We’re less than two weeks away from Emmett’s first birthday, and every day brings a growing feeling of dread. Logically, it doesn’t make any sense. He’s doing really well, all things considered, and it’s not like anything bad is going to happen on his first birthday or anything. It should be a happy day. But I suppose this is just part of the PTSD experience — and from what I gather from other preemie moms — normal, even.
I have this app on my phone called Timehop. Most of the time I love it. It shows you pictures you took or things you posted to social media this time last year and every year it has access to. It’s been fun to revisit baby photos of Theo or to see some of the ridiculous thoughts that occupied my mind eight years ago that I somehow thought all of Facebook needed to know. But you know what’s been popping up lately from this time last year? Pregnancy photos. Casual, breezy selfies I snapped in the bathroom at work, or in front of the mirror in our bedroom. And while I rarely take selfies normally, I’ve always felt an uncharacteristic sense of body confidence while pregnant, and found myself admiring and snapping photos of my growing bump quite often.
And so it’s weird to juxtapose last year’s carefree photos with my current state of anxiety. It’s haunting to see these photos now, knowing what was about to happen. I had no idea my world was about to come crashing down while exploding with love, all at the same time. Oblivious that I was about to embark on the hardest year of my life. Unaware I would soon come to think of a hospital room as home and that I would create familial bonds with the caregivers who held my son’s life in their hands.
I also find myself reopening Pandora’s Box with the whys. We were told my preterm labor was unexplained, and that we’d probably never know why it happened. For the first couple weeks, that bothered me a lot. And then we got preoccupied with other life or death matters (literally) and I was able to push the questions out of my mind. But I find myself asking why a lot more again these days. Was it the fertility treatments? Did all the medications I took to prevent me from miscarrying again trigger something else that caused labor? Was there some connection medically between the losses and the preterm labor? My OB says no, but that seems hard to believe. Did I work out too much or too hard? I was really into barre while pregnant and took pride in the strength and flexibility I was capable of, even as I got bigger and my center of gravity shifted. Did I overdo it hosting Theo’s birthday? I remember my back hurt really badly that evening, and that was just a week before Emmett was born. Was it the pedicure I got just three days before Emmett arrived? I’ve heard there are acupressure points on your foot that are supposed to induce labor and that sometimes women who are overdue will get a pedicure or foot massage in hopes of kick starting labor. Could any of these things have triggered it? And the reciprocal question that haunts me: is there anything I could have done to prevent it?
So many questions that I’ll probably never have the answers to.
True to form, this seven-month update is closer to his eight-month birthday. But at least the photo was taken at exactly seven months. Time is flying and this little man has become such an important part of our lives. I’m so proud of him and how far he’s come.
Adjusted age: 4 months
Stats: 13.4 lbs. and 25.5 inches
Milestones: rolling like crazy. Babbling with consonants. Really wants to crawl! Theo was an early crawler at six months, and I won’t be surprised if Emmett crawls by six months adjusted (which would be nine months actual).
Sleeping: Still waking up 1-2 times most nights. Naps are getting more substantial and consistent – usually around 3 per day: one long one mid-day with a shorter one in the morning and late afternoon.
Eating: Nursing is going well, despite some supply issues (more on that later). He’s taking about 3.5 oz per bottle at daycare, still fortified with NeoSure, and then we’re pretty much exclusively nursing at home. I don’t even bring backup bottles with me anymore, which is so nice.
Personality: Still the happiest baby I’ve ever met. He’s been sick a lot since he started daycare, but even that doesn’t get him down. Pretty much the only time he cries is when he’s hungry. He gets a little fussy and needy in the evenings before bed, but that’s easily remedied by just holding him. I think after a long day at daycare he’s just a little tired and probably misses us.
Likes: Being tickled. His neck is especially ticklish and sometimes when I’m getting him dressed, just pulling his shirt over his head sends him into a fit of giggles. I need to capture this on video one of these days. He also adores his big brother. Anything T does is basically the most hilarious thing he’s ever seen. The bond these two already have is honestly my favorite part of being a mom.
Dislikes: Saline and suction. Because he’s been sick so much we’ve had to give him saline drops and suction out his nose. He really fights it, and he’s freakishly strong. But after I’m done he’s back to his happy self.
