Aisling's first month! NICU and coming home

It's been so long since I blogged! We've just moved to a new apartment and I decided to sit down and get it all out. I'll go month-by-month. Enjoy!

Month 1 – June 11-July 11

Week 1: NICU Stay
Aisling was in the UCSF NICU for about 6 days. She was only 34 ½ weeks along when I delivered, and many babies that young have trouble breathing, maintaining their body temperature, and eating. Aisling was a big strong preemie, though: they took her off of support step-by-step just to make sure her body's systems could handle independence, and each step took at least 12 hours because that was the timing of shift changes when the doctors came around and did evaluations.

They had her on a CPAP unit (not oxygen, just gentle air pressure through a face mask) for her first 12 hours(Weds morning) just to make sure her lungs got fully expanded, since many babies haven’t yet produced the surfactant that keeps the walls of our lungs' alveoli from sticking together when we exhale. I started latching her onto the breast just after they took her off of CPAP (early Weds afternoon). She liked to suck but she wasn’t very hungry because they had her on IV nutrients and hydration. They did not give her any fluids, sugar-water, or formula by mouth, so her “virgin gut” remained intact, which was very important to me. If you wonder what the heck a virgin gut is, click here.

UCSF has a great NICU which includes the parents in all aspects of the baby’s care. They allow parents to be in the NICU 24 hours a day, except for 30 min blocks at 7 am and pm for shift changes. We stayed in the hospital and visited Aisling to feed her every 3 hours, with one of us usually staying with her for most of the time between daytime feedings.

Doug spent lots of “skin-to-skin” time with her lying on his chest, and she got to cuddle with me during and after nursing sessions. Doug got to sleep all night, but I got up religiously and shuffled sleepily to the NICU at 11, 2, and 5 to feed and hold her. She didn’t particularly care about eating because of her IV, but she needed the “first milk” (colostrum) to get her gut moving, so I was pumping like crazy and feeding her with a syringe and my finger to suck on at first. Colostrum is transparent yellowish sticky fluid. In the first day I was lucky to get a total of 3 ml every 3 hours. By the second day I was getting up to 10 ml, which seemed like a lot at the time! By 72 hours I was starting to get real milk at about 2 oz (40 ml) every 3 hours. This is normal, because babies’ stomachs are just the size of a marble when they’re born, and expand very slowly over the first week.

At 24 hours old they turned off the heat in her isolette, and she maintained her own body temp just fine. At about 36 hours, her nurse noticed that she was starting to look orange, and predicted that Aisling would need the “bilibed” treatment soon, for jaundice. Sure enough, her bilirubin levels shot up between 36-48 hours and they put her under lights. Jaundice is the accumulation of a substance called bilirubin in an infant’s blood, which makes their skin look yellow or orange-ish. The worst part of this time was that we couldn’t hold her constantly, because she needed to be under the lights so the UV could break down the bilirubin. I still came religiously to feed her every 3 hours but I had to put her right back in bed after about 30 mins. The best part of this time was that Doug and I got to have some alone time, and had time to walk to a restaurant where I had my first postpartum beer! It was delicious.

After 24 hours under lights, she came out and we could hold her all we wanted again. Yay! Going home seemed imminent. But then after a day her bilirubin level rose again, and back came the lights. Boo. This meant at least another 2 days in the NICU – one for lights, and one to make sure her bilirubin stayed down once she was out of the lights. We were exhausted. Since I was breastfeeding and the delivery rooms weren’t full they let us stay in my postpartum care room for an extra day after I was discharged. But then the rooms filled up and they kicked us out to a tiny little room that had been re-purposed from an infant isolation room by sticking a mattress on the floor. They gave Doug a vinyl mattress-y thing so he could stay, too – I was so thankful for that! By day 5, running on very little sleep and still recovering from delivery, my feet had swollen into shoe-sausages. I would lay on the bed with my feet propped up on the wall while I made phone calls to relatives with status updates. We wanted our own bed so badly.

On Monday morning, June 18, while Aisling was under lights, we were banking on the likelihood of her coming home the next day, so we came back to the apartment to get everything set up and ready. Since I delivered 5 weeks early we weren’t entirely prepared, but at least we actually owned all of the necessities. We took a nap in our bed and I remember it being the sweetest possible experience I could imagine at that moment.

Sure enough, Aisling was cleared to come home the next morning. We tucked her tiny body into her car seat at around noon, and headed home. We stopped at REI on the way home to get her a smartwool hat and fuzzy socks because it was very chilly and windy, and our apartment would be colder than the NICU.

Once we got home, we snuggled into bed. Doug put baby onto his chest and read her some of Beowulf, which he’d been dreaming of doing for my entire pregnancy. The recovery napping began. Aisling was home.

Weeks 2-4
The rest of the first month was fairly easy and uneventful. Aisling’s first pediatrician appointment was the day after we brought her home, and she was doing great and back up to her birth weight. Even though she was a preemie, she was already on the full-term charts (albeit in low percentiles) for weight, height, and head circumference. Compared to other preemies her age, she was huge and healthy.

During this month, she spent most of her time sleeping and eating. She was latching on great, nursing for a long time, and I was changing lots of wet and dirty diapers and pumping extra milk, so I wasn’t worried at all about her getting enough to eat. She woke herself to eat at night, which is a big deal for preemies. I never put her on any kind of schedule, but let her lead with her own rhythms. She slept in the play-yard bassinet right next to me, where I could hear her wake up and feed her right away. We didn’t really have any issues with colic or reflux... she rarely cried and never spit up (which was weird!). I know how blessed we were, and am so thankful!!

We were also truly blessed that Doug got 6 weeks of paid paternity leave. This was a wonderful time for us to bond as a family and establish our own rhythms without the stress of work and commute for either of us. We’d decided to get in the habit of being active with Aisling right away. We carried her in a soft sling when we’d go out walking, and we took her all over the neighborhood with us. Since we don’t own (or particularly want) a stroller or an infant seat with a handle, we got used to holding her all the time. We generally took it easy in those first few weeks.

At her 1-month pediatrician appointment, Aisling had gained an impressive 22 oz in 2 weeks and was now close to 9 lbs. Her head circumference and length were on similar growth trajectories, putting her squarely in the middle of full-term baby growth charts and completely off the chart for a preemie. She was still not due for another 8 days, and I was very thankful that I’d been spared that last month of bladder-torture.
We’d been waiting for this appointment to make the final decision about taking a week-long road trip to Oregon for Aisling to meet Doug’s family. Since the results were so good and she was a trooper in the car seat, we decided to make the trip.