November 3, 2021

My Baby is a NICU Warrior

Today we start the countdown to World Prematurity Day, which will be commemorated on November 17th. As a preemie mother I want to share my story for a memoir and a very tiny little bit of education for preemie parents out there.

My daughter was born on 32 weeks, just like a size of acorn squash. Judged by her gestational age, she was born in good condition and with a great weight which is 1.9kg. I heard her crying very loud when I was still lying on the surgery table and unfortunately I can't see her face at all, because the pediatric immediately brought her to NICU for observation.

My brain can't stop thinking while my obgyn finalized her job to sew up my belly and it made me wide awake. Not because of scared but I just want to watch the doctors perform the surgery, like watching Greys Anatomy but this one is real. Also it can distract my brain from worry about my baby.

Before I gave birth I was hospitalized for almost a week and my Obgyn gave me five dose of Corticosteroids (lung maturity injection). It can make the baby's lung more mature and indeed we better get that injection because the prediction of premature birth. 

I felt constant contraction and it hurt very much, I even can't move my body from lying to sit. Giving birth during pandemic is another story to tell and actually it make everyhting worse.

One day passed-I need to recover from c-section first, such as learn to sit, walk and to make sure that the suture is in well condition. Finally I can see my baby, she is very beautiful, looks firm and strong. Tiny but mighty. They put her in an open box and wrap in plastic, they will move her to incubator if she is more steady. As far as I can see, her skin was so delicate and looks so transparent, just to cover a flesh and a very little amount of fat.

Of course I'm crying the first time I met her but it was a tears of joy. I just feel so grateful to finally meet her and I can see that she is strong and a warrior. Strong like her mama, even more.

As predicted they install CPAP ventilation on my baby, NGT, many IV and a lot of cables that I don't even know the name, all I know those things is to keep my baby alive.

Long short story, the CPAP was unplug on seventh day but I still can't hold her in my arms. I don't know why the doctor don't let me practice Kangaroo Mother Care (KMC) as soon as possible, she seems steady. But yes the pediatrician know the best. So I can't make another pressure.

After a lot of screenings, blood test and phototeraphy, we decided to make a request to hospital management to transfer my baby to government hospital. Because the NICU fee at current private hospital is very expensive. The bill running down like a leak faucet and it almost reach the insurance limit and actually we need pediatrician second opinion as well.

Transfer a NICU baby to government hospital was not an easy process and fortunately we got lucky to transfer her on the same day we made a request. I call my cousin who work at that hospital, asking for help to contact the pediatrician to accept my baby on their NICU and yes it called privilege.

On the new hospital she got a new treatment, she can drank a lot of breast milk from a bottle, start from 10ml per 2 hours up to 20 ml per 2 hours. On the previous hospital she only allowed to drink 1ml per 3-4 hours because of weak digestion. They admit her to Perina room, no more NICU and of course that was a good news.

Eventough I can't meet my baby everyday because of Covid-19 protocol (they update the visitor policy) but I can do KMC on third day. The feeling to hold my baby for the first time after a quite long journey was remarkable. They limit the KMC time to one hour only and it include the time to learn how to do a breast feeding to my preemie baby.

The advantage in the previous hospital is I can visit my baby whenever I want and as long as I want because she was the only patient there. The limit of ventilator machine make they only admit one NICU patient at a time.

Everyday I drop a bags of breast milk to the Nurse and I am beyond grateful because she can drink all of the breast milk and it increase my spirit to pump my breast milk.

Finally the day has come, the day I can bring her home. She spent nine days in the second hospital. Now I can hug her everytime I want and actually it's such a way to caring a preemie baby, it called Kangaroo Mother Care (KMC).

My baby's pediatrician ask me to do KMC 24/7 to keep her warm, to boost her weight (increase her appetite) and they believe it can increase breast milk production as well. Actually, every babies need to get a skin to skin contact, not only a preemie. Because it's their live transition from a warm and safe womb to the world that have a lof of germs and challenge 😂. Baby need to have a smooth adaptation process, don't expect them to be an independent human being in an instant.

I did a research about a preemie, like how to take a very gentle care of this tiny baby, how to feed her and how to control her temperature. Usually preemie baby is too weak to do a Direct Breast Feeding (DBF) because of weak suction, so we use many method to feed the baby like using a cup feeder, SNS system and OGT or NGT. 

On this case I use a bottle so the baby can get more milk and I can catch her correction weight. I need to count how much milk she can take per hour and usually a preemie need additional formula/vitamin to mix in the breast milk which is Human Milk Fortifier (HMF). It really boost the weight of my baby and alhamdulillah we can catch her correction weight just in time. Every baby is different, some may tolerate HMF and some baby just can't take it. She need to consume 18 sachet of HMF per day so I don't have any chance to feed her directly from my breast. She can drink milk directly at four month cronological age and i thinks  it is another time for my relactation story.

For their age, preemie baby has three age:
1. Gestational age, we use this age until 50 weeks.
2. Chronological age, baby actual age.
3. Correction age, following the week the baby was born. We usually use  correction age until the baby reach two years old and three years old for an extreme premature. Correction age as a benchmark for their growth and developement .

To keep in mind, preemie baby need to do a lot of screenings. The most important are:
1. Eye-Retinophaty of Prematurity (ROP)
2. Echocardiography (heart USG)
3. Head-USG to check if there are some blood on the brain, etc. It need to check since born and before the fontanelle closes.
5. Blood screening.

On my baby case, she got two screening on the first hospital which is for heart and head. It was a little bit late to know that eye is very urgent and top priority to check. I did the screening on 40 week gestation age and thankfully my baby didn't have any ROP but she got a little thing on her heart and I believe she can make through it. We will continue to do quarterly screening for her heart.

She teach me how to life the live the moment I heard her crying.
She teach me how to survive in the glass box called incubator.
She teach me that there is always silver linings even on the darkest cloud.

My baby girl and any other preemie in the whole world is a true warrior.

She is destined to be greatness.

Preemie parents is not a failure, they are the strongest and the one who really can learn from a mistake. Learn how not to blame all the things to themselves and to accept that everything happen for a reason.
Afterall, every good mother is a strong and brave creature.

This dunya is the field of tests and God promise there is a reward in the afterlife.

So, cherish every moment with your baby. It only happen in very short time. Enjoy while it last mama.


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