As I mentioned in the birth story post, Daniel aspirated some meconium before delivery so a NICU team was standing by to tend to him when he was born. Within probably 15 minutes of the birth, and after I'd only gotten to hold him for a few short minutes, Daniel was taken to the NICU.
Here are pictures of me holding him for the first time. I never noticed till now that the nurse handing him to me was in a plastic suit. I guess the whole NICU team probably was but it didn't register at the time.
After Cecily finished sewing me up and we had gotten our things packed we moved to our recovery room on the 7th floor then headed over to the NICU nursery to visit Daniel. My parents came with us to meet their first grandchild.
When we first saw Daniel he was lying on his tummy in an incubator bassinet with a big breathing mask strapped to his face and a feeding tube in his mouth and taped to his cheek. He had a hep lock in his right arm for an IV and a big soft blue pad strapped to his arm so he wouldn't scratch himself or try to pull out an IV. He also had wires taped to his chest to monitor his heart and more wires on his foot to measure who knows what. It looked like so much equipment on such a tiny little body, and to top it off he had antibiotic ointment in his eyes.
Despite all of that, he still looked beautiful. We were also impressed by the way he was already lifting his head up and trying to move around. He might have been covered in wires and tubes but he was proving himself to be a strong little boy already.
We didn't get to hold him on that visit because he was hooked up to the CPap breathing machine. But when we came back a few hours later his breathing had improved enough that he was off the CPap and breathing with a nasal cannula tube (like what people on oxygen tanks use).
Now that he was off the CPap we could hold him. For Kevin this was his first time. We also dressed him in some of the newborn clothes we'd brought. Unfortunately we hadn't counted on a 4 day hospital stay so we didn't pack enough clothes for him (or us) so he had to wear hospital shirts most of the time. But getting to hold Daniel and dress him in his own clothes gave us a little more of a chance to bond and feel more like his parents and less like visitors.
Thursday, July 22: The good news, the bad news, and a very ugly diaper change
The next morning Dr. Moin, the NICU doctor caring for Daniel, came by our room and told us that over the night Daniel's breathing had improved enough to remove the nasal cannula and let him breathe room air. We were optimistic that since the initial reason for his NICU stay had been resolved we might get to take him home soon.
But as we learned, news in the NICU tended to follow a pattern of one step forward, one step back. A few hours later came the news that Daniel's white blood cell count reflected a high number of immature white cells. Dr. Moin explained that this could be a sign of bacterial infection or just be related to the normal stress of birth. To find out, they would run cultures and see what they found in 48 hours and in the meantime Daniel would be given antibiotics preventatively. Even assuming all was fine, this meant the best case scenario didn't have Daniel going home sooner than Saturday morning.
Thursday and Friday we were still staying in our NICU recovery room. We learned the NICU's schedule of feeding every 3 hours on the 3's and timed our visits so we could feed him and change his diaper.
One thing Baylor was great about was supporting breastfeeding. Wednesday afternoon a hospital breast pump was delivered to our room so I could start pumping, and whatever we collected from that we'd take to the NICU in syringes to be fed to Daniel.
My ideal birth plan had called for Daniel to room in with us and be exclusively breastfed, but in the NICU they require the babies to eat 40ml at every feeding and before the milk comes in, a nursing mom couldn't possibly produce enough so they had to supplement with formula. We did give him whatever milk I was able to pump and I got help from several of the hospital's lactation consultants as we made our first attempts at breastfeeding. It may be a natural process but it certainly didn't come naturally to Daniel or me right away so their advice really helped.
On one visit Thursday we were changing his diaper and experienced a close encounter of the gross kind. We had taken off the dirty diaper and were wiping Daniel's booty when he decided it was time to poop again. As we were cleaning up the new mess and laughing hysterically Daniel started spitting up so I left Kevin to tend to the diaper mess while I wiped up the spit-up (and yes, I would say I got the better end of that deal!). Before we could put a new diaper on, Daniel decided to add another bodily function to the mix and peed all over his shirt and Kevin's hand. We put a new diaper on quickly before Daniel could unleash something else then changed the shirt (which was quite hard with the hep lock and blue pad on the right arm and all the wires to work around). That would have been the end of the drama except that as Kevin was trying to fold up the dirty diaper he stuck his finger right in the poopy part! Needless to say during all of this Daniel was crying frantically, no doubt as startled as we were by all that output from 3 sources in such a short time!
Friday, July 23: Feeding troubles
While Daniel was otherwise doing well the NICU team was concerned because he wasn't eating 40ml of milk/formula at his feedings. Whatever he didn't take from a bottle they gave him through the feeding tube in his nose, aka "gavage." Sometimes he'd get close to taking the full 40 but other times he'd take half or less. It seemed like all of our time with him was spent trying to make him eat rather than getting to hold and enjoy him.
I remember one feeding Friday night when he was just not hungry and we had to give up and have him gavaged. We held him while the gavage was going and he seemed so content in our arms like he just wanted us to love on him instead of trying to force-feed him. It was hard because there was so little we were able to do as his parents at that point and it felt like we weren’t even succeeding at the main job we could help with.
The nurse on duty said even if the blood cultures came back negative and everything else looked good, they couldn't discharge him till he was eating well. It felt like he'd be there forever. It was especially frustrating because they even agreed with me that if he was rooming in with us he'd just be getting a little colostrum every day and that would be all he needed, but because he was in the NICU he was on what seemed to be an arbitrary schedule and dosage. I made it through 37 hours of labor and pushing with no medication and very little sleep and don't recall crying at all but the frustrations with feeding definitely brought out the tears.
