Tag Archives | Preemie

A Special Valentine Arrival

It seems as though an entire season of laughter, tears, and gratitude has elapsed between February 1 and today. It’s hard to believe that it’s already the middle of March. Last month, our dear friends welcomed a precious little boy into their lives. He was born at 33 weeks exactly. This type of news is always a mixed bag of emotions. On the one hand, you are thrilled for the new parents and their growing family. At the same time, your heart sinks because you are all too familiar with some of the challenges that come with prematurity… the uncertainty, the waiting, the back-steps, and so much more. Life is just so darn fragile!

Despite feeling overwhelmed and scared, I remember being in awe of Olivia’s tenacity to get better each day she was in the hospital. Her courage gave me strength- the human body and spirit are incredibly resilient, strong, and brave. As we celebrated each tiny milestone along Olivia’s journey, moments of heartache were slowly replaced with joy and gratitude.

Olivia made this Valentine card for her fellow 33-Week buddy, Owen:

Valentines-Card

I’m sure that Owen will continue teaching his parents life lessons as they all grow together. Right now, he is snuggled safely in his mama’s arms and thriving at home!

To all the mama’s of sweet preemies, I think YOU are amazing. You have been asked to find new depths of strength inside yourself and to search for the thread of love in even the most impossible situations. This Valentine’s Day, I am celebrating the fierce and unfailing love that we {as mama’s} have for our precious children.

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World Prematurity Awareness Day

November 17th is World Prematurity Awareness Day.  The March of Dimes currently states that 1 out of 9 women will deliver prematurely in the United States.  I am now part of that statistic.

World Prematurity Awareness Day

Today, I’m thinking of all the sweet babies that are literally fighting to breathe and grow as quickly as they can.  I’m humbled by their strength and beautiful spirits.  I am thinking of all the mamas that have had to wait to hold their sweet blessings for days or weeks all the while trying to manage a complex constellation of feelings ranging from fear to grief to amazement.

I am feeling especially grateful today for all the prayers from dear family and friends about Olivia’s health.  We are so blessed.

To read more about our journey, visit the Preemie Archives.

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Pumping Breast Milk for a Preemie

As I mentioned HERE, pumping for your baby can be extremely challenging, tiring, overwhelming, and incredibly rewarding.  While I absolutely HATED the actual process of expressing breast milk, I loved that I was able to give Olivia a nutritious blend of my protective immune cells and all the necessary ingredients to GROW.

I have very few photos of this aspect of my life- it’s not exactly a period I want to relive.  However, I will never forget:

  • The first time James and I were allowed to feed Olivia a bottle as she was learning how to coordinate her suck, swallow, breathe reflexes.
  • Texting James a photo of two bottles full of milk after a really productive pumping session… I felt so proud to have produced so much!  Building up a supply with a preemie can be a challenge.
  • Setting my alarm to wake up in the middle of the night to pump.  Oh, the endless flights of stairs up and down to get supplies and clean pump parts.
  • Feeling amazed that my body was keeping up with the myriad of challenges it was facing.
  • The endless supply of bottles that we were washing on a daily basis… they seemed to multiply!
  • The familiar hum of the pump.
  • Wondering how I was going to juggle caring for a newborn by myself and keep up with a pumping routine- I needed to clone myself and add about 10 extra hours to the day!

Pumping

I am by no means an expert on this topic, but here are 7 thoughts based on my unique experience in no particular order:

1.  Rent a hospital grade pump.

They are SO much more gentle and quieter than a double electric pump that you would typically purchase from your local baby store.  I would also absolutely INSIST that a lactation specialist visually observe your pumping efforts before you leave the hospital to make sure that the pump is working correctly and the pump flanges are the correct size.

From my own experience, I can definitely say that not all pumps are created equal.  The Ameda pump that the hospital provided me immediately after Olivia was born did not effectively draw out my milk.  For 2 days, I pumped around the clock and got NOTHING even though I was becoming increasingly engorged.  Talk about a painful start to the world of pumping!  A lactation consultant recommended that my husband go out and purchase a competitor’s pump after evaluating the situation.

