Wednesday, December 23, 2015

Little Guy. Rough Start.

When Caleb came into this world five weeks early, he did remarkably well. His Apgar scores were 8 and 10, which was quite amazing for such a little guy. He didn't ever need any oxygen or extra suctioning when he was born. But in the few days following, he gave us a little run for our money. Granted, it could have been much worse, and we are incredibly blessed that he is so healthy. But here's a recap of his first couple weeks of life.

Often times, premature babies have difficulties that term babies don't have. Caleb had three of those difficulties:  trouble keeping his blood sugar up, trouble keeping his temperature up, and jaundice. 

For the first 24 hours,  they checked his blood sugar each time before he ate. That meant a heel poke every 2 hours, but thankfully he was able to keep his sugar high enough that it only lasted 24 hours.

His temperature was monitored every 4 hours, plus occasionally after being unwrapped to eat. It dropped low a couple times, so we had to be sure to keep him bundled with extra layers and keep a hat on at all times. He doesn't have the brown fat that term newborns have to keep them warm, so he just needs a little extra layering.

The jaundice was his biggest problem. He had a double whammy of risk factors-- his prematurity and a positive direct coombs test. That basically means that my blood and his blood are incompatible, and at some point they mixed, and therefore his red blood cells were being broken down in his body. Because he was so early, his liver wasn't able to process the bilirubin quickly enough, and he became jaundice. [Ella had the same problem of the + direct coombs, but because she was term, she didn't need to be treated.] They began to measure his bilirubin levels at 7 hours old, even though they don't usually start until at least 12 hours of age. His was high enough that he needed to be treated with phototherapy-- he was put under special lights to help his body breakdown the bilirubin. He was under the lights for 24 hours, then came out when his bili level was lower. But after a while, his level rose again and he needed another 12 hours of phototherapy. During those days, they drew blood every 2-8 hours, and while under the lights we only got to hold him for 30 minutes every 2-3 hours so he could eat. It was a rough few days, and there was brief talk of him needing to be transferred to a NICU for more intense treatment. But thankfully, and by the grace of God, he improved and was able to come home with us on Day 5.

When we left the hospital, he had to be in a car bed rather than a regular car seat. He was too little to tolerate the incline of a car seat, so his oxygen level dropped after sitting in it for a while. It is a interesting [weird] seat, but whatever it takes to keep him safe!

By discharge, he was down to 5lb 2oz. For a full two weeks we were feeding him with a syringe in addition to me nursing him. He was quite yellow and fairly lethargic due to the high bilirubin level. We've taken him for follow-up appointments every few days, and he has now surpassed his birth weight and is 5lb 13oz! We'll follow up again at the 1 month mark, and hopefully we'll be in the clear for both weight and jaundice -- and done with the car bed!

Big sister Ella checking him out on his birth day!

She's such a great big sister.

First round of phototherapy.

So in love with my little guy!

Finally going home!!

I have to give a huge shout-out of thanks to Mike for stepping up to the plate to take care of Ella, groceries, laundry, dishes, and so much more. And to my mother in law Marie, who hopped on the first flight out here to give us two extra hands of backup. You two saved my sanity!!!

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