We were among the lucky ones in the NICU. Ryder’s main priority was to grow. There are always ups and downs in that kind of environment, but we were very blessed that Ryder progressed so quickly!
He was only on the CPAP (Continuous Positive Airway Pressure) for 24 hours to open up his lungs. He was on the nasal cannula next, but that only lasted 24 hours because he kept pulling the prongs out of his nose! He was also under the Bili Light on day 3 to help reduce the Bilirubin in his blood. Preemies are more likely to be jaundiced, but Ryder’s levels went down quickly and never went back up! They actually kept the velcro on his face for the mask just in case. He had several leads for monitors attached to his chest, stomach, and one of his feet at any given time. It was hard not to constantly watch those monitors. Preemies tend to have brady/apnea episodes where they forget to breathe and their heart rate drops. It is fine if they can bring their heart rate back up on their own, but there was at least one time where a nurse had to come over and stimulate Ryder. Talk about scary! Had he continued to have those episodes, they could have given him caffeine to help. He also had a feeding tube and an IV for nutrition and antibiotics. The IV did infiltrate his leg at one point where the nutrition was going into his tissue instead of the vein. His poor little leg was so swollen, but luckily they caught it early and there was no further damage. Initially the feeding tube was in his mouth, but they moved it to his nose after about a week. He HATED it in his nose! He was constantly pulling at it! The only other scare we had while we were there was when they found old blood in his stomach. They ran tests and held his feeds to make sure he was digesting properly. We later found out that he had probably ingested the blood from when the placenta abrupted. They were able to resume feeds, and he was a rock star from there on out!
I was prepared to not be able to hold Ryder right away, but we were surprised when they let me do some kangaroo time (skin to skin) on the very first night. We learned very quickly that there was a schedule in the NICU. Ryder was on an 8,11,2, and 5 schedule. At those times he would be changed, his temperature taken, and his feeding would be administered. They would weigh all of his diapers to see how much output he was having. He was weighed every night and had a bath every 3 days. We were able to change his diapers and do his baths while we were there. He hated the sponge baths, but loved the real baths once his umbilical cord fell off! The nurses suggested we do skin to skin time during his feeds so that he would associate feeding with me. We were also trying to increase my milk supply because at the time I was pumping every 3 hours. I did not get to hold him at every feed initially because they were worried that he would be over stimulated or become extra tired. Chad was not able to hold him for a while because of that stomach bug, but after a few days he also did skin to skin time in the evenings.
Someone said that being in the NICU is like having training wheels, and it really is! I feel like the nurses would also make great kindergarten teachers. They have to be so patient with the parents who are learning how to do everything for the first time! I almost felt offended at times when a nurse would tell me not to rock my baby, or that I wasn’t holding him properly. I know now that they were just doing their job and trying to help prepare us for taking him home. They also showed us lots of great tips and tricks!
It was surprising to me how things seemed to move so slowly in the NICU. It felt like Ryder would never be at full feeds. He started off getting such a tiny amount! The nurses kept telling us that 1800 grams (about 4 pounds) would be a big milestone. At 1800 grams, babies should be able to hold their own temperature. That meant he would finally be able to wear clothes and they would turn off the warmer. He would also get to try bottle feeding around 1800 grams. As a side note, we did finally get used to talking in grams and milliliters by the time we left!
The nurses kept telling the doctor how hungry Ryder seemed to be. He loved his paci and was usually pretty alert at feeding times. We were able to give him his first bottle at only one week old when he was 3 lbs 11.5 oz! He surprised the doctors and therapists with how good he did! We had to learn to feed him on his side so that he would not choke. It was very much a marathon and not a sprint with bottle feeding. It takes a lot of endurance to suck, swallow, and breathe! He even lost a little weight at first. He started off taking one or two bottles a day and within a week he was taking all of his full feeds by bottle! Ryder final hit that 1800 gram/4 pound goal on January 7th. We learned right off the bat that his legs were way too long for some preemie clothes! On January 13th he pulled out his own feeding tube, and they never had to put it back in! We kept getting warned that preemie boys have tend to have a feeding slump around 36 weeks and they just stop eating. I was so grateful that once Ryder started eating, he never stopped!
My baby shower was not scheduled until January 19th. We were really hoping Ryder would not be discharged before that so that we would have what we needed at home! He actually might have been ready a little before that, but the attending physician that week did not like to discharge babies until they were 36 weeks gestation. The other requirements to go home included: Chad and I had to take a car seat class and an infant CPR class, Ryder had to pass his car seat test (stay in the car seat without dropping his sats), he had to take all feeds by bottle for 3 consecutive days, and he had to go a week without a Brady episode. I think that last week was the hardest for me. I was tired of having to ask permission to hold my baby. I was tired of leaving him there at night. One night in particular we had a pediatric nurse who was just covering in the NICU. While I am sure she was a great pedi nurse, it really bothered me to leave my baby with her that night. I think at that point I was done. I wanted to have Ryder home with us and to finally be a family of three!
Other than that night and the day I came home from the hospital, I think we stayed pretty strong. My survival depended on having a schedule and a routine. Because of the C-Section I could not drive. Chad would usually take me to the hospital for the 11AM feed and then my parents would pick me up for lunch. I stayed for the 2 PM and 5 PM feeds while sometimes running errands in-between. We would both come back for the 11 PM feed and to “tuck him into bed”. As I mentioned earlier, I was also trying to pump every three hours. After 3 weeks of only getting a half an ounce to an ounce at each feeding, it became too much. They were having to supplement all of Ryder’s feeds with at least 2 ounces of formula! Even though I was trying herbal supplements, eating yeasty foods, and pumping at Ryder’s bedside… I just could not get my supply up. The lactation specialist told us that Ryder being so early would hurt my supply, but also that women with PCOS don’t always produce as much milk. I wanted what was best for my baby, and I knew that when he came home I needed to take care of myself so that I could take care of him. I made the hard decision to quit pumping and go straight to formula. I do not think Ryder is any worse off. I know how hard I tried to make it work, and that is enough for me. He is still thriving on formula.
I had a wonderful baby shower on January 19th. It was a mad dash that afternoon to put everything away and get up to the hospital to room in. It was our first time to hold him without any monitors or wires! I don’t think either of us slept that night even though the nurses only checked on us a couple of times! The next morning we had his pictures taken in the studio up stairs, then off we went! We were so excited that Dr. Bowman was back to discharge Ryder. He was the attending physician on the day Ryder was born.
Ryder came home on January 20th after 24 days in the NICU weighing in at a little over 5 pounds!
Ryder’s first few weeks at home coming soon!