Did you know that Medela makes 5 (yes, 5!) different flange sizes for optimal comfort and flow?  (Most kits will only come with the 2 most common sizes: 24mm and 27mm.)  Using the right size will make a huge difference in how effectively milk is released.

2. Get organized.

Pumping breast milk involves a LOT of parts that have to be cleaned after each session.  James and I couldn’t believe how many little attachments and bottles we were cleaning each day.  My words of wisdom on this subject are simple: find a system that works for you.

In our case, we kept a bucket right next to the kitchen sink to collect all the dirty bottles of day.  The top shelf of the fridge was dedicated to storing breast milk.  For our preemie, the nurses instructed us to chill the milk obtained from each pumping session before we combined it with any other session.  This reality equates to a lot of bottles- ones for pumping and ones for feeding!  Oh, the dishes!

 After pumping, I quickly washed and rinsed the pump parts and sanitized them using these wonderful steam bags.  Then, I laid out the parts on a towel on our vanity to dry so they would be ready for the next session in 2 hours!  Also part of my pump station: the steam bag ready to go, Medela tender care, quick cleaning wipes, roll of paper towels, all purpose nipple cream (APNO), and coconut oil.

Tip: If you read any review on Medela pumps, you will probably run across commenters discussing condensation in the pump tubing.  To tackle this problem and prevent mold from growing, I sterilized the tubing by following the instructions on the steam bag and then used a hair dryer to force any remaining water droplets out!

3.  Kill the Boredom.

I lived on Pinterest during pumping sessions.  Pumping really started to take a toll on my spirit and body after the first month we were home from the hospital.  Time I could be cuddling with my sweet babe was being spent hooked up to a machine.  Due to a very rare metabolic condition, it was also unclear whether Olivia’s system would be able to tolerate all the milk I was so diligently pumping each day.  Pinterest was literally a saving grace- it kept my mind occupied and focused.

About halfway through my pumping adventure, I decided to make a playlist.  Songs to keep me motivated, songs to quiet my mind, songs to help me cope with lingering anxiety and feelings of loss, songs to energize.  Best. Decision. Ever.  Find your theme song.

I might have had Sara Bareilles & Ingrid Michaelson’s version of Winter Song on repeat for stretches at a time.  Its lyrics and beautiful melody still give me chills, especially since Olivia was born in December with such a rough beginning.  I LOVE its overall message that the pain is temporary- love never leaves and brighter days are ahead.  

4.  Boost your supply.

Explore lactogenic foods.  These items are great for increasing supply: papaya, asparagus, hummus, lentils, oatmeal, almonds, brown rice, brewer’s yeast, flax seed, and LOTS of water.  Many women have also had great results using the herb Fenugreek or the supplement Motherlove More Milk.  I noticed that I was hungry all the time while pumping.  My doula recommends this recipe for cookies that will boost your milk supply.

I ended up taking a prescription called Domperidone to help build my supply.  I loved that this particular drug doesn’t cross the blood brain barrier AND doesn’t carry the elevated risks of depression associated with the popular supplement, Reglan.  (See this article: Prescription drugs used for increasing milk supply.)  You can get a prescription for this drug to be filled by a compounding pharmacy in the United States.

5.  Enhance your diet with probiotics!

Because of the emergency nature of my delivery, both Olivia and myself were pumped full of antibiotics.  My doula immediately warned me that these drugs probably wiped out a good portion of all the “good” bacteria in my system and significantly increased my chances for developing thrush on my breasts.  Probiotics are your BEST friend to ward off any outbreaks!  Save your self the misery of *extremely* painful pumping by taking LARGE doses of probiotics.  (See Rebecca Haworth’s 3 Day Thrush Cure for specifics on which brands of probiotics to take and why it makes a difference!)

6.  Ask and accept others’ offers to help with housework or baby care.

Committing to a pumping routine is extremely demanding.  Some days, you just might need to channel your inner superwoman.  If others offer to watch the baby for a stretch or help you with the dishes, graciously accept their kindness!  Don’t feel like you need to need to do it all.

My husband was incredibly supportive of my pumping efforts even though it was a significant investment of time, money, and effort.  I’m not sure I would have kept my sanity without his steadfast encouragement.

