NICU

Neonatal Intensive Care Unit. It sounds way more intimidating than it actually is. This is coming from a nurse, though. The tubes and alarms are a comforting thing for us. Monitors do a 24/7 job more efficiently than we, as humans, could manage. They alert us to problems, to which we then must use our knowledge base to act & solve. Of course I didn't want my precious newborn in NICU, but since he had tachypnea and a shoulder injury, I would much rather him be in an intensive care unit with monitors than in-room with an exhausted first time mom.

Speaking of shoulder injuries, he had X-rays in NICU immediately after he was born. Josh took a picture, because he thought the lead apron they put over his business was cute.

The X-rays came back fine. No broken collarbone. Hallelujah! He had some fluid around the joint from injury, but that was all. By the second day, he was flailing that arm around like no body's business.

Back to tubes and such. Looking back at pictures of my sweet baby with all of those tubes coming from his tiny, swollen body, crushes me. It's heartbreaking to see him like that. It was different at the time, though. We had a great NICU nurse that first day. She was so nonchalant. She'd say, "this is just a tube in his tummy to get out the air bubbles from the oxygen. And his oxygen is just room air. The little central line in his umbilicus is just so we don't have to poke him a bunch to draw blood, and we are going to give him some lipids and good stuff through that line." It made every little tube seem important, but like no-big-deal at the same time. She was great.

Day 1 (Saturday: the birth day)
Probably the hardest. After pushing for 2 hours, not sleeping or eating in over 24 hrs, I was give out. I tried to rest, but we had lots of eager, loving visitors coming and going. It was impossible to turn anyone away. I WANTED to see them. I WANTED to visit and chitchat. I also WANTED to rest. It was a hard time. The worst part is that everyone travelled at least an hour and no one got to see Luke. He was whisked away to NICU right after birth. There are no windows in NICU. It's a restricted access area, very quiet and private for the babies. By that night, our baby had oxygen, an OG tube, a central line in his umbilicus, EKG leads, an oxygen saturation monitor, and warmers on him. It sounds overwhelming, but I was just glad he wasn't intubated. Two other tiny babies (weighing less than 3 lbs) were. Because he was breathing so fast, they decided not to let him eat anything for 24 hrs. Babies typically have a poor appetite during that time, anyway. Nature's way of allowing the small amounts of colostrum from mom to be sufficient until the milk supply comes in. I was really bummed. I had always imagined I would feed him within hours of being born. They told us he was diuresing well, so the swelling would keep improving. He was so swollen! He was also very lethargic. Again, Mother Nature at work so that baby could recover from labor. It was hard work for him, too!

We were allowed in NICU at any time we wanted except during shift change, when confidential reports were being exchanged on all babies. This was between 6-8 am and pm. The very first night I tried to come see him alone (Josh was home feeding our dogs), I had a quarrel with a nurse. Long story short, I was given the run around and only allowed 5 minutes with my baby. Josh and I were only allowed to hold him once per shift (every 12 hrs), and we were told it was at his nurse's discretion. This was because he had a central line in his umbilicus. It was sewn in place with a clear dressing over it. I felt like saying, "I'm a friggin nurse. I know what this is and how to handle it. Now let me hold my freaking son!" That place made me want to pull my hair out.

Day 2 (Sunday: the last day with our favorite weekend crew)
The lactation consultant informed me that I could finally breastfeed my baby! I was overcome with joy. She assisted me. I had been pumping every 2-3 hrs (even all night) to increase my supply. It wasn't working well. I was logging my progress and seeing improvements, but I was very behind in my supply. He was a little rockstar baby when it came to eating. He latched perfectly. Everyone was very impressed by that. Made me a proud momma. The only thing that could have made me any happier would have been more colostrum. Boy, that was frustrating. We had to supplement with formula until I could produce enough for him. That was pretty disappointing. It was also hard to manage around all of the cords and tubing, get him situated on pillows, and me in the chair to feed him. My LC would weigh him before and after feedings to see how much he was getting. It was really cool. He was only getting about 10 mls (just less than 1/2 oz), though. The whole day seemed to be about both of us learning to breastfeed. He was weaned off of his oxygen on this day, too. That was exciting to come in for an afternoon visit with him and see no oxygen on him! His O2 sats were in the high 90s-100 without it! We were so happy. It was starting to look like maybe he could go home sooner. We were in and out of NICU all day on this day. I cried when I looked at him; I cried when I had to leave him; I cried at the thought of him. I was so overrun with emotions and gratitude. The situation may not have been favorable, but my baby was in this world and doing okay.

