Neonatal Care

Reuben 1 day old

In my previous post I wrote about my pregnancy and premature birth experience. A few people who have read it have said how brave and strong I was, I honestly don't feel that I was. I just felt I was doing what I had to do and I got on with it. Having said that the birth and pregnancy was the easy bit. Reuben's time in hospital was far harder it was like living in limbo, time felt like time was standing still. Our lives revolved around visiting the hospital and it felt to me like the world outside of that didn't exist, just stopped and didn't matter. I wish I had written some sort of journal whilst Reuben and I were in hospital but just getting through the days was exhausting. So this account of our experience of neonatal care maybe scrambled, I'm going to try to write in chronologically but things may have happened in a different order to how I remember. Others who have experienced neonatal care may think I've missed out some things, I really am writing everything I remember so Reuben may have had more tests that I cant remember. These are just my memories and I hope it makes those who have experienced similar or are currently going through something similar feel they are not alone and perhaps it can help those who don't know what to do or say to support loved ones going through the after effects of a preemie birth.

So Reuben was born on 8th February 2013 at 31 weeks and 3 days gestation weighing 3lbs 15oz. The birth was natural and straight forward and as I said in my previous post after giving birth I got to see him briefly before he was whisked away to the neonatal intensive care unit (NICU). My husband and I then got to see him again once he was settled in his incubator. Seeing him in the incubator wasn't really as scary or intimidating as I had thought, I think it helped that he was quite big for his gestation so he wasn't as small as I expected and he looked nice and pink and strong. There were wires and tubes everywhere and he was on oxygen but he looked comfortable. I immediately felt a bond and a huge rush of love for him, that sort of fluttery butterfly feeling in your stomach. I just wanted to hold him and love him and be his mummy.



Cuddle with daddy

I still felt extremely weak and tired from my time in hospital and the labour and stayed in hospital over night in a private room on the maternity ward. I didn't feel uncomfortable or jealous being near other mums who had their babies. It just was what it was, I just felt lucky my son was okay and excepted what the situation was. I had a midwife come and show me how to express milk using their pumps and was given lots of little bottles to fill and label and keep in their fridge. They recommended that I expressed every three hours to get my supply going. I found the expressing easy, it wasn't painful at all and oh my gosh I produced crazy amounts of milk! what was difficult was the waking every three hours to express when I hadn't slept for a week and had recently given birth. But of course this is hard for every new mum whether they've had a prem labour or not. I was allowed to visit Reuben in the Neonatal ward whenever I wanted and it was just up on the next floor of the hospital but I really was scared I was going to faint or collapse when I walked anywhere on my own, I felt so weak and shaky. So I couldn't really see Reuben if my husband wasn't there.
The following day when my husband and I went up to see Reuben he was off of the oxygen and we were able to hold him for the first time. Holding him was a little bit scary as we were told one of the wires going into his belly button must not fall out as it could bleed a lot. It was magical though and I just wanted to hold him all the time but I was also paranoid that he would get cold. We did skin to skin contact and kangaroo care and tried to put him to my breast. He sort of latched but he was getting my expressed milk though a feeding tube that went up his nose and into his stomach. In the NICU Reuben was connected to a monitor which showed his breathing and heartbeat and I think blood pressure and you couldn't help but look at it all the time! It hypnotised you, every time it beeped you panicked! There were about four other babies in the NICU at the same time as Reuben and so the noise from the machines was quite intense, I would hear beeping even in my sleep! That day the midwives said I was okay to go home but could leave that day when I was ready. I'm not sure I was really ready to leave but I knew I had to so I left at five in the evening so I could spend the whole day with Reuben before going home. It was hard leaving even though I was on a completely different floor of the hospital to Reuben because I felt like if something did go wrong I wouldn't be there. The first night at home was the hardest, I had my mobile phone on loud just in case and I had to start my expressing though the night routine at home.

 My husband took a week off work as paternity leave so we were able to go into the hospital early and spend the day there together with Reuben. The Neonatal unit was amazing as were all the nurses. there was a family room with a play area, kitchen and locker area, a pumping room and a quiet room where breastfeeding support meetings took place. I got a locker so I could fill it with food and books etc. I'm not really sure what tests Reuben had and when but I remember him having a couple of brain scans whilst in the NICU so they must have been during his first week in hospital as he was only there for a week. We arrived at the hospital whilst one was taking place so were able to watch. It was a bit like an ultrasound but on his head! So he had lots of gel stuff on his head and they were able to look at his brain on the monitor. Both scans came back as fine so it enabled us to have some relief. After about a week Reuben's body temperature stabilised and so he was moved into what was called the nursery room next door and into an open incubator.

