sex positions and conception).

Enjoy! And remember: you can submit questions for future weeks here.

Our baby came a bit early. She was born at 29 weeks and is currently in a very capable NICU here in Michigan. She is small, 1,090 grams, but that seems to be the biggest hurdle in front of her. We wondered if you had any suggestions on data or readings that could help guide us on the amount of time we should spend in the NICU. Daily visits are occurring with skin on skin, but we are wondering how to spend our time to give our baby everything she needs from us.

—Sam (Dad), Kate (Mom), and Margot (Baby) 

First, congratulations on Margot’s arrival, and I hope you are doing as well as possible.

This is a hard question to answer. There is an instinct that “more time must be better — shouldn’t I be with the baby all the time?” But if you were home with your baby, you wouldn’t be with her all the time. They sleep a lot; preterm babies sleep even more. 

There is some literature suggesting that regularly visiting the NICU is associated with better developmental outcomes for kids later (here is one paper). But the variation in that paper isn’t around spending many hours in the NICU per day — the average family goes four times a week, for example, and only 1% of fathers go every day. In addition, as you might imagine, having time to frequently visit the NICU is associated with other family characteristics — income; two-parent households — that are also associated with positive outcomes for other reasons. So even this link, at these lower levels, is probably tenuous.

The other major topic in this literature is the link between having a baby in the NICU and depression. For both parents, the stress of a NICU baby is a significant risk for depression. This is especially true with long stays. The result is that much of the very sensible advice is to balance your own needs with your desire to spend time with your baby. I will not say here “with your baby’s needs,” because those are largely being met by the amazing NICU nurses. You’ll want to be at the NICU to spend time with your baby, but framing it as “What is the best way to balance this with our own need to heal?” is important. 

What we do not have, which it sounds like what you might want, is some kind of elaborate mapping from time spent in the NICU to outcomes. The reality is that there are too many pieces, too much noise in the data, for this even to be answerable.

In terms of a book: it’s not precisely a guide, but Early is very good on the science of preterm birth.

I hope Margot is thriving and that you are all home as soon as you can be.