7.  Do your research!

I frequently checked KellyMom.com for info on pumping issues and milk storage guidelines.  This post by Happy Home Fairy is another amazing reference filled with helpful hints.  Reading her suggestions would have been SO helpful at the beginning of my pumping journey back in December.  I absolutely love how she ended her post.  The breast milk vs. formula debate is ripe with so much judgment.  I often found myself feeling like a failure for not being able to produce more milk and agonizing over the decision on whether to switch Olivia to 100% formula in light of her specific metabolic condition (that’s a story for a different time!).  Julie’s concluding thoughts are just perfect and so eloquently put things in perspective.  Read also: her “funeral” for her pump post for amazing encouragement to face your fears and be at peace with your decisions.

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Marking 33 Weeks and 4 Days.

I was pregnant for exactly 33 weeks and 4 days.

32-Weeks-6-days-Pregnant

Today, Olivia is 33 weeks and 4 days old.

7-Months-Olivia

So many mixed emotions running through my mind today…

Olivia has been outside as long as she was safely tucked away inside my tummy. It’s crazy how quickly this much time has passed…although I can still vividly recall the feelings of fear, shock, failure, and overwhelm as we realized our sweet girl was coming so many weeks early as if it were yesterday. Her beautiful spirit and strength have changed our lives so profoundly and I am so grateful to all the family and friends that have kept her in their prayers. We are SO fortunate that she is thriving. We love you, Olivia.

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Inspirational Words for Mamas with Preemies

For the second time in less than 2 months, a status on my Facebook wall has popped up about a friend (or a friend of a friend) delivering early… like really early.  26 or 28 weeks early.

When these updates appear, I actually have a physical reaction.  A rush comes over me- knowing what we know about the challenges of Olivia’s early start, I have a small (albeit, very small) window of understanding into their situation.

I think about how small Olivia was when she was in the Special Care incubator struggling to breathe.  We were so blindsided by all the challenges associated with prematurity and slapped in the face with a potentially devastating newborn screening complication.  Then, I think about these tiny babies, who are just starting out on a long journey.  I just want to hug their mamas tight.  Thinking back on our experience, these words really inspired and comforted me.

The flow of these words reminds me of the famous “Everybody’s Free to Wear SUNSCREEN.”  Someone should make an inspiring video of wise advice for mamas of preemies.  In addition to what’s on this graphic, I would add a couple of other nuggets:

  • Some days, you are going to feel like a complete and utter failure.  Even in the worst moments, have confidence that you are doing the absolute best you can for your baby.
  • This will be HARD on your marriage.  If you pull together, it will bring you closer than you could ever have imagined.  Pull together.
  • No one can truly understand the heartache and uncertainty of this journey unless they themselves have traveled the path.  The things that can fly out of people’s mouths in an effort to “comfort” you can be utterly devastating!  Forgive them.  They can’t and don’t understand.
  • Prayer is SO POWERFUL.
  • It’s ok to feel like “this is not what I signed up for.”
  • Grieve your losses- especially, the loss of not being pregnant and the loss of the normal newborn experience.
  • Lean on your closest family and friends.  Accept their help, love, and prayers.

If these words strike a chord, here’s a PDF version: Preemie Inspiration Words

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A Typical Day in the Early Weeks

Sweet-Baby

We were blessed in countless ways during the first couple weeks after my early delivery and Olivia’s release from the hospital.  That being said, the beginning weeks were hard, especially since I was attempting to balance a pumping schedule with Olivia’s care.  To establish my milk supply, I diligently tried to pump between 8 and 10 times a day.  For the most part, we let Olivia set the schedule in terms of when she wanted to eat and nap.  In case you’re curious, here’s a glimpse into how our day went:

12:30 -12:53 am: Last pumping session of the night followed by a trip downstairs to refrigerate milk and clean pump supplies.

1:30 -1:50 am: Olivia is up and hungry.  After being changed, she eats about 60 mL.

4:03 -4:40 am: Olivia is changed and fed.

6:30 -6:49 am: Pumped and cleaned supplies.