Mama: As I briefly mentioned earlier, I’ve been battling some milk supply issues, and it’s been stressing me out (which I have heard can also affect your supply, but I have yet to figure out how to break THAT cycle!). It all started when I got mastitis a couple months ago. Then it dipped again when I got my period, but seemed to recover. But then it plummeted again. There are times when I get ONE ounce total (from both sides) in a pumping session. And even on a normal day, I’m not making enough to send with him to daycare the next day. I’m thankful I have such a huge freezer stash, and truthfully it’s good to have an excuse to use that before it all goes bad. But the low pump output made me worry that I might not be producing enough to exclusively nurse while we’re home together. I mean, if I’m only pumping an ounce in a session sometimes, that’s obviously not enough for a full meal for him. But I had also heard that babies are more efficient than a pump, and that pump output isn’t necessarily indicative of what you’re producing. So I rented a baby scale from the breastfeeding center at the hospital for a couple weeks and weighed him before and after feeding just like when we were back in the NICU. And while there were definitely times he didn’t eat much, I noticed he would usually make up for it at the next feeding. I’m assuming this is all normal (after all, my appetite varies throughout the day too), and it was reassuring to see he’s probably nursing enough. I still find it depressing when I have a sucky pumping session, but I’m not as worried about his intake anymore. The real test will be at his next appointment, whether he’s still following his growth curve.
It’s hard to believe half a year has passed already. By this time with Theo it felt like he’d been in our lives forever. But since we only got to take E home three months ago, he still feels pretty new. I remember when he was born, I tried to adopt an optimistic outlook about his impending NICU time — I told myself the NICU was essentially taking over for me for the third trimester. And while those three months in the NICU felt like an eternity at the time, now that we’re on the other side, it really does kind of feel like those three months were my third trimester, and now we have a three month-old. Who’s actually six months old. Minor details.
Adjusted age: three months.
Stats: 12.2 lbs and 23 inches.
Milestones: Laughing (yay!), and grabbing toys. Puts everything in his mouth. Really close to rolling over.
Sleeping: Naps are mostly cat naps. Still doing pretty well with nighttime sleep – compared to Theo, at least! It’s probably a good thing we had a bad sleeper for our first child, because it makes E’s sleep habits feel like a cake walk. I hear other moms complaining about their babies waking up twice a night and I’m over here like, two wakeups? That’s not bad! Depending on what time E goes down for the night, he’s usually up once around 2 or 3 a.m., and then again around 5 or 6. Since I get up for work at 6 on weekdays anyway, this isn’t terrible. When he wakes at 6 I quickly feed him before hopping in the shower. And we’ve finally mastered the sidelying nursing, which means when he wakes closer to 5, I can just pull him into bed with me to nurse, and I can fall back asleep until my alarm goes off.
Eating: I’m happy to report we are FINALLY almost exclusively nursing – when we’re together, anyway. I still have to pump at work, but that’s been the plan all along. He usually takes four 3.5 oz bottles at daycare, each fortified with 1T of NeoSure powder, and then we almost exclusively nurse at home. Every once in a while he’s finicky at the breast, so I still usually pack a backup bottle when we’re out and about, just in case, but I rarely find myself needing it anymore. It’s been a long road — we’ve been fighting this for five months — but I think my stubborn nature has paid off, despite how many times I wanted to give up.
Personality: He is just a really happy baby. Smiles and laughs at anyone and everyone, and still rarely cries, unless he’s hungry. He’ll fuss a bit in the evenings, but there’s never a problem that can’t be solved by milk, a toy, or standing up and walking around.
Likes: Being upright and walking around (Theo was the same). He always wants to see what’s going on. Also loves being naked, diaper changes and bathtime … probably because those involve being naked.
Dislikes: Shots! Poor bubs was a human pincushion at his last appointment. He got his six-month shots, plus his flu shot, plus his first dose of Synagis (protection against RSV). I’ve never heard him scream like that and it made me cry too. He goes back later this month for his second flu shot, second Synagis dose and his Hep-B vaccine (they opted not to do it at the last series since he was getting so many shots already). I’m officially calling “not it” and making D take him to that one.
Mama: I think the postpartum hair loss has finally subsided. I also chopped about 10 inches off my hair, so it’s been a bit more manageable overall. I got mastitis a few weeks ago, which was awful, and my milk supply took a serious hit. I’ve been taking fenugreek, drinking milk-boosting teas and trying to work oatmeal and other galactagogues into my diet and was seeing a small improvement, but then a couple weeks ago it tanked yet again. E still seems to be nursing well, but my pump output has been abysmal. But then I got my period last week and have actually seen a significant increase again, so maybe the dip in supply was hormone-induced. I didn’t get my period until Theo was 9 months old, and by then he was eating solid food in addition to breastfeeding, so I didn’t notice an effect on my supply, though I’d heard that can happen. Hopefully that’s all it was! My weight loss has plateaued, and while I’m still under my pre-pregnancy starting weight, I’d love to take advantage of the extra calories nursing burns and drop about five more pounds. I haven’t been working out since E came home, and may need to start that up again. After being gone 10 hours a day for work, though, I feel guilty spending even more time away from the boys.