Day 3 (Monday: the start of a long week)
Ok, I lied. This was probably the worst day, emotionally. I had read that the breastfed baby should not receive any bottles or pacifiers in the hospital as it could sabotage the efforts, causing nipple confusion. Not to mention, it takes a completely different suck reflex to hold onto a pacifier than it does to express milk. Without my consent, my baby had been given a pacifier and ready-to-feed formula several times. I was so bummed. Any time he was hungry, the nurses would just throw a bottle of formula in his mouth instead of calling me from my room to come and feed him. They weren't supportive at all for a breastfeeding mother. They would peek in the curtain every 5 minutes to see how it was going, if we needed anything, etc. In fact, I did need something: privacy. 

How is a new mom suppose to get any bonding or confidence with her child when she is constantly being bombarded with intruders?! He latched really well without any difficulties, though. It would have been perfect had I actually had supply. But I didn't. And it was hard. The lactation consultant was wonderful and very supportive. She had my back with one of the NICU nurses that kept throwing a bottle to my child at every whimper. She let that nurse have it. The nurse was older than myself, late 50s early 60s maybe? And because this was our first baby, she treated us as though we knew nothing! She wanted to tell us how to touch him, hold him, change him, feed him... Okay, he may be OUR first, but we've cared for babies before. Sheesh. I think it was that "I'm older and far more experienced than you first-timers" syndrome, because the younger nurses (more our age) were much more understanding and gave us our privacy and autonomy with him. 

I was trying to breastfeed one day, and he just wasn't interested. So, I just held him and enjoyed our time together until he gave me some more cues that he was actually hungry. Then, here comes that hag-of-a-nurse (excuse my bluntness, but it's how I felt at the time) poking her head in the curtain, invading our privacy once again, asking how he was feeding, etc. I told her he wasn't hungry and that we were just relaxing for the time. She asks, "Do you mind?" while holding her arms out. I didn't know what she wanted, but I shrugged in an annoyed manner loosening my arms from him. She then took him from my arms and shoved a bottle of formula in his mouth right in front of me. Fed him the entire bottle, burped him, and handed him back to me. Then, had the audacity to say, "See? He just needed some convincing he was hungry." Rage was flowing through my veins like hot lava. I was almost in tears. You totally just sabotaged every effort I was trying to put into feeding him and our privacy and bonding! I almost got up and walked out while she was feeding him. I was so upset, and I could tell that she even sensed it. She had the nerve to say to me, "Oh don't worry sweetheart. You'll get the hang of it." I wanted to punch her in the throat. It's easy to look back and say I would have done this or I would have said that, but the truth is that in that situation, it was different. I didn't want to make any of his nurses mad. I wanted a good rapport, because they controlled my access to him. Sad and ridiculous, I know. 

I packed my things (pump, blankets, stuff I'd bring to feed him) and went back to my room and just cried my eyes out. It was hard enough, I didn't need someone like that skewing every effort I attempted to put forth. Obviously, she ignorantly didn't even realize how incredibly invasive she was being, but she didn't even hand me, his mother, the bottle to feed him (which I likely would have launched across the room, anyway). She blatantly sat right in front of me and fed MY child. The one I had just given birth to, barely known for one day, and only held twice. I was livid. Again, a time when Josh was out getting lunch. Seems like they bullied me when he wasn't around. When we were changing his diaper once, she walked over and said, "See? You guys are really getting the hang of this!" Josh laughed and said, "This ain't our first rodeo, lady." She walked away, and didn't bother us the rest of that visit. Why are his words so magical, I wonder? Is he more intimidating than a weepy, washed-up-looking new mom? When I think of it for what it was in that sense, yeah, yeah I guess he definitely was. 