7:30 am: James is up, showered, and feeding Olivia while I catch a little more sleep.

7:57 am: James takes the dogs out.

8:30 am: Pumped and cleaned supplies.

8:50 am: Quick cup of decaf coffee and bowl of oatmeal.  Re-swaddled Olivia as she’s escaped from her blankets.

9 -10 am: Mix of holding Olivia, unloading the dishwasher, responding to emails, and putting a load of laundry in the machine.

10 -10:45 am: Olivia is changed and fed.  Time for a new outfit.

10:45 -11:03 am: Pumped and cleaned supplies.

11:03 -11:45 am: Took some pictures of Olivia to update her album for the family.  Loaded pics on my computer for editing.  Placed next load of laundry in the washer.

11:45 -12:30 pm:  Olivia has started to root again.  Finished combining refrigerated breast milk.  Changed and fed Olivia.

12:30 -1 pm: Pumped and cleaned supplies.

1 -2 pm: Waited for the home health nurse to arrive.  She weighed Olivia and we discussed common newborn issues.

1 -2:35 pm: Olivia is changed and fed.

2:35 -3 pm: Pumped and cleaned supplies.

3 pm: Edited photos in Photoshop and loaded them to a Picasa folder.

3:30 pm: Tummy time for Olivia is interrupted by dogs barking at the door.  UPS delivered a package.

4:30 pm: Pumped and cleaned supplies.

5 -6:30 pm: Olivia is changed and fed.  James returned from work.  He took the baby after she ate to give me a chance to fold laundry, open mail, and pick up around the house.

6:30 pm: Pumped and cleaned supplies.

7 pm: Dinner at my parents.  Olivia eats again.

8:30 pm: Pumped and cleaned supplies.

9 pm: Olivia is changed and fed.  James worked on his computer while holding Olivia.  They both drift to sleep while I’m making a to-do list on the couch next to them.

Bottles

10:30 pm: Pumped and cleaned supplies.  James washed and sanitized the massive bucket of bottles for the day.

11 -12:30 am: James worked a little more on his computer while I read and got ready for my last pump at 12:30 am.

I never will forget how grueling the first 2 months were for our little new family.  James really had to step up in terms of taking an active role in Olivia’s care, even at 2 and 4am!  Not only was I absolutely exhausted, but I was also battling some pretty significant pain issues related to pumping and attempts at breastfeeding.  I am so grateful for his support, presence, and attitude that “we are in this together.”

After pumping for 5 months for Olivia, I am in awe of mamas that pump exclusively for their babes throughout the first year of life.  It is truly a commitment- not only on a physical level, but also in terms of time!  I read somewhere that you tend to develop a love/hate relationship with your pump…  I couldn’t have said it better myself… I loved the fact that the machine was my ticket to giving Olivia nutritious meals packed with my antibodies and other protective cells.  I absolutely HATED the process- it is awkward, sometimes painful, boring, noisy, and absolutely DEVOID of the typical bonding moments that accompany traditional nursing.  Trying to calm an upset baby while hooked up to a contraption that keeps her at arms length is not always easy.  Feeling like you are missing out on the special bond created during nursing that you’ve read about in countless books is utterly heartbreaking at times.

Despite the moments of unpleasantness and uncertainty, I am so grateful for everything that our experience has taught us.  I am now even more keenly aware of how important it is to enter into every situation with an open and compassionate heart that focuses on savoring joy.

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5 Months After the Special Care Unit

5 Months After the NICU

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10 Ways to Help a New Mom of a Preemie

I was overwhelmed by the love and support given to us after Olivia’s early arrival.  So many people wanted to know how to help our family during this difficult transition.  Asking and receiving help, especially when you are still processing so many raw emotions and your mind feels scattered, is complicated.  On the one hand, you don’t want to feel like a burden and aren’t even sure of what you need.  On the other, you recognize that your family is quite literally in a crisis where all the “unknowns” can breed an overwhelming and isolating case of fear.