I’ll wrap this up with a few pictures from the last month. He just keeps getting cuter by the day.
Time is flying. This will be the last monthly post I write while on maternity leave, as I return to work on Monday. I know it’s time to get back to the real world, but it’s going to be hard to leave my boys again, after getting used to spending every day with them. At least I won’t have to send them to daycare just yet, as D will be taking the next 4 weeks off to stay home with them.
Here’s what’s going on with Mr. E at five months…
Adjusted age: two months.
Stats: 10 lbs 13 oz and 21.5 inches long.
Milestones: Smiling and cooing! The best. He is such a happy little guy and quite talkative too. I’m really looking forward to those first laughs next.
Sleeping: Dare I say it? I think we may have gotten a good sleeper this time. Or at least compared to Theo. He wakes up one or two times per night, but lately it’s usually just one time. And he slept completely through the night twice! Of course, T was only up 2-3 times per night until he hit the four-month sleep regression, and then he was up practically hourly until he was about nine months old. So I don’t fully trust E’s sleep habits just yet. Naps are pretty inconsistent — sometimes he’ll sleep almost all day and just wake up to eat. Other days he barely sleeps at all. I had hoped to be on a little more of a schedule by the time I went back to work. I guess D will have to figure it out himself.
Eating: This continues to be the area where we struggle most, but has finally turned a corner and we’re doing more nursing than bottles. We’re down to about 3-4 bottles per day (3 oz each) and nursing the rest. Nursing is going better, most of the time, though there are some frustrating days where I can’t seem to get him composed or focused enough to stay latched. When we’re home alone we can usually work through it with a little patience, and I have the option to go make a bottle if he gets too frustrated. But when we’re out in public it’s harder to get him focused. He doesn’t always like the nursing cover, especially when he’s frustrated, and his frequent unlatching and flailing make it impossible to nurse discreetly sans cover without flashing everyone around me. But if I give a bottle, I have to pump to make up that feed to keep my supply up — which is even more inconvenient in public. When I go back to work I’ll obviously need to pump while I’m away from him, but my ultimate goal is to only pump when we’re apart, and always nurse when we’re home together. I think we’re getting closer.
Personality: So sweet and happy. Even on his fussy days, “fussy” is about as escalated as he gets. He rarely even full-on cries. And now that he’s smiling and cooing, his happy personality is showing through even more.
Likes: Bath time! I’ve started putting the boys in the tub together (well, I put E’s baby tub in the big tub) and they both just love it. E kicks and talks to big brother, who loves to help me wash him. He also loves having his diaper changed. T was like that too. We called it his “reset button.” If he was fussy and we changed him he’d suddenly get so focused on what we were doing that soon he was smiling and talking and forgot why he was upset. So far E is the same.
Dislikes: Still reflux. We’ve got the head of his bed elevated, we keep him upright after feeds and he’s on Prevacid, but he’s still so grunty and arches his back in pain often. I’m really hoping he grows out of it soon.
Mama: Still shedding like crazy, though it seems like it may finally be slowing. I’m surprised I have any hair left. I’m chopping my hair tomorrow and am hoping that makes everything more manageable.
I’m feeling kind of sad about my maternity leave coming to an end, since this is the last time we’re doing this, and I wish I had done more with the time I had. I had visions of taking the boys on frequent outings, having dinner made every night, and doing all the things around the house I never have time for when I’m working. Instead, there were more days than I’d care to admit where I managed to squander my entire morning juggling the very different needs of an infant and a three year-old, and by the time I finally cleaned up the breakfast dishes and reheated my coffee for the eighth time, it was time to start lunch, followed by nap and then we were stuck at home until T woke up, and then it was time to start dinner. Entire days simultaneously dragged on and passed in the blink of an eye. Yesterday, my last day of maternity leave, I felt like I managed to do things “right” – I took the boys to the zoo, took Theo out to ice cream, and then nursed Emmett in the park while Theo played. It was a day full of the things I imaged maternity leave would be… of course, I skipped my shower and we missed Theo’s nap, so something had to give! But it truly was a great day, and I ended my leave on a high note.
I had drafted the following post weeks ago – on his actual 4 month birthday- but never got around to finishing it until now. You could say life has been a little busy.
