NICU

Most young preemies have to be put on caffeine.  The caffeine is a stimulant and helps keep their heart rate up and them breathing.  There were days when we would hold Cam and he would stop breathing for a few seconds.  Those were initially terrifying.  Sometimes he would even turn slightly blue.  We were taught how to respond in these situations and eventually began to predict when they were going to happen (by watching his monitors).  It was difficult to hold him and not be on edge constantly.  Every episode of this was recorded in his chart.  The older he got, the less frequently they occurred and the smaller amounts of caffeine he was given. They eventually wean the babies off of caffeine and the episodes occur only once in a while. That is one of the markers that show when it was safe for babies to come home.

Preemies often develop jaundice.  Within the first 3 days Cameron developed jaundice.  He was put in a special incubator with bilirubin lights for 3 days.  He was placed back into a regular incubator once his liver enzymes returned to normal.  This was a hard 3 days because we were limited to holding him only an hour at the most a day.  I just sat next to him or with my hand on him during that time.  Approximately a week after he was born we were able to dress him.  We bought preemie sized onesies for him.  He was adorable. 

Another challenge preemies need to over come is the ability to gain weight and maintain their body temperature on their own.  This is not a fast moving process.  Initially young preemies are placed on TPN which is a vitamin and mineral enriched fluid to sustain them.  Once they are stable and progressively getting healthier, they start the feeding tubes.  Feeding tubes are usually placed through the nasal passageway (nasogastric) or directly down the esophagus through the mouth (orogastric).  Cameron initially had his placed as an orgastric tube until he got older then it was switched to nasogastric.  His poor little sinuses got so stuffy and he had to be suctioned a couple of times a day.  They started Cam with smaller amounts (just a few mls) and worked their way up.  Once they determined that he could handle the tube feedings with no issues (reflux etc) we were able to attempt to bottle feed.

Bottle feeding can be disappointing at times.  Preemies need to learn the ability to suck, swallow and breathe.  This is a 34 week and up skill generally.  This is a big skill.  During those feedings they can sometimes get bradycardic (heart rate will drop) or choke.  This is a time when you have to be extremely patient.  Cameron progressed through these stages very well.  There were days we would get frustrated, even cry.  We were however, very lucky.  During bottle feeding stages the NICU will begin to lower the incubator temps to watch and make sure the little ones can maintain their body temperatures on their own.  This stage also goes hand in hand with weight gain.  The better they do, the more bottle feeds are added and tube feeds are decreased (and the more weight they gain).  Bottle feeding is very tiring for them and it takes a lot of energy.  You will have good and bad days.  One day Cam would take all of his bottle feeds and the next he would only be able to do 2 or 3.  Cameron was on a set every 3 hours feeding schedule.  Not gaining weight in a day or losing weight can be a sign of distress.  He really only had one day that I remember the he didn’t gain weight.  Most of the time, preemies in incubators are given sponge baths.  Once they hit a certain point they are allowed to have real baths.  Our nurse stayed with us the first time and showed us how to properly bathe him and keep him warm.  This was very exciting for us. We were learning to be parents one day at a time.  Each and everyday was a new exciting skill we learned and one day closer to him coming home.

While ALL of that was going on in some simultaneous and progressive manner, I was still struggling with breastfeeding.  Pumping every two hours was rigorous and exhausting.  I just didn’t do well.  I was extremely sore and irritated and my supply had begun to slow down.  The nurse game me a pamphlet on “power pumping” but it didn’t’ help me much.  There were only two times that I was able to attempt to breast feed him with a lactation consult.  I feel like that lady man handled me and wasn’t very much help.  She just wasn’t nice.  Neither attempt went well.  Cam wasn’t ready and just kept falling asleep.  I cried both times after these sessions.  I was honestly frustrated with Cam because I wanted him to “get it” and I felt like a complete failure at the same time.  I wanted that bond with him and it wasn’t working.  My spirit and hopes to breastfeed were broken.  I should have been trying to feed him every day, even a few times a day.  I didn’t know. I didn’t know that there were prescription medications that could help with my supply.  I didn’t know pumping isn’t supposed to make your skin red and raw.  By the time Cameron left the NICU, I was pumping the exact amount he was eating…not good.  We switched to formula.  If only I had known what we were going to go through with formula.  It was a disaster to say the least.