Once my husbands week of paternity leave ended things got harder for me but we didn't want to use too much as we wanted to have time together once Reuben was out of hospital. It was harder for me because it meant I had to get the train into Gloucester everyday and the walk to the hospital. It made the day alot more tiring, I still felt quite shaky on my feet and generally weak. I imagine it must have been hard for my husband too but we've never really spoken about it. My daily routine was getting up at about 7am and expressing then catching the train that got in at about quarter to the hour, so by the time I had walked to the hospital it was 10am. This meant I could attempt to breastfeed at 10am, 1pm and 4pm and at 7pm before my husband and I went home. My husband would come over straight from work and we would leave straight after the 7pm feed. Whilst I was in the hospital all day I got into a routine to break up the day. I would feed Reuben at 10am and then immediately after go and express. Then I would sit with him for a bit sometimes with a book but mainly I would just look at how beautiful he was! Then I would have a lunch break and even though I wouldn't want to leave him I made myself have an hour to myself to eat and read to almost have some me time. One other thing I remember is purposely leaving our flat as quietly as possible and walking through town to the train station as fast as I could to avoid bumping into anyone I might know and have to talk to them about what was going on. I can honestly say I never once cried or broke down about our situation but I think its because I really tried to avoid any situation where I might i.e talking to someone about what was going on who wouldn't really understand. It's a bit like when you really hurt yourself and you've managed not to cry by biting your lip then someone goes and saying oh my gosh are you okay? and then you cant stop crying! I didn't mind having text messages from people as I didn't have to be face to face and it was nice to know people were thinking of us.

The routine pretty much stayed like this until we were moved into transitional care together. During this time whilst Reuben was in the nursery room I think he had a hearing test, I didn't see them do it but it came back all fine. I also reduced the amount I was expressing because the hospital told me they had no more space in their fridge or freezer as I had produced so much milk! By this time I had also filled a shelf in our freezer and my mother in laws! So I stopped expressing every three hours during the night and instead gave myself a 6 hour break so I could catch up on some sleep. Another memory I have from whilst Reuben was in the nursery room was going out for dinner one night with some friends. I really didn't want to go but my husband seemed to want to and I felt I couldn't say no, when we got to the restaurant there was no signal on any ones phones, which didn't help me to relax. When we finally got home my boobs felt like they were going to explode with milk and they sort of did, i got in the bath and they didn't just leak milk properly squirted out in a stream! And thankfully there were no missed calls on our phones.

After Reuben had been in hospital for around 3 weeks he was ready to be moved into transitional care. transitional care was a small ward with 4 beds for mums and their baby or babies. It was a lovely time because it meant that breastfeeding could be established properly as we were with our babies all the time. It also meant that we could talk to people in a similar situation. Whilst in the nursery room it was hard to talk to other mums and dads as you didn't know what they were going through and didn't want to say something that might upset them. Whereas when you are in the transitional room you know that everyone is on the path home so is feeling more positive. It was also nice to get a routine established before going home. Whilst we were in there Reuben had his eyes tested, which I didn't see and they recommended that I didn't. I did see the preparation of the test and that was bad enough. Reuben had to have eye drops put in each eye I'm not sure how many times they put the drops in but it was at least twice. When Reuben returned from the test his eyes were so red and puffy it bought tears to your eyes just to look at him. Even now looking back it makes my eyes water. But his eyes are absolutely find so I guess it's worth it for the reassurance. I found out after Reuben had his tests that he had had so many because he was under 32weeks gestation. There were twins born at exactly 32 weeks in the next bed who didn't have any of the tests. I actually felt a bit grateful Reuben was born before 32 weeks when I heard that as I think if I knew he wasn't having any tests because he was born 4 days later I'd be worrying he might have hearing and sight problems that we my not find out about for ages. I feel bad saying that as obviously the longer in the womb the better but it did give me such relief to know everything was fine. We weren't in transitional care for long but it felt like ages, for us we needed Reuben to be gaining weight whilst breast feeding, they weighed them every 3 days at midnight and on one of the weigh ins Reuben had lost some weight. Luckily after spending my birthday and mothers day in transitional care we were finally allowed home!

I know my story is a positive one and many others have very different outcomes with their preemie babies. My husband and I are so grateful to all of the staff at Gloucester Royal Hospital who were truly amazing at looking after all of us whilst Reuben was in neonatal care. I am now pregnant with my second son and I will be writing a post about deciding to have another baby after have a preemie.