Taleja's First Couple of Weeks

As mentioned in my last post, Taleja was induced on December 18 because her peak systolic blood flow had reached 1.5 MoMs (multiples of median.) Above 1.5 MoMs, a baby typically has anemia. At or below it, the baby may or may not have anemia. The doctor, resident, and ultrasound tech spent a long time double and triple checking to make sure that the readings were as accurate as possible. And of course, we always had to wait on Taleja to stop moving or practice breathing, because that changed the blood flow a lot. The one thing that I thought was awesome about that last ultrasound was that their prediction for her weight was exactly what she weighed when born.

I will tell you, I was scared that Taleja had anemia. And I was concerned about her being born early. I was scared that I wouldn't get to hold her before she was taken to NICU. And I worried about how well she could tolerate labour. But, she did beautifully! And most importantly, she did not have anemia.

Still, she was in the NICU for one week. Like many late preterm babies, she had trouble regulating her blood sugars, so she was put on IV fluids for four days to help her keep her sugars up. They couldn't actually start an IV in her hands, so they decided to put a line in through her umbilical cord. (Poor girl has veins like her mama: they disappear as soon as they are poked.) Within a couple of hours, she was proactively set up on a light bed, surrounded by intense photo-therapy. She was under the lights for five days. These lights kept her bilirubin levels under control. They never even reached the point where light therapy is typically started in Calgary.

While she was under the lights, we were not able to hold her or cuddle her very much - just for short periods of time while feeding her. Those were special times for us. Also, I was really happy that the grandparents and siblings of babies in the NICU were able to visit in the NICU. The hardest day for me was Christmas day. I had really had my heart set on bringing her home on Christmas day and being together as a family. But, it did not happen. I shed some tears, and then worked hard to enjoy the rest of the day with my family, both in the hospital and at my parents.

Taleja was discharged from the hospital on December 26. She had already surpassed her birth weight. Her bilirubin levels were checked every two days for the next week and had peaked and begun to decrease by the time she was 12 days old. And she hasn't needed to see a doctor since then.

One thing that I was not anticipating was our journey towards successful breast feeding. Initially, she was too weak to actually get anything while breast feeding. A preterm baby needs to get a certain amount of milk or formula in within a 30 minute window, otherwise she is using more energy to eat then she is getting from the food she is eating. Also, preterm babies tend to be quite sleepy and do not recognize hunger cues. To remember to feed her, we had to set alarms for every three hours. Also, Dave and I needed to learn the special technique required to feed her. Fortunately, she was a very efficient bottle-feeder.

But, those two weeks after her discharge were extremely difficult for me. Pumping took a very long time, feeding took a long time, and every night, we ended up missing a feeding because we were just to exhausted to even respond to the most obnoxious alarms. It was so discouraging. Also, my basic medela electric pump that I'd gotten 4 1/2 years before started to malfunction and I really disliked how it worked. After some research, I decided to upgrade to a Medela swing pump. I found a used one online and Dave went to buy it for me. Let me just say that as much as I dislike pumping, I love my "new" breast pump and highly recommend it. I found that a double pump is impractical for me. Also, the mechanism the swing pump uses is very similar to the hospital grade pumps, which I find gentler and more effective and efficient.

When she turned three weeks old (or age adjusted to 38 weeks), she was able to breast feed efficiently within the specified time limit. And she was satisfied. She also was able to cue us for her next meal. That turned a chapter in our lives. I was able to stop the pumping/feeding cycle and turn off the alarms!

We are still working on some challenges to breast feeding. She is quite lazy when latching on - more of a slurper or sipper than opening her mouth wide. This has caused a lot of pain for me. But, we have persevered and things are getting much better now.

Anti- little "c" Antibodies: The Next Chapter - Induction and Birth

Our assumption was right. Our ultrasound on Monday, December 17 showed that the peak systolic blood flows had reached critical levels and it was time for our baby to be born. After speaking with the specialist I had been seeing, we decided that Tuesday morning was the time to start the induction. Foothills Hospital has been using a method called "mechanical induction" for some time now. Instead of inserting a prostaglandin gel or cream to "ripen the cervix" a catheter is inserted through the cervix and the balloon is filled with water. This puts pressure on the cervix and irritates it, causing your body to release its own prostaglandins. Inserting the catheter was extremely painful, but the upside of the process meant that I could spend the rest of the day at home. After 12 hours (or if the catheter fell out), I was to return to the hospital for the next phase of induction: pitocin.

By 6 pm, I was ready for the next phase and headed back in to the hospital. We didn't actually get everything set up until after 11 pm, because all the labour and delivery rooms were full and there were a couple people ahead of me that needed L and D rooms first. This labour was my easiest one so far. I certainly felt the contractions regularly, but they were not unbearable. I found that I was quite able to manage the pain throughout most of the night, simply through breathing. In fact, we all were wondering when my labour would actually start.

Around 6 am, I decided that I wanted to have an epidural and when I was checked, they said I was 5 cm. And that is actually when they decided I was in labour. I got my epidural, but it did nothing for me, absolutely nothing. I ended up using entenox for the last part of labour and through transition. And that went fast. The nurses tried to convince Dave that there was lots of time for him to go down to get some breakfast, but we knew better.  I was starting to have the urge to push, but my mind was not ready for me to do that yet. After psyching myself up, and after about 3 pushes, Taleja Isabel was born at 7:27 am.

My prayers had been answered. She was a beautiful, healthy baby girl, with no signs of anemia. Her apgars were 9 and 9, so after cleaning her up a little, they brought her to me and I was able to hold her for several minutes before they took her off to the NICU. And her brothers and grandparents were able to come in to visit her as well.

Next time, I'll share a few details of her NICU stay and what the effects of the antibodies were on her.

At Home

*this post was prepared over a week ago, but life got in the way and it was not posted.*

It is the beginning of February already and I am just starting to feel like I am finally home and ready to get back to normal life. In January, we came home for just over two weeks, before we took a week-long journey. Dave had meetings in Edmonton last weekend and then pastors' meetings at our church's camp from Sunday until Wednesday. And I just couldn't imagine myself alone with three children for a whole week, I decided to go along. I am so glad that I did. We got to see my sister Emily, as well as my Uncle Cliff and cousins Rob and Bonnie while we were in Edmonton. And we all had a great time visiting with friends, learning, and having meals provided while at camp.

Taleja with Auntie Emily

Also, it meant that we could take the time to visit my family, since my parents live only an hour away from the camp. You might wonder at my need to visit them, since we'd just spent a couple of months living with them, but I take every opportunity to visit that I can. My mom is battling cancer, and each visit is precious. This week was very eventful for my parents. On Sunday, my mom ended up in the ER with a minor seizure and on Monday, my dad was admitted to the hospital with severe abdominal pain. It was providential that my brother and his family had made plans to visit. They arrived just when support was needed the most. They were able to be at home with my mom and take her to all her appointments as well as to visit dad. Dad was discharged on Friday morning and is feeling much better than he has in a couple of months. But, our plans for my birthday dinner ended up getting changed quite a bit.

Taleja with Gramma

Our boys got to have a sleep-over with their cousin, Levi. They were over the moon to play with him and sleep in the same room. They had a fabulous time! And this time, there was no bickering or fighting or whining involved...music for the mamas' and papas' ears! And of course, everyone enjoyed meeting little Taleja or seeing her again.

Taleja with Auntie Melanie and Seth

Introducing...

Taleja Isabel

born December 19, 2012 at 7:27 am

5 pounds 5 ounces, 18 1/2 inches of sweetness