I can’t even describe how good it feels to be writing this update from home. I know I keep saying this, but the NICU really does feel worlds away, and life at home is pretty normal for a newborn, if he were an actual newborn, that is. I go back and forth on how detailed I get on the “how old is he” questions when out in public. I’ve never been more aware of just how often this question gets asked! I’ve kind of fallen into a habit of quickly triaging the situation: what’s the likelihood I’ll see or interact with the person again? If slim, I just tell them his adjusted age. If I’m likely to see them again or we have friends in common, I say he’s four months old but was born three months early, so he’s more like a one month-old. Of course, this usually prompts a million questions. Some days I feel like a bit of a freak show with all the questions and shocked expressions. Other days I don’t mind telling the story. And some days I even feel downright proud. Why yes, he is a miracle! Yes, I am superwoman!
With that, here’s what our little miracle is up to at four months…
Adjusted age: One month.
Stats: 8 lbs 13 oz and 20 inches long.
Milestones: E lifts his head up and shows pretty good neck control for the most part — though he will occasionally slam his face into us or throw his head back while we’re holding him, usually when we least expect it. I’m terrified he’s going to backflip out of our arms.
Sleeping: He wakes pretty consistently every three hours to eat but has given us a few four-hour stretches. We’re still dealing with some reflux, which prevents him from falling back asleep sometimes, and for about a week there he was regularly awake and fussing between 3 and 6 a.m. Just in time for Theo to wake for the day. We have learned keeping him upright or inclined for a bit after eating helps some, so we’ve fallen into a routine where D will give him a bottle at night while I pump, and then since he usually finishes before I’m done, he’ll prop him up on a pillow in front of me while I finish pumping. By the time I’m done and have rinsed out all my parts, he’s usually sound asleep and his tummy has settled enough for us to put him down. During the day he mostly naps in his swing, which is inclined. We borrowed a Rock n Play from some friends, thinking he might like to sleep in that at night, but for some reason he hates it. He’s back on Prevacid, which seems to help some.
Eating: We’re still struggling a bit here. After the pediatrician had us increase the number of fortified bottles from four to six, we were given permission to drop down to five after he had some better gains. So I’m getting to breastfeed two to three times per day and then pumping and bottle feeding for the rest. It’s pretty time consuming. He still isn’t a great nurser and with us having to give so many bottles doesn’t give us much opportunity to practice. I’ve seen a lactation consultant and have started attending a weekly breastfeeding group where I can weigh him before and after nursing so I can see how much he’s getting. He is slowly getting better. It’s really an uphill battle, though, and I’ve been tempted to throw in the towel on nursing on numerous occasions.
Personality: He is still very snuggly. He’s also starting to show a bit more of his spunky side. When he’s hungry, he doesn’t usually cry; he yells! He really sounds quite demanding. I’m looking forward to seeing his personality develop more as he gets older.
Likes: Snuggles with mom, the sound of big brother’s voice.
Dislikes: Reflux and gas. This baby is like a whoopie cushion with the impressive amount of gas he can produce. It’s not just a little toot; it just keeeeeps going. I swear he farts out twice his body volume. No wonder he gets so agitated.
Mama: I’m feeling pretty good, though I’m still shedding hair like crazy, which is really annoying. My hair is longer than it’s been in a while but it’s permanently in a top knot so I don’t have to deal with pulling hair off my clothes all day. Washing my hair is frightening and I’m always surprised I have anything left by the time I’m done. The weight is still falling off, thanks to breastfeeding. Other than that, I’m beyond tired, but not feeling too overwhelmed.
I’ll wrap this with a few photos from the past month and will feebly vow to be more timely with his five-month update. How do I almost have a five month-old?!
Today Emmett is two months old. And we’ve been here 61 days now. With any luck we’re about 2/3 of the way through this NICU journey.
I went into the office today so D was here most of the day. He seems to be doing better with his breathing and reflux, though they were having to chase his oxygen levels all over the place today. He’d desat and they’d turn his O2 up — and then he’d high-sat and they’d turn it down. They’re still having to suction him a fair amount, but he sounds better than he did the other day.
This evening I hurried back to the hospital after dinner so I could get here for his 8:30 cares and give breastfeeding another shot. I’m happy to say we had, by far, the most successful session to date. More about that below.
So here’s what’s going on at two months…
Adjusted age: 35 weeks
Stats: 5 lbs 5 oz and 17.5 inches. Like last month, I created the image below before they did his evening weigh-in. I figured like last month he’d maybe be an ounce or so off but wasn’t expecting him to put on a whopping 110 grams tonight!
