Tag Archive | immunity

First Days in the NICU

When people think of having a baby, they generally picture a very round pregnant lady going into the hospital and coming out thinner with a baby in her arms. She stays home from work (if she works) for anywhere between six weeks to a couple of months, leaving her baby in the hands of a daycare or nanny or trusted relative.

When I went into the hospital on May 13, I had only gained about 10 pounds. I didn’t really look pregnant yet. I hadn’t had any cute maternity pictures taken. I had only been wearing maternity clothes for about a month. When I left a week later, I had probably gained about 15 more pounds in water weight from the massive swelling of my hands and legs. My shoes wouldn’t fit, my maternity jeans wouldn’t fit, and I was only able to walk slowly and hunched over, due to my C Section incision. The biggest difference between me and the stereotypical pregnant lady was the baby I didn’t have in my arms.

Preemies as young as Little Miss Minion don’t become regular full term babies upon graduating from the NICU. They aren’t even referred to in the same age terms. LIttle MIss Minion is chronologically 2 weeks old, but her adjusted age is 30 weeks gestation. This means that she won’t act like a 2 week old newborn, but will instead behave like a baby at 30 weeks gestation. Her adjusted age clock will start at her due date, when she should have been born. In September, her adjusted age will be one month, even though she will chronologically be around four months old. She will not act like a four month old, though, since she only recently will have developed and matured enough to be born, had things gone differently. She will act like a one month old. Her immune system will be much weaker than a full term baby as well, and we were told that the general recommendation is for preemies to avoid daycare for at least a year, and to stay as isolated from the general public as possible. No shopping trips, no restaurant outings, no going to the zoo or anywhere else where there are lots of people. Anyone who will have regular contact with her needs to have all their vaccinations and boosters.

Where the stereotypical new parents have sleepless nights trying to get their baby to sleep through the night, rocking them, feeding them, singing to them, NICU parents set alarms to wake up every two or three hours during the night to pump or to  call the NICU nurses to see how their baby is doing. Did she have any apneas or bradys (breathing pauses or heart rate drops)?

Every day since she was born, Mr Minion and I have seen Little Miss Minion in the NICU. The first step is signing in and verifying who we are. Most of the receptionists know us by sight already, and after signing in, the buzz us through the double doors. Instead of going straight to our daughter’s room, we make a pit stop at the row of sinks to scrub our hands with the special NICU soap for a full 2 minutes. Since my rings haven’t fit me for weeks, I don’t have to bother with removing any jewelry, but all rings and watches should be removed before proceeding, since they are hard to clean and harbor germs.

After drying our hands, we walk down the hallways to the pod where Little Miss Minion lives. There are large monitors on the walls that stream the vitals of every baby in that pod. Nurses’ stations line the center of the pod so the nurses are usually within 15 feet of their patients. Each nurse is assigned between 1 and 3 babies to care for during their shift. When we get to Little Miss Minion’s room, the first thing we do is peek in at her in her isolette, which is a big plastic crib with a domed lid on it. This isolette keeps her warm and semi-shielded from light, since there is a large quilt draped over the top of it. The second thing we do is check the monitor to see if she had any As or Bs and when. The nurse will check in with us, giving us a rundown of Little Miss Minion’s day so far and any changes that were made to her feeding schedule or other details.

Then we sit. We can’t leave the quilt up to see her, since she needs to sleep in as dark an environment as possible to prevent ROP, a preemie issue with too much light that could cause blindness. So we sit, watch the monitors, and spend time with our daughter in the way that has become our normal: sitting on the couch a few feet away, hoping she can tell that her parents are nearby, waiting for the chance to kangaroo with her or to change her diaper. These opportunities only come about every 4 hours, during what is known as “cares.” Doing cares with Little Miss Minion consists of taking her temperature, changing her diaper, doing a touch hold while the nurse takes her blood sugar, and maybe getting to kangaroo her, as long as she remembers to breathe.

Since preemies are so small and not developed, there are only certain ways that they should be touched. Rocking them is out of the question until they are much older. Stroking them lightly is something that stresses them out because that movement and feeling is not something they experience before they are born. And so we learned the touch hold. This is the calming process for a preemie. I would take my hand and press gently on the top of her head while containing her arms with my other hand. It makes them feel secure, like they are back inside the womb.

For about a week, I spent about 12 hours a day up there with her. Mr Minion would drop me off on his way to work and we would go home at night to sleep. I’m not sure what the plan will be once I have to go back to work. I hope to go back sooner than I originally planned so that I can have some time left to spend with her once she gets to come home in a few months. That is why Mr Minion went back so soon.

Today and yesterday, I have stayed home in the mornings, trying to put our house back together after being gone for basically two weeks. The nurses say that it isn’t healthy to spend too much time in the NICU, and I believe them. By Tuesday morning, I was hearing the alarms from the monitors in my head. It isn’t always hers that is going off. If any alarm in the whole pod goes off, it sounds on every other monitor so the nurses know about it if they are in another room. It also sounds on their phones, which they carry everywhere. There is no escaping it.

LIttle Miss Minion’s big accomplishment yesterday was pooping and farting. Since she is so small, if there is a buildup of gas or poop in her stomach or intestines, it can press up on her diaphragm and make it harder to breathe. This is what the problem was yesterday. Her nasal cannula (the prongs that deliver her room air) pushes a little bit of air into her stomach and she wasn’t getting rid of it because she was constipated and the way was blocked. So her stomach got puffy and she wasn’t breathing deeply enough. After some adjustments and several rounds of X rays to make sure that is what the problem really was, she ended up going to the bathroom and fixing it mostly on her own.

Things I never thought I would be excited about: that my daughter farted and pooped enough that she can breathe normally again. That’s life in the NICU for you.