I’ve thought a lot about the very early days of Olivia’s arrival- what worked for us, how we struggled, and the small gestures of support from family and friends that really made a big difference.  We didn’t have hardly ANYTHING prepared before Olivia’s arrival.  While not an exhaustive list, here are several suggestions for helping a new mama of a preemie:

10 Ways to Help a Mom of a Preemie

1.  Offer to prepare dinners or freezer meals.

Several friends prepared meals for us- I honestly don’t know what I would have done with these beautiful care packages.  In addition to shuffling back and forth to the hospital, James went back to work so he could take some time off when she was discharged.  In the meantime, I attempted to pump every 3 hours to establish a milk supply.  It was incredibly helpful not to worry about what we were going to eat at night.

2.  Find and share educational material on preemies.

I didn’t have a clue on what to expect with a premature infant.  I turned to Pinterest to explore articles and information that might be relevant to our situation.  The website, Hand to Hold, and the blog, Preemie 101, were particularly helpful.  Unfortunately, I simply didn’t have time to read everything I wanted to in order to be an informed advocate for Olivia.  For instance, after reading The Premature Baby Book, I would have been much more insistent that we start kangaroo care with our girl sooner.  I also would have highly encouraged the hospital to use slow flow nipples when they fed Olivia a bottle to make breastfeeding attempts easier in the long run.

  • Ask if you can help find articles or books on the latest research concerning kangaroo care, feeding challenges, etc…ANYTHING relevant to preemie care.
  • If you know of another mom in the area that has gone through a similar situation, offer to connect this resource to the new mama.

3.  Provide emotional support.

For all of the support we received, there were occasional comments that really got under my skin.  In an attempt to help me focus on the positive, several nurses told me, “Wow, she would have been a 10 pound baby if she had gone to term- aren’t you glad you didn’t have to push that out?!”  I start to cringe even thinking about these words as defensive alarms blast through my brain.  First of all, my precious baby was right on track in terms of her growth and would have probably been close to 8.5 pounds at birth.  Second, I would have given ANYTHING to keep her safely protected inside of me until she was able to breathe on her own comfortably.  I would have gladly pushed out a 10 or 11-pounder if that meant I didn’t have see my girl hooked up to various machines struggling to inflate her lungs.

Some others commented, “well at least you can catch up on your sleep while Olivia is being cared for at the hospital.”  If it were only this simple. If only I didn’t feel guilty every minute we weren’t with Olivia at the hospital.  If only I didn’t have to pump every 3 hours, even in the middle of the night.  If only we weren’t in store for several “extra” weeks of sleepless nights that most parents experience.

I share these stories because words are so powerful, especially when they are directed at a hormonal and scared new mama.  I needed the people closest to me to listen to our unfolding drama and stand with me in awkwardness of waiting.  We had a LOT to be grateful for…. but, I didn’t need someone constantly reminding me to be positive, especially when we received news that one of Olivia’s newborn screenings was flagged.  Our fears and accompanying losses, including our grief over an incomplete pregnancy and the typical newborn experience, needed space to be processed and not simply dismissed because Olivia was making progress.

Our supporters were our greatest cheerleaders, celebrating our perseverance and Olivia’s milestones.  At the same time, they validated our feelings and acknowledged everything we had been through.

4.  Offer breastfeeding/pumping support.

Breastfeeding can be a challenge when dealing with a full term newborn.  It is an entirely different ballgame with a preemie.  Instead of cuddling and bonding with my newborn, I was handed a pump.  I won’t go into the full saga of how my breastfeeding story unfolded here, but I will say I was (and still am to this day) continually amazed at how much judgment exists on this particular issue from both sides.

For mama’s that choose to pump for their preemies, here are a few ideas on how to be supportive in this area:

  • Highly encourage her to rent a hospital grade pump, like the Medela Symphony, to establish a supply.  (They also make a version of this pump that is tailored for moms that are beginning to pump for preemies.)
  • Insist that a lactation specialist visually observe her pumping efforts before she leaves the hospital to make sure that the pump is working correctly and the pump flanges are the correct size.  Medela, for instance, manufactures 5 different sizes of breast shields to provide optimal comfort.  I learned the hard way that the particular brand and style of pump can make a huge difference in how effectively milk is released.
  • Ask your friend if she already has a hands free pumping bra.  If not, offer to go get one for her.
  • I didn’t have time to read The Nursing Mother’s Companion before Olivia’s birth.  Offer to read a few chapters (particularly chapters 2-4) and give her the bullet points of what to expect and what’s normal.
  • Offer to get her this supplement to help produce more milk: Motherlove More Milk.
  • Send her funny texts during her regular pumping sessions.
  • When difficulties arise, remind her multiple times that she isn’t a failure if she isn’t able to keep up with her preemie’s increasing demand.  This article might be helpful: Changing the Definition of “Nursing” Your Preemie.