Milestones: Getting moved to an open crib, stepping down to low-flow nasal cannula at 1 liter, beginning to breastfeed.
Sleeping: So far so good, but as I mentioned last month, at this gestation most preemies sleep pretty well. Within the next few weeks he should start showing his true colors.
Eating: 45 ML of breastmilk every three hours via NG tube, plus 26kcal of fortification added to my milk. We got to try breastfeeding for the first time last week, and as of tonight I think it’s finally starting to click with him. I think it was a combination of him feeling better, simply getting bigger and more mature, and I think a lot of it was that I was more comfortable. For the past several days the lactation nurses had been telling me to hold him a particular way (“cross body” hold, with my hand holding his head), and I had been following their direction, even though it felt unnatural to hold him this way (I had always preferred to nurse Theo in a “cradle” hold, with his head in the crook of my arm). But since I had never fed a preemie before, I followed their direction. Tonight I did what felt natural to me, and was far more successful. Moral of the story? Listen to your instincts, mamas.
He still isn’t able to get much, but he was rooting around, opening his mouth and truly giving it his best effort. And several times he would latch and actually get in several good sucks before losing his “grip.” He probably would have done even better, but he got a vicious bout of the hiccups about halfway through and I could tell that just wiped all his energy. It was just such a relief to see him actually doing what he should, though, even if he needs more practice. I think the most discouraging part about the past few days is that he just didn’t seem to know what he was supposed to do. We’ll probably try weighted feeds tomorrow (where they weigh him immediately before and after to see how much he got), now that he seems to be actually getting a little. As he gets more and more by breast, they’ll start subtracting that amount from his tube feedings.
Personality: Like last month’s update, it’s still pretty early to see much personality shine through, but he’s certainly gotten more vocal about when he’s unhappy with something lately! Whether it’s reflux or those horrible eye exams he isn’t shy about speaking his mind.
Likes: Being held. His oxygen and heart rate are always at their best when one of us is holding him.
Dislikes: Reflux and eye exams. And boogers.
Mama: is down to pre-pregnancy weight but feeling pretty squishy still. I went to barre for the first time postpartum last week and am hoping to start making that a regular habit again.
I’m back at work now so that I can save the rest of my leave for when E comes home. It’s actually been kind of nice to be back. I only go into the office twice a week (usually Mondays and Fridays) and I work from the hospital Tuesday, Wednesday and Thursday. I’m thankful to have such an understanding employer, and this schedule allows me to have two “consecutive” days in the office (Friday and Monday), but still lets me get 2-3 days of hospital time in between so I don’t feel like I’m missing E too much. I also have most of my standing in-person meetings on Mondays and Fridays, and all the others I can easily call into. I’ve discovered the kids’ play room on our floor is quiet, has a desk, and is rarely used (the only kids allowed in the NICU anyway are siblings and they’re probably spending most of their time in their brother/sister’s room), so it’s perfect for taking calls.
I’m still obsessive about pumping (even though I despise it), but I’ve been able to stretch it out to every three hours during the day and and 4-6 hours at night, while still increasing supply. Currently getting about 33-35 oz per day, which is way more than he’s eating right now and we’re running out of freezer space in both the kitchen and the garage freezer!
Today had its ups and downs. After yesterday’s conversation with E’s team, I was excited to get to the hospital today and try breastfeeding. When I mentioned it to the nurse this morning, though (a new nurse we’d never had before), she said, “we usually don’t try that with babies who have breathing problems.” I instantly felt disappointed — and a bit defensive. First of all, he’s on 1 liter of oxygen and we were told we could try nursing once he got down to 2. Second of all, he has chronic lung disease, so by her standards we’d never breastfeed. Third, despite the CLD, he’s been doing pretty well lately (and the doctor said he’d hesitate to even label him CLD at this point since he responded so well to the steroids) so her “breathing problems” comment rubbed me the wrong way. Thankfully I was able to talk to the lactation consultant, who was still on board with trying today, and the doctor was in agreement this was the right time too. So the nurse finally agreed.
The nursing went pretty well. He would latch and then fall off, latch and fall off, and then went to sleep after about 20 minutes of this. So I don’t think he really got much and they didn’t bother weighing him before and after to check, but the LC said it was a great effort for his first time, considering how little he still is. Our plan is to do this once a day until he starts to get the hang of it, and then we’ll kick off the official 72 hour breastfeed. Meanwhile, he’s still getting full meals via feeding tube.
