When we were in the delivery room after the birth Dixie remarked that the placenta was quite small. Due to that and the fact that his heart rate had issues during labor the protocol was to send the placenta to pathology. Also, when she was collecting the cord blood for banking she remarked that the cord was exceptionally small and she wasn't sure if she could get enough blood. I thought very little about either of these thing at the moment (I was too busy being overwhelmed by the fact that I'd just met our sweet baby boy).
A NICU nurse came to the delivery since there was some meconium present when my water broke. She checked Gabriel's blood sugar shortly after birth and commented that it was low (I can't remember the exact number. Somewhere between 30-40). He ate a tiny bit and she checked it again about 30 minutes later. It was slightly above 40. She told us not to worry, but that they would check it every hour for a couple hours to make sure that it kept going up.
As the night went on I can't remember exactly how many times they checked it (his poor little heel still has scabs on it) or exactly what the numbers were, but by about 6:30 am on Sunday morning the nurse came to tell us that it was still less than 40. I could not get him to eat anything and the nurses in the nursery could not get him to take any formula either. We were told that they were moving him to their Transition Nursery (basically, you can stay there for a few hours until they decide if you're stable enough to stay on the postpartum floor or if you need to be admitted to the NICU or Special Care Nursery).
The neonatologist came to see him shortly after he was brought down. We were there when he came by. He took no time in saying that the safest thing was to admit him for 24 hours to monitor him and make sure that his blood sugar stabilized and that he was able to eat.
I don't think that I've ever felt so scared and overwhelmed. I hadn't slept in who knows how long and this was certainly not a scenario that I had prepared myself for. I know very little about babies, but I think that my nursing brain tends to jump to the worst care scenario when it comes to medical things.
Anyway, over the next couple days the drill was to try and get him to eat. If he couldn't take in a certain about the nurses would supplement it with tube feedings. His blood sugars stabilized once he was able to get adequate intake going, but it really was mostly tube feeding at this point. He had very little energy to eat anything himself. Also, his bilirubin climbed for a couple of days and his platelets dropped for a couple of days as well. On Sunday and Monday he ate very little himself, but the nurses assured us that at some point a switch would just flip and he'd start eating himself.
Talking with the neonatologist (who was great, by the way), he said that all of it could simply be explained by the fact that his placenta and cord were so small. He just didn't grow like he should have toward the end of the pregnancy. There's really no way to know exactly why that happened, since the ultrasound at 20 weeks was normal. When I talked to the midwife about it the day we were discharged she said she'd seen that happen when people got very sick toward the end of their pregnancy. I had a virus for several weeks in October, but who knows if that contributed or not.
I was discharged from the hospital on Monday night, and little Gabe just wasn't ready to come home with us. That was a rough night too. I did not anticipate packing up the car to go home without him when I anticipated his birth. He was moved that evening to a different part of the nursery though, where babies that aren't quite as sick can still be monitored, but there is a little more privacy and space. They took him feeding tube out that night as well. Even though he still took a very long time to eat and had to be forced a little, he could at least get down enough to stop tube feedings.
On Tuesday the doctor decided that he needed just one more day before he came home. His platelets started trending up, but he wanted to make sure that the bilirubin had peaked since it was still climbing. As frustrating as that was, we certainly wanted to make sure that after everything that he'd gone through he was ready to come home and wouldn't be bouncing right back into the hospital.
One more thing that I simply must mention. I have never been so impressed with a group of nurses as I was with everyone we came in contact with in the nursery, on the postpartum floor, and in the lactation department. I've seen a lot of nurses in a lot of different hospitals and work environments, and never have I seen a group so competent, compassionate, and passionate about what they do. Every single one of them was so supportive and helpful. They let us ask a million questions, let us take care of him (feed him/change him/hold him) as much as we wanted, taught us all kinds of tricks and ideas for how to get him to eat, and at the same time encouraged us to rest and take care of ourselves. One night when we were there the nurse told me that I had to go and take something for pain and sleep, even if that meant missing his 3 am feeding. I needed someone to give me that permission since I had been up all day and night and had barely rested myself.
This has gotten long enough :) Needless to say, we got to take Gabriel home on Wednesday afternoon. He is still learning how to eat better, which is frustrating, but we're trying to maintain perspective. He's doing so much better than a week ago. We can't expect him to learn it all in one day. When we went to the pediatrician on Thursday he had gained a little weight and we'll take him to get checked again later this week. Never have I been compelled to pray about something so fervently, and never have a seen God so quickly answer prayer. Every day he is so much better and I am amazed. What a beautiful blessing this sweet little boy is to our family.
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