5.  Provide a basket of snacks on the go.

I was incredibly hungry ALL the time when I first started pumping.  It was so handy to have the following snacks on hand: clementines, whole almonds, chocolate covered blueberries, mozzarella sticks, and my favorite wheat crackers from Trader Joe’s.  A dear friend brought us a batch of homemade brownies the day after Olivia’s birth.  What a gift!  Don’t underestimate the power of surprising a new mama with a thoughtful treat.

6.  Purchase one or two preemie outfits.

Dressing Olivia in her own clothes was a definite milestone while in the Special Care Unit.  Good friends and family gave us several adorable preemie outfits that were so essential for her tiny size.  It was so handy to have these outfits ready to go.  Changing Olivia’s diaper and dressing her in her own clothes somehow humanized our situation, even when she was still connected to so many machines.  These mundane tasks were simply NORMAL parts of being a new parents.

Any errand that a new mama doesn’t have to run is also a gift of time.  Since I didn’t need to go out looking for preemie clothing, I was able to spend more time either at the hospital or resting at home.

7.  Offer to help organize.

My parents came over one afternoon and helped us arrange furniture and hang a couple of pieces of artwork in Olivia’s nursery.  Was this a necessary action?  Absolutely not.  It was, however, immensely helpful for me in terms of feeling ready for our girl to come home from the hospital.  Clearing the clutter and restoring order to her space was incredibly healing for me.

Ask a new mama if there are any “rituals of readiness” you can help her complete.  I remember staying up late one evening to remove the tags from all the beautiful outfits we received at Olivia’s shower.  I then sacrificed several precious hours of sleep to complete a marathon of laundry to get her all of her clothes ready.  I also had to find time earlier in the day to run out and buy a baby friendly detergent.  In hindsight, asking someone to help me wash all of Olivia’s new outfits would have been extremely helpful.

8.  Explain the value of probiotics.

My doula warned me that I was particular susceptible to getting thrush on my breasts due to the multiple rounds of antibiotics they pumped through my system while I was in labor.  I truly wish that I had followed up with some research on which brands are most helpful and how much to take.  My particular case of thrush did not present itself in a typical fashion- I could have saved myself weeks of painful pumping and attempts of breastfeeding.  I had wonderful success getting rid of thrush for good after reading the 3-Day Get Rid of Thrush Cure by Rebecca Haworth.  What I loved the most: she provided recommendations on specific brands of probiotics.

9.  Be specific with your offers to help.

Take your kind offer to help one step further by being specific.  Since my focus was split in so many directions, it was hard to know exactly what I needed before I needed it.  By educating yourself on the world of preemies you can ask more targeted questions like “Do you need xyz?”   or “Can I help you with xyz?

10. Don’t underestimate the power of your responses to progress reports.

Believe it or not, it takes quite a bit of time to craft an email that provides the latest updates to family and friends.  I am so appreciative to those that responded with loving and supportive words when we sent out an progress report.  The reverse is true as well: it’s hard to forget which family members and friends were completely silent in response to such a life changing event.

Bottom line: Be responsive without any expectations.  In my own experience, I wasn’t always able to respond to emails in a timely fashion.  My thank you cards for loving care packages weren’t sent within the proper 2-week turnaround time frame.  But, that doesn’t mean that I didn’t cherish every kind word and gesture extended to our family during Olivia’s hospital stay.

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Preemie 101

With Olivia’s early arrival, we were welcomed into a brand new exclusive club: the world of preemies.  We didn’t ask for this entrance pass and I wouldn’t wish our experience on my worst enemy.  There were endless hours of waiting, grieving, worrying, and coordinating arrangements.