Unfortunately, his reflux seems to be bothering him quite a bit today. He was desatting a ton and he just sounds so uncomfortable when he breathes. This evening at one point he even sneezed and milk shot out his nose. It had been over an hour since his last feed so it was all his previous meal that was backed up all the way into his nose. It’s frustrating listening to him snort and grunt and not be able to help him.
This evening I went to barre for the first time since before I gave birth. It was good to be back, but I definitely felt like I hadn’t been there in two months! I am definitely going to be sore tomorrow, but it feels good to work out again. I’m back to my pre-pregnancy weight, but I just feel squishy. I need to build up some muscle tone again. I grabbed a quick beer with my friend after class and then headed back to the hospital for the night. I have a feeling we’re in for a long night with all the snorting and desat alarms.
Weight was up 78 grams tonight, bringing him to 4 lbs 13.5 oz.
One year ago, we got the news 13 weeks into our pregnancy that our baby no longer had a heartbeat. And while I’m grateful for how well E is doing, I can’t help but feel sad about the rough journey we’ve had to this point, and still have ahead of us. Four pregnancies: two miscarriages; one perfect, textbook pregnancy; one premature birth. My OB doesn’t think my preterm labor had anything to do with our losses, but she doesn’t know what caused it either, and we’ll probably never know. She did say if we were to get pregnant again I’d have to be on progesterone injections throughout the pregnancy — possibly in addition to the drug cocktail I was on this time around just to keep from miscarrying. Even then, there are no guarantees. Yeah, no thanks. My body hates babies. We’re done.
Interestingly, we have plans for the Fourth tomorrow with the same group of friends, at the same house we were at this time last year, after just learning we had lost our baby. I was still carrying my baby because I couldn’t get in for a D&C until the following week because of the holiday weekend. I was still wearing maternity pants, with a flowy top to hide a small baby bump. Many people at the party didn’t know we had even been pregnant, and I didn’t feel like talking about it. They had no idea the multiple glasses of wine I drank that night were the first I’d had in three months and that I so desperately wanted to escape the nightmare I was living yet again. Now here we are, one year later, living a different nightmare. It’s more bearable this time because our baby is alive. But it’s a lot more draining because it’s so drawn out and there are still so many unknowns.
But I should try to focus on the positives. Emmett is really doing very well, all things considered. The CLD is still haunting me because we don’t know how severely he’ll be impacted, but for the time being, he’s making forward progress. He’s continuing to gain weight. He’s still having occasional events but they aren’t too frequent or severe. He handled the drop to 2 liters of oxygen like a champ, and they’re talking about possibly dropping him to 1 tomorrow. He put on 28 grams today, bringing him to 3 lbs 14 oz.
His heart rate has been jumping up frequently these last couple days, but that seems to only happen when he’s agitated. The higher heart rate episodes seem to have coincided with when they started swaddling him – perhaps he just prefers having his arms free. And he has shown us that despite his lung issues, he can let out an impressive cry when he wants us to know he’s unhappy!
This is certainly not a post I ever thought I’d be writing at just 26 weeks 2 days.
I really should go to sleep right now. It’s been a long, emotional day. But I’m completely wired and I don’t really feel like leaving the NICU, so I thought I’d grab my laptop, sit by my baby, and try to make sense of the day’s events in one of the most therapeutic ways I know — writing. And, much like my birth story with Theo, I know is is probably way more information than most people would ever want to read, but recalling all the details helps me process.
The short version:
Emmett John Hoffman made a dramatic entrance into this world today at 2:20 p.m. At just 26 weeks 2 days gestation, he weighed in at 1 lb. 14 oz and is 13 inches in length. We have a long road ahead of us, as doctors estimate he’ll stay in the NICU until close to his original due date of August 22. But this guy is already a fighter. He came out crying and already peed on the nurses.
For the last couple days, things have felt, shall we say — a little more damp than normal. A lot of this I just chalked up to one of the less glamorous things about pregnancy that no one talks about. I remember The Grossness with my pregnancy with T, but I couldn’t quite shake the concern that it seemed to come on fairly suddenly this time. By last night it had increased to the point where I was genuinely starting to worry. Still, I know I can be a bit of a hypochondriac, and the fact that we’ve had two losses certainly doesn’t help that. After googling whether you can check for amniotic fluid at home, I hopped onto Amazon around midnight last night and one-day-Primed some Ph test strips. I figured $10 was a small price to pay to put my mind at ease. I’d test today and if anything looked questionable or I wasn’t reassured, I’d head to labor and delivery to get checked out. Just to be safe.
