Today I was putting my children to bed. Three gorgeous healthy boys. My joy, my happiness, my pride. And then I thought that if we were living just one hundred years ago the chances are that none of them would be with me, because all three were premature. Quite premature. So I am so very grateful for the progress and development of 21st century medicine and for all the assistance we received in hospitals. Still... there are a few things I wish I had known then...
They are small. Not just small: they are tiny. Every week of your pregnancy you read how much bigger your baby is becoming by way of crazy comparison with vegetables and then all of a sudden your baby is here. All small and red and wrinkled and with an old man’s face. Just ask to hold him anyway. It is probably your first and last chance to hold him for a while.
Desats (desaturation: a decrease in oxygen concentration in the blood resulting from any condition that affects the exchange of carbon dioxide and oxygen) are scary. Every time the machine behind your child’s incubator starts making that alarming noise your heart sinks and you start looking to the nurses in panic. They usually come quickly and are all calm and confident, and to be fair most times the baby corrects itself. However, there are also those times when the nurse rushes for an oxygen mask and puts it on your baby’s tiny face and you simply stare in paralysed fear. Here my advice is: trust the nurse not the machine, as long as she is calm, things are going well.
Your milk is precious, especially those first tiny drops of colostrum. They are like millilitres of gold that are extremely important for your child. It is important for premies to be fed asap after birth, so I had to agree to formula for first feed with all three of my sons but I wish I knew how to express and save those first drops. Don’t be shy, ask the nurses for syringes and ask them to teach you how to express.
There will be jaundice; there will be ultraviolet lights; there will be funny-looking eye masks. Your baby will be lying in his incubator in a huge size one nappy and you will be staring at him waiting for the jaundice to be tamed and go under the line. And after a couple of nights it probably will go down and you will be happy, but then it might go back up, and then again, and then again. The nurses might talk about prolonged jaundice and give fluids to your baby, as lots of exposure to ultraviolet lights dehydrates him and makes his little body’s skin go dry. It WILL eventually go away. In rare cases the baby might need dialysis, but most likely the bilirubin will go down with the assistance of the light. Just keep asking the questions if you are worried about something.
They lose A LOT of weight. In all the baby books they say it is ok for a newborn to lose up to ten per cent. of its birth weight. Well, premies lose more most of the time. Again, all three of mine lost almost twenty per cent. And I was panicking and I was reading about long term conditions and consequences, but in the end they managed to gain it all back and as soon as they are back on the rise and feeding you worry a little less.
Ask for skin-to-skin at EVERY POSSIBLE OPPORTUNITY. Your tiny premie is in shock: he is not ready to be in this world yet, he wanted to be inside you with calming waters around him and the steady heart beat of his mother. You can still try and create this environment of comfort and warmth. Kangaroo care is miraculous: it soothes the baby, helps him digest food, regulate his temperature and tolerate the light and smells of the real world. He can hear your heartbeat and take comfort in it. Most nurses are helpful but sometimes they come up with restrictive rules and in reality don’t really want to disturb the baby. Just keep asking, tell them you will stay for a while and will monitor all his parameters yourself. Just keep asking.
Don’t read too much on the internet. Happy people do not post in forums and do not sit there writing about their happy life after hospital. So the chances are you will read a lot of information about pain, loss, tragic mistakes and consequences, about infections, diseases and complications that most likely have nothing to do with you or your preemie. However, after reading all those sad stories (most likely in the middle of the night) you won’t be able to rest and to think clearly, and that is the last thing you and your baby need. You need to be rested - he needs a positively charged mom.
There will be setbacks. So, they told you he was doing well, steady weight gain for a week, trying to breastfeed, good dirty nappies etc. You believe that all the worst is behind you and then all of a sudden one morning the routine blood tests come back and there’s an infection, and he’s stopped taking milk, and he is refluxing, and the special doctor has to be called, and in a second your life is turned upside down and you are once again in the limbo of uncertainty and have no idea what tomorrow will bring. Try and stay positive: most likely it will level out and he will bounce back, just keep believing and keep doing things the way you are.
The first bath is scary. Doesn’t matter whether it finally happens five days or two weeks after your baby’s birth. He is still so small, his head is floppy, his legs are like chopsticks and you are worried that he might slip through your fingers or get water in his mouth or nose. He won’t. Just listen to the nurse, try and keep your hands as steady as you can, talk and sing to your baby while bathing him and concentrate on the beauty of this moment. If you are bathing him that means he is doing well; it means you are going home soon.
And going home is scary. VERY SCARY. You count the days until this moment, the day you hear that your baby is being discharged, that you are going home, even if with an apnea monitor or feeding tube or whatever else. However, when you hear this wonderful news, after the initial wave of relief and happiness, another bigger wave takes over you: how? Home? Without all the equipment? The doctors? The nurses? The safety net of the special baby unit. What if something goes wrong in the night and I won’t be able to see or notice it? How are the nights at home anyway? All these questions start attacking your poor tired brain and you end up crying in the ward asking yourself whether it is from happiness or from panic. It is from happiness, just take your baby and go home! I promise. If you managed to get through all those days and weeks and months in hospital you will be a super-pro at home. Trust me. I did it three times.