Friday evening we were discharged from our hospital room but rather than go home we checked into a room at the hospital hotel. The room was certainly nothing to write home about but at least we were close enough that one or both of us could still make every feeding, even the middle of the night ones. Leaving our hospital room and going to the hotel rather than home was the hardest time of the whole birth and hospital stay for me. It hit me then that we didn't know when we'd get to take him home and just when it had looked like all we had to do was wait for the blood cultures, now the feeding issue was looming over everything and suggesting our stay might be extended again even though he was otherwise healthy.
The absolute low point for me came around 2:45 Saturday morning. I had woken up at 2:15 to pump some milk to take and feed him at 3:00. I sat on the edge of the bed pumping in the dark then walked the halls to the NICU tired but looking forward to seeing and feeding my son. When I arrived the nurse said Daniel had woken up early and while they tried to hold him off with a pacifier, he was hungry and she'd had to give him his bottle. He had sucked down the whole thing and was now sound asleep. I was so disappointed at having gone through all that and not even getting to hold him that I headed back to the hotel crying and it wasn't till I was halfway back that I realized the good news that he had taken a full bottle for the first time.
Saturday, July 24: Close but no cigar
As it turned out, Daniel wouldn’t need to be gavaged anymore from that point on. When Kevin went back at 6 Daniel took a full bottle from him, he nursed well from me at 9, and we went back at noon optimistic about the blood cultures and hoping this might be the day we got to take him home.
The good news was that the cultures were negative, so there was no infection. But in NICU fashion, there was also some less positive news. Another blood measurement for C-reactive protein, which had tested high the day before, had fallen significantly but hadn't yet dropped to the normal range. So, while Daniel had no infection and was eating well, he still couldn't go home. The doctor said they wanted to keep him till Sunday morning and check his CRP and assuming it was normal, Daniel would be discharged. While we were disappointed to be facing yet another day of staying at the hotel and seeing him only for feedings we were glad that momentum had turned.
Daniel continued to eat well throughout the day, nursing from me and taking bottles of pumped milk from Kevin. We woke up Sunday feeling very optimistic.
Sunday, July 25: Free at last!
Sunday morning the doctor said the CRP hadn't quite dropped to normal but was close enough and showing sufficient progress that they were ready to discharge him. We set about packing up our room, loading the car, and getting Daniel's car seat and going-home outfit ready.
Here’s Daniel in his going-home outfit, which reads “Daddy’s #1 draft pick.” The hospital photographer suggested this pose and as she was taking her professional pictures I was snapping away behind her with my camera.
The discharge seemed to take forever but soon enough he'd had (and passed) his hearing test and gotten his picture taken, we'd packed up all the contents of his bassinet tray (along with keepsakes like his wristband and blood pressure cuff), and it was time to go. We put him into his carseat and we were finally on our way home. As we pulled out of the garage I pulled out my sunglasses for the first time in 5 days.
On the way home we pointed out landmarks to a sleeping Daniel telling him about places we wanted to take him. Once we got him home I carried him around all the rooms and then sat rocking him for a long time in the recliner in his room, so happy to finally have our little boy home.
Daniel received wonderful care in the NICU and the nurses and doctors there were great, but being separated from him for so much of the day and being limited in what we could do with and for him was a rough way to begin parenthood. Looking around the NICU certainly gave us a lot of perspective though. Daniel was among the healthiest babies we saw and over some of the bassinets we saw signs wishing the baby occupant a happy 2-month or 3-month birthday. Some of the parents waited weeks and even months to take their baby home while others were just praying that they would ever be able to take their baby home and most of the other NICU parents would have happily traded places with us. I know that by comparison 4 days, during which his health was never at serious risk, is a small inconvenience. But I also know that someday when we give Daniel a little sister or brother if we're lucky enough to have an uncomplicated birth and room in with our baby, I definitely won't take it for granted.
And the NICU experience did have a few silver linings (aside from the obvious one of ensuring we took home a healthy baby). I hadn't planned to bottle feed for the first few weeks because I was worried introducing a bottle, even of expressed milk, too soon might derail my attempts to get breastfeeding established. But since Daniel took bottles in the NICU and it didn't seem to interfere with nursing we have a schedule that lets Kevin give several feedings in a row of expressed milk every night so I can get some sleep and Kevin and Daniel get some boy bonding time.
Also, before we had Daniel I had imagined that when we left the hospital we might be feeling overwhelmed and anxious about how to care for him. "Oh my gosh, I can't believe they're actually going to let me leave with this baby!" But after 4 days of worrying about him, getting up at all hours of the night to walk the long halls, just to take advantage of every chance I could to see him, feed him, and even change his diaper, I realized I wasn't nervous when it was time to take him home. I may not have known how to do everything (and still don’t, and never will) but I knew the mother instincts were there and that we’d be fine.
And almost three weeks later, we are doing just fine. We're still learning on the job and there have been some hard hours and days but on the whole things are going quite well. Daniel has been perfectly healthy since we brought him home and the little boy who had to be gavaged because he wouldn't eat is now quite the eater and getting bigger, weighing 7lb 8oz at his checkup last week and measuring 21 inches, up from 7lb and 20in at delivery. Looking at him now you wouldn't believe he was ever anything less than completely healthy. And when I have to get up early to feed him, or he won't go down for a nap, or he pees all over the place when I'm changing his diaper, I can remind myself that at least I am lucky enough to have him to take care of round the clock in my own house rather than having to scrub in to visit him in the NICU every few hours.
Awwww, that made ME cry! Thanks for sharing your story. Y'all are doing more than "just fine" :)
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