Wednesday, February 13, 2013

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.

3 comments:

  1. good article here's some more info on anemia if required http://www.whatisanemia.info/

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  2. Hi there! I'm in calgary, and I am 20 wks pg with anti-c too. my titres have been really low stiill 1:<1 and hopefully they will stay that way. I just wanted to ask you about your perinatologist. I just have a regular OB and was wondering if they would ever refer me to a peri. Who did you see when you came into Calgary? Was the peri based out of the ultrasound clinic?

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  3. Great questions. And that's awesome that your levels have been so low. I hope they remain low too. To answer your questions. I was referred to Dr. Chada at a clinic in the Calgary Women's Health Centre once my titres reached the critical levels. I also spoke with a specialist each time I had an ultrasound at the Maternal Fetal Medicine Centre, located on the Foothills/UofC med school campus. In my second pregnangy, when I first learned about the anti-c issues, I saw a specialist twice (this was in Indiana) first to help answer our questions and get an initial ultrasound and then towards the end of the pregnancy when my titres increased, to make sure nothing had changed for the baby. In my second pregnancy, I was able to go to term and go into labor naturally. With this last pregnancy, the titres were much higher and I was monitored much more closely.

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