Our Preterm Baby Part Three: NICU and Beyond

The NICU at NYU is staffed by incredible doctors and nurses doing everything they can for an array of preterm and ill babies. It’s an incredible place, filled with incredible people. It is also cramped and loud. Monitors are going off incessantly and just about everyone has a worried look on their face. There is no place to comfortably sit. Everyone is in everyone else’s way. Kind as everyone was, it isn’t a place you wanted to spend time.

And yet, here we were.

While E was recovering from labor, I went up to see how Baby A was doing. She was, at first, on the monitors, but without supplemental air or an IV. As described below, in the coming days, this would change.

All and all, she was doing well for now. The nurses were unconcerned, but cautious. Many pre-term babies have a sort of honeymoon period directly after delivery, with complication occurring later. Still, we were hopeful this would be painless.

I wheeled E down to see Baby A at about 7pm and went home to our son. E stayed with her till midnight. Holding her and pumping breast milk at her crib side. The next morning, I’d return to see our little one again. The day after, E would come home and we’d trade off being with Baby A and being with our son, day in, day out, for the next ten days.

As NICU stays are probably what most parents are curious about here’s a day by day breakdown of what happened with Anna:

Day 1 (Day of birth)

  • Anna is initially breathing on her own. However, a few hours after birth it is determined that while her oxygen levels are fine, she is laboring a bit to get enough air. A nasal cannula is placed on her nose. It pumps room air into her nostrils allowing her to breath with less effort.
  • An IV is inserted to provide her with fluids and antibiotics (a standard practice with PPROM babies, test would soon reveal no infection).
  • E is able to do a couple of hours of skin to skin and pump breast milk to hopefully feed Anna on Day 2

Day 2

  • Anna remains on IV and nasal canula. She begins taking feedings by the bottle and they start decreasing her IV fluids.

Day 3

  • Anna remains on IV and nasal canula. She’s taking feedings by the bottle and the breast and they continue to decrease her IV fluids.
  • Unsurprisingly for a pre-term baby, she has developed jaundice and been placed under the bili lights. This will turn out to be her biggest challenge.

Day 4

  • Anna comes off the nasal canula, but remains on the IV to supplement her bottle and breast feedings.
  • Her Bilirubin (i.e. jaundice indicator) remains high, so she’s still under the jaundice lights.

Day 5

  • Anna comes off the IV, but remains under the bili lights for jaundice.
  • She takes “full feeds”. Sometimes from the bottle; sometimes from the breast.

Day 6

  • She comes off the bili light, at the time we thought perhaps only temporarily, but it turned out to be the final time she was under it.
  • Now, she’s just eating and growing, the only wires she’s hooked up to are the monitors. Without the bili light time and the IV, it becomes much easier to hold her for long periods of time.
  • We’re told that if everything stays the same, she will go home when she turns 35 weeks, as is the hospital’s policy.

    Off the light, IV and nasal canula!
    Off the light, IV and nasal canula!

Day 7

  • Anna is moved to a “step down” unit aka the “nest” aka “feed and grow”. This is much quieter, less medicalized environment for preterm babies who just need time to develop. All the kids here are preterm, but none of them have serious medical issues. It’s a relaxing space with much more room for breast feeding and family time.

Day 8

  • Feeding and growing, feeding and growing.
  • Anna undergoes a hearing test (which she passes) and car seat test wherein she needs to be able to maintain her breathing and heart rate for 90 minutes in her car seat. She passes this as well.
  • With a clean bill of health, it looks like we’re going home in two days.

Day 9

  • More of the same: eat, sleep, repeat. Anna is still on a combination of bottles of breast mile and breast-feeding.
  • Throughout the 10 days, I’ve been going to the hospital first thing in the morning, then going to work, E has been spending all day there, until I get back in evening, we go home together and her grandparents arrive for the evening. At night, we call the floor to get an update on her progress at least once. So far, so good.
  • When we return home, we plan to do only breast-feeding, unless she isn’t gaining enough weight.

Day 10

  • Home! Anna is discharged. The only medical instruction are to give her vitamin D and iron and bring her to the doctor’s in three days for a weigh in.

We’re overjoyed.

Post script.
First doctor’s visit and she’s gained three ounces. Great news. Bad news – they’ve detected a heart murmur. Another trip to another doctor, this time a pediatric cardiologists for an EKG and an echocardiogram. A couple of nervous hours later, we get the word – Anna has a functional murmur. She’s fine. We’re on our way.

She’s been home now for almost a week and we’re completely in love with her and so, so happy to have her here. They’ll be more tests, I’m sure, and more bumps, but all in all, we were very, very lucky. If you’re a mom or dad worried about your own pre-term baby, I wish you all the luck. Stay strong.


Read about our PPROM stay here and our labor here.

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  1. Our Preterm Baby Part One: PPROM | Milo and the Calf

    […] Read the labor story here. Read about out NICU stay here. […]

  2. Our Preterm Baby Part Two: Labor | Milo and the Calf

    […] Read about our PPROM stay here and our NICU stay here […]

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