This morning I woke up around 5 a.m. to not only more of The Grossness, but it was tinged with blood and I was having mild contractions about 3-5 minutes apart. Even though I’ve been getting Braxton Hicks contractions for a few weeks now, I’d never had them this regularly. This was all making me feel really uneasy so I called the on-call OB. Without hesitation she told me, “Go to labor and delivery.” Unfortunately, D was out of town for work, so I had to get T off to daycare myself first. Getting him ready has been a bit of a struggle lately and timeliness has not been our strong suit. I may have bribed him with candy just to hurry and get in the damn car. Dropping him off was an incredibly emotional experience. This was possibly his last day as an only child but I had to rush him into his class while trying not to appear too worried (after all, there was a part of me still holding out hope it was nothing). I fought back tears as I kissed both cheeks, the top of his head and inhaled the smell of his hair. And then I practically ran out the door and sped to the hospital.
When I went to check into triage, I burst into tears and could hardly even tell them my name. I was alone and scared. D had no clue what was happening because he was on a plane and I couldn’t reach him. And I didn’t want to worry anyone else until I knew what was going on. They took me back and monitored my contractions and the baby’s heartrate for what felt like hours, and then finally the on-call OB checked me and determined I was 1 cm dilated. A tad concerning, but since I’d already had a baby, some dilation can actually be normal. She also took some swabs to send to the lab to see if there was amniotic fluid. She said it didn’t necessarily look like amniotic fluid to her, but that there was definitely more fluid than she was comfortable with. She said it actually looked more like what your cervix produces when you’re in labor (I had no idea this was a thing). Either way, not ideal, but no amniotic fluid was certainly the preferred outcome, so this sounded promising. If it were “just” preterm labor they said there was still a lot they could do for me. They would give me some magnesium to slow labor and could maybe even send me home tomorrow!
After the OB exam, I was sent to Maternal Fetal Medicine for an ultrasound to assess the baby’s size and viability. The MFM told me baby looked beautiful for a 26-weeker, but was very honest about what a rocky road we’d have ahead if we were to deliver now. Survival rate is about 90%, but beyond sheer survivability, we face potential heart, lung, eye and brain complications. He said the magnesium would help protect the brain and that they’d give me a steroid shot that would strengthen the lungs — just in case. The good news was that there was still a fair amount of fluid around the baby, so even if I were leaking amniotic fluid (we were still waiting on test results), it was likely a slow leak. And he said in rare cases, a pinhole leak could even repair itself. Either way, he didn’t think I was in immediate danger of “draining the pool,” so to speak, but if I were to completely rupture, I’d deliver within 48 hours.
About this time, we got the labwork back on the amniotic test. It was showing very small amounts of amniotic fluid. Not great news, but they were optimistic we could still keep this baby baking for longer with magnesium to slow contractions and antibiotics to stave off any infections threatened by the leak. I was able to catch D on a layover and update him on what was going on. While he was worried, everything I had been told sounded promising at that point. I told him not to worry – just get here when you can. I got officially admitted to the maternity ward for 24-hour observation.
Unfortunately, after a couple hours on the magnesium, contractions were getting progressively stronger, not weaker, even after they upped my dosage. And when I stood up to use the restroom, it was clear we were dealing with more than the slow leak we had suspected. When the doctor observed me writhing in pain and yelling through a contraction, she thought we should probably check my dilation. I’ll never forget the way her face fell and she said in a quiet voice. “You’re complete. We’re taking you to delivery.”
At that point I kind of traveled out of my body. I heard myself let out a scream that sounded like no sound I’d ever made before. Suddenly there were about 12 doctors and nurses in the room. We weren’t sure whether I’d need an emergency c-section, and they knew they needed the NICU team on standby, so they wheeled me down to the OR, even though the regular rooms are typically set up for delivery. I had about three contractions on the way and was yelling like they do in the movies (nothing like Theo’s calm but long birth!). I had completely lost control and I think it was part pain and part complete and utter fear. I had an overwhelming urge to push, but they kept telling me not to because the NICU team wasn’t ready yet. I knew the only way I could not push was to get an epidural. I asked if it was too late, and they all looked at each other like they didn’t know. They paged the anesthesiologist anyway and he met me in the OR. He agreed to the epidural. Unfortunately, he was working so quickly that he didn’t get me completely numb before putting the giant needle and tubing in my spine and digging around to get it into position. I think I yelled as loud as I had during contractions. To make matters worse, he messed up and had to start over. So I’m the lucky girl who got two epidurals today.
