Monday, September 5, 2011

the NICU post

(Are you a new NICU parent? Read here for tips about what to do during your baby's NICU stay.)

I go more in detail into the birth in a previous post, but I'll start here with a quick recap: Rosemary was born at 33 weeks gestation. With the full moon, my body tried to push her out. The doctors were able to stop the contractions, but my liver fought back in the form of HELLP Syndrome, demanding that the baby get OUT. Start up the pitocin; my body couldn't handle being pregnant anymore. That's how my baby was born.

She had received the steroids for her lungs while she was still in utero, so she came out with a healthy cry. At least three of the many people in the operating room focused on her as soon as she came out. Is she breathing? How's her heartbeat? Any liquid in the lungs? Very fast-- within a couple of minutes-- she was cleaned up, wrapped up, and brought over to me (though still out of reach) to see that sweet, tiny face for all of one second. Just as fast as they brought her over they took her away, out of the room, down the hall, to NICU. Senpai asked if he could follow, and then my family was gone. Being left behind, without either my husband or newborn baby in the delivery room was an intensely lonely feeling that tasted bittersweet. My thoughts were along the lines of, "I carried this baby for seven months, I've been in pain for her, I just delivered her, and now... I can't see her." I clung to the image of her little red face, already fading in my memory, as I was taken back to my room and monitored by the nurses. She had been born at 9:29 pm. When I still hadn't seen her two hours later, I demanded to be taken to her. I touched my baby for the first time at 12:20 am.

Going to see Rosemary First trip to the NICU.

Entering the NICU, it was so uniquely different from the rest of the hospital. People had to be buzzed in, signed in, watches and jewelry removed, and hands and arms scrubbed with disinfecting soap up to the elbow (I just remembered the smell of the soap). Children, the little germ harvesters that they are, were not allowed in. Parents and two family members (that you choose, but must specify on a form) were the only people allowed to see the baby, but only two at a time.

The NICU was divided into different sections with varying levels of care, labeled from A to G. Rosemary started out in an open bed in the last room, G. After the first night they then moved her to an incubator (they call them "isolettes" these days) against the wall to the right when you walked in the door. The first time I saw her in the NICU, she was on her stomach in her open bed, breathing with the help of a respirator tube. I wasn't worried. I knew she had received the steroids for her lungs, and I had heard her healthy cry after she had been delivered. I think I was also too tired to be worried. I was just so elated to finally see and touch the tiny 4 lb 13 oz little girl that had made my uterus her home for so long. I was taken back to my room after only about 20 minutes because I was starting to fall asleep in the wheelchair.

Happy Rosemary Day!

I was not one of those Moms who spends every minute in the NICU. I was still healing for one, very exhausted, trying to get my body's systems back to normal, and two, I believed that the doctors and nurses in the NICU were taking good care of my baby. She wasn't sick, she just wasn't meant to be out in the world yet. All she needed was to grow and learn how to eat, otherwise she was a healthy little camper. She would forget to breath sometimes, and for that she was put on a daily caffeine injection. I never saw her get stuck with anything. I would see the aftermath-- a new IV line in her head, little red spots on her hands-- but the nurses did the dirty work when the family wasn't around. I'm sure seeing her in pain would have broken my heart in two.

Howdy Y'all!

Senpai got to hold her first. I wasn't there to see it, but he came back to my room looking so excited. The first time I held her, maybe two days after she had been born, was so magical. She was itty bitty and warm, and red like a little lobster from the jaundice.

Kyla's first time holding her

Photobucket Under the bilirubin lights.

I think it was the fourth day when Senpai came back into my hospital room after visiting Rosemary in the NICU and said, "They want to start putting clothes on her." I looked over at the duffel bag we had packed with things from home, inside of which I knew was a teeny-tiny sweater I had crocheted while I was still pregnant. I had followed a pattern, but even with using a larger hook size the gauge came out incredibly small and the sweater looked like it could fit a doll. I had shaken my head at the microscopic sweater when it was completed, wondering how it would ever fit a full-term baby. There in my hospital room, I felt foolish all of a sudden for wanting to put it on her. Senpai had asked me before if he should bring it over to the NICU, but I hadn't wanted him to, I don't know why. It wasn't until the "order" as it were came down from the nurses that I knew she needed that sweater. We went right over, me clutching the smallest little sweater in the world, and miraculously, it fit her. That sweater I made was the first piece of clothing my baby ever wore. There was a matching hat, too, but it wouldn't fit over the IV line they had just put in her head.