As a mama-to-be, I had heard countless stories of women going past their due date and trying anything to get their labors started.  I had NO CLUE how common the other extreme was!  The March of Dimes currently states that 1 in 9 women will deliver prematurely… I nearly fell out of my chair when I heard this number!  Our own qualitative research immediately validated this high prevalence.  It seemed everyone we talked to about our experience either knew someone that had delivered early or was themselves a preemie!  In my humble opinion, it seems like a knowledge gap exists in providing critical information to women on this reality.  There has to be a way to communicate this statistic so women can prepare their minds and create realistic expectations… all without creating needless worry or planting a seed of doubt into their minds that they can carry the baby to term.

Caring for a Preemie

I’ll never forget what the attending neonatalogist told us after Olivia’s delivery.  After explaining a procedure and seeing the worried looks on our faces, he stated: “Olivia will be the person she is meant to be.  She is just going to have a longer story.”  That little nugget of reassurance was such a comfort.

It quickly became clear that the medical goals for our 33 Week-er included:

Breathing easily and safely.

  • Olivia’s breathing began to deteriorate after she was born to the point she was on 70% oxygen.  The doctors immediately suggested treating her lungs with a round of surfactant, which would help keep her the tiny alveoli in her lungs from sticking together and allow her lungs to inflate more easily.
  • For the first couple of days, Olivia was hooked up to a C-PAP machine (continuous positive airway pressure).  This device delivered oxygen along with gentle pressure to keep her airways open.
  • Olivia graduated to a nasal cannula emitting high humidity before she was taken off all oxygen.
  • One of the nurses called Olivia her little hummingbird as our girl would have periods where her breathing became very rapid.  Other times, she experienced periods of apnea.  To counteract this problem, the doctors started her on a brief regimen of caffeine.  This drug had to be gradually stepped down and out of her system for at least 1 week before they considered letting her go home.

Regulating her temperature.

  • Olivia’s journey started in an open air bed with a warmer directly overhead to maintain her temperature.  When her condition stabilized, she was moved to an isolette.  This little incubator, even though it looked more intimidating, was actually a step in the right direction!  After Olivia was able to regulate her temperature, she was moved to an open air crib with frequent temperature checks.

Coordinating her suck/breathe/swallow reflex.

  • Progress in this department was SLOW.  The nursing team placed a g-tube down Olivia’s nose into her tummy relatively early so they could “gavage” her feedings or directly provide breastmilk/formula to her stomach.
  • During some of Olivia’s first attempts at bottle feeding, she only took in about 5-15 mL of fluids.  She progressively worked her way up to taking 60 mL during most feedings throughout the day.  If Olivia was awake, the nurses would allow us to attempt bottle feeding.  Any amount that she did not finish in 30 minutes was then given through the g-tube.  If Olivia didn’t finish within this critical window, the nurses explained that she would be expending too many precious calories compared to the amount she was taking from the bottle.  After Olivia’s breathing improved and she was capable of regulating her temperature, we were in a holding pattern waiting for this particular reflex to properly mature.  Some days, she took her bottle feedings like a champ.  Other days, Olivia was more interested in sleeping so many of her meals were “gavaged.”  The nurses reassured us that one day, everything would just click.  Imagine our surprise when we arrived at the hospital one day to find Olivia had pulled out her g-tube by herself!  Our spirited sweetheart was ready!
  • Thoughts in general:  I have an incredible amount of respect for this reflex.  Olivia choked two times during her feedings while I was home alone after we brought her home from the hospital.  My heart nearly jumped out of its chest from sheer panic.  Her system was still sorting out glitches in the required sequence of movements.

We are eternally grateful that Olivia’s prognosis was always positive during her time in the Special Care Unit.  We never questioned whether or not she would make it.  All in all, our experience was a CAKE WALK compared to the complications awaiting parents of other premature babies, especially micro-preemies (infants born before 26 weeks gestation or weighing less than 800 grams).  I can’t even imagine, even though I’ve had a first hand glimpse into the preemie world, the roller coaster of emotions that these parents face on a daily basis and the compounding effects of stress.

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