About this time, D burst into the OR in scrubs. I’ve never seen him look so scared in my life. He held my hand while I yelled through two more contractions, fighting the urge to push (why was the epidural not working yet?!) and then suddenly the NICU team was ready and it was go time. About 20 seconds and two pushes and he was out. It would have been one push but they actually made me slow down. He cried once he was out, which the doctors said was amazing for a 26-weeker. They held him up so I could see him and then they whisked him away to the NICU. He was bright pink, not blue – which the doctors also said was a good sign. His APGAR scores were 1, 4 and 8, which I’m told is also pretty amazing for a preemie this small. We later learned in the NICU they had to intubate him and then perform CPR to get his heartbeat back – not uncommon, but scary nonetheless.
While I was waiting for my placenta to deliver, I felt my lower half begin to tingle and go numb. Huh. Nice of the epidural to start working now. I delivered the placenta and got a quick exam, and then they rolled me back up to my room. It took forever before we were allowed to go see Emmett, partially because we had to wait for my epidural to wear off (again, so glad I got that ). He is hooked up to a lot of tubes and wires, which is a bit intimidating, but everyone assures us he looks great for such a tiny preemie. We aren’t allowed to hold him yet, but they said we might be able to as soon as tomorrow or Friday. In the meantime, we’re allowed to hold his hand or foot, or sort of cup his head and feet while he’s awake. When he’s sleeping, they’ve advised us to let him rest. Meanwhile, I’m pumping every 3 hours around the clock to give him what I can to help him grow. I’m not producing anything just yet, but the frequent pumping should tell my boobs to get with the program!
I will get discharged from the hospital tomorrow, but I think we’re just going to camp out in E’s room and not go home just yet. Grandparents are watching T for a couple days, and I think the NICU is going to become our second home/office for a while. The doctors have told us he’ll likely stay in the NICU until close to his actual due date in August. I don’t think I’ve grasped the magnitude of spending three months in the NICU at this point, and I have a feeling we aren’t getting off the emotional roller coaster any time soon. For now, I’m trying to look at the NICU as an extension of my pregnancy – only now they’re carrying the baby, not me. We hadn’t planned on meeting him until August anyway, so this is sort of a sneak peek, and we’ll get him in August as planned. We’ll see how long this optimism holds up, anyway!
I didn’t get around to writing my update for last week, so this week’s will be a combined update. Not a ton going on at this point, anyway — I’m now remembering this is the stage of pregnancy that just sort of stretches on, and if things are going well, is pretty uneventful! So let’s get to it…
Baby: is about 14 inches long and 2 lbs now. He has eyelashes and can now open and close his eyes, after having them closed for the past few months. Supposedly that means he is now receptive to light, though I would imagine it’s pretty dark in there most of the time, regardless of time of day. He certainly tends to be really active at night and has even woken me up a few times with his acrobatics. I’ve heard this is pretty common, as the movement you make during the day rocks babies to sleep, and they wake and party once you’re still. Baby’s primary job at this point is to fatten up, though his lungs are the other major thing he needs to strengthen to prepare him for life on the outside. He’s practicing “breathing” amniotic fluid now, which seriously blows my mind. I’ve mentioned this before, but how do they not drown? Crazy.
Mama: now has heartburn almost ALL THE TIME. Fun! Maybe this baby will have a lot of hair. Isn’t that the old wives’ tale? I also have restless legs when I’m tired, and the nightly waking every two hours to pee routine means I’m tired a lot. Hard to believe I’ve still got about 14 weeks to go. I am noticing I’m just sort of “over” pregnancy this time around. Don’t get me wrong, I’m beyond thankful that things are going so well and I really take nothing for granted. But the novelty of pregnancy itself has sort of worn off now that we’ve been through this before and I’m just kind of ready to be done so I can meet my baby! The good news is, I passed my gestational diabetes test, and my thyroid is still looking good, so no changes to the dosage of my thyroid medication. I was a little anemic at my last blood draw so I have to start taking iron supplements, but other than that, things are going well! We have our next appointment in two weeks, at which we’ll get a growth ultrasound. It’ll be nice to see baby again and I hope he’s growing like he should. After next week we move to biweekly appointments, and then at 36 weeks, we’ll have weekly check-ups. Home stretch.
Weight: up 1 lb. between weeks 24 and 25, and then no gain between 25 and 26, bringing the total to 14 lbs. gained so far.
Cravings: Nothing really. The heartburn kinda puts a damper on most food!