Friday, March 18, 2011

The first 48...what we'd like to forget

The first 48 hours of Beatrice's life are not exactly something any of us will ever remember too fondly.  All we wanted to do was cuddle and stare and smile and cry tears of joy. But instead it was a lot of anxiety, fear,  frustration and worry over two issues that created a whole lot of drama.

Basically, it all comes down to this.  Since she was born inside the amniotic sac and since the pushing phase of labor was so quick (literally 3 pushes inside one contraction - bag, head, shoulders) that meant that all the "goo" that normally gets pushed out of a baby as she makes her entrance into the world didn't happen for Baby Bea. Translation: she nursed like a champ straight out of the gate in the delivery room but once she got a good shake-up from her first bath by Nurse Ratched, she start vomiting up all that stuff that was stuck in her tummy. For the first 24 hours of her life, someone had to stay awake by her side with a suction bulb in hand so she wouldn't choke on the fluid, mucus, dried blood, etc that kept coming up and out of her (poor little thing).  It was awful to see such a little thing struggling so much and a couple of times we had to push the nurse button to get someone in there right away because she was gagging and choking.  The nurses "deep suctioned" her with a tube twice to try to get it all out, but it didn't help much. The consensus was to wait for 24 hours to pass before intervening in the hopes that it would all work itself out.  But it didn't.

We hit the 24 hour mark with little to no improvement and she was very, very uninterested in nursing. (The dang nurses didn't believe that she had latched at birth but I had a room full of people to prove that she had.)  I persisted at getting her at least awake and on the breast every 2 hours to stimulate production, but she was not hungry (and who would be with a belly full of goo and a very sore throat).  Once the 24 hour mark came on Wednesday afternoon, we decided with the pediatrician to "pump and wash" her little stomach, despite the fact that the nurse referred to it as "traumatic to the babies". Basically, they ran a tube down to her stomach and sucked out everything then flushed it out twice with water. Louie watched our poor little girl get emptied out, which I can only imagine was pretty awful but the good news is that IT WORKED! 

Almost instantly, the vomiting and choking stopped and it was just replaced by a pretty strong gag reflux that was the result of 24 hours of her body being trained for things to work the wrong way.  We kept plugging away with nursing but noticed another problem pretty was NEARLY IMPOSSIBLE to keep the little darling awake. She was very lethargic and even when woken up wouldn't stay awake very long (not ideal for breastfeeding obviously).  The nurses taught us all kinds of tricks to try to keep her up long enough to eat and we started to have some success as Wednesday pressed on. (Knowing what I know about breastfeeding, I knew she was fine with just the colostrum and that she wasn't starving but the nurses definitely pushed that I should supplement with formula. This will likely be the topic of a later post, but I'll just say now that we were heartbroken by this - not because they were contradicting what we know to be true and what we knew to be right for us and for Bea but because it was so easy to see how a mother who didn't have the support and knowledge about breastfeeding would be compelled to very easily give up if presented with the same situation.)

Anyway... Josie was jaundiced when she was born and Lou has a liver condition that causes jaundice as well, so we knew we wanted Bea checked for jaundice as early as possible. (They didn't catch Josie's until we were literally getting discharged and it was a chaotic mess that we didn't want to repeat with Bea.)  Not surprisingly, her jaundice screening came back positive and the warnings from the pediatrician came that we might not be able to take her home with us on Thursday as we had planned. We good news was that we did have an explanation now for the lethargy but the bad news was that we knew the quickest way to get rid of the jaundice was for her to eat! It really was a complicated problem - she won't wake up because she's jaundiced but she needs to eat to get rid of the jaundice. And all of this was made worse by the stomach problems from the first 24 hours and the gagging that was still occurring whenever she did try to eat. 

I'm not gonna lie folks, I sort of started to panic!  After all we had been through...all the drama of the pregnancy and all of the complications along the way and now all of this.  We didn't know what to do. I guess, looking back, we just sort of muddled through it minute by minute. 

Beatrice was hooked up to the bili-blanket for the jaundice by 5pm Wednesday night. They gave her 12 hours on the blanket with the plan to retest at 5am to determine if she'd need to stay at the hospital (while we went home!) or get to come home with us.  Overnight Wednesday became "Mission: Feed Bea!"  Needless to say, it was a looooong night and we ended up having some success with feeding her my pumped milk with a syringe in addition to keeping her on the breast as much as possible.  Thank goodness the test results came back low enough that we didn't have to leave her there but we did have to rent the goofy bili-blanket to take home.  (Little Bea already trying to be just like her big sister!)

And then, finally on Thursday afternoon...we got to come home!  
And boy oh boy we could not wait to get home!!!  

Fortunately, the bili-blanket worked its magic in the first 24 hours (her case was not as bad as Josie's - who needed it almost 3 days).  Here is Bea with the blanket next to her. The lit-up part goes up through the baby's clothes against the skin and must remain on at all times (through feedings but not diaper changes). It's a really stiff piece of plastic that can't possibly be comfortable for the baby. The most annoying part is the tube and the cord which makes holding and nursing difficult. But you do what you gotta do, right?  (I should mention that we were so sure Bea would probably require this thing that Lou made a special point to show Josie the other "glow-worm babies" in the nursery so that this wouldn't freak her out. Don't get me wrong, Josie was as glad to see this thing go as we were, but Lou did an awesome job of preparing her for it.)
Glow-worm Bea

Fast forward to today: Beatrice is back up to her discharge weight and doing just fine.  My milk came in very quickly once I was home and she's nursing like a champ!  She's sleeping well and a very content and relaxed baby (one extreme difference from her sister).  She is showing some early signs of reflux which we recognize having gone through that with Josie as well.  We are hoping that this is just a lingering side effect of those first 24 hours and that it's not the beginning of a chronic reflux problem like Josie had.

One last thing... I want to just say that we feel extremely lucky for a healthy child.  Beatrice's issues those first two days, while stressful and hard, absolutely pale in comparison to some of the things newborns and their families face every day in that same hospital.  Twice I have had to leave that hospital without a baby that I walked in there with (my first miscarriage sent me to the ER there and my third was the D&C there on year earlier) and it made it all the more special to put Beatrice into our car and take her home with us. Trust me, we are grateful.


Megan Germano said...

Hmmm... Those nurses sound a little like my nurse who was insistent that I needed to take Percocet and/or Vicoden even though I told her I was NOT about to drug myself up and try to take care of two itty bitty brand new babies only hours old. Sometimes I am wondering what people are thinking.

Anonymous said...

Carri I am sorry you all had to go through those trying 48 hours, although am so glad everything turned out good. I am glad you stayed persistent with the feeding and not give into what the nurse suggested. Your a terrific mom. Laurie