Luke had been getting fluids, nutrition, and antibiotics through his IV, but because he was eating and doing well, it was taken out that night. That was exciting, because it meant that we could finally dress him in his own clothes and hold him as much as we wanted! And we did just that. He was starting to look like a little carrot, though. I could tell his bilirubin was building up in his blood making him jaundiced. They were going to draw labs and see what his levels were. He was such a little fighter. 

Worst part of this day: I was discharged. I was told I could stay until midnight if I wanted. And I did, so I could be with my son for as long as possible. But that night, I left the hospital without my baby for the second time in my life. The same hospital. It was such a crappy feeling. I just had to keep telling myself that this time was different. My baby wasn't in my arms going out the door on this day, but he would be soon.

Day 4 (Tuesday)
Baby boy's labs came back, and his bilirubin was in the medium-high category. The NP broke it down like anything above normal is low risk, medium/med-high, then critical. She said he wasn't at a critical level yet, but he wasn't far from it. So, they wanted to start phototherapy on him ASAP. It was a simple pad with blue fiber optic lights that he laid on while wrapped up in a blanket. They said they would check his bilirubin levels again that night. Nursing him with the Bili-light was kind of a pain, but I never took him off of it. I wanted his levels to come down, so we could bring him home. I was also concerned with his levels getting critical, as that could cause brain damage. I hate being a nurse when it comes to certain situations. It makes them 10x worse. It really does.

This day was kind of blurry. I didn't sleep much, because I would get up every 3 hours and pump. I was dedicated. As soon as I had enough sleep, I got dressed, packed my things, and drove the 45 minutes to the hospital to be with my baby. I stayed ALL day with him. I took a small break to go get lunch, then came back to be by his side. He stayed on the Bili-light the rest of the afternoon, if I remember correctly, and they were going to draw his labs again in the morning.

Day 5 (Wednesday: room-in night)
After being off of the light for several hours, his levels had risen just slightly. They expected this. Later that day, they began to decline. Still elevated, but dropping. It was reassuring enough that they told us we could room-in with him. Rooming-in is where we come back to the hospital and are given a room for the night without being admitted. Luke got to sleep in our room all night, without monitors. Kind of like a trial before we took him home. 

I was in NICU all day with him again. One of the nurses even commented about how I had been there all day. Well, yeah. My son was in there. Where else would I want to be? I guess the other babies were born extremely premature and had extended stays, so it probably wasn't feasible for their mothers to be with them all day. Plus, the other moms all lived close; I lived almost an hour away. 

He had to pass a carseat test. They put him in his own carseat for 45 minutes (since that was about how long it would take to get home), and kept O2 monitors on him. He oxygen levels couldn't fall below a certain percentage while sitting in his carseat, or he would fail. He dropped a couple of times (I can't remember the exact criteria), but they passed him. I also had to sit through an infant CPR training video and be quizzed. I am BLS certified, as required in my profession. This means I am certified in basic life support, including infant, child, and adult CPR, first aid, and AED usage. I did not hesitate this training, though. I was quite afraid that I may very well have to use these skills, and a refresher was more than welcomed. 

It was a long night. I may have slept an hour or two. The nurses came in to check on him and check his temperature every few hours throughout the night. About 3am, his temperature had dropped to a point of getting close to hypothermia. They took him away and brought him back to NICU to be under the warmers again. Apparently, it's typical for a preemie to have low temps just due to immaturity. It sucked. I was so worried that it could mean he wouldn't get to come home. But then again, I was worried about it dropping if he were at home.

Day 6 (Thursday: We Go HOME!)
After one of the docs came in to round on him in NICU, he was discharged. They said his temperature was fine and that he could go home. We were so excited! We got the rundown on discharge instructions and care. My Lactation Consultant came in to have a few last words with me and write down some pointers I would need. We packed him up in his carseat (that tangible item that made it all real for me, remember?!), and headed out the door. Finally, I was leaving the hospital with my baby.