The letter is very informative and clinical.  You might want to give her an accompanying letter on a more personal note.  You could start with a little thank you for watching Anika during this special time.  You could also write a little informal list of other fun things like what she likes to do or play with. 

This might off-set any negative vibes she might get from the more formal letter.  Then you can have it both ways.  After all, you don’t want your MIL stewing over this while she is watching your precious daughter.  An advanced thank-you can go a long way and it takes such little effort.

My MIL is a retired nurse and would be very comfortable with instructions like that, but MY mother would become nervous (not offended) with words like "sharp and exact".  She would be so focused on getting these things right that it would occupy her mind for most of the time and take her thoughts away from the fun things she could be doing with my child.

Also, you hadn’t mentioned the solu-cortef shot.  If she feels that Anika is ill enough to warrant a trip to the hospital does she know about giving the shot BEFORE she goes?  Then everyone can relax a little knowing that your daughter has enough meds "on board" to help in preventing a complete adrenal crisis.

Chances are that everything will go well on her end freeing you and your husband up to focus on the miracle of bringing another baby into your family and making her a Grandmother all over again.(;>)

I had a somewhat similar experience when I had my son.  My daughter was only 14  months old when I went into labor and my MIL was taking care of my daughter.  It turned out that I was in the hospital for over a week so my daughter’s stay was extended as well.  My son had to stay in the hospital for 28 days so we depended on the kindness of my MIL to take care of her Grandaughter while we sat by our son’s side.   While my daughter does not have CAH, my son has a severe case and he had contracted an infection at birth.  They didn’t know he had CAH at first so the infection ran rampant and we almost lost him.  Finally the CAH showed up and they knew what to do.  Needless to say, the detailed instructions we left my MIL came in very handy as we couldn’t focus on anything else but making sure Ryan made it through the night each night.  I felt so guilty being away from my daughter for so long but, at the same time, I was comforted by the knowledge that I had left  detailed instructions for my In-laws.

Only you and your husband can know how your MIL will interpret the letter as that very same letter could make some people feel a bit incompetent and others could feel extremely grateful to have something so specific to refer to.  Follow your heart.  After all, how could anything done with love steer you wrong? 

I will say a prayer for you and your new baby as well as one for your MIL and your daughter.  God bless you all.

 

P.S.  Be prepared to be surprised at how big Anika will look after holding your new baby.  When my MIL brought my daughter in to visit me in the hospital she was WALKING with the assistance of her Grandma’s hand.  Before I went  to the hospital she was trying to walk but hadn’t quite managed it yet.  It did bring a little tear to my eye.  What a difference a few days make.(;>)