34 weeks

The first way her Daddy and I got to care for her was to change her diaper. I don't know about Senpai, but I felt odd doing it at first, like it wasn't my place. I thought, "The nurses handle everything, feeding, diapering, changing bed linens, etc... Who am I to care for my baby? Wait, I'm her mother. I'm supposed to be doing this anyway. But she's in their charge; they make the important decisions, not I. Oh well, just change your baby's diaper, already!" That's how my head struggled with the facts. But the more we did it, of course, the more comfortable we became being Rosemary's parents.


My Mom and Dad drove up from Florida after Rosemary was unexpectedly born. Mom was able to stay Easter weekend, but she had to return back to work after that. Dad is retired, so he stayed with us the entire time I was in the hospital and even later. I was discharged after a week, but Rosemary was still in the NICU. It was strange.. I was discharged home without my baby. I am so grateful to both of my parents for being there for me when I was weak. Senpai, too, of course. But it would have been really hard if Dad hadn't stayed longer. He helped around the house, drove the 26 miles when I was too tired to do it myself, and kept me company while Senpai was at work. He was glad to help, but he was also happy when Rosemary finally came safely home, so he could return home, too. Thanks, Dad.

I pumped breastmilk to go into her tube, but her little body needed more nutrition than I could provide at first, and she was given formula as well. It was actually more like she was given formula plus the little bits of colostrum that I produced. I put my heart and soul into pumping, waking up every three hours even into the night, trying to rev up production. It wasn't until after I had been discharged home that my breasts finally produced enough milk so the NICU staff could feed her breast milk alone without formula. I was so thrilled to get to that point. I worked with a lactation consultant to try to breastfeed, too. One day I was trying to breastfeed Rosemary behind a screen when I could hear the doctor going over Rosemary's chart with the nurses. A male nurse relayed that Rosemary didn't tolerate formula well, and the doctor got the wrong idea, thinking that I was stopping giving her breast milk. The female doctor became all bullish all of a sudden, "Where's the mom? She's here?" and she poked her head over the screen, while I had my baby to my breast, and demanded to know why I wasn't breastfeeding. I just looked at her incredulously. It's humorous now. I'm glad they had Rosemary's best interests at heart.

Grandad looks on

Even though the breastmilk was there, getting her to ingest it for herself was a tall mountain to climb. She was born before her sucking reflex had developed. Every day the nurses, Senpai, and I would try to put a bottle in her mouth, just to have her mouth form an "o" from which she would poke her tiny little tongue out. It was the cutest thing in the world. I said, "That's adorable, Sweetie, but it's not going to help you eat." When she finally did learn to suck, it started as only one or two little sucks and then she would stop, mostly from exhaustion. The rest of the bottle had to go down her feeding tube. Gradually she started to drink more and more, still never finishing her bottle. She was just too short on strength and energy. When she had been there for 18 days, I finally broke down. When I got there I learned that the nurse that day had put an entire bottle down her tube, without even trying to get her to drink it. That was the standard procedure-- If a baby doesn't do well for one feeding, just tube feed the next-- but I was ready to punch her. They wouldn't send Rosemary home on a feeding tube, and she wouldn't be rid of the damn thing if they kept using it without even trying to get her to drink the milk for herself. I expressed my concerns to the nurse in the nicest way possible without actually punching her. She went and found the doctor-- a nice Asian fellow, not the bull woman from before-- and after hearing what happened he changed Rosemary's feeding schedule from every 3 hours to... whenever she was hungry.


This simple directive made an unbelievably profound difference. What a brilliant idea! Feed the baby when she's hungry! And, oh man, she ate SO WELL after that. It turned out that every 5 hours was her personal schedule. The NICU staff squirmed at that timeline, not really liking the idea of pushing feedings beyond 4 hours, but it was so good for her. She wasn't eating at 3 hours because she was still tired! She was supposed to be sleeping then according to her own schedule, but here were these nurses prodding her awake and forcing a bottle in her mouth, expecting her to chug it down. But when she was hungry, 5 hours later, she finished the whole bottle, every single one of them. She was discharged a day and a half later.



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